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Interleukin-15 and vitamin A

Researchers have discovered that a metabolite of vitamin A, known as retinoic acid, together with interleukin-15 (IL-15) in the intestines of patients with celiac disease, may be responsible for generating the inflammation that eventually leads to the development of celiac disease.1  Due to the fact that the inflammation does not develop if IL-15 is not present, it may be possible to development a treatment program based on a drug capable of  blocking IL-15.  Isotretinoin is a first-generation retinoid (similar to retinoic acid) that's used as the active ingredient in the product Accutane, and other similar medications used in the treatment in acne.  For some users, these products have been blamed for the development of inflammatory bowel disease.  That implies that this discovery may also have implications for both the prevention and treatment of microscopic colitis.

With this in mind, until a safe and effective way to block IL-15 is developed, or until/unless vitamin A supplements are reformulated to eliminate/minimize retinoic acid, research data imply that it may be prudent to avoid the use of vitamin A supplements (or multivitamins) that contain relatively large amounts of retinol.  Using supplements based on the beta-carotene form of vitamin A appears to be a much safer choice.  Products that contain the esters of retinol may also carry a risk similar to retinoic acid.

An example of such a product is palm oil, since the main component of palm oil is retinyl palmitate (an ester of retinol).  It appears that terms such as "retinyl acetate", "retinol acetate", and "vitamin A acetate", all refer the same basic ingredient (the acetate ester of retinol), which is subsequently converted to retinoic acid by the body.  Apparently the same conversion occurs regardless of whether the product is applied topically (to the skin) or ingested.  The bottom line is that for anyone who is sensitive to gluten, there is a significant risk that the retinol that results from the conversion process could combine with IL-15 to generate enteritis, (intestinal inflammation).  And as we are well aware, chronic enteritis tends to lead to the development of celiac disease, microscopic colitis, or one of the other IBDs, and it can also lead to the development of other autoimmune diseases.

1. Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens.

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