dicative of mild inflammation, had lower average plasma retinol levels.

The extent to which inflammation is a factor in low plasma retinol in

children is uncertain but likely significant in acute infectious diseases

such as measles, and possibly in chronic inflammatory conditions such

as cystic fibrosis.

FUNCTIONS OF VITAMIN A AND

MECHANISMS OF ACTION

Except for its role in vision, the pleiotropic actions of this micronutrient

are mediated by all-trans-retinoic acid (RA), which is a ligand for specific

nuclear transcription factors, the retinoid receptors; RARs and RXRs

regulate the expression of several hundred genes. When an RAR is

activated by RA, an RAR-RXR complex is formed, which binds to and

activates specific DNA sequences present in retinoid-responsive genes,

RAREs and RXREs. Genes can be either induced or repressed, depending

on additional co-activators or co-repressors recruited to the RAR-RXR

complex. Retinoid-regulated genes are involved in several fundamental

NAMES AND

SYNONYMS CHARACTERISTICS

BIOCHEMICAL

ACTION

EFFECTS OF

DEFICIENCY

EFFECTS OF

EXCESS SOURCES
Retinol (vitamin A1);

1 µg retinol = 3.3 IU

vitamin A = 1 RAE

Provitamins A: the

plant pigments α-,

β-, and γ-carotenes

and cryptoxanthin

have partial retinol

activity: 12 µg

β-carotene, or 24 µg

other provitamin A

carotenoids = 1 µg

retinol

Fat-soluble;

heat-stable;

destroyed by

oxidation, drying

Bile necessary for

absorption

Stored in liver

Protected by

vitamin E

In vision, as retinal, for

synthesis of the visual

pigments rhodopsin

and iodopsin

In growth, reproduction,
embryonic and fetal

development, bone

growth, immune and

epithelial functions,

via retinoic acid as a

ligand for specific

nuclear transcription

factors, regulating

genes involved in

many fundamental

cellular processes

Nyctalopia

Photophobia,

xerophthalmia, Bitôt

spots, conjunctivitis,

keratomalacia

leading to blindness

Faulty epiphyseal bone

formation

Defective tooth enamel

Keratinization of

mucous membranes

and skin

Retarded growth

Impaired resistance to

infection, anemia,

reproductive failure,

fetal abnormalities
Anorexia, slow

growth, drying and

cracking of skin,

enlargement of

liver and spleen,

swelling and pain

of long bones,

bone fragility,

increased

intracranial

pressure, alopecia,

carotenemia

Fetal abnormalities

Liver, fish liver oils

Dairy products,

except skim milk

Egg yolk, fortified

margarine,

fortified skim milk

Carotenoids from

plants: green

vegetables, yellow

fruits, and

vegetables

RAE, Retinol activity equivalent.

Table 61.1 Vitamin A Characteristics

0.0

0.5

1.0

1.5

2.0

2.5