2018-01-11
Should vitamin K be supplemented instead of antagonised in patients with idiopathic pulmonary fibrosis?
Publication
Publication
Introduction: There is an ongoing need for additional interventions in idiopathic pulmonary fibrosis (IPF) as antifibrotic drugs currently available only inhibit and do not stall disease progression. Vitamin K is a co-factor for the activation of coagulation factors. However, it is also required to activate proteins with functions outside of the coagulation cascade, such as matrix Gla protein (MGP), a defender against soft tissue calcification. Vitamin K antagonists are anticoagulants that are, for unknown reasons, associated with increased mortality in IPF. Areas covered: We advance the hypothesis that modulation of vitamin K-dependent MGP activation in IPF patients by either vitamin K antagonism or administration may result in acceleration and deceleration of fibrosis progression, respectively. Furthermore, shortfall in vitamin K could be suspected in IPF based on the high prevalence of certain co-morbidities, such as vascular calcification and lung cancer. Expert commentary: We hypothesize that vitamin K status is reduced in IPF patients. This, in combination with studies suggesting that vitamin K may play a role in lung fibrosis pathogenesis, would provide a rationale for conducting a clinical trial assessing the potential mitigating effects of vitamin K administration on progression of lung fibrosis, prevention of co-morbidities and mortality in IPF.
Additional Metadata | |
---|---|
, , , , , | |
doi.org/10.1080/17476348.2018.1424544, hdl.handle.net/1765/104318 | |
Expert Review of Respiratory Medicine | |
Organisation | Department of Pathology |
De Brouwer, B. (Bart), Piscaer, I. (Ianthe), von der Thusen, J., Grutters, J., Schutgens, R.E. (Roger EG.), Wouters, E.F. (Emiel FM.), & Janssen, R. (Rob). (2018). Should vitamin K be supplemented instead of antagonised in patients with idiopathic pulmonary fibrosis?. Expert Review of Respiratory Medicine, 1–7. doi:10.1080/17476348.2018.1424544 |