Association between serum 25-hydroxyvitamin D level and pulmonary exacerbations in cystic fibrosis

Vanstone, Michelle B.; Egan, Marie E.; Zhang, Jane H.; Carpenter, Thomas O.

doi:10.1002/ppul.23161

Cited by 40 publications

(33 citation statements)

References 19 publications

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“…One retrospective cohort found that vitamin D status was positively associated with FEV1 in patients with CF(8). Other studies in CF populations have demonstrated that higher vitamin D status has been associated with better lung function and lower rates of pulmonary exacerbation(8, 21–23). The potential mechanisms by which vitamin D may preserve lung function based on studies in cystic fibrosis and other chronic lung disease include improved airway remodeling in response to injury, decreased airway inflammation, and decreased airway bacterial colonization (19).…”

Section: Potential Role Of Vitamin D In Cfmentioning

confidence: 97%

Treatment of vitamin D deficiency in cystic fibrosis

Chesdachai

Tangpricha

2016

The Journal of Steroid Biochemistry and Molecular Biology

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Vitamin D deficiency occurs frequently in patients with cystic fibrosis (CF). Vitamin D is important for optimal mineralization of bone and may be important for other comorbidities commonly occurring in patients with CF. Vitamin D deficiency in patients with CF can arise from various causes including pancreatic exocrine insufficiency, lack of outdoor activity, and alterations of vitamin D metabolism. Due to fat malabsorption stemming from pancreatic insufficiency, higher oral doses of vitamin D are necessary to correct and maintain optimal vitamin D status in patients with CF. Recent studies have demonstrated that higher vitamin D status is associated with better lung function and that vitamin D therapy may help recovery from pulmonary exacerbations of CF. The mechanisms by which vitamin D may exert its beneficial actions in CF are unclear but likely related to the role vitamin D has in modulating the adaptive and innate immune response. Large randomized clinical studies to evaluate the potential role of vitamin D as adjunctive therapy in CF that goes beyond bone are necessary.

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Section: Potential Role Of Vitamin D In Cfmentioning

confidence: 97%

Treatment of vitamin D deficiency in cystic fibrosis

Chesdachai

Tangpricha

2016

The Journal of Steroid Biochemistry and Molecular Biology

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“…There is a high prevalence of VDD in patients with interstitial lung disease, and it is associated with reduced lung function 11 . Low 25(OH)D levels are associated with pulmonary exacerbations in cystic fibrosis patients 12 . Previously, studies mainly investigated the curative effect of vitamin D analogues or the aggravating effect of VDD on disease models in animals.…”

Section: Introductionmentioning

confidence: 99%

Chronic vitamin D deficiency induces lung fibrosis through activation of the renin-angiotensin system

Shi

Liu

Yao

et al. 2017

Sci Rep

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Pulmonary fibrosis, which influences lung function and exacerbates a patient’s condition, is the ultimate stage of many lung diseases. Vitamin D deficiency is associated with pulmonary fibrosis and impaired lung function, but the underlying mechanism has not yet been fully elucidated. Moreover, vitamin D deficiency may cause over-activation of the renin-angiotensin system (RAS), which aggravates extracellular matrix (ECM) deposition and lung fibrosis. This study aims to investigate the effect of chronic vitamin D deficiency on lung fibrosis in otherwise healthy mice and to explore the role of RAS in this process. Mice were depleted of vitamin D through diet control and were compared with healthy subjects. Chronic vitamin D deficiency destructs lung structures, impairs lung development and stimulates ECM deposition. RAS components are also found to increase. These effects seem to worsen with prolonged vitamin D deficiency. By giving RAS blockers, these changes can be largely rescued. However, a smooth muscle relaxant whose regulatory effect on blood pressure is independent of RAS does not show similar effects. This study demonstrated that chronic vitamin D deficiency may induce RAS activation, which subsequently stimulates the expression of profibrotic factors and activates the fibrotic cascade. This profibrotic effect of RAS is independent of elevated blood pressure.

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“…2,3 In addition to its importance for bone health, vitamin D acts as a potent immune modulatory agent with complex effects. 4,5 In CF, vitamin D concentrations have been associated with lung function, 2,6 annual number of pulmonary exacerbations 7 and with total serum IgG levels. 2 The current recommendations for vitamin D supplementation in CF were designed with focus on bone health.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of vitamin D treatment in cystic fibrosis: a pilot randomized, controlled trial

et al. 2016

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BACKGROUND/OBJECTIVES: Vitamin D insufficiency in cystic fibrosis is common. Vitamin D3 is currently preferred over D2. We aimed to study the efficacy of vitamin D2 and D3 at increasing serum 25-hydroxyvitamin D (s25OHD) concentrations and their effect on respiratory health in cystic fibrosis. SUBJECTS/METHODS: Sixteen CF patients were randomized to receive vitamin D2 or D3 or to serve as controls. The starting dose of 5000 IU (o 16 years old) or 7143 IU/day (⩾16 years old) was further individually adjusted. Three months of intervention were followed by two of washout (ClinicalTrials.gov NCT01321905). RESULTS: To increase s25OHD, the mean daily dose of vitamin D2 and D3 had to be increased up to 15650 and 8184 IU, respectively. The combined group of vitamin D2 and D3 treated patients decreased plasma IL-8 (Po 0.05). Patients provided vitamin D3 improved FVC at the end of the trial (P o 0.05). Change in s25OHD was positively correlated with changes in the adult Quality-of-Life respiratory score at the end of supplementation (P = 0.006, r = 0.90), and with changes in FEV1 (P = 0.042, r = 0.62) and FVC (P = 0.036, r = 0.63) at one month of washout. CONCLUSIONS: Vitamin D supplementation may contribute to reduced inflammation and improved lung function in CF.

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Association between serum 25-hydroxyvitamin D level and pulmonary exacerbations in cystic fibrosis

Abstract: The annual number of Pex in pediatric CF patients is significantly associated with 25-OHD levels and gender, raising the consideration that maintaining vitamin D sufficiency may lead to decreased incidence of Pex and hospitalizations requiring antibiotic therapy.

Cited by 40 publications

References 19 publications

Treatment of vitamin D deficiency in cystic fibrosis

Treatment of vitamin D deficiency in cystic fibrosis

Chronic vitamin D deficiency induces lung fibrosis through activation of the renin-angiotensin system

Clinical impact of vitamin D treatment in cystic fibrosis: a pilot randomized, controlled trial

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