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VITAMIN A DEFICIENCY DURING GROWTH AND

DEVELOPMENTAL PROCESS

RINI ROSSELLINI UTAMI

030.08.209

JAKARTA, 31 MEI 2011


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INTRODUCTION

Every single bodily function depends on an adequate supply of vitamins and

minerals in the bloodstream, including the growth process. Nutrition has a major

influence on the quality and speed of cell growth, starting in the uterus and continuing

into adulthood. Poor prenatal nutrition will not only retard the growth process, but

may also lead to birth defects and other physical abnormalities.

Vitamin A is essential for growth, development and survival. For children in

deprived settings an adequate vitamin A status may be more critical to survival

protection than to growth and development. Because vitamin A is required for the

normal functioning of the immune system, even children who are only mildly

deficient in vitamin A have a higher incidence of respiratory disease and diarrhoea, as

well as a higher rate of mortality from infectious diseases, than children who consume

sufficient vitamin A. Some diseases may themselves induce vitamin A deficiency,

most notably liver and gastrointestinal diseases, which interfere with the absorption

and utilisation of vitamin A.

In populations where vitamin A availability from food is low, infectious

diseases can precipitate vitamin A deficiency by decreasing intake, decreasing

absorption, and increasing excretion. Infectious diseases that induce the acute-phase

response also impair the assessment of vitamin A status by transiently depressing

serum retinol concentrations. According to literatures(2), deficiency of vitamin A

intake during growth and developmental process will decrease immune response of

the children.


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ABSTRACT

The underlying basic for the use of vitamin A supplementation to

reduce infectious disease morbidity and mortality is its role in enhancing

immunity. Vitamin A deficiency (VAD) can lead to blindness it is in fact the

leading cause of greater risk of dying from ailments such as measles, diarrhoea

or malaria. Infectious diseases that induce the acute-phase response also

impair the assessment of vitamin A status by transiently depressing serum

retinol concentrations. Vitamin A deficiency impairs innate immunity by

impeding normal regeneration of mucosal barriers damaged by infection, and

by diminishing the function of neutrophils, macrophages, and natural killer

cells. Vitamin A is also required for adaptive immunity and plays a role in the

development of T both-helper (Th) cells and B-cells. In particular, vitamin A

deficiency diminishes antibody-mediated responses directed by Th2 cells,

although some aspects of Th1-mediated immunity are also diminished. These

changes in mucosal epithelial regeneration and immune function presumably

account for the increased mortality seen in vitamin Adeficient infants, young

children, and pregnant women in many areas of the world today.


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I. Children Growth and Development and Nutrition Needed to Support

Proper nutrition for a healthy child should provide adequate essential

nutrients, sufficient enough to maintain proper growth, maximize cognitive

development and promote health. Any nutrients that enter the body have its

own function, here are the nutrients it needs little in the process of growth and

development :

Essential fatty acids (EFAS) is a nutrition that useful to build the cell,

regulate the nervous system, strengthens the cardiovascular system,

boost the immune system, is required for brain and eye function and

help the body absorb energy.

Magnesium is working to keep the bones stay strong, steady heart

rhythm, muscle and nerve function and supports the immune system.

Its source of avocado, banana, raisins, brown rice.

Calcium is useful for building strong bones and teeth, nerve and

muscle function promotes a healthy, help the process of blood clotting

and helps convert food into energy. Its source of tofu, tofu, yogurt,

milk, cheese.

Potassium work together with sodium to control the fluid balance in

the body, keeping blood pressure, muscle function and reduce the risk

of kidney stones and osteoporosis. Its source of the potato, tomato

juice, sunflower seeds, spinach, almonds, watermelons.

Iron is important in making hemoglobin (the red pigment in blood

oxygen carrier) and myoglobin (oxygen storage pigment in muscles).

Its source of the spinach, beans, oatmeal.


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Zinc needed by more than 70 enzymes that help digestion, metabolism

and is essential for growth. Its source skinless chicken breasts, fruit

yogurt, tofu, mozzarella and cheddar cheese.

Vitamin A plays an important role in vision and bone growth,

protecting the body from infection, increasing the growth of cells and

tissues. Its source of carrot juice, sweet potatoes, broccoli, raw spinach,

papaya.

Vitamin C helps to improve and shape of red blood cells, bone and

tissue, keeping the child's gums and strengthen blood vessels, and

helps the body absorb iron. Its source of red guava, kiwi, mango,

strawberries, potatoes with skin.

Vitamin D helps the body absorb minerals like calcium and build

strong teeth and bones, play a role in cell regulation and insulin

production. The source is egg yolk, salmon, mackerel.

Vitamin E, This vitamin is limiting production of free radicals that can

damage cells, DNA repair and other metabolic processes. The source is

corn oil, soybean oil, mango, and kiwi.


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II. The Effect of Vitamin A Deficiency in Growth and Development

For children, lack of vitamin A causes some of more serious

manifestations of vitamin A deficiency such as:

Blindness due to inability to synthesize adequate quantities of

rhodopsin. Moderate deficiency leads to deficits in vision under

conditions of low light ("night blindness"), while severe deficiency can

result in severe dryness and opacity of the cornea (xeropthalmia).

Increased risk of mortality from infectious disease Vitamin A

deficiency increases susceptibility of some type of infection. Vitamin

A deficiency contribute to lowering resistant to infection and vice

versa disease influence on the occurrence of infection

Xerophthalmia(2).

Abnormal function of many epithelial cells, manifest by such

diverse conditions as dry, scaly skin, inadequate secretion from

mucosal surfaces.

Abnormal bone growth in vitamin A-deficient animals can result in

malformations and, when the skull is affected, disorders of the central

nervous system and optic nerve.


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III. The Effect of Vitamin A Deficiency in Immune Response

Vitamin A is required for the normal functioning of the immune

system and therefore helps to protect against infections in a number of ways. It

is essential in maintaining the integrity and function of the skin and mucosal

cells, which function as a mechanical barrier and defend the body against

infection(3). Vitamin A also plays a central role in the development and

differentiation of white blood cells, such as lymphocytes, killer cells and

phagocytes, which play a critical role in the defence of the body against

pathogens(2).

In the other hand, if our body can not get Vitamin A adequately, here

are some effects to bodys defense(1) :

Mucosal Immunity

Vitamin A deficiency impairs the function of the mucosal as

one aspect of immune function through several mechanisms, namely

through the loss of cilia respiratory tract, loss microvillus on

genitourinary tract, loss of mucin and goblets respiratory,

gastrointestinal and genitourinary, metaplasia with abnormal

keratinization in the respiratory tract and genitourinary, secretory

alterations specific antigen concentration immunoglobulin A (IgA),

mucosal damage which associated with immune cell function and

decreased bowel function.


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Natural Killer Cell (NK Cell)

Deficiency of vitamin A reduces the number of

circulating NK cell activity and destruction of cell cytolitic

NK. These cells play a role in anti-viral immunity and

anti-tumor and involved in the regulation of immune responses.

Netrophile

Deficiency of Vitamin A affects the impairment function of

neutrophile. Neutrophile act as non specific immune response.

Netrophile not only phagocyte bacteria and parasite but also phagocyte

tumor cell and viral infected cell. Retinoic acid itself plays a role in

netutrophile normal maturation.

Haematopoetic

Deficiency vitamin A in human body is characterized with the

decreasing of total lymphocytes and CD4 + lymphocytes in peripheral

blood. Retinoids implicated in the maturation of pluripotent cells into

cell lineages that generate cells hematoputik, such as lymphocytes,

granulocytes and megakariosit. Retinoids also play a role in the

maturation of differentiation pluripotent cells become multipotent

colony-form cells combined unit-granulocyte-eritroid makropag

(CFUGEMM) and differentiation and CFU-GEMM into

eritroid-form unit and later became the colony eritroid form of units.

T-Lymphocyte and B-Lymphocyte

Vitamin A maintains the balance of T-helper type-1 and T

helper type-2. Vitamin A Deficiency damage the growth, activation

and b-lymphocyte function. B-Lymphosyte for the use of metabolites


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of retinol, 14-hydroxy-4, 14-retro-retinol, including acid retinoic as a

mediator of growth. T cell-dependent antigen used for differentiation

of sensitization B-Lymphosyte into immunoglobulin-secretion and cell

all trans retinoic acid increased the synthesis of IgM and IgG. The high

T- lymphosyte incubation with acid retinoic increase the synthesis of

IgM by limphosit B, shows that retinoic acid affects T cells through

production of cytokines.

Monocyte and Macrophage

Retinoic plays a role in differentiation and cell activation of

monocytes macrophage.

Antibody Responses

Signs of vitamin A deficiency can be identified by the

destruction of the capacity to generate antibody responses against T-

cell antigen dependent and T cell-independent antigens type 2, such as

pneumococcal polysaccharide. Antibody response associated with

protective immunity against many types of infections and is the main

basic for protection.


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CONCLUSION

Vitamin A is required for the normal functioning of the immune

system and therefore helps to protect against infections in a number of ways.

Due to the important role of vitamin A in supporting the functions of the

immune system, individuals with insufficient intake of this vitamin often

experience increased susceptibility to viral infections, most notably measles,

diarrhea, malaria and respiratory syncytial virus (RSV).


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REFFERENCES

1. Alamtsier, Sunita. 2002. Prinsip Dasar Ilmu Gizi. Jakarta. PT.Gramedia

2. Semba, Richard D. 2002. Vitamin A, Infection and Immune Function. USA.

CABI Publishing

3. How Vitamin Influences Immune Function. Article reviews. Available at :

http://findarticles.com/p/articles/mi_m0ISW/is_2002_April/ai_84211197/

4. Vitamin A Deficiency. Medscape reference. Available at :

http://emedicine.medscape.com/article/126004-overview#a0101

5. The Role of Vitamin A and Related Retinoids in Immune Function. Available

at : http://onlinelibrary.wiley.com/doi/10.1111/j.1753-

4887.1998.tb01643.x/abstract

6. Vitamin A, Infection and Immune Function. Available at :

http://www.annualreviews.org/doi/full/10.1146/annurev.nutr.21.1.167
http://findarticles.com/p/articles/mi_m0ISW/is_2002_April/ai_84211197/http://emedicine.medscape.com/article/126004-overview#a0101http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.1998.tb01643.x/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.1998.tb01643.x/abstracthttp://www.annualreviews.org/doi/full/10.1146/annurev.nutr.21.1.167http://findarticles.com/p/articles/mi_m0ISW/is_2002_April/ai_84211197/http://emedicine.medscape.com/article/126004-overview#a0101http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.1998.tb01643.x/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.1998.tb01643.x/abstracthttp://www.annualreviews.org/doi/full/10.1146/annurev.nutr.21.1.167

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