Understanding the role of vitamin A and its precursors in the immune system

Nutritional Deficiencies and Management in Tuberculosis: Pharmacotherapeutic and Clinical Implications

Tuberculosis is an infectious condition caused by Mycobacterium tuberculosis, primarily targeting the pulmonary system, with the potential to disseminate to various other organs via the haematogenous pathway, ranking among the top ten causes of global mortality. Tuberculosis remains a serious public health problem worldwide. This narrative review aims to emphasise the clinical importance of the inter-relationships between nutrition, pharmacotherapy, and the most common drug-nutrient interactions in the context of tuberculosis and multi-drug-resistant tuberculosis management. Nowadays, pharmacologic approaches utilise polytherapeutic regimens that, although showing increased efficacy, prominently affect the nutritional status of patients and modify multiple metabolic pathways, thus influencing both the effectiveness of therapy and the patient outcomes. There is much evidence that antituberculosis drugs are associated with deficiencies in essential vitamins and various micronutrients, leading to serious adverse consequences. Moreover, poor nutrition exacerbates TB outcomes, and TB further exacerbates nutritional status, a vicious cycle that is particularly prevalent in low-resource environments. Nutritional support is necessary, and clinicians ought to evaluate it on a patient-by-patient basis, as empirical evidence has shown that it can improve immune recovery, decrease tuberculosis-associated morbidity, and increase adherence to therapy. However, drug-food interactions are increasingly prevalent, and patients with tuberculosis require personalised dietary and pharmacological regimens. In this context, antituberculosis treatment requires a holistic approach, based on the collaboration of the prescribing physician, pharmacist, and nutritionist, to assess the patient's needs from a nutritional and pharmacological perspective, with the ultimate goal of decreasing mortality and improving the prognosis of patients through personalised therapies.

P. Oliveira MB, Carpena M, Prieto MA. Therapeutic and Preventive Potential of Plant-Derived Antioxidant Nutraceuticals

Oxidative stress and its relation to the onset of several chronic diseases have been increasingly highlighted in recent years. In parallel, there has been an increasing interest in the antioxidant properties of phytochemicals. Phytochemicals are products of plant secondary metabolism, including structural polysaccharides, unsaturated fatty acids, pigments (chlorophylls, carotenoids, and anthocyanins), or phenolic compounds. Phytochemicals can be obtained from lower and higher plants, their fruits, and even from macro- or microalgae. Their diverse structural features are linked to different beneficial effects through various molecular mechanisms, contributing to disease prevention. Beyond antioxidant activity, many phytochemicals also display anti-inflammatory, antidiabetic, anti-obesity, and neuroprotective effects, which can be intertwined. Beyond these, other natural antioxidants can also be obtained from animal, fungal, and bacterial sources. Thus, a wide range of antioxidants have the potential to be used as nutraceuticals with chemopreventive effects on the onset of various diseases related to antioxidant stress. Given their enormous structural and sourcing diversity, the present work provides an updated insight into the therapeutic and preventive potential of plant-derived antioxidants and nutraceuticals.

The Role of Vitamins in Pediatric Urinary Tract Infection: Mechanisms and Integrative Strategies

Urinary tract infections (UTI) are among the most frequent bacterial infections in children, representing a significant cause of morbidity with potential long-term complications, including renal scarring and chronic kidney disease. This review explores the multifaceted roles of vitamins A, D, E, and C in the prevention and management of pediatric UTI. Vitamin A supports mucosal barrier integrity and immune modulation, reducing pathogen adhesion and colonization. Vitamin C exhibits antioxidant and antimicrobial properties, acidifying urine to inhibit bacterial growth and enhancing the efficacy of antibiotics. Vitamin D strengthens innate immunity by promoting antimicrobial peptide production, such as cathelicidins, and improves epithelial barrier function, while vitamin E mitigates oxidative stress, reducing renal inflammation and tissue damage. The interplay between oxidative stress, immune response, and nutritional factors is emphasized, highlighting the potential of these vitamins to restore antioxidant balance and prevent renal injury. Complementary strategies, including probiotics and phytotherapeutic agents, further enhance therapeutic outcomes by addressing microbiome diversity and providing additional antimicrobial effects. While these approaches show promise in mitigating UTI recurrence and reducing dependence on antibiotics, evidence gaps remain regarding optimal dosing, long-term outcomes, and their integration into pediatric care. By adopting a holistic approach incorporating vitamin supplementation and conventional therapies, clinicians can achieve improved clinical outcomes, support antibiotic stewardship, and reduce the risk of renal complications in children with UTI.

A Comparative Study of a Potent CNS-Permeable RARβ-Modulator, Ellorarxine, in Neurons, Glia and Microglia Cells In Vitro

Vitamin A (retinol) and its derivatives (retinoids) assume critical roles in neural development, cellular differentiation, axon elongation, programmed cell apoptosis and various fundamental cellular processes. Retinoids function by binding to specific nuclear receptors, such as retinoic acid receptors (RARs) and retinoid X receptors (RXRs), activating specific signalling pathways in the cells. The disruption of the retinoic acid signalling pathway can result in neuroinflammation, oxidative and ER stress and mitochondrial dysfunction and has been implicated in a wide range of neurodegenerative diseases. The present study explored the potential therapeutic application of our innovative CNS-permeable synthetic retinoid, Ellorarxine, for the treatment of neurodegenerative disorders in vitro. An MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay, lactate dehydrogenase (LDH) assay, enzyme-linked immunosorbent assay (ELISA), immunocytochemistry and immunofluorescence staining were performed. Ellorarxine increased Cyp26 and, selectively, RARβ protein expression in neurons, glia and microglia. Ellorarxine significantly reduced cell death (neurons, glia), increased mitochondrial viability (neurons), modulated cytokine release (microglia), and positively regulated cellular autophagy (neurons, glia, microglia). These results suggest that Ellorarxine is a promising drug candidate that should be further investigated in the treatment of neurodegenerative diseases.

Vitamin A concentration in bovine liver and milk does not only depend on characteristics of the farming system

The study examined the vitamin A status in commercially managed suckler cows and lactating dairy cows and identified primary influencing factors. Liver retinyl ester concentrations were higher in multiparous than primiparous cows (p < 0.01). Pasture availability was associated with higher β-carotene concentrations (p < 0.001). In dairy cows, pasture access during the dry period did not affect any of the parameters assayed. β-Carotene and retinol in milk increased with parity. No vitamin A deficiency or hypervitaminosis A was detected. Liver and milk retinol and retinyl ester concentrations that were analysed in the present study and data from a recent German total diet study were used to estimate the exposure to preformed vitamin A in vulnerable groups (children, 0.5-5 years). 95th percentiles of preformed vitamin A intake do not exceed tolerable upper intake levels in individuals between 1 year and 5 years, but in infants 6 to 12 months of age.

Cancer prevention at the microscopic level with the potent power of micronutrients

Cancer remains a leading cause of morbidity and mortality worldwide, necessitating ongoing exploration of effective prevention strategies. Micronutrients, vital for maintaining cellular health, offer promising avenues for cancer prevention. This review delineates the critical roles of micronutrients in cancer prevention, elucidating their mechanisms at the cellular level. Focusing on essential vitamins and minerals like Vitamins A, C, D, E, selenium, and zinc, we explore their profound effects on fundamental cellular processes such as DNA repair, oxidative stress regulation, cellular proliferation, and immune surveillance. These nutrients, characterized by their antioxidative, anti-inflammatory, and immune-enhancing properties, have shown potential in reducing the risk of cancer. The article synthesizes outcomes from a broad spectrum of clinical trials, epidemiological studies, and systematic reviews to evaluate the efficacy of micronutrients in thwarting cancer development. This critical analysis explores significant trials, addresses controversies in nutrient efficacy, and highlights the implications for clinical practice and public health policy. The review underscores the importance of integrating nutritional strategies into comprehensive cancer prevention frameworks and suggests directions for future research to optimize the preventive potentials of micronutrients.

Nano-silicon and sodium mitigate damage by potassium deficiency in chicory

Chicory is a food with high nutritional. The use of beneficial elements in plants, such as sodium (Na) and silicon (Si), may be important to mitigate nutritional disorders, such as potassium (K) deficiency, but research is lacking on this topic. The objective was to evaluate the effects of sodium and nano-silicon on the nutritional, physiological, growth, and quality parameters of chicory under K deficiency and sufficiency. We used a concentration for sufficient K (3.0 mmol L-1), K-deficiency (1.5 mmol L-1), combined with the lack or presence of Na (2.0 mmol L-1) and Si (2.0 mmol L-1). The experiment was carried out in a greenhouse with six treatments corresponding to K sufficiency, K-sufficiency with Na, K-sufficiency with Si, K deficiency, K-deficiency with Na, and K-deficiency with Si, with six replications. The following growth variables were evaluated: (i) plant height, (ii) stem diameter, (iii) number of leaves, (iv) leaf area, and (v) plant biomass. Potassium and Si contents in the above ground part and K utilization efficiency were assessed, and the accumulation of K, Na, and Si was calculated. The efficiency of the quantum yield of photosystem II (Fv/Fm) and the photosynthetic pigments was determined. Electrolyte leakage index and relative water content, as well as phenolic compounds, ascorbic acid, and leaf firmness index were also determined. We found that supplying nano-Si and Na to a K-deficient nutrient solution increased K accumulation by 60% and 50% and K use efficiency by 79% and 62% compared to plants without supply of those elements. Nano-Si reduced electrolyte leakage, being 41% less than Na in K-deficient chicory. However, when Na was added to a nutrient solution with sufficient potassium, the K use efficiency decreased by 48% compared to sufficient potassium without Na. Under the same condition of sufficient supply of potassium and Na, K accumulation decreased by 20% in chicory compared to sufficient potassium without Na, and the photosynthetic pigments-total chlorophyll and carotenoids-were reduced by 5% and 10%, respectively. Our findings contribute to improve cultivation systems with low supply of K as the supply of Na and nano-Si mitigates the damage caused to the metabolism of chicory under K deficiency.

Pathways in formulating foods for the elderly

The growth of the elderly population worldwide is posing significant challenges to human society. The progressive physical and physiological changes occur with aging, including decreased appetite, incomplete digestion, and reduced absorption of nutrients. A common feature of many elderly people's diets is a deficiency in proteins (especially easily digestible ones) and micronutrients (e.g., vitamins, zinc, iron, and calcium). One of the solutions to this problem is the incorporation of these components into suitably texture-modified foods. There is a dearth of products that meet the needs of the elderly with special medical/health conditions such as dysphagia, osteoporosis, diabetes, and cardiovascular disease, as well as those who are in hospital and palliative care. Future research and development of foods for the elderly must address specific dietary needs of different subgroups of elderly people with underlying health conditions. The existence of different physical and physiological stages of the elderly means that their specific dietary requirements must be considered. This review summarizes current knowledge on nutritional requirements including those with underlying health problems and outlines the research and innovation pathways for developing new foods considering nutrition, texture, flavor, and other sensory aspects.

Pet Wellness and Vitamin A: A Narrative Overview

The health of companion animals, particularly dogs and cats, is significantly influenced by nutrition, with vitamins playing a crucial role. Vitamin A, in particular, is indispensable, with diverse roles ranging from vision to immune modulation and reproduction. Despite its importance, the metabolism and dietary requirements of vitamin A in companion animals remain complex and not fully understood. This review provides a comprehensive overview of the historical perspective, the digestion, the metabolism, the physiological roles, the deficiency, the excess, and the interactions with other micronutrients of vitamin A in companion animals. Additionally, it highlights future research directions and gaps in our understanding. Insights into the metabolism of vitamin A in companion animals, personalized nutrition strategies based on genetic variability, longitudinal studies tracking the status of vitamin A, and investigations into its immunomodulatory effects are crucial for optimizing pet health and wellness. Furthermore, understanding the stability and bioavailability of vitamin A in pet food formulations is essential for ensuring the provision of adequate micronutrients. Overall, this review underscores the importance of vitamin A in companion animal nutrition and the need for further research to enhance our understanding and to optimize dietary recommendations for pet health and well-being.

Vitamin A Status in Preterm Infants Is Associated with Inflammation and Dexamethasone Exposure

Vitamin A has a key role in lung development and its deficiency is associated with an increased risk of bronchopulmonary dysplasia. This secondary cohort analysis of the ImNuT trial (Immature, Nutrition Therapy NCT03555019) aimed to (1) explore vitamin A status in preterm infants <29 weeks gestation and (2) assess the influence of inflammation and postnatal dexamethasone exposure on vitamin A concentrations in blood. We report detailed information on vitamin A biochemistry, vitamin A intake, markers of inflammation and dexamethasone exposure. After four weeks of age, infants exposed to dexamethasone (n = 39) showed higher vitamin A concentrations compared to unexposed infants (n = 41); median (IQR) retinol was 1.0 (0.74, 1.5) vs. 0.56 (0.41, 0.74) µmol/L, p < 0.001. Pretreatment retinol concentrations were lower in the dexamethasone group compared to non-exposed infants (p < 0.001); 88% vs. 60% of the infants were considered deficient in vitamin A (retinol < 0.7 µmol/L) at one week of age. Small size for gestational age, mechanical ventilation and elevated levels of interleukin-6 were factors negatively associated with first-week retinol concentrations. In conclusion, preterm infants <29 weeks gestation are at risk of vitamin A deficiency despite intakes that accommodate current recommendations. The presence of inflammation and dexamethasone exposure should be considered when interpreting vitamin A status.