Adjuvant effect of vitamin A on recurrent lower urinary tract infections

Yılmaz, Aygen; Bahat, Elif; Yilmaz, Gülsün Gülay; Hasanoğlu, Alev; Akman, Sema; Güven, Ayfer Gür

doi:10.1111/j.1442-200x.2007.02370.x

Cited by 28 publications

(12 citation statements)

References 17 publications

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“…Despite its intricate relationship with pathogen control, vitamin A is often overlooked as a defense against clinical UTIs or respiratory diseases, particularly in developed countries [47,52]. Our results illustrate the dysfunctional immune parameters and poor outcomes of VAD and encourage clinicians to consider abnormal vitamin A levels as a cause of poor outcome.…”

Section: A Focus On the Cross Regulatory Signals Of Nuclear Receptorsmentioning

confidence: 67%

“…Acute pyelonephritis is a frequent cause of serious bacterial UTIs in infants, with renal scarring followed by hypertension and chronic renal failure being the most common long-term sequelae [40][41][42][43][44]. Vitamin A/retinoid supplementation can be protective in some (but not all) cases [39,[45][46][47][48][49][50][51][52], perhaps in part by preventing the adhesion of bacteria to respiratory epithelium [33].…”

Section: Vad Keratinizing Metaplasia Utis and Respiratory Tract Dismentioning

confidence: 99%

See 1 more Smart Citation

Consequences of Vitamin A Deficiency: Immunoglobulin Dysregulation, Squamous Cell Metaplasia, Infectious Disease, and Death

Surman

Penkert

Sealy

et al. 2020

IJMS

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Vitamin A is an important regulator of immune protection, but it is often overlooked in studies of infectious disease. Vitamin A binds an array of nuclear receptors (e.g., retinoic acid receptor, peroxisome proliferator-activated receptor, retinoid X receptor) and influences the barrier and immune cells responsible for pathogen control. Children and adults in developed and developing countries are often vitamin A-deficient or insufficient, characteristics associated with poor health outcomes. To gain a better understanding of the protective mechanisms influenced by vitamin A, we examined immune factors and epithelial barriers in vitamin A deficient (VAD) mice, vitamin D deficient (VDD) mice, double deficient (VAD+VDD) mice, and mice on a vitamin-replete diet (controls). Some mice received insults, including intraperitoneal injections with complete and incomplete Freund’s adjuvant (emulsified with PBS alone or with DNA + Fus-1 peptide) or intranasal inoculations with Sendai virus (SeV). Both before and after insults, the VAD and VAD+VDD mice exhibited abnormal serum immunoglobulin isotypes (e.g., elevated IgG2b levels, particularly in males) and cytokine/chemokine patterns (e.g., elevated eotaxin). Even without insult, when the VAD and VAD+VDD mice reached 3–6 months of age, they frequently exhibited opportunistic ascending bacterial urinary tract infections. There were high frequencies of nephropathy (squamous cell hyperplasia of the renal urothelium, renal scarring, and ascending pyelonephritis) and death in the VAD and VAD+VDD mice. When younger VAD mice were infected with SeV, the predominant lesion was squamous cell metaplasia of respiratory epithelium in lungs and bronchioles. Results highlight a critical role for vitamin A in the maintenance of healthy immune responses, epithelial cell integrity, and pathogen control.

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Section: A Focus On the Cross Regulatory Signals Of Nuclear Receptorsmentioning

confidence: 67%

Section: Vad Keratinizing Metaplasia Utis and Respiratory Tract Dismentioning

confidence: 99%

Consequences of Vitamin A Deficiency: Immunoglobulin Dysregulation, Squamous Cell Metaplasia, Infectious Disease, and Death

Surman

Penkert

Sealy

et al. 2020

IJMS

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“…A randomised, placebo controlled trial of vitamin A to prevent recurrent UTI in children [43] showed a reduced rate of UTI in the follow-up period, but only 24 children participated so the estimate of efficacy is imprecise and there are also concerns over selection bias.…”

Section: Complementary Treatmentsmentioning

confidence: 99%

Preventing Urinary Tract Infections in Early Childhood

Williams

Craig

Carapetis

2012

Advances in Experimental Medicine and Biology

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Urinary tract infection (UTI) is common in children, causes them considerable discomfort, as well as distress to parents and has a tendency to recur. Approximately 20% of those children who experience one infection will have a repeat episode. Since 1975, 11 trials of long-term antibiotics compared with placebo or no treatment in 1,550 children have been published. Results have been heterogeneous, but the largest trial demonstrated a small reduction (6% absolute risk reduction, risk ratio 0.65) in the risk of repeat symptomatic UTI over 12 months of treatment. This effect was consistent across sub groups of children based upon age, gender, vesicoureteric reflux status and number of prior infections. Trials involving re-implantation surgery (and antibiotics compared with antibiotics alone) for the sub-group of children with vesicoureteric reflux have not shown a reduction in repeat UTI, with the possible exception of a very small benefit for febrile UTI. Systematic reviews have shown that circumcision reduces the risk of repeat infection but 111 circumcisions would need to be performed to prevent one UTI in unpredisposed boys. Given the need for anaesthesia and the risk of surgical complication, net clinical benefit is probably restricted to those who are predisposed (such as those with recurrent infection). Many small trials in complementary therapies have been published and many suggest some benefit, however inclusion of children is limited. Only three trials involving 394 children for cranberry products, two trials with a total of 252 children for probiotics and one trial with 24 children for vitamin A are published. Estimates of efficacy vary widely and imprecision is evident. Multiple interventions to prevent UTI in children exist. Of those, long-term low dose antibiotics has the strongest evidence base, but the benefit is small. Circumcision in boys reduces the risk substantially, but should be restricted to those at risk. There is little evidence of benefit of re-implantation alone, and the benefit of this procedure over antibiotics alone is very small. Cranberry concentrate is probably effective.

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“…The results of this study revealed that the vitamin C group had a significantly lower incidence of UTIs than the control group. Similarly, the use of vitamin A in the management of UTIs in children was evaluated by Yilmaz et al (2007). This study tested 24 children, 12 in the vitamin A group who received 200,000 IU of vitamin A, in addition to antimicrobial therapy for 10 days and 12 in the control group who just received the antimicrobial.…”

Section: Dietary Interventionsmentioning

confidence: 99%