Document Detail

Pharmacokinetics of retinyl palmitate and retinol after intramuscular retinyl palmitate administration in severe malaria.
MedLine Citation:
PMID:  11052924     Owner:  NLM     Status:  MEDLINE    
Retinol (vitamin A alcohol) is an accepted adjunctive treatment in infections such as measles. There is also indirect evidence from in vitro, animal and human studies that retinol supplementation may be beneficial in severe malaria. There have, however, been no studies that have examined the pharmacokinetics of acute retinol supplementation in severe illness. To establish whether mobilization of intramuscular retinyl palmitate (RP) and its availability as retinol are adequate in complicated falciparum malaria, we administered a single dose of 400000 i.u. of RP to six Vietnamese adults with severe malaria. Another 28 patients were not given RP. All patients had blood samples taken over 96 h for RP and retinol assay using HPLC, and received conventional anti-malarial and supportive therapy. Admission serum retinol concentrations were below the lower limit of the reference range (<1.0 micromol/l) in 74% of the 34 patients. In supplemented patients, analysis of serum RP between 0 and 96 h using a multi-compartmental model revealed a median (range) delay in mobilization of 6.9 h (0.7-15.1 h), a bioavailability of 55% (19-100%) and an elimination half-life of 13.5 h (4.2-23.7 h). The area under the serum retinol curve expressed as an absolute or percentage change from baseline was greater in supplemented than in unsupplemented patients (P<0.05). The separation in median serum retinol concentrations in the two groups was maximal at 48 h. The model-derived retinol half-life [1.5 (0.7-15.8) h] suggested rapid uptake, metabolism and/or excretion. In conclusion, there is variable RP bioavailability in severe malaria, but a significant if delayed increase in serum retinol over that associated with recovery from the infection. In severe infections, RP supplementation appears simple, well tolerated and of potential benefit once anti-microbial and supportive therapy have been established.
T M Davis; T Q Binh; L T Thu; R Rossi; P T Danh; P H Barrett; J Beilby
Related Documents :
7579024 - Vitamin b12 deficiency and dementia.
19387474 - Vitamin k deficiency in ckd patients: a modifiable risk factor for vascular calcification?
21112524 - Craniofacial characteristics in cri-du-chat syndrome.
18081374 - Sevelamer hydrochloride: a review of its use for hyperphosphataemia in patients with en...
3898284 - Thymopentin treatment in a patient with pluriorificial pyoderma vegetans.
25304744 - Optimal cut-off values for cyfra 21-1 expression in nsclc patients depend on the presen...
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  99     ISSN:  0143-5221     ISO Abbreviation:  Clin. Sci.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-26     Completed Date:  2001-03-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  433-41     Citation Subset:  IM    
University of Western Australia, Department of Medicine, Fremantle Hospital, P.O. Box 480, Fremantle, Western Australia 6959, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Antimalarials / therapeutic use
Area Under Curve
Biological Availability
Chromatography, High Pressure Liquid
Drug Therapy, Combination
Malaria, Falciparum / blood,  drug therapy*
Palmitates / blood,  pharmacokinetics*,  therapeutic use
Vitamin A / blood,  pharmacokinetics*,  therapeutic use
Grant Support
Reg. No./Substance:
0/Antimalarials; 0/Palmitates; 11103-57-4/Vitamin A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Effects of the Japanese herbal medicine 'Inchinko-to' (TJ-135) on concanavalin A-induced hepatitis i...
Next Document:  Characterization of an in vitro model for the study of the short and prolonged effects of myocardial...