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Effect of high-dose vitamin A supplementation on the immune response to Bacille Calmette-Guerin vaccines

Diness, Birgitte R.; Fisker, Ane B.; Roth, Adam LU ; Yazdanbakhsh, Maria; Sartono, Erliyani; Whittle, Hilton; Nante, Jose E.; Lisse, Ida M.; Ravn, Henrik and Rodrigues, Amabelia, et al. (2007) In American Journal of Clinical Nutrition 86(4). p.1152-1159
Abstract
Background: Vitamin A supplementation (VAS) at birth has been associated with decreased mortality in Asia. Bacille Calmette-Guerin (BCG) vaccine is given at birth in tuberculosis-endemic countries. Previous studies suggest that VAS may influence the immune response to vaccines. Objective: Our objective was to examine whether VAS influences the immune response to simultaneously administered BCG vaccine. Design: Within a randomized trial of 50 000 IU vitamin A or placebo Given with BCG vaccine at birth in Guinea-Bissau, 27 10 infants were examined for BCG scar formation and delayed-type hypersensitivity (DTH) to purified protein derivative of Mycobacterium tuberculosis (PPD) at 2 and 6 mo of age. The ex vivo cytokine response to PPD was... (More)
Background: Vitamin A supplementation (VAS) at birth has been associated with decreased mortality in Asia. Bacille Calmette-Guerin (BCG) vaccine is given at birth in tuberculosis-endemic countries. Previous studies suggest that VAS may influence the immune response to vaccines. Objective: Our objective was to examine whether VAS influences the immune response to simultaneously administered BCG vaccine. Design: Within a randomized trial of 50 000 IU vitamin A or placebo Given with BCG vaccine at birth in Guinea-Bissau, 27 10 infants were examined for BCG scar formation and delayed-type hypersensitivity (DTH) to purified protein derivative of Mycobacterium tuberculosis (PPD) at 2 and 6 mo of age. The ex vivo cytokine response to PPD was measured in 607 infants. Results: At 2 mo of age, 39% (43% of the boys and 34% of the girls) responded to PPD. The prevalence ratio of a measurable PPD reaction for VAS compared with placebo recipients was 0.90 (95% CI: 0.80, 1.02) for all infants. 0.81 (95% CI: 0.69, 0.95) for boys, and 1.04 (95% CI: 0.86, 1.26) for girls. At 6 mo of age, 42% of the infants responded to PPD. No difference was observed between VAS and placebo recipients. The prevalence of BCG scar was not affected by VAS. The ex vivo interferon-gamma response to PPD was increased by VAS (means ratio: 1.40: 95% CI: 1.03, 1.91). Conclusions: VAS with BCG vaccination does not appear to interfere with the long-term immune response to BCG. However, VAS temporarily altered the DTH reaction to PPD in boys at 2 mo of age, suggesting sex differences in the immunologic response to VAS Given with BCG. This trial was registered at www.clinicaltrials.gov as #NCT00168597. (Less)
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published
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keywords
BCG vaccination, Bacille Calmette-Guerin, vitamin A, purified protein derivative of Mycobacterium tuberculosis response, PPD response, sex-differential effects, randomized trial
in
American Journal of Clinical Nutrition
volume
86
issue
4
pages
1152 - 1159
publisher
American Society for Clinical Nutrition
external identifiers
  • wos:000250134600036
  • scopus:35148876454
ISSN
1938-3207
language
English
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yes
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ba14edba-4d94-410f-9e9e-173b433f974d (old id 655529)
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http://www.ajcn.org/cgi/content/abstract/86/4/1152
date added to LUP
2007-12-07 12:24:30
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2017-03-12 04:14:19
@article{ba14edba-4d94-410f-9e9e-173b433f974d,
  abstract     = {Background: Vitamin A supplementation (VAS) at birth has been associated with decreased mortality in Asia. Bacille Calmette-Guerin (BCG) vaccine is given at birth in tuberculosis-endemic countries. Previous studies suggest that VAS may influence the immune response to vaccines. Objective: Our objective was to examine whether VAS influences the immune response to simultaneously administered BCG vaccine. Design: Within a randomized trial of 50 000 IU vitamin A or placebo Given with BCG vaccine at birth in Guinea-Bissau, 27 10 infants were examined for BCG scar formation and delayed-type hypersensitivity (DTH) to purified protein derivative of Mycobacterium tuberculosis (PPD) at 2 and 6 mo of age. The ex vivo cytokine response to PPD was measured in 607 infants. Results: At 2 mo of age, 39% (43% of the boys and 34% of the girls) responded to PPD. The prevalence ratio of a measurable PPD reaction for VAS compared with placebo recipients was 0.90 (95% CI: 0.80, 1.02) for all infants. 0.81 (95% CI: 0.69, 0.95) for boys, and 1.04 (95% CI: 0.86, 1.26) for girls. At 6 mo of age, 42% of the infants responded to PPD. No difference was observed between VAS and placebo recipients. The prevalence of BCG scar was not affected by VAS. The ex vivo interferon-gamma response to PPD was increased by VAS (means ratio: 1.40: 95% CI: 1.03, 1.91). Conclusions: VAS with BCG vaccination does not appear to interfere with the long-term immune response to BCG. However, VAS temporarily altered the DTH reaction to PPD in boys at 2 mo of age, suggesting sex differences in the immunologic response to VAS Given with BCG. This trial was registered at www.clinicaltrials.gov as #NCT00168597.},
  author       = {Diness, Birgitte R. and Fisker, Ane B. and Roth, Adam and Yazdanbakhsh, Maria and Sartono, Erliyani and Whittle, Hilton and Nante, Jose E. and Lisse, Ida M. and Ravn, Henrik and Rodrigues, Amabelia and Aaby, Peter and Benn, Christine S.},
  issn         = {1938-3207},
  keyword      = {BCG vaccination,Bacille Calmette-Guerin,vitamin A,purified protein derivative of Mycobacterium tuberculosis response,PPD response,sex-differential effects,randomized trial},
  language     = {eng},
  number       = {4},
  pages        = {1152--1159},
  publisher    = {American Society for Clinical Nutrition},
  series       = {American Journal of Clinical Nutrition},
  title        = {Effect of high-dose vitamin A supplementation on the immune response to Bacille Calmette-Guerin vaccines},
  volume       = {86},
  year         = {2007},
}