Vitamina D en la hipertensión pulmonarVitamin D in pulmonary hypertension

Abstract

Pulmonary arterial hypertension (PAH) is a vascular chronic disorder, characterized by sustained vasoconstriction, vascular remodelling, thrombosis in situ and inflammation. Although there have been important advances in the knowledge of its pathophysiology and consequently of its pharmacological treatments, PAH remains a debilitating, limiting and rapidly progressive disease. In recent years, epidemiological, nutritional studies and animal models have reported an association between nutritional factors and PAH. Moreover, some authors suggest that nutritional intervention may be a new preventive strategy in PAH. Vitamin D (vitD) deficiency is a worldwide health problem of pandemic proportions. Preliminary studies have suggested that vitD deficiency is more prevalent in PAH patients than in general population. There are some basic and clinic evidences which suggest that hypovitaminosis D may negatively impact on disease progression. The active form of vitD, i.e.,calcitriol, exerts its functions through the vitamin D receptor (VDR), which acts as a transcription factor, regulating changes in gene expression. The discovery of VDR in many tissues and cell types that do not participate in calcium and phosphorous homeostasis, (the main functions of calcitriol), led to identify a great variety of functions mediated by VDR, and of potential relevance in the cardiovascular system, such as cell proliferation, differentiation, control of vascular tone or immunomodulation...