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Retinol (vitamin A) and the neonate: special problems of the human premature infant
1Department of Pediatrics, University of Wisconsin-Meriter Hospital Perinatal Center, Madison 53715.
Insights
Premature infants have lower retinol reserves, impacting lung health. Supplementation is being explored to aid pulmonary adaptation and repair in these vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Pulmonology
Background:
- Premature infants exhibit lower serum retinol and retinol-binding protein compared to term infants.
- Fetal tissue accumulates retinol during gestation, leading to reduced reserves in premature neonates.
- Parenteral retinol supplementation in premature infants has been challenging due to losses onto intravenous tubing.
Purpose of the Study:
- To investigate the role of retinol in premature infant adaptation and lung health.
- To explore the potential of retinol supplementation for repairing pulmonary injury in neonates.
- To clarify the relationship between retinol metabolism and function in the neonatal lung.
Main Methods:
- Review of existing literature on retinol stores and supplementation in premature infants.
- Analysis of physiological differences in retinol reserves between premature and term infants.
- Examination of basic research on retinol's role in lung epithelial cell function.
Main Results:
- Premature infants possess diminished retinol reserves essential for extrauterine adaptation.
- Retinol is crucial for epithelial cell function, with nearly 40% of lung cells being of epithelial origin.
- Pulmonary complications and chronic lung disease are common in premature infants, linked to low retinol levels.
Conclusions:
- Retinol deficiency may exacerbate lung injury and disease in premature infants.
- Retinol supplementation is a potential therapeutic strategy for supporting lung repair in neonates.
- Further research is needed to elucidate retinol's specific metabolic functions in the developing lung.
Abstract:
Retinol stores accumulate in fetal tissue during gestation. Hence, the premature infant faces extrauterine adaptation with less total reserves of retinol than does the term infant. Retinol-binding protein in serum is also lower in the premature infant population. The parenteral retinol supplementation frequently required for these infants has only recently become adequate by the finding of methods to avoid large losses of retinol onto intravenous tubing. Retinol is an essential vitamin for epithelial cell function; nearly 40% of lung cells are of epithelial origin. The premature infant's lung often is the initial site of difficulties during extrauterine adaptation, and respiratory system epithelial-cell damage and chronic lung disease frequently develop. Because these infants have associated low retinol reserves, retinol supplementation to help repair pulmonary injury is being considered. Some of these relationships are beginning to be clarified by basic research on the metabolism and function of retinol in lung.