Low Vitamin K Status Is Associated with Increased Elastin Degradation in Chronic Obstructive Pulmonary Disease

Piscaer, Ianthe; Ouweland, Jody M.W. van den; Vermeersch, Kristina; Reynaert, Niki L.; Franssen, Frits M.E.; Keene, Spencer; Wouters, Emiel F.M.; Janssens, Wim; Vermeer, Cees; Janssen, Rob

doi:10.3390/jcm8081116

Cited by 32 publications

(47 citation statements)

References 35 publications

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“…In the present study, an inverse correlation was found between vitamin K status and pDES in COVID-19 patients, suggesting a pathomechanistic link between vitamin K deficiency and accelerated elastolysis. This relationship has previously also been demonstrated in patients with COPD [15] and may be an indication for a link between vitamin K deficiency, insufficient MGP carboxylation and aberrant tissue remodeling in patients with COVID-19.…”

Section: Discussionsupporting

confidence: 62%

“…Measuring levels of dp-ucMGP has previously been proven to be a useful method to assess vitamin K status [22]. Dp-ucMGP inversely relates to mortality and other clinical meaningful endpoints in various cohorts [12,15,[23][24][25][26][27][28][29][30]. Supplementation of vitamin K has a reducing effect on dp-ucMGP levels [22,31], and the opposite holds true with regard of the use of VKAs [22,[32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we hypothesized that vitamin K status could be reduced and inversely related to survival in patients with severe COVID-19. In addition, a total of 184 control subjects from a previous study were included (www.controlled-trials.com, identifier ISRCTN86049077) [15], of which 85 (46%) were male, 3 subjects (1.6%) used VKAs, and mean age was 61±6.5 years. COVID-19 and control subjects in which use of VKAs was unknown were excluded from analysis.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Dofferhoff¹,

Piscaer²,

Schurgers³

et al. 2020

Preprint

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Introduction: Coronavirus 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2. The majority of patients have at most mild symptoms, however, a significant proportion develops respiratory failure. COVID-19 may also progress beyond the lungs. Coagulopathy and thromboembolism are prevalent in severe COVID-19 and relate to decreased survival. Coagulation is an intricate balance between clot promoting and dissolving processes in which vitamin K plays a well-known role. We hypothesized that vitamin K status is reduced in patients with severe COVID-19. Methods: Vitamin K status was assessed by measuring desphospho-uncarboxylated matrix Gla protein (dp-ucMGP; inversely related to vitamin K status) and the rate of elastin degradation by measuring desmosine. We included 123 patients who were admitted with COVID-19 and 184 controls. Results: Dp-ucMGP levels were significantly elevated in COVID-19 patients (1,673Å}1,584 pmol/L) compared to controls (536±291 pmol/L; p<0.0005). Dp-ucMGP levels were significantly higher in COVID-19 patients with unfavorable outcome compared to those with less severe disease. Furthermore, dp-ucMGP and desmosine levels were significantly associated (r=0.65; p<0.0005). Conclusions: Vitamin K status was reduced in patients with COVID-19 and related to poor prognosis. Also, low vitamin K status seems to be associated with accelerated elastin degradation. An intervention trial is now needed to assess whether vitamin K administration improves outcome in patients with COVID-19.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Dofferhoff¹,

Piscaer²,

Schurgers³

et al. 2020

Preprint

Self Cite

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“…A previous study has shown that reduced vitamin K status in COPD patients was associated with high mortality rates (39). The study also showed that elastin degradation is accelerated in chronic COPD and is partially regulated by Matrix Gla Protein (MGP), via a vitamin K-dependent pathway.…”

Section: Discussionmentioning

confidence: 96%

“…Although vegetables have been shown to have beneficial nutrients that can aid healthy lung structure (34,36,37), more research is warranted to link specific nutrients in the greens that can help protect the alveoli from developing emphysematous lung injuries. Since vitamin K is mostly obtained from dark green vegetable, it is highly likely that it may have an impact on the biology of lung airway or alveoli structure (38,39). Low intake of vitamin A also from dark green vegetables has been associated with COPD in different populations (40)(41)(42) and a few studies have shown the potential role of vitamin A in maintaining the integrity of the lung epithelium, non-emphysematous state and exerts anti-inflammatory effects (43,44).…”

Section: Introductionmentioning

confidence: 99%

Consumption of Vitamin K and Vitamin A Are Associated With Reduced Risk of Developing Emphysema: NHANES 2007–2016

et al. 2020

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Chronic obstructive pulmonary disease (COPD) comprising of emphysema and chronic bronchitis are the most common chronic respiratory diseases that impart a huge economic and clinical burden. Factors other than smoking and air pollutants can cause inflammation and emphysematous changes in the lung airspaces or alveoli have been understudied. Using a cross-sectional study design, we assessed the association of dark green vegetables, vitamin K and Vitamin A with emphysema status among adults at U.S. These nutrients have a role in lung biology. A complete case NHANES data (n = 17,681) was used. After adjusting for modifiable and non-modifiable confounders, consumption of recommended amounts of vitamin K was associated with 39% decrease in odds (Odds Ratio: 0.61; 95% CI: 0.40-0.92, P-val: 0.02) of emphysema. Similarly consumption of recommended amounts vitamin A dose was associated with 33% decrease in odds (Odds Ratio: 0.67; 95% CI: 0.44-1.00, P-val: 0.05) of emphysema. Vitamin K shows an inverse association suggesting that it may be important in slowing the emphysematous process. Vitamin A is important in maintaining the anti-inflammatory process. Together vitamin K and vitamin A are important in the lung health.

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The biology of vascular calcification

Quaglino

Boraldi

Lofaro

2020

International Review of Cell and Molecular Biology

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Low Vitamin K Status Is Associated with Increased Elastin Degradation in Chronic Obstructive Pulmonary Disease

Cited by 32 publications

References 35 publications

Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Consumption of Vitamin K and Vitamin A Are Associated With Reduced Risk of Developing Emphysema: NHANES 2007–2016

The biology of vascular calcification

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