Physiological and clinical aspects of vitamin A and its metabolites.

Retinoids, including retinol and retinoic acid (RA), are a group of naturally occurring and synthetic compounds that exhibit vitamin A-like biological activity. They achieve their effects by binding to intracellular proteins. Important sites of action are the nuclear retinoic acid receptors (RAR). These receptors, namely, RAR alpha, RAR beta, and RAR gamma, function as transcription factors by binding to RA-responsive elements (RARE) of multiple genes. Retinoids play a role in vision, embryogenesis, immune modulation, growth and differentiation of normal, premalignant and malignant tissues, the suppression of carcinogenesis, and the inhibition of tumor growth in experimental systems and humans. Reports of the significant antitumor effect of all-trans-RA in acute promyelocytic leukemia and the synthesis of new, less toxic, and more potent retinoids has generated renewed interest in these compounds. Retinoids may have an important role to play in the chemoprevention and therapy of cancer.