Details

Autor(en) / Beteiligte

• Dancer, Rachel C A
• Parekh, Dhruv
• Lax, Sian
• D'Souza, Vijay
• Zheng, Shengxing
• Bassford, Chris R
• Park, Daniel
• Bartis, D G
• Mahida, Rahul
• Turner, Alice M
• Sapey, Elizabeth
• Wei, Wenbin
• Naidu, Babu
• Stewart, Paul M
• Fraser, William D
• Christopher, Kenneth B
• Cooper, Mark S
• Gao, Fang
• Sansom, David M
• Martineau, Adrian R
• Perkins, Gavin D
• Thickett, David R

Titel

Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS)

Ist Teil von

• Thorax, 2015-07, Vol.70 (7), p.617-624

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2015

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• RationaleVitamin D deficiency has been implicated as a pathogenic factor in sepsis and intensive therapy unit mortality but has not been assessed as a risk factor for acute respiratory distress syndrome (ARDS). Causality of these associations has never been demonstrated.ObjectivesTo determine if ARDS is associated with vitamin D deficiency in a clinical setting and to determine if vitamin D deficiency in experimental models of ARDS influences its severity.MethodsHuman, murine and in vitro primary alveolar epithelial cell work were included in this study.FindingsVitamin D deficiency (plasma 25(OH)D levels <50 nmol/L) was ubiquitous in patients with ARDS and present in the vast majority of patients at risk of developing ARDS following oesophagectomy. In a murine model of intratracheal lipopolysaccharide challenge, dietary-induced vitamin D deficiency resulted in exaggerated alveolar inflammation, epithelial damage and hypoxia. In vitro, vitamin D has trophic effects on primary human alveolar epithelial cells affecting >600 genes. In a clinical setting, pharmacological repletion of vitamin D prior to oesophagectomy reduced the observed changes of in vivo measurements of alveolar capillary damage seen in deficient patients.ConclusionsVitamin D deficiency is common in people who develop ARDS. This deficiency of vitamin D appears to contribute to the development of the condition, and approaches to correct vitamin D deficiency in patients at risk of ARDS should be developed.Trial registrationUKCRN ID 11994.