RT Journal Article
SR Electronic
T1 Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS)
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 617
OP 624
DO 10.1136/thoraxjnl-2014-206680
VO 70
IS 7
A1 Dancer, Rachel C A
A1 Parekh, Dhruv
A1 Lax, Sian
A1 D'Souza, Vijay
A1 Zheng, Shengxing
A1 Bassford, Chris R
A1 Park, Daniel
A1 Bartis, D G
A1 Mahida, Rahul
A1 Turner, Alice M
A1 Sapey, Elizabeth
A1 Wei, Wenbin
A1 Naidu, Babu
A1 Stewart, Paul M
A1 Fraser, William D
A1 Christopher, Kenneth B
A1 Cooper, Mark S
A1 Gao, Fang
A1 Sansom, David M
A1 Martineau, Adrian R
A1 Perkins, Gavin D
A1 Thickett, David R
YR 2015
UL http://thorax.bmj.com/content/70/7/617.abstract
AB 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.