Abnormal T-cell subset proportions in vitamin-A-deficient children

Lancet. 1993 Jan 2;341(8836):5-8. doi: 10.1016/0140-6736(93)92478-c.


Although vitamin A deficiency in children seems to increase susceptibility to infection and community trials have shown that vitamin A 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 vitamin A deficiency is associated with abnormalities in T-cell subsets and whether vitamin A 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 vitamin A supplementation (60 mg retinol equivalent) and 29 received placebo. 5 weeks later the vitamin A 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 vitamin A supplementation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analysis of Variance
  • CD4-CD8 Ratio*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • T-Lymphocyte Subsets / immunology*
  • Vitamin A / blood
  • Vitamin A / therapeutic use*
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / complications
  • Vitamin A Deficiency / drug therapy
  • Vitamin A Deficiency / immunology*
  • Xerophthalmia / blood
  • Xerophthalmia / etiology
  • Xerophthalmia / immunology


  • Vitamin A