Should vitamin K be supplemented instead of antagonised in patients with idiopathic pulmonary fibrosis?. (4th March 2018)

• Record Type: Journal Article
• Authors: De Brouwer, Bart; Piscaer, Ianthe; Von Der Thusen, Jan H.; Grutters, Jan C; Schutgens, Roger EG.; Wouters, Emiel FM.; Janssen, Rob
• Is Part Of: Expert review of respiratory medicine. Volume 12:Number 3(2018)
• Page Start: 169
• Page End: 175
• Publication Date: 2018-03-04
• Subjects: Coagulation -- idiopathic pulmonary fibrosis -- matrix Gla protein -- pulmonary ossifications -- vitamin K antagonists -- vitamin K supplementation; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1080/17476348.2018.1424544
• Languages: English
• ISSNs: 1747-6348

Abstract

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.