Vitamin D/K in COPD

Elastin is a unique protein providing elasticity and resilience to dynamic organs, such as lungs and arteries. Elastin is a basic requirement for both respiration and circulation. The rate of elastin degradation is accelerated in chronic obstructive pulmonary disease (COPD). Desmosine (DES) is an amino acid that is only found in elastin fibers, and plasma (p)DES levels consequently reflect the rate of elastin degradation. pDES is a strong predictor of mortality in COPD. We regard decelerating elastin degradation as an attractive novel therapeutic target in COPD. Vitamin D has anti-inflammatory properties, which might potentially have an attenuating effect on elastin degradation. However, we did not find a decreasing effect of vitamin D supplementation on pDES levels in a previous RCT, potentially due to an elastin calcifying effect of vitamin D. Elastin calcification stimulates elastin degradation and vice versa. Elastin calcification is inhibited by Matrix Gla Protein (MGP), a protein which needs vitamin K to become activated. Serum inactive levels of MGP, dephospho-uncarboxylated (dp-uc)MGP, are inversely associated with vitamin K status. Recently, we found significantly lower vitamin K status in COPD patients compared to controls. Furthermore, we found an inverse association between vitamin K-status and the rate of elastin degradation in both subjects with COPD and controls with no lung disease.

We hypothesize that improving vitamin D and K-status by vitamin D3 plus K2 supplementation could have a favorable synergistic decelerating effect on elastin degradation.

14 weeks

Patients are randomized between capsules of vitamin D3 plus vitamin K2 OR capsules of vitamin D3 plus capsule placebo (12 weeks).