Vitamin Deficiency or Insufficiency Hypothesis: A Global Health Crisis of Biological Influence Towards Development of Antimicrobial Resistant Strains. A Perspective View.

BACKGROUND AND AIM: Antimicrobial resistance (AMR) has been a growing crisis of economic, clinical, and public health concern for years. Different mechanisms of why and how AMR develops have been suggested and studied. Vitamins' immunological and genomic influence towards the evolution of resistant microbial agents makes them among the potential candidates to be examined when questioning the genesis and evolution of the AMR crisis. Unfortunately, this area is less explored. This perspective article aims at highlighting the potential role of vitamins towards the global AMR crisis development and suggesting potential hypothetical biological link and areas of further studies.

FINDINGS: Antimicrobial effect and reversal genomic influence of different vitamins among resistant microbial strains suggest a potential biological link in terms of resistant genes genesis and suppression when subjected to environments with some vitamins' concentrations below optimal levels and vice versa. Inadequate intake of fruits and vegetables along the effects of climate changes on nutritional quality and quantity of crop products are among the key potential driving factors towards AMR crisis globally. Since different vitamins like vitamin C play a key role towards DNA stability by preventing and controlling DNA mutations, the potential biological influence of different vitamins towards AMR development is worth consideration for further exploration and should not be underestimated.

CONCLUSION

Screening and supplementing strategies of specific vitamins of interest among resistant microbial- infected patients should be studied further to understand the biological link between specific vitamin deficiency or insufficiency levels and the development of specific antimicrobial-resistant strains. The role and influence of climate change on this biological link should also be explored in detail from a health perspective. Furthermore, different global health interventions should be implemented to increase the global intake of fruits and vegetables as one of the potential sustainable approaches towards prevention and control of AMR crisis, especially in developing countries.