Vitamin D Deficiency and Chronic Lung Disease

Abstract

Vitamin D deficiency is increasingly being recognized as a prevalent problem in the general population. Patients with chronic lung diseases such as asthma, cystic fibrosis, chronic obstructive lung disease and interstitial pneumonia appear to be at increased risk for vitamin D deficiency for reasons that are not clear. Several studies indicate that vitamin D possesses a range of anti-inflammatory properties and may be involved in processes other than the previously believed functions of calcium and phosphate homeostasis. Various cytokines, cellular elements, oxidative stress and protease/antiprotease levels appear to affect lung fibroproliferation, remodelling and function, which may be influenced by vitamin D levels. Chronic lung diseases such as asthma and chronic obstructive lung disease have also been linked to vitamin D on a genetic basis. This immune and genetic influence of vitamin D may influence the pathogenesis of chronic lung diseases. A recent observational study notes a significant association between vitamin D deficiency and decreased pulmonary function tests in a large ambulatory population. The present review will examine the current literature regarding vitamin D deficiency, its prevalence in patients with chronic lung disease, vitamin D anti-inflammatory properties and the role of vitamin D in pulmonary function.

Vitamin D treatment improves survival and infant lung structure after intra-amniotic endotoxin exposure in rats: potential role for the prevention of bronchopulmonary dysplasia

“…Previous studies have shown that low vit D levels in premature neonates correlate with predisposition for a variety of long-term sequelae (13,46). Our data demonstrate a potential proangiogenic mechanism for vit D, which acts directly on endothelial cells by improving growth and tube (Fig.…”

“…Recent epidemiological studies have linked vit D deficiency with increased severity of inflammatory chronic lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD) (8,10,29,33,47,48,50). Low vit D levels are associated with decreased lung function in asthma and COPD after exposure to air pollution (7,13,19). Vit D treatment attenuates inflammation in experimental autoimmune diseases and modulates cytokine production by vascular endothelial cells and human decidual cells (20,49).…”

Vitamin D receptor agonists inhibit pro-inflammatory cytokine production from the respiratory epithelium in cystic fibrosis

“…A link between vitamin D deficiency and chronic lung disease is becoming increasingly clearer [35]. As part of a national adult health survey in the US, low levels of 25(OH)D were strongly linked to lower FEV1 and FVC after adjustment for other variables [36].…”

An estimate of the global reduction in mortality rates through doubling vitamin D levels

“…A cross-sectional study from the United States linked serum 25(OH)D levels to lung capacity (Black and Scragg, 2005), as did an observational study of current and former smokers (Janssens et al, 2010). The mechanism of COPD risk reduction by vitamin D seems to include its influence on the prevalence of 'various cytokines, cellular elements, oxidative stress and protease/antiprotease levels (that) appear to affect lung fibroproliferation, remodelling and function' (Gilbert et al, 2009). Tuberculosis TB mortality rates are highest in Africa and the Western Pacific regions.…”