Recommendations for vitamin A intake are based on maintaining liver stores of
≥ 0·070 μmol/g, which is sufficient to
maintain normal vision. We propose that higher levels may be required to maintain normal
immune function. To test this hypothesis, we conducted an 8-week residential study among
thirty-six healthy Bangladeshi men with low vitamin A stores. Subjects were randomised to
receive vitamin A (240 mg in four doses) or placebo during study weeks 2 and 3.
Vitamin A stores were estimated by isotopic dilution at week 8. Total T-cells, the naive
T-cells:memory T-cells ratio and mitogen-induced lymphocyte proliferation were positively
and significantly correlated with vitamin A stores
(P < 0·05). Mitogen-stimulated IL-2,
IL-4 and TNFα increased significantly
(P < 0·05) in the vitamin A but not
placebo group after supplementation, while IL-10 production was significantly and
negatively correlated with vitamin A stores
(P < 0·05). Segmented linear regression
analysis revealed that naive T-cell counts and T-cell blastogenesis were positively
associated with vitamin A stores above but not below
0·070 μmol/g liver. These data show that increasing vitamin A
stores above the level that maintains normal vision enhances some measures of
T-cell-mediated immunity, suggesting a difference in requirements for maintaining vision
and immune function.