TY - JOUR T1 - Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS) JF - Thorax JO - Thorax SP - 617 LP - 624 DO - 10.1136/thoraxjnl-2014-206680 VL - 70 IS - 7 AU - Rachel C A Dancer AU - Dhruv Parekh AU - Sian Lax AU - Vijay D'Souza AU - Shengxing Zheng AU - Chris R Bassford AU - Daniel Park AU - D G Bartis AU - Rahul Mahida AU - Alice M Turner AU - Elizabeth Sapey AU - Wenbin Wei AU - Babu Naidu AU - Paul M Stewart AU - William D Fraser AU - Kenneth B Christopher AU - Mark S Cooper AU - Fang Gao AU - David M Sansom AU - Adrian R Martineau AU - Gavin D Perkins AU - David R Thickett Y1 - 2015/07/01 UR - http://thorax.bmj.com/content/70/7/617.abstract N2 - Rationale Vitamin 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.Objectives To 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.Methods Human, murine and in vitro primary alveolar epithelial cell work were included in this study.Findings Vitamin 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.Conclusions Vitamin 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 registration UKCRN ID 11994. ER -