Vitamin A to prevent bronchopulmonary dysplasia in extremely low birth weight infants: a systematic review and meta-analysis

Araki, Shunsuke; Kato, Shin; Namba, Fumihiko; Ota, Erika

doi:10.1371/journal.pone.0207730

Cited by 43 publications

(39 citation statements)

References 24 publications

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“…Though it should be noted that wide-scale studies have not shown a beneficial effect in areas of high prevalence of vitamin A deficiency [45]. Vitamin A is believed to have antioxidative properties, and has a key role in the development of bronchopulmonary dysplasia and neonatal respiratory distress syndrome [46,47]. This finding was pioneered by Hustead et al in 1984 with his work on retinol concentrations in preterm infants, in which it was discovered that neonates developing bronchopulmonary dysplasia had lower concentrations of retinol at birth [48].…”

Section: Respiratory Infectionsmentioning

confidence: 99%

Could Vitamins Help in the Fight Against COVID-19?

et al. 2020

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There are limited proven therapeutic options for the prevention and treatment of COVID-19. The role of vitamin and mineral supplementation or “immunonutrition” has previously been explored in a number of clinical trials in intensive care settings, and there are several hypotheses to support their routine use. The aim of this narrative review was to investigate whether vitamin supplementation is beneficial in COVID-19. A systematic search strategy with a narrative literature summary was designed, using the Medline, EMBASE, Cochrane Trials Register, WHO International Clinical Trial Registry, and Nexis media databases. The immune-mediating, antioxidant and antimicrobial roles of vitamins A to E were explored and their potential role in the fight against COVID-19 was evaluated. The major topics extracted for narrative synthesis were physiological and immunological roles of each vitamin, their role in respiratory infections, acute respiratory distress syndrome (ARDS), and COVID-19. Vitamins A to E highlighted potentially beneficial roles in the fight against COVID-19 via antioxidant effects, immunomodulation, enhancing natural barriers, and local paracrine signaling. Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respiratory diseases, ARDS, and sepsis. Although there are currently no published clinical trials due to the novelty of SARS-CoV-2 infection, there is pathophysiologic rationale for exploring the use of vitamins in this global pandemic, supported by early anecdotal reports from international groups. The final outcomes of ongoing trials of vitamin supplementation are awaited with interest.

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Section: Respiratory Infectionsmentioning

confidence: 99%

Could Vitamins Help in the Fight Against COVID-19?

et al. 2020

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“…Vitamin A has been shown to play an important role in the development of bronchopulmonary dysplasia and acute respiratory distress syndrome (ARSD) [42,43]. Retinoic acid is important in the production of IL-1β and IL-1 receptor antagonists by alveolar macrophages and infiltration of pulmonary neutrophils [44], which means that both oxidative damage and the regenerative capacity of the lungs may be mediated in part by vitamin A dependent mechanism.…”

Section: Discussionmentioning

confidence: 99%

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

Berrocal

Irriguible

Philibert

et al. 2020

Preprint

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Objective: To analyse whether the micronutrient deficit predicts a worse prognosis in patients infected by SARS-CoV-2 who developed the COVID-19 disease.Methods: We carried out an observational and retrospective study with 120 patients admitted for COVID-19 in the ICU and in the Internal Medicine ward of a tertiary hospital. In the nutritional admission analysis of these patients, we analysed plasmatic levels of vitamins A, B6, C, D, E and zinc. In addition, different variables of interest were collected, such as the need for orotracheal intubation, hospital stay, mortality and multi-organ failure.Results: One hundred and twenty patients were included. The independent variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was independently associated with the need for orotracheal intubation was vitamin A deficiency (standard error 0.58, 95% CI 0.042 to 0.405, p = 0.000).Conclusions: Low levels of vitamin A and zinc are associated with a greater need for admission to the ICU and orotracheal intubation. Patients older than 65 years had higher mortality. Randomized clinical trials are needed to examine whether micronutrient supplementation could be beneficial as an adjunctive treatment in COVID-19.

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“…Has a role in lung maturation and repair Reduces the development of BPD at 36 weeks PMA, but has no effect on long-term respiratory morbidity [130][131][132][133][134][135]…”

Section: Surfactantmentioning

confidence: 99%

Present and Future of Bronchopulmonary Dysplasia

Bonadies

Zaramella

Porzionato

et al. 2020

JCM

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Bronchopulmonary dysplasia (BPD) is the most common respiratory disorder among infants born extremely preterm. The pathogenesis of BPD involves multiple prenatal and postnatal mechanisms affecting the development of a very immature lung. Their combined effects alter the lung’s morphogenesis, disrupt capillary gas exchange in the alveoli, and lead to the pathological and clinical features of BPD. The disorder is ultimately the result of an aberrant repair response to antenatal and postnatal injuries to the developing lungs. Neonatology has made huge advances in dealing with conditions related to prematurity, but efforts to prevent and treat BPD have so far been only partially effective. Seeing that BPD appears to have a role in the early origin of chronic obstructive pulmonary disease, its prevention is pivotal also in long-term respiratory outcome of these patients. There is currently some evidence to support the use of antenatal glucocorticoids, surfactant therapy, protective noninvasive ventilation, targeted saturations, early caffeine treatment, vitamin A, and fluid restriction, but none of the existing strategies have had any significant impact in reducing the burden of BPD. New areas of research are raising novel therapeutic prospects, however. For instance, early topical (intratracheal or nebulized) steroids seem promising: they might help to limit BPD development without the side effects of systemic steroids. Evidence in favor of stem cell therapy has emerged from several preclinical trials, and from a couple of studies in humans. Mesenchymal stromal/stem cells (MSCs) have revealed a reparatory capability, preventing the progression of BPD in animal models. Administering MSC-conditioned media containing extracellular vesicles (EVs) have also demonstrated a preventive action, without the potential risks associated with unwanted engraftment or the adverse effects of administering cells. In this paper, we explore these emerging treatments and take a look at the revolutionary changes in BPD and neonatology on the horizon.

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Vitamin A to prevent bronchopulmonary dysplasia in extremely low birth weight infants: a systematic review and meta-analysis

Cited by 43 publications

References 24 publications

Could Vitamins Help in the Fight Against COVID-19?

Could Vitamins Help in the Fight Against COVID-19?

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

Present and Future of Bronchopulmonary Dysplasia

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