IMPAIRMENT OF SECRETORY IMMUNE SYSTEM IN VITAMIN A DEFICIENCY STATE*

STITAYA SIRISINHA

ABSTRACT: The synergistic interaction between malnutrition and infection has long been recognized; not only is there a higher incidence of infection, but the mortality rate for some infectious diseases is also higher in the malnourished than in the well-nourished individual. 1 Both clinical observations and experimental animal studies suggest that the malnourished subject responds to infection in a way different from the well-nourished individual. 2, 3 For example, there is a tendency for the malnourished child to develop afebrile gram-negative septicemia. Likewise, when localized infection spreads, it often does so with the development of gangrene rather than suppuration.

The underlying mechanisms by which diet may alter the interaction between host and invading agent are poorly understood and rather complex. This is not entirely unexpected as the quality and the quantity of dietary intake are not the only factors that affect the host defenses; the immunological status of the host and the metabolism of the invading agents also come into play. Because of such complications, this review will be focused on the effect of vitamin A deficiency on secretory (local, mucosal) immune system, with special emphasis on findings contributed from our group.

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Department of Microbiology, Faculty of Science, Mahidol University, Bangkok

* Based on the Outstanding Scientist of Thailand Award Lecture, Bangkok, 18 August 1988.