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Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in Coronavirus disease 2019

Janssen, Rob ; Visser, Margot P. J. ; Dofferhoff, Anton S. M. ; Vermeer, Cees ; Janssens, Wim ; Walk, Jona

British journal of nutrition, 2021-07, Vol.126 (2), p.191-198 [Periódico revisado por pares]

Cambridge, UK: Cambridge University Press

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Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in Coronavirus disease 2019
Autor: Janssen, Rob ; Visser, Margot P. J. ; Dofferhoff, Anton S. M. ; Vermeer, Cees ; Janssens, Wim ; Walk, Jona
Assuntos: Anticoagulants ; Calcification ; Calcification (ectopic) ; Calcium-Binding Proteins - metabolism ; Clinical trials ; Coagulation ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - pathology ; Damage ; Degradation ; Depletion ; Diabetes ; Disease ; Extracellular Matrix Proteins - metabolism ; Humans ; Hypertension ; Liver ; Lung - physiopathology ; Matrix Gla Protein ; Metabolism ; Mortality ; Nutritional Immunology ; Phylloquinone ; Pneumonia ; Prevention ; Protein S ; Protein S - metabolism ; Proteins ; Proteolysis ; Public health ; Respiratory diseases ; Respiratory failure ; SARS-CoV-2 ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Signs and symptoms ; Soft tissues ; Thromboembolism ; Thromboembolism - etiology ; Thromboembolism - prevention & control ; Thrombosis ; Thrombosis - etiology ; Thrombosis - prevention & control ; Viral diseases ; Vitamin K ; Vitamin K - antagonists & inhibitors ; Vitamin K - metabolism ; Vitamin K Deficiency - etiology ; Vitamin K Deficiency - metabolism
É parte de: British journal of nutrition, 2021-07, Vol.126 (2), p.191-198
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Coronavirus disease 2019 (Covid-19), caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2, exerts far-reaching effects on public health and socio-economic welfare. The majority of infected individuals have mild to moderate symptoms, but a significant proportion develops respiratory failure due to pneumonia. Thrombosis is another frequent manifestation of Covid-19 that contributes to poor outcomes. Vitamin K plays a crucial role in the activation of both pro- and anticlotting factors in the liver and the activation of extrahepatically synthesised protein S which seems to be important in local thrombosis prevention. However, the role of vitamin K extends beyond coagulation. Matrix Gla protein (MGP) is a vitamin K-dependent inhibitor of soft tissue calcification and elastic fibre degradation. Severe extrahepatic vitamin K insufficiency was recently demonstrated in Covid-19 patients, with high inactive MGP levels correlating with elastic fibre degradation rates. This suggests that insufficient vitamin K-dependent MGP activation leaves elastic fibres unprotected against SARS-CoV-2-induced proteolysis. In contrast to MGP, Covid-19 patients have normal levels of activated factor II, in line with previous observations that vitamin K is preferentially transported to the liver for activation of procoagulant factors. We therefore expect that vitamin K-dependent endothelial protein S activation is also compromised, which would be compatible with enhanced thrombogenicity. Taking these data together, we propose a mechanism of pneumonia-induced vitamin K depletion, leading to a decrease in activated MGP and protein S, aggravating pulmonary damage and coagulopathy, respectively. Intervention trials should be conducted to assess whether vitamin K administration plays a role in the prevention and treatment of severe Covid-19.
Editor: Cambridge, UK: Cambridge University Press
Idioma: Inglês

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Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in Coronavirus disease 2019

Janssen, Rob ; Visser, Margot P. J. ; Dofferhoff, Anton S. M. ; Vermeer, Cees ; Janssens, Wim ; Walk, Jona

Cambridge, UK: Cambridge University Press

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