{"doi":"10.1093/jn/nxaa260","title":"High-Dose Neonatal Vitamin A Supplementation to Bangladeshi Infants Increases the Percentage of CCR9-Positive Treg Cells in Infants with Lower Birthweight in Early Infancy, and Decreases Plasma sCD14 Concentration and the Prevalence of Vitamin A Deficiency at Two Years of Age","abstract":"BACKGROUND: Vitamin A (VA) stores are low in early infancy and may impair development of the immune system. OBJECTIVE: This study determined if neonatal VA supplementation (VAS) affects the following: 1) development of regulatory T (Treg) cells; 2) chemokine receptor 9 (CCR9) expression, which directs mucosal targeting of immune cells; and 3) systemic endotoxin exposure as indicated by changed plasma concentrations of soluble CD14 (sCD14). Secondarily, VA status, growth, and systemic inflammation were investigated. METHODS: In total, 306 Bangladeshi infants were randomly assigned to receive 50,000 IU VA or placebo (PL) within 48 h of birth, and immune function was assessed at 6 wk, 15 wk, and 2 y. Primary outcomes included the following: 1) peripheral blood Treg cells; 2) percentage of Treg, T, and B cells expressing CCR9; and 3) plasma sCD14. Secondary outcomes included the following: 4) VA status measured using the modified relative dose-response (MRDR) test and plasma retinol; 5) infant growth; and 6) plasma C-reactive protein (CRP). Statistical analysis identified group differences and interactions with sex and birthweight. RESULTS: VAS increased (P = 0.004) the percentage of CCR9+ Treg cells (13.2 ± 1.37%) relative to PL (9.17 ± 1.15%) in children below the median birthweight but had the opposite effect (P = 0.04) in those with higher birthweight (VA, 9.13 ± 0.89; PL, 12.1 ± 1.31%) at 6 and 15 wk (values are combined mean ± SE). VAS decreased (P = 0.003) plasma sCD14 (1.56 ± 0.025 mg/L) relative to PL (1.67 ± 0.032 mg/L) and decreased (P = 0.034) the prevalence of VA deficiency (2.3%) relative to PL (9.2%) at 2 y. CONCLUSIONS: Neonatal VAS enhanced mucosal targeting of Treg cells in low-birthweight infants. The decreased systemic exposure to endotoxin and improved VA status at 2 y may have been due to VA-mediated improvements in gut development resulting in improved barrier function and nutrient absorption. This trial was registered at clinicaltrials.gov as NCT01583972 and NCT02027610.","journal":"Journal of Nutrition","year":2020,"id":87705,"datarank":0.5389097325367583,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.1661737350685582,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.1661737350685582,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":8,"citers_with_citation_signal":6,"citers_with_endowment":6,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9613,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01583972","NCT02027610"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":235505,"name":"M. Nazmul Huda","orcid":"0000-0003-2775-4470","position":1,"is_corresponding":false},{"id":312381,"name":"Rubhana Raqib","orcid":"0000-0002-8116-4511","position":2,"is_corresponding":false},{"id":352718,"name":"Firdausi Qadri","orcid":"0000-0001-8459-304X","position":3,"is_corresponding":false},{"id":445580,"name":"Jahangir Alam","orcid":"0000-0002-7935-6346","position":4,"is_corresponding":false},{"id":445581,"name":"Md Nure Alam Afsar","orcid":"0000-0002-7251-7661","position":5,"is_corresponding":false},{"id":445582,"name":"Janet M Peerson","orcid":"0000-0001-6816-1909","position":6,"is_corresponding":false},{"id":413104,"name":"Sherry A. Tanumihardjo","orcid":"0000-0002-7022-1760","position":7,"is_corresponding":false},{"id":235511,"name":"Charles B. Stephensen","orcid":"0000-0002-2117-2237","position":8,"is_corresponding":false},{"id":445579,"name":"Shaikh Meshbahuddin Ahmad","orcid":"0000-0003-0319-8430","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T22:00:29.831859Z","pmid":"32939553","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}