Carotenoids, retinol, and intestinal barrier function in children from northeastern Brazil.

Clinical Research Unit and Institute of Biomedicine, School of Medicine, Federal University of Ceará, Brazil.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.18). 11/2008; 47(5):652-9. DOI: 10.1097/MPG.0b013e31816bf4bf
Source: PubMed

ABSTRACT To investigate the association of carotenoids and retinol (vitamin A) with intestinal barrier function in children in an urban community in Fortaleza, northeastern Brazil.
Descriptive analysis of serum carotenoids and retinol concentrations with intestinal barrier function in 102 children from an urban community, July 2000 to August 2001.
The weight for height z score (wasting) showed that 19.6% (20/102) had mild malnutrition (-1 to -2 z score). All of the children's serum retinol concentrations were determined and none were severely deficient (< or =0.35 micromol/L), 2.9% (3/102) were moderately (0.36-0.70 micromol/L) deficient, 20.6% (21/102) were mildly (0.71-1.05 micromol/L) deficient; 76.5% (78/102) were vitamin A sufficient (>1.05 micromol/L). The lactulose:mannitol (L/M) ratio was elevated (> or =0.0864) in 49% (47/97) of children when compared with healthy children with normal L/M ratio (<0.0864) in the same geographic area. Serum carotenoids, lutein, beta-cryptoxanthin and beta-carotene showed significant inverse correlations with the L/M ratio, but not lutein after adjusting for age. Acute phase proteins (C-reactive protein and alpha-acid glycoprotein) were significantly inversely correlated with retinol but not with carotenoids. Retinol and retinol-binding protein were not significantly associated with L/M ratio.
These data suggest a disruption of intestinal barrier function in the paracellular pathway with low serum concentrations of carotenoids. Carotenoids may provide a better marker for disrupted intestinal barrier function than retinol-binding protein or retinol.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study evaluates the effects of retinol on intestinal barrier function, growth, total parasites, and Giardia spp infections in children in northeastern Brazil. The study was a double-blind, randomized placebo-controlled trial (; register no. #NCT00133406) involving 79 children who received vitamin A 100,000-200,000 IU (n = 39) or placebo (n = 40) at enrollment, 4, and 8 months and were followed for 36 months. Intestinal barrier function was evaluated using the lactulose:mannitol ratio test. Stool lactoferrin was used as a marker for intestinal inflammation. The groups were similar with regard to age, sex, nutritional parameters (z scores), serum retinol concentrations, proportion of lactoferrin-positive stool samples, and intestinal barrier function. The lactulose:mannitol ratio did not change during the same time of follow-up (P > 0.05). The proportion of lactoferrin-positive samples evaluated at 1 month did not change between groups (P > 0.05). Total intestinal parasitic, specifically new, infections were significantly lower in the vitamin A treatment compared with control group; these were accounted for entirely by significantly fewer new Giardia infections in the vitamin A treatment group. The cumulative z scores for weight-for-length or height, length or height-for-age z scores, and weight-for-age did not change significantly with vitamin A intervention for 36 months of follow-up. These data showed that total parasitic infection and Giardia spp infections were significantly lower in the vitamin A treatment group when compared with the placebo group, suggesting that vitamin A improves the host's defenses against Giardia infections.
    Journal of pediatric gastroenterology and nutrition 03/2010; 50(3):309-15. · 2.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. Probiotics have a possible role in pediatric acute gastroenteritis. We report the effect of the probiotic Lactobacillus rhamnosus GG (LGG) on intestinal function, immune response and clinical outcomes in Indian children with cryptosporidial or rotavirus diarrhea. Methods. Children with gastroenteritis aged 6 months to 5 years, testing positive for either rotavirus or Cryptosporidium spp. in stool (co-infections were excluded), were randomized to LGG (ATCC 53103) or placebo, once daily for four weeks. Baseline demographic and clinical details were obtained. Sera were tested for IgG and IgA antibodies to Cryptosporidium and rotavirus, and the lactulose:mannitol test for intestinal permeability was performed at baseline and at the end of follow-up. Results. Of the 124 children enrolled, 82 and 42 had rotavirus and cryptosporidial diarrhea respectively. Median diarrheal duration was 4 days; one-third of the children had severe diarrhea. Baseline and clinical parameters were comparable between children receiving LGG and placebo. At the end of follow-up, fewer children with rotavirus diarrhea on LGG had repeated diarrheal episodes (25% vs. 46%; P=0.048) and impaired intestinal function (48% vs. 72%, P=0.027). Significant increase in IgG levels post-intervention (456 vs. 2215 EU, P=0.003) was observed in children with rotavirus diarrhea receiving LGG. Among children with cryptosporidial diarrhea, those receiving LGG showed significant improvement in intestinal permeability. Conclusion. LGG has a positive immunomodulatory effect and may be useful in decreasing repeated episodes of rotavirus diarrhea. Improvement in intestinal function in children with rotavirus and cryptosporidial gastroenteritis emphasizes the role of probiotics in treating intestinal impairment, post-infection.
    Clinical Infectious Diseases 02/2014; · 9.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Apolipoprotein E4 may benefit children during early periods of life when the body is challenged by infection and nutritional decline. We examined whether apolipoprotein E4 affects intestinal barrier function, improving short-term growth and long-term cognitive outcomes in Brazilian shantytown children. A total of 213 Brazilian shantytown children with below-median height-for-age z-scores (HAZ) received 200,000 IU of retinol (every four months), zinc (40 mg twice weekly), or both for one year, with half of each group receiving glutamine supplementation for 10 days. Height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, and lactulose:mannitol ratios were assessed during the initial four months of treatment. An average of four years (range 1.4-6.6) later, the children underwent cognitive testing to evaluate non-verbal intelligence, coding, verbal fluency, verbal learning, and delayed verbal learning. Apolipoprotein E4 carriage was determined by PCR analysis for 144 children. Thirty-seven children were apolipoprotein E4(+), with an allele frequency of 13.9%. Significant associations were found for vitamin A and glutamine with intestinal barrier function. Apolipoprotein E4(+) children receiving glutamine presented significant positive Pearson correlations between the change in height-for-age z-scores over four months and delayed verbal learning, along with correlated changes over the same period in weight-for-age z-scores and weight-for-height z-scores associated with non-verbal intelligence quotients. There was a significant correlation between vitamin A supplementation of apolipoprotein E4(+) children and improved delta lactulose/mannitol. Apolipoprotein E4(-) children, regardless of intervention, exhibited negative Pearson correlations between the change in lactulose-to-mannitol ratio over four months and verbal learning and non-verbal intelligence. During development, apolipoprotein E4 may function concomitantly with gut-tropic nutrients to benefit immediate nutritional status, which can translate into better long-term cognitive outcomes.
    Clinics (São Paulo, Brazil) 01/2012; 67(1):11-8. · 1.59 Impact Factor

Full-text (2 Sources)

Available from
May 16, 2014