Journal of Medicinal Plants Research Vol. 5(20), pp. 4977-4979, 30 September, 2011 Available online at http://www.academicjournals.

org/JMPR ISSN 1996-0875 2011 Academic Journals

Review

Vitamin A: A review article

M. Akram1*, Naveed Akhtar2, H. M. Asif1, Pervaiz Akhtar Shah3, Tariq Saeed3, Arshad Mahmood4 and Nadia Shamshad Malik5
Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan. Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Pakistan. 3 University College of Pharmacy, The University of Punjab Lahore, Pakistan. 4 Department of Pharmaceutical Sciences, COMSATS Institute of Information Technology, Abbottabad, Pakistan. 5 School of Pharmacy, The University of Lahore, Islamabad Campus, Islamabad, Pakistan.
2 1

Accepted 8 June, 2011

Vitamin A has important function in the body. Vitamin A is involved in vision, growth, and reproduction. In this paper, description, function and deficiency diseases of vitamin A has been delineated herewith. Key words: Vitamin A, retinol, deficiency disease, research study. INTRODUCTION Vitamin A (called retinol in mammals) is a fat-soluble vitamin. Human ingest two types of vitamin A: provitamin A from plants and preformed vitamin A from animal source. It is related to growth and differentiation of the tissues. The main sources of preformed vitamin A or retinol are liver, whole milk, fish oil and egg. Vitamin A is present in many animal tissues and is readily absorbed from such dietary sources in the terminal small intestine. Vitamin A is a constituent of visual pigment and maintains epithelium. Vitamin A deficiency occurs with the chronic consumption of diets that are deficient in both vitamin A and beta-carotene. Deficiency symptoms are night blindness and dry skin (Brazis, 2004). Prolonged and severe vitamin A deficiency can produce total and irreversible blindness. Vitamin A deficiency is also common in areas like Southeast Asia, where polished rice, which lacks the vitamin, is a major part of the diet. Animal sources of vitamin A include halibut fish (richest source), shark and cod liver oil, animal liver, egg yolk, milk and colostrums. Plant sources include carrot, spinach, yellow corn and potato. Daily requirement for infant, children and adults is 400, 700 and 1000 g (Nishimura et al., 1998). Food fortification is the most cost effective, long-term approach, while supplementation is considered to be the fastidious way to uplift vitamin A status. FUNCTIONS Vitamin A contributes for vision in dim light. Vitamin A maintains the integrity and normal functioning of glandular and epithelial tissues. It supports skeletal growth and acts as anti-infective agent. It protects against some epithelial cancer (Borel et al., 2005). Vitamin A is oxidized to retinal, or vitamin A aldehyde, which combines with opsin, a protein, to form rhodopsin, the light sensing pigment in the retina. Thus, the earliest symptom of vitamin A deficiency is night blindness. In addition, vitamin A is required to form and maintain epithelial surfaces through a mechanism that is still unknown (Sale, 2004).

Role in immune system Vitamin A, along with certain carotenoids, enhances the activity of the immune system and helps in controlling infections and even malignancies (Mushtaq, 1998). Vitamin A has strong effect on the immunity of the body. Vitamin A deficiency compromises the immune system, and can increase the risk of illness and death from diseases such as malaria and measles.

Antixerophthalmic activity
*Corresponding author. E-mail: makram_0451@hotmail.com. Tel: 92-021-6440083. Fax: 92-021-6440079.

Vitamin A

protects

skin and mucous membranes

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(especially front of eye and lining of digestive and respiratory tracts). It is essential for regeneration of visual purple (Forsmo et al., 2008). Generally Retinyl acetate and retinyl palmitate are used in different food products as fortificants against the vitamin A menace. Each year the deficiency of vitamin A in developing countries has identified as a serious nutritional handicap like blind.

Keratomalacia It is a condition, in which cornea becomes dull, insensitive and necroses resulting in loss of vision. Extra ocular manifestation (1) Follicular hyperkeratosis (2) Anorexia (3) Intestinal infections (4) Degeneration of myelin sheath Effect on respiratory system Retinoic acid is used in the body for regulating the development of various tissues, such as the cells of the skin, and the lining of the lungs and intestines. If deficiency occurs then cilia are lost, causing respiratory tract infections. REPRODUCTION Infertility results due to interference with ovulation (Schulz et al., 2007). Vitamin A is important during embryological development, since, without vitamin A, the fertilized egg cannot develop into a fetus. Effect on kidneys Kidney stones are formed due to accumulation of stone forming compounds normally present in urine around shed keratinized epithelium cells. Tooth changes A defective formation of the tooth enamel takes place and this may lead to abnormalities of dentine (Takita et al., 2006). Bone remodeling Vitamin A plays an important role in normal functioning of osteoblasts and osteoclasts, vitamin A is use in prevention of diseases, which include (Crabb, 2001): (1) Acne (2) AIDS (3) Alcoholism (4) Atopic dermatitis (5) Cataracts (6) Cervical dysplasia

Role in gene structure Retinol is the immediate precursor to two important active metabolites: retinal, which plays a critical role in vision, and retinoic acid, which serves as an intracellular messenger that affects transcription of a number of genes. Vitamin A does not occur in plants, but many plants contain carotenoids such as beta-carotene that can be converted to vitamin A within the intestine and other tissues (Duester, 2008). DEFICIENCY DISEASE The World Health Organization (WHO) estimates that as many as 140 million children, especially in Africa and Southeast Asia, suffer from vitamin A deficiency (VAD). Vitamin A deficiency is a world wide nutritional problem especially in the developing countries that afflicts severely the health of pregnant and lactating women, infants and children. It is considered a wide spread public health problem among preschool children in the developing countries. Vitamin A deficiency causes follicular hyperkeratosis (that is, the development of keratin plugs in hair follicules, as seen in scurvy and a xeropthalmia (that is, corneal dryness) that can progress to corneal ulcers and resultant blindness. Acute vitamin A intoxication has occurred in arctic explorers who ate polar bear livers. Chronic hypervitaminosis A usually occurs after enormously excessive vitamin A ingestion by food faddists or in the treatment of acne (Strobel et al., 2007). Its features may include arthralgias, fatigue, night sweats, and headaches due to benign intracranial hypertension. Though harmless, excessive beta carotene ingestion makes yellow or orange. In distinction to the observation in cases of jaundice, the sclera remains white (Strobel et al., 2007). Different strategies like food diversification, fortification and supplementation are helpful to cope with vitamin A deficiency (Tang et al., 2005). Ocular manifestation (1) Night blindness (2) Conjuctival xerosis (3) Bitot spot (4) Corneal xerosis

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(7) Diabetes (8) Dry eyes (Duester, 2008) (9) Fibrocystic breast disease (10) Hyperkeratosis (11) Inflammatory bowel disease (12) Kaposi's sarcoma (13) Leukoplakia (14) Osteoarthritis (15) Otitis media (ear infection) (16) Poor vision (17) Psoriasis (18) Thyroid disorders (19) Ulcers (20) Vaginitis (21) Varicose veins (22) Viral infections TOXICITY Acute toxicity Headache, nausea and vomiting are examples of acute toxicity (Myhre et al., 2003). Chronic toxicity Dry skin, cracking of lips and painful areas of bone are examples of chronic toxicity (Penniston et al., 2006). Diet Vegetables are primary source of vitamin A. Vegetable containing carotene do not produce teratogenic or toxic effects. Ingestion of food containing beta-carotene maintains vitamin A level in the blood. DISCUSSION Vitamin A is an essential micronutrient for the normal functioning of the visual system, growth and development, immunity and reproduction. This has been pointed out by nutritional survey of Pakistan 1970 and 1976. The serum levels of vitamin A indirectly reflect its status in the body. A pilot study for the nutritional problems in Pakistan showed that majority of the children in the study group was suffering from vitamin A deficiency. A study was carried out to evaluate the perception of eye health in schools in Pakistan. Study indicated that schoolchildren and their teachers had a good knowledge of eye health, but many of them had serious misconceptions for example, use of kohl, medicines and eye drops keeps eyes healthy. Kohl is an important source of lead and can reduce children's intelligence even at low blood levels. Health education in schools must take into account children's existing knowledge of and misconceptions about various aspects

of eye health. Such steps if taken could improve the relevance of eye health education to schoolchildren (Khabir et al., 2006). Women are the most vulnerable group affected by vitamin A deficiency during their pregnancy and lactating periods. Vitamin A deficiency also causes night blindness and increases the risk of child deaths, especially from diarrhea and measles, as well as maternal deaths. CONCLUSION Vitamin A has important function in the body. It is required for growth and bone development and to maintain the health of the skin and eye sight. Night blindness is the first symptom of vitamin A deficiency. Low levels of vitamin A may cause vision problems (such as night blindness) and permanent eye damage. Besides, blindness, vitamin A deficiency can cause abnormal changes in the epithelial tissues, these are the tissues that cover the external surface of the body.
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