Chronic obstructive pulmonary diseaseHow does vitamin D work?

An important role of vitamin D in reducing exacerbations of COPD may relate to an enhanced protection or eradication of viral and bacterial infections which are currently believed to be the main triggers of exacerbations.  

As pointed out by Hughes and Norton1, there is an involvement of matrix metalloprotease-9 (MMP-9) in the pathology of COPD2, which is up regulated by tumor necrosis factor-alpha (TNF-alpha)3, and down regulated by interleukin-10 (IL-10)4. Vitamin D inhibits MMP-95, enhance IL-10 function6 and 1,25-dihydroxyvitamin D prevents TNF-alpha induction of inflammatory cytokines through a process likely to be mediated by the vitamin D receptor7.

Also, there is evidence for a role for vitamin D receptors and the vitamin D-binding protein in COPD8. Most circulating 25(OH)D is bound to vitamin D-binding protein.

See, also, the related paper by Shen et al9.

Page last edited: 06 May 2011


  1. Hughes, D. A. Norton, R. Vitamin D and respiratory health. Clin Exp Immunol. 2009 Oct; 158 (1): 20-5.
  2. Mercer, P. F. Shute, J. K. Bhowmik, A. Donaldson, G. C. Wedzicha, J. A. Warner, J. A. MMP-9, TIMP-1 and inflammatory cells in sputum from COPD patients during exacerbation. Respir Res. 2005; 6151.
  3. Li, Y. Zhang, Z. Xu, Y. Xiong, S. Ni, W. Chen, S. TNF-alpha up-regulates matrix metalloproteinase-9 expression and activity in alveolar macrophages from patients with chronic obstructive pulmonary disease. Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban. 2006; 26 (6): 647-50.
  4. Lim, S. Roche, N. Oliver, B. G. Mattos, W. Barnes, P. J. Chung, K. F. Balance of matrix metalloprotease-9 and tissue inhibitor of metalloprotease-1 from alveolar macrophages in cigarette smokers. Regulation by interleukin-10. American journal of respiratory and critical care medicine. 2000 Oct; 162 (4 Pt 1): 1355-60.
  5. Coussens, A. Timms, P. M. Boucher, B. J. Venton, T. R. Ashcroft, A. T. Skolimowska, K. H. Newton, S. M. Wilkinson, K. A. Davidson, R. N. Griffiths, C. J. Wilkinson, R. J. Martineau, A. R. 1alpha,25-dihydroxyvitamin D3 inhibits matrix metalloproteinases induced by Mycobacterium tuberculosis infection. Immunology. 2009 Aug; 127 (4): 539-48.
  6. Robinson, D. S. Regulatory T cells and asthma. Clin Exp Allergy. 2009 Sep; 39 (9): 1314-23.
  7. Diaz, L. Noyola-Martinez, N. Barrera, D. Hernandez, G. Avila, E. Halhali, A. Larrea, F. Calcitriol inhibits TNF-alpha-induced inflammatory cytokines in human trophoblasts. Journal of reproductive immunology. 2009 Jul; 81 (1): 17-24.
  8. Chishimba, L. Thickett, D. R. Stockley, R. A. Wood, A. M. The vitamin D axis in the lung: a key role for vitamin D-binding protein. Thorax. 2010 May; 65 (5): 456-62.
  9. Shen, L. H. Zhang, X. M. Su, D. J. Yao, S. P. Yu, B. Q. Wang, H. W. Lu, F. Z. Association of vitamin D binding protein variants with susceptibility to chronic obstructive pulmonary disease. J Int Med Res. 2010 May-Jun; 38 (3): 1093-8.