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Department of Nutritional Sciences, University of Wisconsin, Madison, WI 53706
* To whom correspondence should be addressed. E-mail: sherry{at}nutrisci.wisc.edu.
| ABSTRACT |
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| Introduction |
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Children with VA deficiency have a higher risk of blindness and dying from infectious disease than VA-sufficient children. More than 250 million children <5 y of age have insufficient VA to maintain optimal health. VA supplements are periodically given to infants and children to improve VA status (9). Supplements have ranged from 25,000 to 50,000 IU (26.2 and 52.4 µmol) retinyl ester for infants at immunization contacts to 100,000 and 200,000 IU (105 and 210 µmol) for infants and preschool children administered biannually. VA supplements may change VA status (10–12) and decrease the mortality rate of infants (13–17) but do not always result in an adequate VA status (18). A lactating sow-piglet model showed that liver VA reserves of young infants improve after direct or maternal supplementation but not dose dependently (19–21). When piglets from sows on a VA-depleted diet were administered 0, 26.2, 52.4, or 105 µmol VA, 26.2 µmol did not result in a mean liver reserve >0.07 µmol/g liver (the deficiency cutoff) and 24% of piglets were still VA deficient after 52.4 or 105 µmol VA (19).
In contrast to liver, the storage and distribution of VA in extrahepatic tissues of piglets have not been studied after VA supplementation. The distribution of VA in extrahepatic tissues was studied in rat (8,22–24), monkey (25), gilt (26), and seal (27). Extrahepatic tissues are involved in VA metabolism, especially during VA deficiency. Kidney has an auxiliary role during VA deficiency (28) due to increased acyl CoA:retinol acyl transferase activity. Lung contains retinyl esters (1,8,29,30) and can metabolize retinyl palmitate from chylomicron remnants into retinoic acid (31). Greater utilization of retinol in lungs may be necessary for lung development of prenatal rats (32). Spleen can take up VA from perfused chylomicra or emulsions (33). Adrenal glands contain a significant amount of retinoic acid for development (34). In transthyretin-deficient mice, although the concentration of circulating retinol-RBP was low (i.e. 5% of normal), VA status in extrahepatic tissue remained normal (35).
If some tissues receive VA predominantly through chylomicron delivery, continued intake through supplements, fortified foods, or food would be needed to maintain optimal health. However, current practices include periodic supplementation to infants at immunization contacts and to children < 5 y of age biannually (9). Periodic supplementation may not maintain optimal tissue levels in critical organs if chylomicron delivery is necessary. The objectives of this study were to determine the distribution of VA in extrahepatic tissues of weaned piglets after graded VA supplementation 10 d after administration and to evaluate the uptake of newly ingested 3, 4-didehydroretinol (DR) by these tissues 4 h after dosing with 3, 4-didehydroretinyl acetate (DRA). In sows, DR esters peaked in the serum at 3 h after dosing, demonstrating that DR can be used as a chylomicron tracer (36). In piglets given standard 5.3-µmol doses of DRA, DR bound to RBP continued to rise or began to peak at 4 h (37). Furthermore, piglets are a good model because of similar body weight to infants and therefore identical dose sizes can be used as those periodically administered in public health programs (i.e. 25,000–100,000 IU).
| Materials and Methods |
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Lung (5 g), adrenal gland (0.5 g), or spleen (2 g) were ground with sodium sulfate in a mortar; 0.99, 0.20, and 0.40 nmol retinyl butyrate was added, respectively. The samples were extracted with 20 mL dichloromethane 3 times. The extract was dried in a round-bottom flask using a rotary evaporator. The residue was dissolved in 1 mL dichloromethane (3 times) and transferred to a glass tube (13 x 100 mm). The combined solution was dried under argon and redissolved in 100 µL 50:50 methanol:dichloromethane; 70 µL was injected. HPLC analysis of lung was the same as that for kidney. For adrenal and spleen, a gradient with solvent A [70:30 acetonitrile:water (v:v) (0.05% triethylamine)] and B [85:15 acetonitrile:dichloroethane (v:v) (0.05% triethylamine)] was: 0 min, B = 0%; 5 min, B = 50%; 20 min, B = 100%. The flow rate was 1 mL/min for 20 min and ramped to 2 mL/min by 27 min; run time was 55 min.
Retinol, retinyl esters (linoleate, oleate, palmitate, and stearate), and DR peaks were identified by comparing their retention times with standards, as well as characteristic spectra. Retinol and retinyl esters were quantified using retinyl butyrate and the
for retinol (1832) and combined for the retinol concentration (nmol/g tissue) or total retinol in each tissue (nmol/tissue). DR was quantified using its
(1455). All values were calculated based on tissue wet weight.
The percent retention of VA in piglet tissues for treatment groups was calculated: total amount of retinol in the treatment group minus the control, divided by the ingested VA amount. Percent retention of DR in piglet tissues was calculated from the recovered 5.3 µmol DRA dose (19). Based on DR concentrations in the serum of the piglets, the minimum chylomicron contribution to the tissues was estimated by determining the maximum exposure to DR on RBP in the 4-h period after supplementation and subtracting it from the total measured DR.
Statistical analysis.
SAS software (version 9.1) was used. ANOVA and multiple comparisons with the Student-Newman-Keuls test were used to investigate the effects of VA treatment on retinol and retinyl esters among different tissues (38).
= 0.05 was considered significant. We used Levene's test for homogeneity of variances to test for unequal variances. One-way ANOVA was used to evaluate the effect of different VA doses within each tissue and 2-way ANOVA among tissues (VA treatment x tissue) on retinol concentration, total amount of retinol, retention of ingested VA, DR concentration, and retention of DR. Two-way ANOVA was also used to assess the difference in concentrations affected by treatment and compounds in the same tissue (VA treatment x retinol or retinyl ester). Data were expressed as means ± SD.
| Results |
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Retention of ingested VA in piglet tissues. Retention of ingested VA in the 7.5 mg group was significantly higher than that in the 30 mg group for adrenal gland (P < 0.05); no other differences were found (data not shown). The retention of VA from the supplements was the highest in kidney (0.03–0.09%) and the other tissues did not differ.
Concentration of retinol and retinyl esters in piglet tissues. Unesterified retinol concentration in the adrenal glands and kidney of the control group were lower than that of the VA treatment groups (P < 0.01) and concentrations of retinyl esters in control kidney were lower than that of the 15 mg VA group (P < 0.01) (Table 2). For control and VA treatment groups, the retinol concentration was much higher than that of retinyl esters in each extrahepatic tissue (P < 0.01). Retinol concentrations were highest in kidney, followed by adrenal, lung, and spleen (P < 0.01). Retinyl ester concentrations were the highest in kidney, followed by adrenal (P < 0.01). Retinol was higher than the esters in each extrahepatic tissue (P < 0.05). Unesterified retinol was 66–73% of total retinol in adrenal gland, 86–89% in kidney, 93–96% in lung, and 79–81% in spleen.
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DR concentration and retention in piglet tissues. DR was not detected in the extrahepatic tissues of the reference piglets that died just after birth but was detected in all tissues of piglets dosed with DRA. The DR concentration in adrenal gland was 0.11 ± 0.05 nmol/g, 0.10 ± 0.05 nmol/g in kidney, 0.07 ± 0.03 nmol/g in lung, and 0.13 ± 0.10 nmol/g in spleen. The DR concentrations did not differ among the groups within a tissue. Spleen contained a higher DR concentration than lung (P < 0.01) but not higher than adrenal gland and kidney. Retention of DR in each tissue did not differ among the 4 groups. The ratio of DR:total retinol (DR:R) was 0.19 ± 0.08 – 0.31 ± 0.13 for adrenal gland, 0.03 ± 0.02 – 0.07 ± 0.04 for kidney, 0.31 ± 0.19 – 0.47 ± 0.30 for lung, and 0.60 ± 0.39 – 1.40 ± 1.27 for spleen. The treatment groups did not differ in ratio (P = 0.075) and no interaction was found between organ and treatment (P = 0.76). However, the DR:R difference among organs was significant (P < 0.0001), which was the highest in spleen, followed by lung and kidney. DR:R in adrenal gland did not differ from kidney or lung. DR:R in kidney was similar to that in serum of these piglets (19).
Estimation of the chylomicron contribution to DR concentrations in the tissues.
At 4 h, the mean DR concentration in the serum was 0.0913 µg/L (0.321 nmol/L). The minimum chylomicron contribution to each tissue was estimated by assuming that the DR bound to RBP incrementally increased by 0.00038 ng (0.0013 pmol) DR·mL–1·min–1 from time 0 to 4 h, which is reasonable based on prior data in piglets with similar VA status (37). Gastrointestinal [106 ± 9 mL·min–1·100 g–1 tissue)] (39) and cerebral blood flow [73–101 mL·min–1·100 g–1 tissue)] (40) have been measured in piglets. The value of 100 mL blood–1·min–1·100 g–1 tissue) was used for this estimation. We assumed this value is reasonable for the organs studied, because the calculation is corrected for organ weight. The reported range of hematocrits for piglets is 0.26–0.41 (41). The mid-value hematocrit used for this calculation was 0.34; therefore, 66 mL plasma was estimated to pass through 100 g tissue in 1 min. Eq. 1 was used to calculate the amount of DR that passed through 100 g of tissue in 4 h:
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Thus, 7.3 ng DR on RBP circulated to 1 g tissue/min (Table 3). Using mean tissue weight, the maximum DR through RBP delivery and the minimum DR amount from chylomicron delivery measured in the tissue were estimated. The minimum chylomicron contribution ranged from 63% higher in lung to 280% higher in spleen than the maximum DR amount that passed through the tissue in 4 h bound to RBP (Table 3).
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| Discussion |
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The rank of total retinol concentration in tissues agrees with that of Schweigert et al. in adult pigs, which was: liver > kidney > adrenal glands > lung (26). The mean retinol concentrations in VA-sufficient adult pigs (liver stores of 740 nmol/g) were 2.05 nmol/g for kidney, 0.74 nmol/g for adrenal gland, and 0.46 nmol/g for lung (26), which were similar to our data in these piglets. Lespine et al. (44) measured retinol and retinyl ester concentrations in several tissues to verify that total parenteral nutrition with retinyl palmitate allows an adequate supply of VA to peripheral tissues. Orally fed VA-deficient control rats had increased VA content of kidney and lung after treatment. Retinol as a percentage of total VA was higher in kidney than lung; retinol increased in kidney and retinol and retinyl esters increased in lung after refeeding (44). Ten days after VA dosage, we observed a substantial increase in retinol concentration in kidney but not in lung, implicating that chylomicron delivery to lung is an important contribution.
In VA-adequate animals, unesterified retinol in extrahepatic tissues is usually lower than retinyl ester concentration (26,43,46,47) but is a higher percentage (e.g. 38–47%) of total retinol than in liver (26). In these piglets, the distribution of retinol and retinyl esters in extrahepatic tissues differed from those reported in adult pigs (26). Unesterified retinol was the major form, accounting for 66–96% of total retinol concentrations. The VA status of the adult pigs (740 nmol/g liver) and piglets (70 nmol/g liver) were vastly different, resulting in less storage as esters in the piglets. Hydrolysis of esters may have occurred during storage (48) or thawing (49). Although the storage temperature was –80°C, extrahepatic retinyl ester hydrolase is still moderately active at that low temperature (48). This changes the VA profile but does not affect total VA concentrations.
Retention of DR in piglet liver was 23–51%, which was much higher than that in the extrahepatic tissues. More DR was found in the piglet livers for the VA treatment groups than the control group (19) but did not differ in the kidney, adrenal glands, lung, and spleen. Thus, tissue uptake was relatively similar in the 4-h time frame and did not change due to differences in VA status of the piglets. Retinol concentration in kidney and adrenal glands increased in response to VA treatment compared with control, but the 3 treatment groups did not differ. Therefore, the chylomicron contribution, which occurs within a few hours of VA ingestion, may be limited and has a finite capacity not affected by increasing doses. The spleen had a higher DR concentration than the lung, but the lung took up more total DR presumably due to its size. Because retinol concentration did not differ in spleen and lung 10 d after dosing with VA, frequent dietary intake of VA would be needed for maintaining concentrations.
In 4 h, the minimum chylomicron contribution was 63 and 280% higher in lung and spleen, respectively, than the maximum amount of DR that passed through the tissue in 4 h on RBP. Future studies should assess changes with time in tissue concentrations to better assess these findings. A limitation of this study is that the lag time of the processing and absorption of the DR was not assessed. In rats and sows, the rise from 1 to 3.5 h (50) and 0 to 5 h (36) of DR bound to RBP is quite linear, but values between 0 and 1 h have not been assessed. Nonetheless, the DR exposure extrapolated in the first hour of this study represents only 6% of the total in the calculation. Furthermore, because the chylomicron contribution is calculated by difference, a lag in DR exposure to tissue from RBP would increase the chylomicron contribution to the tissue, strengthening our arguments.
Spleen and lung are active in the immune response (51,52) and VA plays an integral role in immunity. Any initial storage of VA that occurred in these tissues may have been utilized before sampling at 10 d after dosage. The spleen is involved in both innate and adaptive immune processes in humans (51). The lung has constant exposure with the environment and is therefore one of the first defenses to inhaled antigens (52). The DR:R was much higher in these 2 tissues than the kidney or serum. We interpret this to mean that DR was rapidly taken up by these tissues from the chylomicra and initial stores of VA from the VA dose given 10 d prior were low. This is in agreement with the hypothesis set forth by Ross and Li (8). If these 2 essential immune system organs need a constant supply of VA for proper function from the diet or supplements, current practices of biannual supplementation to children may not be optimal. Although few dispute the benefits of VA supplementation to preschool children in the prevention of mortality and overt VA deficiency (53), perhaps food-based approaches to the global VA problem need to be considered (54) alongside of supplementation programs to mitigate morbidity and maintain optimal health.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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2 Author disclosures: T. Sun, R. L. Surles, and S. A. Tanumihardjo, no conflicts of interest. ![]()
3 Abbreviations used: DR, 3, 4-didehydroretinol; DRA, 3, 4-didehydroretinyl acetate; DR:R, ratio of 3, 4-didehydroretinol to total retinol; RBP, retinol-binding protein; VA, vitamin A. ![]()
Manuscript received 11 February 2008. Initial review completed 7 March 2008. Revision accepted 14 March 2008.
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