Vitamin A status in children with asthma Arora P, Kumar V, Batra S. Vitamin A status in children with asthma. PediatrAllergyImmunol2002:13:223–226. # 2002BlackwellMunksgaard Low vitamin A levels have been found in a number of diseases in children. The aim of this study was to examine the vitamin A status in children with asthma and to correlate the changes with severity of disease. Serum levels of vitamin A, retinol-binding protein (RBP), and albumin were estimated in 35 asthmatic children (24 males) in the age group of 2–12 years (mean 5.89 years) and 29 controls (19 males). Both study and control groups were similar with respect to age, sex, and overall nutritional status. Twenty-four children in the study group (68.6%) had moderate to severe persistent asthma and eight children had mild persistent asthma. Only three patients suffered from mild intermittent asthma. Vitamin A levels in children with asthma (mean6SD 22.1465.38 mg/dl) were found to be significantly lower than their controls (mean6SD 27.5464.83 mg/dl) (p50.0001). Age, age of onset of asthma, and gender had no correlation with serum vitamin A levels. Low serum vitamin A levels (,20 mg/dl) were observed four times more commonly in the study group (28.6%) than controls (6.9%). Severity of asthmahadanegativecorrelationwithserumvitaminAlevels(r5–0.61,p 5 0.0001). Children with severe persistent asthma had markedly low serum vitamin A levels (mean6SD 13.4265.19 mg/dl) as compared with mild intermittent asthma (mean6SD 24.6162.32 mg/dl). Therapeutic trials are needed to prove whether low vitamin A levels contribute to asthma severity and the clinical utility of vitamin A supplementation in asthmatic children. Praveen Arora 1 , Virendra Kumar 1 and Sanjay Batra 2 Departments of 1 Pediatrics and 2 Biochemistry, Kalawati Saran, Children’s Hospital, Lady Hardinge Medical College, New Delhi, India Key words: vitamin A; asthma; retinol-binding protein; children Dr Virendra Kumar, Associate Professor, Department of Pediatrics, Kalawati Saran Children’s Hospital, Lady Hardinge Medical College, New Delhi-110 001, India Tel.: +91-11-3365792 Fax: +91-11-3363396 E-mail: batra6@hotmail.com Accepted 12 July 2001 Asthma, a chronic respiratory disorder, is char- acterized by airway inflammation and bronchial hyperresponsiveness to various stimuli. Persistent inflammation and frequent exacerbation are known to produce severe epithelial changes such as denudation of airway epithelium, leaving only a layer of basal epithelial cells; thickening of the subbasement membrane; hyperplasia of goblet cells and mucus glands; and infiltration of eosin- ophils and mononuclear cells into the mucosa and submucosa of airways (1). Repair of epithelial and other structural changes is of utmost importance for the relief of symptoms and control of the disease. Vitamin A is essential for cellular and sub- cellular membrane stability and influences the growth and repair of epithelial cells (2). At the airways level vitamin A deficiency has been shown to decrease proliferation of mucus and basal cells, resulting in squamous metaplasia (3). The epithe- lial change disrupts the normal barrier function, exposing the airways to viral or bacterial infec- tions and obstruction (by increasing bronchial reactivity) in the susceptible host (4). Because little information is available concern- ing vitamin A status and its influence on the disease, this preliminary study was designed to assay serum vitamin A in children with asthma and to correlate the changes with severity of asthma. Material and methods Study subjects were enrolled from the pediatric pulmonology clinic of Kalawati Saran Children’s Hospital, New Delhi. Thirty-five children with asthma, aged 2–12 years, fulfilling the inclusion criteria, were randomly assigned to the study group. The diagnosis of asthma was established on a documented clinical history of recurrent cough and/or wheezing and previous demonstra- tion of improvement of symptoms in response to asthma medication. Severity staging was carried Pediatr Allergy Immunol 2002: 13: 223–226 Printed in UK. All rights reserved Copyright # 2002 Blackwell Munksgaard PEDIATRIC ALLERGY AND IMMUNOLOGY ISSN 0905-6157 223