预防性补充维生素A对提升儿童免疫功能有重要意义
仅供医学专业人士阅读参考充足的维生素A在体液免疫和细胞免疫层面都具有积极的作用 近期针对3-11岁儿童的新冠疫苗接种工作在全国范围陆续展开,接种疫苗是筑牢全人群免疫屏障、阻断新冠病毒传播的重要措施。除了及时接种疫苗,专家还强调,对抗新冠病毒,最有效的药物是人的免疫力,这场肆虐全球的新冠疫情,使人们越来越重视自身的免疫力。营养是提高免疫力的基础,其中有“抗感染维生素”之称的维生素A格外受关注,充足的维生素A在体液免疫和细胞免疫层面都具有积极的作用,特别是针对儿童群体。在一项对哥伦比亚波哥大开展的2774名5-12岁儿童的前瞻性研究,调查不同维生素A水平发生腹泻伴呕吐、咳嗽伴发热的比例,结果显示随着维生素A水平的升高,两者发生频次均逐渐降低。
当血清视黄醇≥1.05μmol/L时,其发病率最低,严重维生素A缺乏(<0.35μmol/L)的儿童中腹泻伴呕吐频次是维生素A充足(≥1.05μmol/L)儿童的2倍(RR:2.17,95% CI:1.20-4.13);其咳嗽伴发热频次是维生素A充足儿童的2.4倍(RR:2.36,95% CI:0.95,4.96)。具体见下图:
[1] Vitamin A deficiency is associated with gastrointestinal and respiratory morbidity in school-age children[J]. J Nutr. 2014,144(4):496-503.[2] Vitamin A Corrects Tissue Deficits in Diet-Induced Obese Mice and Reduces Influenza Infection After Vaccination and Challenge[J]. Obesity (Silver Spring). 2020 ,28(9):1631-1636.[3] Influences of Vitamin A on Vaccine Immunogenicity and Efficacy[J]. Front Immunol. 2019,10:1576.[4] Vitamin A and Vitamin D Regulate the Microbial Complexity, Barrier Function, and the Mucosal Immune Responses to Ensure Intestinal Homeostasis [J]. Crit Rev Biochem Mol Biol. 2019,54(2):184-192.[5] Enhancement of vitamin A combined vitamin D supplementation on immune response to Bacille Calmette-Guérin vaccine revaccinated in Chinese infants[J]. Asian Pac J Trop Med. 2014 Feb;7(2):130-5.[6] Baseline Serum Vitamin A and D Levels Determine Benefit of Oral Vitamin A&D Supplements to Humoral Immune Responses Following Pediatric Influenza Vaccination[J]. Viruses. 2019, 11(10):907.[7] The Prevalence of Vitamin A Deficiency in Chinese Children: A Systematic Review and Bayesian Meta-Analysis[J]. Nutrients, 2017, (12):1285-1294.
当血清视黄醇≥1.05μmol/L时,其发病率最低,严重维生素A缺乏(<0.35μmol/L)的儿童中腹泻伴呕吐频次是维生素A充足(≥1.05μmol/L)儿童的2倍(RR:2.17,95% CI:1.20-4.13);其咳嗽伴发热频次是维生素A充足儿童的2.4倍(RR:2.36,95% CI:0.95,4.96)。具体见下图:
▎研究发现,维生素A在抗感染和免疫方面的主要作用如下:
[1] Vitamin A deficiency is associated with gastrointestinal and respiratory morbidity in school-age children[J]. J Nutr. 2014,144(4):496-503.[2] Vitamin A Corrects Tissue Deficits in Diet-Induced Obese Mice and Reduces Influenza Infection After Vaccination and Challenge[J]. Obesity (Silver Spring). 2020 ,28(9):1631-1636.[3] Influences of Vitamin A on Vaccine Immunogenicity and Efficacy[J]. Front Immunol. 2019,10:1576.[4] Vitamin A and Vitamin D Regulate the Microbial Complexity, Barrier Function, and the Mucosal Immune Responses to Ensure Intestinal Homeostasis [J]. Crit Rev Biochem Mol Biol. 2019,54(2):184-192.[5] Enhancement of vitamin A combined vitamin D supplementation on immune response to Bacille Calmette-Guérin vaccine revaccinated in Chinese infants[J]. Asian Pac J Trop Med. 2014 Feb;7(2):130-5.[6] Baseline Serum Vitamin A and D Levels Determine Benefit of Oral Vitamin A&D Supplements to Humoral Immune Responses Following Pediatric Influenza Vaccination[J]. Viruses. 2019, 11(10):907.[7] The Prevalence of Vitamin A Deficiency in Chinese Children: A Systematic Review and Bayesian Meta-Analysis[J]. Nutrients, 2017, (12):1285-1294.
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