Table 1.
Immunological effect of Vitamins and multi-nutrients.
| Author; Published Year; Country |
Nutrient | Study design; Duration; Jadad score |
Study population; Sample size (I/C); Male/Female; Age (years) |
Intervention; Control; Dose/Frequency |
Purpose | Significant anti-viral outcome |
|---|---|---|---|---|---|---|
| Siddiqui et al. [16] 2001; Pakistan |
Vitamin A | C; 30 days; 0 points |
Healthy participants; 20/20; 30/10; 10–35 |
IG: Vitamin A (100000 IU on 1st vaccine day and 100000 IU on the following day) CG: No placebo Both groups received anti-rabies vaccine |
Study the role of Vitamin A in enhancing humoral immunity produced by anti-rabies vaccine | Clinical: NA Immunological: IG group had significantly greater (2.1 times) serum anti-rabies titre than CG. |
| Patel et al. [2] 2019; USA |
Vitamin A and Vitamin D | R, DB, PC; 28 days; 2 points |
Healthy children; 39/40; 33/46; 2–8 |
IG: Oral gummy (Vitamin A 20,000 IU and Vitamin D 2000 IU), on days 0 and 28 CG: Oral gummy placebo, on days 0 and 28 Both groups received influenza vaccine |
Study benefit of vitamin A&D supplements on humoral immune responses following paediatric influenza vaccination | Clinical: NA Immunological: Higher antibody responses among children who entered the study with insufficient or deficient levels of RBP and 25-hydroxyvitamin D. |
| Abu-Mouch et al. 2011 [24]; Israel |
Vitamin D | R, C; 48 weeks; 1 point |
Chronic hepatitis C (HCV) patients; 36/36; 39/33; 18–65 |
IG: Vitamin D3 (2000 IU/day) with antiviral therapy CG: Antiviral therapy alone |
Determine whether adding Vitamin D improves HCV response to antiviral therapy | Clinical: Similar in both groups. Immunological: Significantly more IG patients were HCV-RNA negative (at week 4, 12 and 24). Vitamin D supplementation was strongly and independently associated with sustained virological response in multivariate analysis. |
| Aglipay et al. [21] 2017; Canada |
Vitamin D | R, DB, C; 4–8 months; 5 points |
Healthy children; 349/354; 404/296; 1–5 |
IG: Vitamin D3 high dose (2000 IU/day) CG: Vitamin D3 standard dose (400 IU/day) |
Compare effects of high-dose vs. standard-dose vitamin D supplementation on prevention of viral upper respiratory tract infections among children | Clinical: No significant difference in incidence of wintertime upper respiratory tract infections in IG compared to CG Immunological: NA |
| Ginde et al. [23] 2017; USA |
Vitamin D | R, DB, PC; 12 months; 5 points |
Elderly participants; 55/52; 45/62; ≥60 |
IG: High-dose group (Vitamin D3 100,000 IU/month) CG: Standard-dose group (A Placebo, for participants taking 400–1000 IU/day as part of usual care or 12000 IU of vitamin D3/month, for participants taking <400 IU/day as part of usual care) |
Evaluate efficacy of high dose monthly Vitamin D for prevention of acute respiratory infection in older long-term care residents | Clinical: IG had significantly lesser number of acute respiratory infections than CG. Immunological: NA |
| Goncalves-Mendes et al. [22] 2019; France |
Vitamin D | R, DB, PC; 3 months; 5 points |
Elderly participants (Vitamin D deficient); 19/19 Both genders ˃65 |
IG: Vitamin D (6 doses 100,000 IU, 1 vial/15 days) CG: Placebo (6 doses, 1 vial/15 days) Both groups received influenza vaccine |
Study whether Vitamin D supplementation in deficient elderly persons could improve influenza sero-protection and immune response. | Clinical: NA Immunological: IG had a higher TGFβ plasma level in response to influenza vaccination without improved antibody response. Vitamin D seems to direct lymphocyte polarization toward a tolerogenic immune response. |
| Nimer and Mouch [25] 2012; Israel |
Vitamin D | R, C; 24 weeks; 1 point |
Chronic HCV patients; 20/30; 31/19; 18–65 |
IG: Vitamin D3 (2000 IU/day) with antiviral therapy CG: Antiviral therapy alone |
Examine whether vitamin D improved viral response and predicted treatment outcome in patients with HCV genotype 2–3. | Clinical: NA Immunological: Ninety-five percent in IG were HCV RNA negative at week 4 and 12. At 24 weeks sustained virological response was significantly more in IG. Logistic regression analysis identified vitamin D supplement as an independent predictor of viral response. |
| Andreone et al. [29] 2001; Italy |
Vitamin E | R, C; 3 months; 2 points |
Chronic hepatitis B, (HBV) patients; 15/17; NM; I: 37 ± 15 C: 42 ± 14 |
IG: Vitamin E (300 mg twice daily) CG: No treatment |
Study the role of Vitamin E as a treatment for Chronic HBV | Clinical: NA Immunological: Significantly higher complete response, HBV-DNA negativization, alanine aminotransferase normalization observed in IG. |
| Fiorino et al. [30] 2017; Italy |
Vitamin E | R, C; 12 months; 3 points |
Children with chronic HBV; 23/23; 34/12; 2–17 |
IG: Vitamin E (15 mg/kg/day) CG: No treatment |
Evaluate the safety and efficacy of vitamin E for the treatment of paediatric HBeAg-positive chronic HBV | Clinical: NA Immunological: Significantly more patients in IG had anti-HBe seroconversion and a virological response. |
| Hemilä and Kaprio [27] 2008; Finland |
Vitamin E and β-carotene | R, DB, PC; 5–8 years; 3 points |
Male participants (smoked at least 5 cigarettes/day and initiated smoking at ≤ 20 years); 10,784/10,873; Males only; 50–69 |
IG: Three groups a) Vitamin E (α-tocopheryl acetate, 50 mg/day) b) β-carotene (20 mg/day) c) Both vitamin E and β-ca CG: Placebo |
Examine the effects of vita-min E and pneumonia risk in males who initiated smoking at an early age | Clinical: Vitamin E supplementation had no effect on the risk of pneumonia in participants with body weight in a range from 70 to 89 kg. Vitamin E increased the risk of pneumonia in participants with body weight <60 kg and in participants with body weight >100 kg. The harm of vitamin E supplementation was restricted to participants with dietary vitamin C intake above the median. Immunological: NA |
| Meydani et al. [28] 2004; USA |
Vitamin E | R, DB, PC; 12 months; 5 points |
Elderly participants; 231/220; 113/338; ≥65 |
IG: Vitamin E (α-tocopherol, 200 IU) in soybean oil, one capsule/day CG: Placebo (4 IU of vitamin E) in soybean oil, one capsule/day |
Investigate effect vitamin E supplementation on respiratory infections in elderly nursing home residents. | Clinical: IG did not have a statistically significant incidence of lower respiratory tract infections. However, a protective effect was noted on upper respiratory tract infections, particularly the common cold. Immunological: NA |
| Girodon et al. [33] 1999; France |
Multi-nutrient (Trace elements [zinc and selenium sulphide] or vitamins [beta carotene, ascorbic acid, and vitamin E]) | R, DB, PC; 2 years; 4 points |
Elderly participants; 182:180:181/182; 185/540; 5–103 |
IG: Three groups a) Trace element: zinc sulphate and selenium sulphide (Zinc 20 mg, Selenium 100 μg) b) Vitamins: ascorbic acid (120 mg), beta carotene (6 mg), αtocopherol (15 mg) c) Trace element and vitamin CG: Placebo group (calcium phosphate and microcrystalline cellulose) |
Effect of long-term daily supplementation with trace elements or vitamins in immunity and incidence of infections in institutionalized elderly. | Clinical: Correction of specific nutrient deficiencies was observed after 6 months and was maintained for the first year, during which there was no effect of any treatment on delayed-type hypersensitivity skin response. Number of patients without respiratory tract infections during the study was higher in groups that received trace elements. Immunological: Antibody titers after influenza vaccine were higher in groups that received trace elements alone or associated with vitamins, whereas the vitamin group had significantly lower antibody titers. |
| Graat et al. [34] 2002; Netherland |
Multi-nutrient (retinol, beta-carotene, ascorbic acid, vitamin E, cholecalciferol, vitamin K, thiamine, niacin riboflavin, pantothenic acid, pyridoxine, cyanocobalamin, zinc, selenium, iron, copper magnesium, iodine, calcium, phosphor, manganese, chromium, molybdenum and silicium) and Vitamin E | R, DB, PC; 15 months; 5 points |
Elderly participants; 163:164:172/153 Both genders ≥60 |
IG: Three groups a) Multivitamin-Mineral, 2 capsule/day b) Vitamin E (200 mg), 2 capsule/day c) Multivitamin-Mineral Plus vitamin E, 2 capsule/day CG: Placebo (soybean oil), 2 capsule/day |
Study the effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly. | Clinical: Neither daily multivitamin mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favourable effect on incidence and severity of acute respiratory tract infections in well-nourished non- institutionalized elderly individuals. Immunological: NA |
C – Controlled; CG – Control group; DB – Double blind; DNA – deoxyribonucleic acid; HBV – Hepatitis B virus; HBeAg – Hepatitis B e-antigen; – Hepatitis B HCV – Hepatitis C virus; IG – Interventional group; IU – International units; NA – Not applicable; PC – Placebo controlled; R- Randomized; RNA – Ribonucleic acid; RBP – Retinol binding protein; TGF – Transforming growth factor.