Book Review
Vitamin A
N Engl J Med 2007; 357:2640December 20, 2007
- Article
Vitamin A
(Vitamins and Hormones. Vol. 75.) Edited by Gerald Litwack. 412 pp., illustrated. San Diego, CA, Elsevier Academic Press, 2007. $149.95. ISBN: 978-0-12-709875-3Vitamin A, part of the Vitamins and Hormones series from Elsevier Academic Press, is a timely, comprehensive, and well-organized collection of reviews on various aspects of the role of vitamin A in health and disease. It serves as a “one-stop shop” for scientific experts in biochemistry, physiology, and molecular biology, as well as for clinicians and public health practitioners who want up-to-date reviews of the regulatory role of vitamin A and its derivatives at the cellular and physiological levels.
The first half of the book (chapters 1 through 7) focuses on vitamin A and its derivatives in various metabolic pathways, and the second half (chapters 8 through 14) describes the role of vitamin A in the modulation of immune function as well as its effect on the skin, heart, and lungs in health and disease. Chapters 1, 2, and 3, which discuss the metabolism of retinol and its derivatives, especially in signaling pathways, and chapter 4, which discusses the metabolism of retinol during placental and embryonic development, are all very well written. A reader need not be an expert in molecular biology, biochemistry, or physiology to find these chapters interesting. The same applies to chapter 7, written by Christopher J. Cifelli and colleagues, which discusses the use of compartmental analysis to study the kinetics and metabolism of vitamin A. Surprisingly, the book does not include a chapter on the assessment of patients' vitamin A status.
The second half of the book should be very interesting to clinicians. Of note are the chapters on vitamin A and other vitamins in persons with human immunodeficiency virus (HIV) or cancer. The excellent chapters on the role of vitamin A in the regulation of antibody responses (chapter 8) and in patients with HIV–AIDS (chapter 13) are written by well-recognized experts. The chapters on the role of vitamin A in cancer, cardiovascular disease, and emphysema describe how vitamin A and its derivatives could influence disease progression, but they are based primarily on studies in animals and could have been strengthened by the inclusion of evidence from epidemiologic studies that have examined these relationships. The absence of a discussion of the role of vitamin A in death and disease in early childhood is surprising, because these are major public health problems in developing countries and have been the focus of considerable research in the past few decades.
Usha Ramakrishnan, Ph.D.
Rollins School of Public Health of Emory University, Atlanta, GA 30032
uramakr@sph.emory. edu
