The effect of vitamin D and vitamin A supplementation on T cell levels of patients with pneumosepsis: A double-blind, randomized clinical trial

Pneumosepsis is a global healthcare challenge associated with substantial morbidity and mortality rates. Its pathogenesis involves intricate interactions among host factors, pathogens, and immune dysregulation. Vitamins A and D are crucial for immune function, acting as regulators and cofactors in immune cell development and function. Given these roles, this study aimed to assess the impact of combined vitamin D and A supplementation on T cell levels in pneumosepsis patients. This double-blind clinical trial enrolled 84 pneumosepsis patients who were randomly assigned to four groups after demographic data collection. Intervention: Group 1 received standard treatment plus 300,000 IU of vitamin D and 50,000 IU of vitamin A. Group 2 received standard treatment plus 300,000 IU of vitamin D. Group 3 received standard treatment plus 50,000 IU of vitamin A. Group 4 received only standard treatment. Main outcome measures: Vital signs were monitored every 6 hours, and T-cell count, ESR, CRP, creatinine, urea, and uric acid levels were assessed at 0, 24, 48, and 72 hours. Initially and one day post-intervention, vital signs and blood factors showed no significant differences among the groups. However, on days two and three post-intervention, the combined vitamin D and A group exhibited significantly lower levels compared to other groups. Lymphocytes expressing CD3+, CD4+, CD25+, CD3,4+, and CD3,4,25+ markers significantly differed in the combined vitamin A + D group versus the control. No significant differences were noted in lymphocyte percentages between the combined vitamin A + D group and those receiving only vitamin D or A. This study underscores the potential benefits of concurrent vitamin D and A supplementation in reducing symptoms among pneumosepsis patients, particularly in modulating key physiological parameters and immune responses. This study is registered on Iranian Registry of Clinical Trials (IRCT) under identifieron IRCT20130424013110N10. (The registration date: Jul 6, 2020).