IntroductionVitamin A (retinol) is essential in vertebrate physiology, and vitamin A deficiency represents an important health problem in many third world countries. 1 The retinol derivative RA is a major pleiotropic mediator regulating diverse developmental processes and cellular functions. It activates the nuclear receptors RA receptor RAR/RXR-heterodimers to regulate the transcription of target genes containing RA-response elements (RAREs). RA is synthesized from retinol via a retinaldehyde intermediate and the enzymes that determine the tissue specificity of RA synthesis are retinaldehyde dehydrogenases (RALDHs) that catalyze the last oxidative step. ALDH1A1 (also known as ALDH1, RALDH1), an important aldehyde-detoxifying enzyme that also accepts retinal as substrate, is widely expressed in adult tissues and is thus likely responsible for low RA levels present in tissues throughout the body. 2,3 The 2 most efficient and selective RA-synthesizing enzymes are RALDH2 (gene name ALDH1A2) and RALDH3 (ALDH1A3). [2][3][4] Expression of RALDH2 is required for the spatial and temporal RA gradients needed for proper embryonic development, as evidenced by the lethal phenotype of RALDH2-KO mice and transgenic RARE reporter mice. [5][6][7][8] In sharp contrast to the extensive research on RALDH2 in the embryo, very little is known regarding the function of this enzyme in the adult: it is unknown whether the enzyme continues to generate local foci of RA synthesis or whether it is involved in any pathophysiological processes, in particular with regard to immune-mediated diseases.It is well established that RA can affect gene expression and function of almost any cell, including cells of the immune system; however, the physiological implications of such findings are uncertain, particularly when pharmacologic RA concentrations are used. Several studies indicate that vitamin A deficiency compromises the function of the immune system, in particular humoral Th2-mediated immune responses. 9 A role of RA in immune regulation is also supported by the observation that RA added as an adjuvant promotes a Th2 bias and inhibits experimental autoimmune disease in rodents. 10,11 Furthermore, very recent findings indicate that RA regulates homeostatic lymphocyte function and trafficking to the gut. 12,13 This large body of data on RA effects in vitro and in vivo contrasts greatly with the lack of knowledge about the regulation of expression of the major RA-synthesizing enzyme RALDH2 in different cell types of the immune system.Immediate-type allergic diseases, such as atopic dermatitis, rhinoconjunctivitis, and asthma, have reached epidemic proportions in industrialized countries. Why the "Western lifestyle" has led to this strong increase in the prevalence of atopic diseases is unclear, although it is believed that better hygiene standards are a cause (hygiene hypothesis). 14 Current concepts of the pathophysiology of allergic diseases emphasize the importance of Th2 lymphocytes and eosinophils, 15 but at least in human asthma there is a...