Abstract
Vitamin A SUPPL.ementation (VAS) at birth was not associated with improved survival in a randomised, placebo-controlled trial in Guinea-Bissau. However, a negative sex-differential effect, which became evident after diphtheria-tetanus-pertussis (DTP) vaccination, was noted; among girls who had received DTP, VAS at birth was associated with two-fold higher mortality than placebo. The objective of the present study was to investigate the immunological effects of VAS at birth within a subgroup of participants in the randomised trial. Guided by the mortality results, we further explored whether VAS had a differential effect according to sex and DTP status. At 6 weeks after randomisation and SUPPL.ementation, we measured differential leucocyte counts and TNF-α, interferon-γ, IL-10, IL-13 and IL-5 production in a whole-blood culture assay. A total of 471 children were included. VAS compared with placebo at birth was associated with a higher proportion of monocytes (relative risk ratio 1·26, 95Â % CI 1·07, 1·49, P=Â 0·04), while spontaneous TNF-α production was lower in the VAS group (geometric mean ratio 0·54, 95Â % CI, 0·37, 0·78, P=Â 0·001). Stratified analysis showed that VAS was associated with lower TNF-α and IL-10 production for girls without DTP and boys with DTP, resulting in significant three-way interactions between VAS, sex and DTP vaccination status (P=Â 0·03 and P=Â 0·04, respectively) for spontaneous TNF-α and IL-10 production. The results substantiate the potential role of VAS as an immunomodulatory intervention, which has different effects depending on concomitant health interventions and the sex of the recipient.
Original language | English |
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Journal | British Journal of Nutrition |
Volume | 109 |
Issue number | 3 |
Pages (from-to) | 467-477 |
ISSN | 0007-1145 |
DOIs | |
Publication status | Published - 14. Feb 2013 |
Keywords
- BCG Vaccine
- Cells, Cultured
- Child Development
- Cytokines
- Dietary Supplements
- Double-Blind Method
- Female
- Guinea-Bissau
- Humans
- Immunity, Cellular
- Immunity, Innate
- Immunomodulation
- Infant, Newborn
- Leukocyte Count
- Leukocytes
- Male
- Monocytes
- Sex Characteristics
- Tuberculosis
- Vitamin A
- Whole-blood stimulation
- Immunology
- Vitamin A SUPPL.ementation
- Diphtheria-tetanus-pertussis vaccination