Abnormal T-cell subset proportions in vitamin-A-deficient children
Lancet 1993 Jan 2; 341(8836):5-8
Semba RD; Muhilal; Ward BJ; Griffin DE; Scott AL; Natadisastra G; West KP; Sommer A
Although vitaminAdeficiency in children seems to increase susceptibility to infection and community trials have shown that vitaminA supplementation can reduce childhood mortality from infectious diseases, the underlying biological mechanisms are largely unknown. We conducted a randomised, double-masked, placebo-controlled clinical trial among children in West Java, Indonesia, to determine whether vitaminAdeficiency is associated with abnormalities in T-cell subsets and whether vitaminA supplementation affects T-cell subsets. We studied 55 children aged 3-6 years--30 with xerophthalmia and 25 without. Acutely malnourished children (< 80% of reference weight-for-height) were excluded. CD4/CD8 ratios and the proportions of circulating CD4 naive, CD4 memory, CD8, CD45RA, and CD8, CD45RO T-cell subsets were measured. Children with xerophthalmia had lower CD4/CD8 ratios (p < 0.08), lower proportions of CD4 naive T cells (p < 0.03), and higher proportions of CD8, CD45RO T cells (p < 0.04) than those without xerophthalmia. 26 children were given vitaminA supplementation (60 mg retinol equivalent) and 29 received placebo. 5 weeks later the vitaminA group had higher CD4/CD8 ratios (p < 0.001), higher proportions of CD4 naive T cells (p < 0.01), and lower proportions of CD8, CD45RO T cells (p < 0.05) than the placebo group. Vitamin-A-deficient children have underlying immune abnormalities in T-cell subsets and these abnormalities are reversible with vitaminA supplementation.