I read with interest the research by Clark et al. in recent issue of Spinal Cord [1]. The article points out that deficient vitamin D levels in chronic SCI patients may be associated with future chest disease. I cannot agree more. Moreover, I have found several points to support this conclusion.

A study conducted by Black et al. [2] found that concentrations of 25-hydroxy vitamin D in serum are strongly related to FEV1 and FVC. FEV1 peaks between the ages of 18 and 25 and then decreases with age [3]. Although lungs do not grow in size in early adulthood, tissue remodeling and repair is likely to occur throughout life. The number of elastic fibers in alveolar wall also decreases with age, but at the same time the body will increase type III collagen levels. 1,25-dihydroxyvitamin D affects collagen synthesis by inhibiting the formation of matrix metalloproteinases and the proliferation of fibroblasts. This also means that 1,25-dihydroxyvitamin D can affect tissue remodeling and repair [4].

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