Should vitamin K be supplemented instead of antagonised in patients with idiopathic pulmonary fibrosis?

Bart De Brouwer*, Ianthe Piscaer, Jan H. Von Der Thusen, Jan C. Grutters, Roger E. G. Schutgens, Emiel F. M. Wouters, Rob Janssen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)

Abstract

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.
Original languageEnglish
Pages (from-to)169-175
Number of pages7
JournalExpert Review of Respiratory Medicine
Volume12
Issue number3
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Coagulation
  • idiopathic pulmonary fibrosis
  • matrix Gla protein
  • pulmonary ossifications
  • vitamin K antagonists
  • vitamin K supplementation
  • MATRIX GLA-PROTEIN
  • DEPENDENT CARBOXYLATION
  • CORONARY CALCIFICATION
  • ORAL ANTICOAGULANTS
  • VASCULAR-DISEASE
  • HUMAN HEALTH
  • LUNG
  • INHIBITOR
  • THROMBIN
  • RISK

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