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Vitamin A deficiency. New knowledge on diagnosis, consequences and therapy

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Zusammenfassung

Durch die Entwicklungen der biochemischen Analytik in den letzten zehn Jahren sind eine Vielzahl von Substanzen, so auch Vitamin A, dessen Stoffwechsel und Wirkungsweise weitgehend aufgeklärt schien, erneut untersucht worden. Dabei haben sich neue Erkenntnisse ergeben, die für die menschliche Gesundheit von Bedeutung sind und hier in Kurzform zusammengestellt sind. So konnte festgestellt werden, daß ein auch in Industrienationen möglicher leichter Vitamin-A-Mangel durch übliche Blutanalysen nicht sicher zu erfassen ist. Die Ursache dieses marginalen Vitamin-A-Mangels kann einerseits durch Erkrankungen bedingt sein, andererseits aber auch durch streng einseitige Ernährung. Folge einer solchen einseitigen Ernährung kann nach epidemiologischen Untersuchungen eine höhere Krebserkrankungsrate bestimmter epithelialer Gewebe ein. Allerdings können Überdosierungen mit Vitamin A auch zu Nebenwirkungen führen. Es ist nicht auszuschließen, daß Vitamin A auch beim Menschen teratogen wirkt. Aus Sicherheitsgründen sollten daher Frauen im gebärfähigen Alter eine Substitutionsempfehlung, über das Zweifache der empfohlenen täglichen Dosis für Schwangere in USA (10 000 I.E./Tag) hinaus, nur bei klarer Indikation gegeben werden. Andererseits sind Mißbildungen infolge eines Vitamin-A-Mangels nicht auszuschließen.

Summary

Due to the rapid development of biochemical analyses in the last 10 years different substances like vitamin A, with an apparent clarified metabolism and action, were re-estimated. As a result, new knowledge was presented which could be essential for human health. Some details and consequences are reviewed in this paper. Marginal deficiency, which also may occur in industrialized nations, cannot be determined with certainty by usual blood analyses. The reasons for marginal deficiency are either different diseases or unbalanced nutrition. From epidemiological research it is argued that low vitamin A intake is associated with a higher incidence of cancer in different tissues. However, vitamin A may lead by over-dosing to toxic side effects. There exists a possibility that vitamin A is teratogenic also in humans. Thus, for safety reasons, woman who can become pregnant should not be advised to supplement the vitamin more than twice the RDA of the US Food and Nutrition Board for pregnant women (10 000 I.U./day) if there is no clear-cut indication. On the other hand there are indications that malformations may also caused by vitamin A deficiency.

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References

  1. ACOG The American College of Obstetricians and Gynecologists (1987) ACOG Committee Statement, vitamin A supplementation during pregnancy. One East Wacker Drive, Suite 2700, Chicago, Ill

  2. Arroyave L, Calcano M (1979) Rescenso de los niveles sericos de retinol y su protein de enlace (RBP) durante los infecciones. Arch Latinoam Nutr 29:233

    CAS  Google Scholar 

  3. Auerbach O, Stout AP, Hammond EC, Garfinkel L (1961) Changes in bronchial epithelium in relation to cigarette smoking and relation to lung cancer. New Engl J Med 265:253

    Article  CAS  Google Scholar 

  4. Bauernfeind JC (1980) The safe use of vitamin A. The Nutrition Foundation, Washington, DC

    Google Scholar 

  5. Bertram JS, Martner JE (1985) Inhibition by retinoids of neoplastic transformation in vitro: cellular and biochemical mechanisms. In: Foundation Symposium. Retinoids in differentiation and disease. Pitman, London, p 113

    Google Scholar 

  6. Biesalski HK (1986) Vitamin A und Innenohr. Entwicklung und Anwendung biochemischer und elektrophysiologischer Untersuchungen. Habilitationsschrift

  7. Biesalski HK, Hafner G, Gross M, Bässler KH (1985) Vitamin A im Serum gesunder Probanden und klinischer Kollektive. Infusionstherapie 12:109–114

    CAS  Google Scholar 

  8. Biesalski HK, Stofft E, Wellner U, Niederauer U, Bässler KH (1986) Vitamin A and ciliated cells. I. Respiratory epithelia. Z Ernährungswiss 25:114–122

    Article  CAS  Google Scholar 

  9. Boat TF (1979) Studies of oxygen toxicity in cultured human neonatal respiratory epithelium. J Pediatr 95:916

    Article  CAS  Google Scholar 

  10. Bollag W (1983) Vitamin A and retinoids: from nutrition to pharmacotherapy in dermatology and oncology. Lancet 01:860–863

    Article  CAS  Google Scholar 

  11. Bonvier G (1957) Richerche Clinico-Sperimentali Sull“Idrycefalo Acuto Benigno” da Vitamina A. Acta Pediat, Lat 10:718–729

    Google Scholar 

  12. Boren HG, Pauly J, Wright EC, Kaufmann DG, Smith JM, Harris CC (1974) Cell population in the hamster tracheal epithelium in relation to vitamin A status. Int J Vit Nutr Res 44:382

    CAS  Google Scholar 

  13. Byers T, Vena J, Mettlin C, Swanson M, Graham S (1984) Dietary vitamin A and lung cancer risk: an analysis by histologic subtypes. Am J Epidemiol 120:769–776

    Article  CAS  Google Scholar 

  14. Ciba Foundation Symposium 113 (1985) Retinoids, differentiation and disease. Pitman, London

  15. CRN Council for Responsible Nutrition, 2100M Street, N.W., Suite 602, Washington D.C. (1987) Vitamin A policy. CRN-NEWS 1–2

  16. Crocetti AF, Guthrie HE (1982) Eating behavior and associated nutrient quality of diets. Anarem Systems Research Corporation, New York

    Google Scholar 

  17. Dickinson A (1987) Benefits of nutritional supplements. Council for responsible Nutrition, 2100 M Street, Suite 602, Washington D.C. 20037

    Google Scholar 

  18. Dostalova L (1982) Correlation of the vitamin status between mother and newborn during delivery. Dev Pharmacol Ther 4:45

    Article  Google Scholar 

  19. Droese W, Stolley H (1959) Sekretion und Resorption. In: Linneweh F (ed) Die physiologische Entwicklung des Kindes. Springer, Berlin

    Google Scholar 

  20. Gerlach T, Biesalski HK, Bässler KH (1988) Serum-Vitamin-A-Bestimmungen und ihre Aussagekraft zum Vitamin-A-Status. Z Ernährungswiss 27:57–70

    Article  CAS  Google Scholar 

  21. Goodman GE, Alberts DS, Ernest DL (1983) Phase I trial of retinol in cancer patients. J clin Oncol 1:394–399

    Article  CAS  Google Scholar 

  22. Graham S, Mettlin C, Marshall J (1981) Dietary factors in the epidemiology of cancer of the larynx. Am J Epidemiol 113:675–680

    Article  CAS  Google Scholar 

  23. Gregor A, Lee PN, Roe FJC, Wilson MJ, Melton A (1980) Comparison of dietary histories in lung cancer cases and controls with specific reference to vitamin A. Nutr Cancer 2:93

    Article  Google Scholar 

  24. Harris CC, Silverman T, Smith JM, Jackson F, Boren HG (1974) Proliferation of tracheal epithelial cells in normal and vitamin A deficient Syrian hamsters. J Natl Cancer Inst 51:1059

    Article  Google Scholar 

  25. Hartung W, Kissler W, Teige K, Thoma H (1971) Pathologisch anatomische Folgen chronischer Bronchitis und deren Beziehung zur Lungenfunktion. Progr Resp Res 6:108–134

    Article  Google Scholar 

  26. Hassell JR, Greenberg JH, Johnston MC (1977) Inhibition of cranial neural crest cell development in the cultured chick embryo. J Embryol Exp Morphol 39:267–271

    CAS  Google Scholar 

  27. Hilding AC (1964) Mucociliary insufficiency and its possible relation to chronic bronchitis and emphysema. In: Mitchell RS (ed) Progress in research in emphysema and chronic bronchitis. Karger, Basel

    Google Scholar 

  28. Hustead VA, Gutcher GR, Anderson SA, Zachmann RD (1984) Relationship of vitamin A (retinol) status to lung disease in the preterm infant. J Pediat 105:610

    Article  CAS  Google Scholar 

  29. Inua M, Duggan MB, West CE, Whittle HC, Kogbe OI, Sandford-Smith JH, Glover J (1983) Post-measles corneal ulceration in children in northern Nigeria: the role of vitamin A, malnutrition and measles. Ann Trop Pediatr 3:181

    Article  CAS  Google Scholar 

  30. IVACG International Vitamin A Consultative Group (April 1986) Position Paper, The safe use of vitamin A by women during the reproductive years. IVACG Secretariat, ILSI, 1126 Sixteenth Street, N.W., Washington DC

    Google Scholar 

  31. Kvale G, Bjelke E, Gart JT (1983) Dietary habits and lung cancer risks. Int J Cancer 31:397–405

    Article  CAS  Google Scholar 

  32. Laditan AAO, Fafunso M (1981) Serum levels of vitamin A, beta-carotene and albumin in children with measles. East African Med J 58:1

    Google Scholar 

  33. Lammer EJ, Chen DT, Hoar RM et al (1985) Retinoic acid embryopathy. New Engl J Med 313:837–841

    Article  CAS  Google Scholar 

  34. Leo MA, Arai M, Sato M, Lieber CS (1982) Hepatotoxicity of vitamin A and ethanol in the rat. Gastroenterology 82:194

    CAS  Google Scholar 

  35. Leo MA, Lieber CS (1982) Hepatic vitamin A depletion in alcoholic liver injury. N Engl J Med 307:597–601

    Article  CAS  Google Scholar 

  36. Marinoni J, Panizon F (1954) Sul Cosidetto Idrocefalo acuto da Vitamina A. Acta Pediat Lat 7:309–317

    Google Scholar 

  37. McDowell EM, Keenan KP, Huang M (1984a) Effects of vitamin A deprivation on hamster tracheal epithelium. Virchows Arch (Cell Pathol) 45:197–219

    Article  CAS  Google Scholar 

  38. McDowell EM, Keenan KP, Huang M (1984b) Restoration of mucociliary tracheal epithelium following deprivation of vitamin A. Virchows Arch (Cell Pathol) 45:221–240

    Article  CAS  Google Scholar 

  39. Migasena S (1969) A study of serum vitamin A levels in patients suffering from parasitic disease in Thailand. Proc 1. SE Asian Seminar on Nutrition (Djakarta)

  40. Mobarhan S, Layden TJ, Friedman H, Kunigkt A, Donahue P (1986) Depletion of liver and esophageal epithelium vitamin A after chronic moderate ethanol consumption in rats: Inverse relation to zinc in nutriture. Hepatology 6:615–621

    Article  Google Scholar 

  41. Nettesheim P, Griesemer RA (1978) Experimental models for studies of respiratory tract carcinogenesis. In: Harris CC (ed) Pathogenesis and therapy of lung cancer. Marcel Dekker Inc, New York

    Google Scholar 

  42. Nettesheim P, Snyder C, Kim JCS (1979) Vitamin A and the susceptibility of respiratory tract tissues to carcinogenic insult. Environ Health Perspect 29:89–93

    Article  CAS  Google Scholar 

  43. Northway WH, Rosan RC, Porter DY (1967) Pulmonary disease following respiratory therapy of hyalinemembrane disease: bronchopulmonary dysplasia. N Engl J Med 276:357

    Article  Google Scholar 

  44. Okabe T, Yorifuji H, Yamada E, Takaku F (1984) Isolation and characterization of vitamin A storing lung cells. Exp Cell Res 154:125

    Article  CAS  Google Scholar 

  45. Olson JA, Gunning D, Tilton RA (1984) Liver concentrations of vitamin A and carotenoids, as a function of age and other parameters, of American children who died of various causes. Am J Clin Nutr 39:903

    CAS  Google Scholar 

  46. Pereira SM, Begum A (1971) Failure of a massive single oral dose of vitamin A to prevent deficiency. Arch Disease Childhood 46:525–527

    Article  CAS  Google Scholar 

  47. Reddy V (1978) Vitamin A deficiency and blindness in Indian children. Ind J Med Res 68:26–37

    Google Scholar 

  48. Reid L, Jones R (1979) Bronchial mucosal cells. Fed Proc 38:191

    CAS  Google Scholar 

  49. Reimer A, Mecklenburg C, Toremalm MG (1978) The mucociliary activity of the upper respiratory tract. Acta otolaryng Suppl 355

  50. Rosa FW, Wilk AL, Kelsey FO (1986) Teratogen Update: Vitamin A congeners. Teratology 33:355–364

    Article  CAS  Google Scholar 

  51. Samsudan D, Karyadi IG, Wirya IJ (1974) A study of the effects of annual administration of 300 000 IU oral vitamin A and deworming for prevention and treatment of vitamin A deficiency. Seminar on vitamin A deficiency, Djakarta:25–29

  52. Santa CR, Sand J, Hirsch J, Sackner MA (1974) Tracheal mucous velocity in normal man and patients with obstructive lung disease: effects of terbutaline. Am Rev Resp Dis 109:458–464

    Google Scholar 

  53. Sato M, Lieber CS (1980) Hepatic vitamin A depletion after chronic ethanol consumption. Gastroenterology 79:1123

    Google Scholar 

  54. Sato M, Lieber CS (1982) Changes in vitamin A status after acute ethanol administration in the rat. J Nutr 112:1188

    CAS  Google Scholar 

  55. Schölmerich J, Becher MS, Hoppe-Seyler P, Matern S, Häussinger D, Löhle E, Koettgen E, Gerok W (1985) Zinc and vitamin A deficiency in patients with Crohn's disease is correlated with activity but not with localization or extent of the disease. Hepato-gastroenterology 32:34

    Google Scholar 

  56. Schölmerich J, Löhle E, Köttgen E, Gerok W (1983) Zinc and vitamin A deficiency in liver cirrhosis. Hepato-gastroenterol 30:119

    Google Scholar 

  57. Shenai JP, Chytil F, Stahlmann MT (1985) Vitamin A status of neonates with bronchopulmonary dysplasia. Pediatr Res 19:185

    Article  CAS  Google Scholar 

  58. Sherman BS (1961) The effect of vitamin A on the epithelial mitosis in vitro and in vivo. J Invest Dermatol 37:469–480

    Article  CAS  Google Scholar 

  59. Sinha DP, Bang FB (1976) The effect of a massive dosis of vitamin A on the signs of vitamin A deficiency in preschool children. Am J Clin Nutr 29:110–115

    CAS  Google Scholar 

  60. Sivakumar B, Reddy V (1972) Absorption of labelled vitamin A in children during infections. Brit J Nutr 27:299

    Article  CAS  Google Scholar 

  61. Smith FR, Goodman DS (1971) The effect of diseases of the liver, thyroid, and kidneys on the transport of vitamin A in human plasma. J Clin Invest 50:2426

    Article  CAS  Google Scholar 

  62. Smith FR, Lindenbaum J (1974) Human serum retinol transport in malabsorption. Am J Clin Nutr 27:700

    CAS  Google Scholar 

  63. Sommer A, Tarwotjo I, Djunaedi ME (1980) Oral versus intramuscular vitamin A in the treatment of xerophthalmia. Lancet 8168:557–559

    Article  Google Scholar 

  64. Sporn MB, Roberts AB (1983) Role of retinoids in differentiation and carcinogenesis. Cancer Research 43:3034–3040

    CAS  Google Scholar 

  65. Stähelin HB, Rösel F, Buess E, Brubacher G (1984) Cancer, vitamins and plasma lipids: prospective Basel study. JNCI 73:1463

    Google Scholar 

  66. Stern L (1979) The role of respirators in the etiology and pathogenesis of bronchopulmonary dysplasia. J Pediatr 95:867

    Article  CAS  Google Scholar 

  67. Teratology Society Position Paper (1987) Vitamin A during pregnancy, recommendations for vitamin A use during pregnancy. Teratology 35:268–275

    Google Scholar 

  68. Underwood B (1984) Vitamin A in animal and human nutrition. In: Sporn M (ed) The Retinoids I. Academic Press, Inc, Orlando

    Google Scholar 

  69. USDA (United States Department of Agriculture) Consumer Nutrition Division (1980) Nutritient intakes: Individuals in 48 states, year 1977–1978. Nationwide food consumption survey Report 1–2:367–370

    Google Scholar 

  70. Vahlquist A (1972) Metabolism of the vitamin A transporting complex: turnover of retinol binding protein, prealbumin and vitamin A in a primate (Macaca Irus). Scand J Clin Lab Invest 30:349

    Article  CAS  Google Scholar 

  71. Wanner A (1977) Clinical aspects of mucociliary transport. Am Rev Respir Dis 116:73

    CAS  Google Scholar 

  72. Wechsler I (1979) Vitamin A deficiency following small bowel bypass surgery for obesity. Arch Dermatol 115:73

    Article  CAS  Google Scholar 

  73. Wiley WC, Stamper MJ, Underwood BA, Taylor JO, Hennekens CH (1983) Vitamins A, E, and carotene: effects of supplementation on their plasma levels. Am J Clin Nutr 38:559–566

    Google Scholar 

  74. Wolf G (1984) Multiple functions of vitamin A. Physiol Review 64:873

    CAS  Google Scholar 

  75. Wong YC, Buck RC (1971) An electron microscopic study of metaplasia of the rat tracheal epithelium in vitamin A deficiency. Lab Invest 24:55

    CAS  Google Scholar 

  76. Woodruff KH, Schneider E, Unger L, Coalson JJ (1973) Ultrastructural changes in hamster tracheal ring cultures exposed to mycoplasma pneumoniae. Am J Pathol 72:92–101

    Google Scholar 

  77. Zile MH, Bunge EC, DeLuca HF (1981) DNA labeling of the rat epithelial tissues in vitamin A deficiency. J Nutr 111:777–788

    CAS  Google Scholar 

  78. Zile MH, Cullum M (1983) The function of vitamin A: Current concepts. Proc Soc for exp Biol Med 172:139–152

    Article  CAS  Google Scholar 

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  1. H. K. Biesalski

    Present address: Physiologisch-Chemisches Institut II, Johannes-Gutenberg-Universität Mainz, FRG

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  1. Anwendungstechnik Lebensmittel/Pharma der BASF, Aktiengesellschaft Ludwigshafen, FRG

    K. Seelert

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Herrn Professor Dr. med. Karl Heinz Bässler zum 65. Geburtstag gewidmet.

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Biesalski, H.K., Seelert, K. Vitamin A deficiency. New knowledge on diagnosis, consequences and therapy. Z Ernährungswiss 28, 3–16 (1989). https://doi.org/10.1007/BF02025561

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