JOINT WEBSITE OF THE HONG KONG THORACIC SOCIETY AND THE CHEST DELEGATION HONG KONG AND MACAU
Chronic obstructive pulmonary disease (COPD) ranks in the top 10 causes of morbidity and mortality in the United States and in affluent and middle-income countries worldwide. According to the Global Initiative for Chronic Obstructive Lung Disease (www.goldcopd.org), extrapulmonary manifestations of COPD include muscle weakness, osteoporotic fractures, deep venous thrombosis, systemic inflammation, cardiovascular disease, and lung cancer and often contribute to disease severity and poor prognosis. Three-year follow-up in the TORCH (Towards a Revolution in COPD Health) study demonstrated that only one third of deaths were due to respiratory failure; the majority was attributed to lung cancer or cardiovascular events. Unfortunately, COPD therapies other than smoking cessation have limited efficacy in reducing COPD-associated mortality.
Vitamin D deficiency is common in persons with COPD and is associated with an increased risk for extrapulmonary manifestations of the disease. Vitamin D supplementation has been proposed to treat both pulmonary and extrapulmonary manifestations. Vitamin D upregulates antimicrobial peptides, such as cathelicidins, and may provide protection against pulmonary bacterial and viral pulmonary infections, the most common precipitants of COPD exacerbations. These peptides also are involved in regulating inflammation and wound repair. Vitamin D may influence airway remodeling in COPD and asthma through inhibition of matrix metalloproteinases involved in the digestion of extracellular matrix and through proliferation of fibroblasts and collagen synthesis.
Higher serum 25-hydroxyvitamin D (25-[OH]D) levels were associated with improved FEV1 in the cross-sectional Third National Health and …
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