Effect of vitamin A on intestinal mucosal injury in pediatric patients receiving hematopoietic stem cell transplantation and chemotherapy: a quasai-randomized trial

Abstract

Objective Vitamin A is involved in maintenance of gut mucosal integrity and normal immune function. However, it is unclear whether these functions of vitamin A have any beneficial effects in patients undergoing hematopoietic stem cell transplantation (HSCT). In this study, we aimed to examine the potential protective effect of vitamin A supplementation on gastrointestinal (GI) mucosal integrity in HSCT recipients using plasma citrulline as a surrogate marker of intestinal integrity. Results We performed a quasi-randomized trial in 30 pediatric patients undergoing HSCT. Half (n = 15) of the patients received a single high dose of vitamin A (200,000 IU) before the conditioning regimen was given, and half (n = 15) did not. Clinical data of patients who developed post-transplant complications were recorded for 60 days after HSCT. There were no significant differences in mean plasma citrulline levels on day 7 after HSCT between the treatment and control groups (5.8 vs. 5.9 µmol/L, respectively). The incidence of mucositis and other complications were not different between the two groups within 60 days of HSCT. Vitamin A supplementation prior to HSCT in pediatric patients had no clinical benefit in protecting GI mucosal integrity.

Dietary Goji Shapes the Gut Microbiota to Prevent the Liver Injury Induced by Acute Alcohol Intake

“…The retinoyl β-glucuronide, a retinoid that is retinoic acid, was upregulated by Goji and its trained microbiota. It is a naturally occurring, biologically active metabolite of vitamin A. Retinol is vital to maintaining the integrity of the epithelium and mucous membranes ( 60 ). Previous studies showed that symbiotic bacteria produced retinol derivatives that could protect the intestinal epithelial barrier ( 61 , 62 ).…”

A Narrative Review about Nutritional Management and Prevention of Oral Mucositis in Haematology and Oncology Cancer Patients Undergoing Antineoplastic Treatments

“…Alternatively, Thornley et al ( 2004) [63] demonstrated an OM incidence and severity reduction along with lower regimen-related toxicity (especially in high-risk patients) thanks to a preparation made of ursodeoxycholic acid, vitamin E, folinic acid and administered as parenteral nutrition as prevention. In contrast, Pattanakitsakul et al (2020) [68] proved in their preliminary quasi-randomized trial that vitamin A did not prevent OM.…”

“…Vitamins were another group that was analysed in different studies (seven articles found) [29,31,63,65,66,68].…”

“…Of the final articles included, six of them addressed the prevention and/or treatment of OM in paediatric patients with cancer [27,29,44,47,63,68]. The ages evaluated in those articles ranged from one to nineteen years old, varying in the different scientific articles.…”

“…An evidence void also occurs when studying the treatment of OM with vitamins E and D since both have some studies (four about vitamin E [31,63,65,66], one about vitamin A [68], and one about vitamin D [29]) that determined different effects of the vitamins on OM and thus cannot be compared due to the characteristics used to analyse each study (they used different laboratories, cohorts, clinical trials, etc.). Therefore, supporting what Yarom et al (2019) [75] mention in their review, it is not possible to determine consistent evidence for the use of vitamins in the treatment of OM.…”