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NEUNHÄUSERER DANIEL, HUDELMAIER MARTIN, NIEDERSEER DAVID, VECCHIATO MARCO, WIRTH WOLFGANG, STEIDLE-KLOC EVA, KAISER BERNHARD, LAMPRECHT BERND, ERMOLAO ANDREA, STUDNICKA MICHAEL, NIEBAUER JOSEF. The Impact of Exercise Training and Supplemental Oxygen on Peripheral Muscles in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Med Sci Sports Exerc 2023; 55:2123-2131. [PMID: 37535316 PMCID: PMC10662626 DOI: 10.1249/mss.0000000000003268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Exercise training is a cornerstone of the treatment of chronic obstructive pulmonary disease, whereas the related interindividual heterogeneity in skeletal muscle dysfunction and adaptations are not yet fully understood. We set out to investigate the effects of exercise training and supplemental oxygen on functional and structural peripheral muscle adaptation. METHODS In this prospective, randomized, controlled, double-blind study, 28 patients with nonhypoxemic chronic obstructive pulmonary disease (forced expiratory volume in 1 second, 45.92% ± 9.06%) performed 6 wk of combined endurance and strength training, three times a week while breathing either supplemental oxygen or medical air. The impact on exercise capacity, muscle strength, and quadriceps femoris muscle cross-sectional area (CSA) was assessed by maximal cardiopulmonary exercise testing, 10-repetition maximum strength test of knee extension, and magnetic resonance imaging, respectively. RESULTS After exercise training, patients demonstrated a significant increase in functional capacity, aerobic capacity, exercise tolerance, quadriceps muscle strength, and bilateral CSA. Supplemental oxygen affected significantly the training impact on peak work rate when compared with medical air (+0.20 ± 0.03 vs +0.12 ± 0.03 W·kg -1 , P = 0.047); a significant increase in CSA (+3.9 ± 1.3 cm 2 , P = 0.013) was only observed in the training group using oxygen. Supplemental oxygen and exercise-induced peripheral desaturation were identified as significant opposing determinants of muscle gain during this exercise training intervention, which led to different adaptations of CSA between the respective subgroups. CONCLUSIONS The heterogenous functional and structural muscle adaptations seem determined by supplemental oxygen and exercise-induced hypoxia. Indeed, supplemental oxygen may facilitate muscular training adaptations, particularly in limb muscle dysfunction, thereby contributing to the enhanced training responses on maximal aerobic and functional capacity.
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Affiliation(s)
- DANIEL NEUNHÄUSERER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - MARTIN HUDELMAIER
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - DAVID NIEDERSEER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, SWITZERLAND
| | - MARCO VECCHIATO
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - WOLFGANG WIRTH
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - EVA STEIDLE-KLOC
- Institute of Anatomy and Cell Biology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - BERNHARD KAISER
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - BERND LAMPRECHT
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Department of Pulmonary Medicine, Faculty of Medicine, Kepler-University-Hospital, Johannes-Kepler-University, Linz, AUSTRIA
| | - ANDREA ERMOLAO
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, ITALY
| | - MICHAEL STUDNICKA
- University Clinic of Pneumology, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
| | - JOSEF NIEBAUER
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
- Research Institute for Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, AUSTRIA
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Viana SMDNR, de Bruin VMS, Vasconcelos RS, Nogueira ANC, Mesquita R, de Bruin PFC. Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study. Respir Med 2023; 220:107441. [PMID: 37944829 DOI: 10.1016/j.rmed.2023.107441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Melatonin (MLT), the main product of the pineal gland, is involved in muscle tissue repair and regeneration, besides several other important physiologic functions. In COPD, MLT administration can improve lung oxidative stress and sleep quality, but its potential effects on the outcomes of pulmonary rehabilitation (PR) have not been previously investigated. A randomized controlled trial was undertaken to test the hypothesis that a combined approach of rehabilitative exercise training and MLT supplementation could maximize functional performance, health status and quality of life in patients with COPD. Thirty-nine individuals with COPD referred to a supervised PR program at the Federal University of Ceara, Brazil, were randomized to receive MLT (3 mg/day; n = 18) or placebo (n = 21). Exercise capacity (6-min walk test - 6MWT), health status (COPD assessment test), and quality of life (airways questionnaire 20) were investigated as primary outcomes. No differences were observed at baseline in demographic, anthropometric and clinical characteristics between MLT and placebo groups. At the end of PR, superiority of the MLT group was demonstrated in improvement in the distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01), health status (-11 ± 6 vs. -3 ± 5; p < 0.01), and quality of life (-6.9 ± 3.0 vs. -1.9 ± 2.4; p < 0.01), compared to the placebo group. In conclusion, MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.
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Affiliation(s)
| | | | | | | | - Rafael Mesquita
- Federal University of Ceara, Fortaleza, Brazil; Masters Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, CE, Brazil
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Henrot P, Dupin I, Schilfarth P, Esteves P, Blervaque L, Zysman M, Gouzi F, Hayot M, Pomiès P, Berger P. Main Pathogenic Mechanisms and Recent Advances in COPD Peripheral Skeletal Muscle Wasting. Int J Mol Sci 2023; 24:ijms24076454. [PMID: 37047427 PMCID: PMC10095391 DOI: 10.3390/ijms24076454] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a worldwide prevalent respiratory disease mainly caused by tobacco smoke exposure. COPD is now considered as a systemic disease with several comorbidities. Among them, skeletal muscle dysfunction affects around 20% of COPD patients and is associated with higher morbidity and mortality. Although the histological alterations are well characterized, including myofiber atrophy, a decreased proportion of slow-twitch myofibers, and a decreased capillarization and oxidative phosphorylation capacity, the molecular basis for muscle atrophy is complex and remains partly unknown. Major difficulties lie in patient heterogeneity, accessing patients' samples, and complex multifactorial process including extrinsic mechanisms, such as tobacco smoke or disuse, and intrinsic mechanisms, such as oxidative stress, hypoxia, or systemic inflammation. Muscle wasting is also a highly dynamic process whose investigation is hampered by the differential protein regulation according to the stage of atrophy. In this review, we report and discuss recent data regarding the molecular alterations in COPD leading to impaired muscle mass, including inflammation, hypoxia and hypercapnia, mitochondrial dysfunction, diverse metabolic changes such as oxidative and nitrosative stress and genetic and epigenetic modifications, all leading to an impaired anabolic/catabolic balance in the myocyte. We recapitulate data concerning skeletal muscle dysfunction obtained in the different rodent models of COPD. Finally, we propose several pathways that should be investigated in COPD skeletal muscle dysfunction in the future.
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Affiliation(s)
- Pauline Henrot
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Isabelle Dupin
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
| | - Pierre Schilfarth
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Pauline Esteves
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
| | - Léo Blervaque
- PhyMedExp, INSERM-CNRS-Montpellier University, F-34090 Montpellier, France
| | - Maéva Zysman
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Fares Gouzi
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, F-34090 Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, F-34090 Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM-CNRS-Montpellier University, F-34090 Montpellier, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
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Jaitovich A. Impaired regenerative capacity contributes to skeletal muscle dysfunction in chronic obstructive pulmonary disease. Am J Physiol Cell Physiol 2022; 323:C974-C989. [PMID: 35993519 PMCID: PMC9484993 DOI: 10.1152/ajpcell.00292.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 01/18/2023]
Abstract
Locomotor skeletal muscle dysfunction is a relevant comorbidity of chronic obstructive pulmonary disease (COPD) and is strongly associated with worse clinical outcomes including higher mortality. Over the last decades, a large body of literature helped characterize the process, defining the disruptive muscle phenotype caused by COPD that involves reduction in muscle mass, force-generation capacity, fatigue-tolerance, and regenerative potential following injury. A major limitation in the field has been the scarcity of well-calibrated animal models to conduct mechanistic research based on loss- and gain-of-function studies. This article provides an overall description of the process, the tools available to mechanistically investigate it, and the potential role of mitochondrially driven metabolic signals on the regulation muscle regeneration after injury in COPD. Finally, a description of future avenues to further expand on the area is proposed based on very recent evidence involving mitochondrial metabolic cues affecting myogenesis.
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Affiliation(s)
- Ariel Jaitovich
- Division of Pulmonary and Critical Care Medicine, Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
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5
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Balnis J, Drake LA, Singer DV, Vincent CE, Korponay TC, D'Armiento J, Lee CG, Elias JA, Singer HA, Jaitovich A. Deaccelerated Myogenesis and Autophagy in Genetically Induced Pulmonary Emphysema. Am J Respir Cell Mol Biol 2022; 66:623-637. [PMID: 35286819 PMCID: PMC9163640 DOI: 10.1165/rcmb.2021-0351oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD)-pulmonary emphysema often develop locomotor muscle dysfunction, which entails reduced muscle mass and force-generation capacity and is associated with worse outcomes, including higher mortality. Myogenesis contributes to adult muscle integrity during injury-repair cycles. Injurious events crucially occur in the skeletal muscles of patients with COPD in the setting of exacerbations and infections, which lead to acute decompensations for limited periods of time, after which patients typically fail to recover the baseline status they had before the acute event. Autophagy, which is dysregulated in muscles from patients with COPD, is a key regulator of muscle stem-satellite- cells activation and myogenesis, yet very little research has so far mechanistically investigated the role of autophagy dysregulation in COPD muscles. Using a genetically inducible interleukin-13-driven pulmonary emphysema model leading to muscle dysfunction, and confirmed with a second genetic animal model, we found a significant myogenic dysfunction associated with the reduced proliferative capacity of satellite cells. Transplantation experiments followed by lineage tracing suggest that an intrinsic defect in satellite cells, and not in the COPD environment, plays a dominant role in the observed myogenic dysfunction. RNA sequencing analysis and direct observation of COPD mice satellite cells suggest dysregulated autophagy. Moreover, while autophagy flux experiments with bafilomycin demonstrated deacceleration of autophagosome turnover in COPD mice satellite cells, spermidine-induced autophagy stimulation leads to a higher replication rate and myogenesis in these animals. Our data suggest that pulmonary emphysema causes disrupted myogenesis, which could be improved with stimulation of autophagy and satellite cells activation, leading to an attenuated muscle dysfunction.
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Affiliation(s)
- Joseph Balnis
- Division of Pulmonary and Critical Care Medicine and.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Lisa A Drake
- Division of Pulmonary and Critical Care Medicine and.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Diane V Singer
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Catherine E Vincent
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Tanner C Korponay
- Division of Pulmonary and Critical Care Medicine and.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Jeanine D'Armiento
- Departments of Anesthesiology and Physiology and Cellular Biophysics, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York; and
| | - Chun Geun Lee
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island
| | - Jack A Elias
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island
| | - Harold A Singer
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
| | - Ariel Jaitovich
- Division of Pulmonary and Critical Care Medicine and.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York
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6
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De Brandt J, Beijers RJHCG, Chiles J, Maddocks M, McDonald MLN, Schols AMWJ, Nyberg A. Update on the Etiology, Assessment, and Management of COPD Cachexia: Considerations for the Clinician. Int J Chron Obstruct Pulmon Dis 2022; 17:2957-2976. [PMID: 36425061 PMCID: PMC9680681 DOI: 10.2147/copd.s334228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Cachexia is a commonly observed but frequently neglected extra-pulmonary manifestation in patients with chronic obstructive pulmonary disease (COPD). Cachexia is a multifactorial syndrome characterized by severe loss of body weight, muscle, and fat, as well as increased protein catabolism. COPD cachexia places a high burden on patients (eg, increased mortality risk and disease burden, reduced exercise capacity and quality of life) and the healthcare system (eg, increased number, length, and cost of hospitalizations). The etiology of COPD cachexia involves a complex interplay of non-modifiable and modifiable factors (eg, smoking, hypoxemia, hypercapnia, physical inactivity, energy imbalance, and exacerbations). Addressing these modifiable factors is needed to prevent and treat COPD cachexia. Oral nutritional supplementation combined with exercise training should be the primary multimodal treatment approach. Adding a pharmacological agent might be considered in some, but not all, patients with COPD cachexia. Clinicians and researchers should use longitudinal measures (eg, weight loss, muscle mass loss) instead of cross-sectional measures (eg, low body mass index or fat-free mass index) where possible to evaluate patients with COPD cachexia. Lastly, in future research, more detailed phenotyping of cachectic patients to enable a better comparison of included patients between studies, prospective longitudinal studies, and more focus on the impact of exacerbations and the role of biomarkers in COPD cachexia, are highly recommended.
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Affiliation(s)
- Jana De Brandt
- Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Joe Chiles
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Merry-Lynn N McDonald
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - André Nyberg
- Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Lakshman Kumar P, Wilson AC, Rocco A, Cho MH, Wan E, Hobbs BD, Washko GR, Ortega VE, Christenson SA, Li X, Wells JM, Bhatt SP, DeMeo DL, Lutz SM, Rossiter H, Casaburi R, Rennard SI, Lomas DA, Labaki WW, Tal‐Singer R, Bowler RP, Hersh CP, Tiwari HK, Dransfield M, Thalacker‐Mercer A, Meyers DA, Silverman EK, McDonald MN. Genetic variation in genes regulating skeletal muscle regeneration and tissue remodelling associated with weight loss in chronic obstructive pulmonary disease. J Cachexia Sarcopenia Muscle 2021; 12:1803-1817. [PMID: 34523824 PMCID: PMC8718068 DOI: 10.1002/jcsm.12782] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/08/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. COPD patients with cachexia or weight loss have increased risk of death independent of body mass index (BMI) and lung function. We tested the hypothesis genetic variation is associated with weight loss in COPD using a genome-wide association study approach. METHODS Participants with COPD (N = 4308) from three studies (COPDGene, ECLIPSE, and SPIROMICS) were analysed. Discovery analyses were performed in COPDGene with replication in SPIROMICS and ECLIPSE. In COPDGene, weight loss was defined as self-reported unintentional weight loss > 5% in the past year or low BMI (BMI < 20 kg/m2 ). In ECLIPSE and SPIROMICS, weight loss was calculated using available longitudinal visits. Stratified analyses were performed among African American (AA) and Non-Hispanic White (NHW) participants with COPD. Single variant and gene-based analyses were performed adjusting for confounders. Fine mapping was performed using a Bayesian approach integrating genetic association results with linkage disequilibrium and functional annotation. Significant gene networks were identified by integrating genetic regions associated with weight loss with skeletal muscle protein-protein interaction (PPI) data. RESULTS At the single variant level, only the rs35368512 variant, intergenic to GRXCR1 and LINC02383, was associated with weight loss (odds ratio = 3.6, 95% confidence interval = 2.3-5.6, P = 3.2 × 10-8 ) among AA COPD participants in COPDGene. At the gene level in COPDGene, EFNA2 and BAIAP2 were significantly associated with weight loss in AA and NHW COPD participants, respectively. The EFNA2 association replicated among AA from SPIROMICS (P = 0.0014), whereas the BAIAP2 association replicated in NHW from ECLIPSE (P = 0.025). The EFNA2 gene encodes the membrane-bound protein ephrin-A2 involved in the regulation of developmental processes and adult tissue homeostasis such as skeletal muscle. The BAIAP2 gene encodes the insulin-responsive protein of mass 53 kD (IRSp53), a negative regulator of myogenic differentiation. Integration of the gene-based findings participants with PPI data revealed networks of genes involved in pathways such as Rho and synapse signalling. CONCLUSIONS The EFNA2 and BAIAP2 genes were significantly associated with weight loss in COPD participants. Collectively, the integrative network analyses indicated genetic variation associated with weight loss in COPD may influence skeletal muscle regeneration and tissue remodelling.
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Affiliation(s)
- Preeti Lakshman Kumar
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Ava C. Wilson
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Alison Rocco
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Michael H. Cho
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - Emily Wan
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Veterans Affairs Boston Health Care System, Jamaica PlainBostonMAUSA
| | - Brian D. Hobbs
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - George R. Washko
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - Victor E. Ortega
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunologic DiseasesWake Forest School of MedicineWinston‐SalemNCUSA
| | - Stephanie A. Christenson
- Division of Pulmonary, Critical Care, Allergy, & Sleep Medicine, Department of MedicineUniversity of California San FranciscoSan FranciscoCAUSA
| | - Xingnan Li
- Department of MedicineUniversity of Arizona College of MedicineTucsonAZUSA
| | - J. Michael Wells
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Surya P. Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Dawn L. DeMeo
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - Sharon M. Lutz
- Department of Population MedicineHarvard Medical SchoolBostonMAUSA
| | - Harry Rossiter
- Rehabilitation Clinical Trials CenterLos Angeles Biomedical Research Institute at Harbor Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Richard Casaburi
- Rehabilitation Clinical Trials CenterLos Angeles Biomedical Research Institute at Harbor Harbor‐UCLA Medical CenterTorranceCAUSA
| | | | | | - Wassim W. Labaki
- Division of Pulmonary and Critical Care MedicineUniversity of MichiganAnn ArborMIUSA
| | | | - Russel P. Bowler
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep MedicineNational Jewish HealthDenverCOUSA
| | - Craig P. Hersh
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - Hemant K. Tiwari
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamALUSA
| | - Mark Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Anna Thalacker‐Mercer
- Department of Cell Development and Integrative BiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Deborah A. Meyers
- Department of MedicineUniversity of Arizona College of MedicineTucsonAZUSA
| | - Edwin K. Silverman
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMAUSA
- Division of Pulmonary and Critical Care MedicineBrigham and Women's HospitalBostonMAUSA
| | - Merry‐Lynn N. McDonald
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamALUSA
- Department of GeneticsUniversity of Alabama at BirminghamBirminghamALUSA
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Bonafiglia JT, Preobrazenski N, Gurd BJ. A Systematic Review Examining the Approaches Used to Estimate Interindividual Differences in Trainability and Classify Individual Responses to Exercise Training. Front Physiol 2021; 12:665044. [PMID: 34819869 PMCID: PMC8606564 DOI: 10.3389/fphys.2021.665044] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Many reports describe statistical approaches for estimating interindividual differences in trainability and classifying individuals as "responders" or "non-responders." The extent to which studies in the exercise training literature have adopted these statistical approaches remains unclear. Objectives: This systematic review primarily sought to determine the extent to which studies in the exercise training literature have adopted sound statistical approaches for examining individual responses to exercise training. We also (1) investigated the existence of interindividual differences in trainability, and (2) tested the hypothesis that less conservative thresholds inflate response rates compared with thresholds that consider error and a smallest worthwhile change (SWC)/minimum clinically important difference (MCID). Methods: We searched six databases: AMED, CINAHL, EMBASE, Medline, PubMed, and SportDiscus. Our search spanned the aerobic, resistance, and clinical or rehabilitation training literature. Studies were included if they used human participants, employed standardized and supervised exercise training, and either: (1) stated that their exercise training intervention resulted in heterogenous responses, (2) statistically estimated interindividual differences in trainability, and/or (3) classified individual responses. We calculated effect sizes (ESIR) to examine the presence of interindividual differences in trainability. We also compared response rates (n = 614) across classification approaches that considered neither, one of, or both errors and an SWC or MCID. We then sorted response rates from studies that also reported mean changes and response thresholds (n = 435 response rates) into four quartiles to confirm our ancillary hypothesis that larger mean changes produce larger response rates. Results: Our search revealed 3,404 studies, and 149 were included in our systematic review. Few studies (n = 9) statistically estimated interindividual differences in trainability. The results from these few studies present a mixture of evidence for the presence of interindividual differences in trainability because several ESIR values lay above, below, or crossed zero. Zero-based thresholds and larger mean changes significantly (both p < 0.01) inflated response rates. Conclusion: Our findings provide evidence demonstrating why future studies should statistically estimate interindividual differences in trainability and consider error and an SWC or MCID when classifying individual responses to exercise training. Systematic Review Registration: [website], identifier [registration number].
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | | | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Jaitovich A. Hypercapnic Respiratory Failure-Driven Skeletal Muscle Dysfunction: It Is Time for Animal Model-Based Mechanistic Research. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1303:129-138. [PMID: 33788191 DOI: 10.1007/978-3-030-63046-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dysfunction of locomotor muscles is frequent in chronic pulmonary diseases and strongly associated with worse outcomes including higher mortality. Although these associations have been corroborated over the last decades, there is poor mechanistic understanding of the process, in part due to the lack of adequate animal models to investigate this process. Most of the mechanistic research has so far been accomplished using relevant individual stimuli such as low oxygen or high CO2 delivered to otherwise healthy animals as surrogates of the phenomena occurring in the clinical setting. This review advocates for the development of a syndromic model in which skeletal muscle dysfunction is investigated as a comorbidity of a well-validated pulmonary disease model, which could potentially allow discovering meaningful mechanisms and pathways and lead to more substantial progress to treat this devastating condition.
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Affiliation(s)
- Ariel Jaitovich
- Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY, USA. .,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA.
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10
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Snow SJ, Henriquez AR, Fenton JI, Goeden T, Fisher A, Vallanat B, Angrish M, Richards JE, Schladweiler MC, Cheng WY, Wood CE, Tong H, Kodavanti UP. Diets enriched with coconut, fish, or olive oil modify peripheral metabolic effects of ozone in rats. Toxicol Appl Pharmacol 2020; 410:115337. [PMID: 33217375 DOI: 10.1016/j.taap.2020.115337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/29/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
Dietary factors may modulate metabolic effects of air pollutant exposures. We hypothesized that diets enriched with coconut oil (CO), fish oil (FO), or olive oil (OO) would alter ozone-induced metabolic responses. Male Wistar-Kyoto rats (1-month-old) were fed normal diet (ND), or CO-, FO-, or OO-enriched diets. After eight weeks, animals were exposed to air or 0.8 ppm ozone, 4 h/day for 2 days. Relative to ND, CO- and OO-enriched diet increased body fat, serum triglycerides, cholesterols, and leptin, while all supplements increased liver lipid staining (OO > FO > CO). FO increased n-3, OO increased n-6/n-9, and all supplements increased saturated fatty-acids. Ozone increased total cholesterol, low-density lipoprotein, branched-chain amino acids (BCAA), induced hyperglycemia, glucose intolerance, and changed gene expression involved in energy metabolism in adipose and muscle tissue in rats fed ND. Ozone-induced glucose intolerance was exacerbated by OO-enriched diet. Ozone increased leptin in CO- and FO-enriched groups; however, BCAA increases were blunted by FO and OO. Ozone-induced inhibition of liver cholesterol biosynthesis genes in ND-fed rats was not evident in enriched dietary groups; however, genes involved in energy metabolism and glucose transport were increased in rats fed FO and OO-enriched diet. FO- and OO-enriched diets blunted ozone-induced inhibition of genes involved in adipose tissue glucose uptake and cholesterol synthesis, but exacerbated genes involved in adipose lipolysis. Ozone-induced decreases in muscle energy metabolism genes were similar in all dietary groups. In conclusion, CO-, FO-, and OO-enriched diets modified ozone-induced metabolic changes in a diet-specific manner, which could contribute to altered peripheral energy homeostasis.
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Affiliation(s)
- Samantha J Snow
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Andres R Henriquez
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, 48824, United States
| | - Travis Goeden
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, 48824, United States
| | - Anna Fisher
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Beena Vallanat
- Center for Computational Toxicology and Exposure, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Michelle Angrish
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Judy E Richards
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Mette C Schladweiler
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Wan-Yun Cheng
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Charles E Wood
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Haiyan Tong
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Urmila P Kodavanti
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States.
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11
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Nikolaou V, Massaro S, Fakhimi M, Stergioulas L, Price D. COPD phenotypes and machine learning cluster analysis: A systematic review and future research agenda. Respir Med 2020; 171:106093. [PMID: 32745966 DOI: 10.1016/j.rmed.2020.106093] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 12/21/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a highly heterogeneous condition projected to become the third leading cause of death worldwide by 2030. To better characterize this condition, clinicians have classified patients sharing certain symptomatic characteristics, such as symptom intensity and history of exacerbations, into distinct phenotypes. In recent years, the growing use of machine learning algorithms, and cluster analysis in particular, has promised to advance this classification through the integration of additional patient characteristics, including comorbidities, biomarkers, and genomic information. This combination would allow researchers to more reliably identify new COPD phenotypes, as well as better characterize existing ones, with the aim of improving diagnosis and developing novel treatments. Here, we systematically review the last decade of research progress, which uses cluster analysis to identify COPD phenotypes. Collectively, we provide a systematized account of the extant evidence, describe the strengths and weaknesses of the main methods used, identify gaps in the literature, and suggest recommendations for future research.
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Affiliation(s)
- Vasilis Nikolaou
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK.
| | - Sebastiano Massaro
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK; The Organizational Neuroscience Laboratory, London, WC1N 3AX, UK
| | - Masoud Fakhimi
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK
| | | | - David Price
- Observational and Pragmatic Research Institute, Singapore, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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12
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Landi F, Salini S, Zazzara MB, Martone AM, Fabrizi S, Bianchi M, Tosato M, Picca A, Calvani R, Marzetti E. Relationship between pulmonary function and physical performance among community-living people: results from Look-up 7+ study. J Cachexia Sarcopenia Muscle 2020; 11:38-45. [PMID: 31800168 PMCID: PMC7015242 DOI: 10.1002/jcsm.12485] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/22/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While respiratory muscle strength is recognized to decline with aging process, the relationship between sarcopenia and pulmonary function remains to be studied. The present study was undertaken to provide a better insight into the comprehension of the relationship between pulmonary function and muscle function (strength and physical performance) using an unselected sample of subjects assessed during the Longevity Check-up 7+ project. METHODS Look-up 7+ is an ongoing cross-sectional survey started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy. Candidate participants are eligible for enrolment if they are at least 18 years of age and provide written informed consent. Muscle strength was assessed by handgrip strength test, and physical performance was evaluated by chair stand test. Spirometer analysis was performed using the AirSmart system, and the largest forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF) values were collected. RESULTS The mean age of 925 subjects participating in the Longevity check-7+ surveys and receiving the spirometer evaluation was 55.6 years (range from 18 to 98 years), and 501 (54%) were women. Overall, both in male and female participants, FVC, FEV1 and PEF positively correlated with handgrip strength and chair stand tests. The receiver operator characteristic curve analysis revealed that the areas under the curves for FVC, FEV1, and PEF were 0.79, 0.80 and 0.80, respectively. CONCLUSIONS The results clearly show that pulmonary function was positively associated with handgrip strength and chair stand tests. Based on this observation, muscle strength, physical performance, and pulmonary function should be recommended as the method of choice for the early detection of individuals at risk of probable sarcopenia and at the same time to better characterized the severity of sarcopenia status.
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Affiliation(s)
- Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Sara Salini
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Beatrice Zazzara
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Maria Martone
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Sofia Fabrizi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariangela Bianchi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Matteo Tosato
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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Balnis J, Korponay TC, Jaitovich A. AMP-Activated Protein Kinase (AMPK) at the Crossroads Between CO 2 Retention and Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease (COPD). Int J Mol Sci 2020; 21:E955. [PMID: 32023946 PMCID: PMC7037951 DOI: 10.3390/ijms21030955] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/17/2022] Open
Abstract
Skeletal muscle dysfunction is a major comorbidity in chronic obstructive pulmonary disease (COPD) and other pulmonary conditions. Chronic CO2 retention, or hypercapnia, also occur in some of these patients. Both muscle dysfunction and hypercapnia associate with higher mortality in these populations. Over the last years, we have established a mechanistic link between hypercapnia and skeletal muscle dysfunction, which is regulated by AMPK and causes depressed anabolism via reduced ribosomal biogenesis and accelerated catabolism via proteasomal degradation. In this review, we discuss the main findings linking AMPK with hypercapnic pulmonary disease both in the lungs and skeletal muscles, and also outline potential avenues for future research in the area based on knowledge gaps and opportunities to expand mechanistic research with translational implications.
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Affiliation(s)
- Joseph Balnis
- Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY 12208, USA; (J.B.); (T.C.K.)
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY 12208, USA
| | - Tanner C. Korponay
- Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY 12208, USA; (J.B.); (T.C.K.)
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY 12208, USA
| | - Ariel Jaitovich
- Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY 12208, USA; (J.B.); (T.C.K.)
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY 12208, USA
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14
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Marillier M, Bernard AC, Vergès S, Neder JA. Locomotor Muscles in COPD: The Rationale for Rehabilitative Exercise Training. Front Physiol 2020; 10:1590. [PMID: 31992992 PMCID: PMC6971045 DOI: 10.3389/fphys.2019.01590] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/19/2019] [Indexed: 12/28/2022] Open
Abstract
Exercise training as part of pulmonary rehabilitation is arguably the most effective intervention to improve tolerance to physical exertion in patients with chronic obstructive pulmonary disease (COPD). Owing to the fact that exercise training has modest effects on exertional ventilation, operating lung volumes and respiratory muscle performance, improving locomotor muscle structure and function are key targets for pulmonary rehabilitation in COPD. In the current concise review, we initially discuss whether patients’ muscles are exposed to deleterious factors. After presenting corroboratory evidence on this regard (e.g., oxidative stress, inflammation, hypoxemia, inactivity, and medications), we outline their effects on muscle macro- and micro-structure and related functional properties. We then finalize by addressing the potential beneficial consequences of different training strategies on these muscle-centered outcomes. This review provides, therefore, an up-to-date outline of the rationale for rehabilitative exercise training approaches focusing on the locomotor muscles in this patient population.
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Affiliation(s)
- Mathieu Marillier
- Laboratory of Clinical Exercise Physiology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Anne-Catherine Bernard
- Laboratory of Clinical Exercise Physiology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
| | - Samuel Vergès
- HP2 Laboratory, INSERM, CHU Grenoble Alpes, Grenoble Alpes University, Grenoble, France
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Kingston General Hospital, Queen's University, Kingston, ON, Canada
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15
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Ding J, Li F, Cong Y, Miao J, Wu D, Liu B, Wang L. Trichostatin A inhibits skeletal muscle atrophy induced by cigarette smoke exposure in mice. Life Sci 2019; 235:116800. [PMID: 31472151 DOI: 10.1016/j.lfs.2019.116800] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 12/20/2022]
Abstract
AIMS It is well known that cigarette smoke (CS) is the main risk factor for chronic obstructive pulmonary disease (COPD) accompanied by skeletal muscle atrophy. Histone deacetylases (HDACs) that remove acetyl groups from target proteins are necessary for the muscle atrophy associated with skeletal muscle disuse. However, the role of HDACs and trichostatin A (TSA), a HDAC inhibitor, in skeletal muscle atrophy caused by CS exposure remains poorly understood. MAIN METHODS Female mice were exposed to CS twice daily for 40 days and TSA injected intraperitoneally into CS-exposed mice on alternate days. Skeletal muscles were weighed and gastrocnemius (Gas) muscle histomorphology examined by hematoxylin and eosin staining. Histone deacetylases 1 and 2 (HDAC1/2), and markers of ubiquitin degradation, muscle differentiation, apoptosis, pyroptosis, and the cytoskeletal proteins were assessed by western blot and immunohistochemistry in Gas. KEYFINDINGS CS exposure decreased body and skeletal muscle weights and triggered an increase in the percentage of fiber with centralized nuclei in Gas. HDAC1/2 proteins were upregulated in the Gas of mice exposed to CS, while TSA effectively inhibited HDAC1/2 protein levels and attenuated the loss of body weight and skeletal muscle wet weight induced by CS exposure. Markers for ubiquitin degradation, muscle differentiation, cytoskeletal proteins, apoptosis and pyroptosis were all upregulated following CS exposure and effectively restored by TSA. SIGNIFICANCE TSA may inhibit skeletal muscle atrophy and histomorphological alterations induced by CS exposure by downregulating markers of ubiquitin degradation, muscle fiber differentiation, cytoskeletal proteins, apoptosis and pyroptosis via HDAC1/2 inhibition.
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Affiliation(s)
- Jingjing Ding
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Fang Li
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Yanfei Cong
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Jianing Miao
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Di Wu
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Bo Liu
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China
| | - Lili Wang
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang 110004, China; Key Laboratory of Research and Application of Animal Model for Environmental and Metabolic Diseases, Liaoning Province, China.
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16
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Kneppers AEM, Haast RAM, Langen RCJ, Verdijk LB, Leermakers PA, Gosker HR, van Loon LJC, Lainscak M, Schols AMWJ. Distinct skeletal muscle molecular responses to pulmonary rehabilitation in chronic obstructive pulmonary disease: a cluster analysis. J Cachexia Sarcopenia Muscle 2019; 10:311-322. [PMID: 30657653 PMCID: PMC6463471 DOI: 10.1002/jcsm.12370] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/20/2018] [Accepted: 11/03/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic obstructive pulmonary disease (COPD), targeting skeletal muscle to improve functional performance. However, there is substantial inter-individual variability in the effect of PR on functional performance, which cannot be fully accounted for by generic phenotypic factors. We performed an unbiased integrative analysis of the skeletal muscle molecular responses to PR in COPD patients and comprehensively characterized their baseline pulmonary and physical function, body composition, blood profile, comorbidities, and medication use. METHODS Musculus vastus lateralis biopsies were obtained from 51 COPD patients (age 64 ± 1 years, sex 73% men, FEV1 , 34 (26-41) %pred.) before and after 4 weeks high-intensity supervised in-patient PR. Muscle molecular markers were grouped by network-constrained clustering, and their relative changes in expression values-assessed by qPCR and western blot-were reduced to process scores by principal component analysis. Patients were subsequently clustered based on these process scores. Pre-PR and post-PR functional performance was assessed by incremental cycle ergometry and 6 min walking test (6MWT). RESULTS Eight molecular processes were discerned by network-constrained hierarchical clustering of the skeletal muscle molecular rehabilitation responses. Based on the resulting process scores, four clusters of patients were identified by hierarchical cluster analysis. Two major patient clusters differed in PR-induced autophagy (P < 0.001), myogenesis (P = 0.014), glucocorticoid signalling (P < 0.001), and oxidative metabolism regulation (P < 0.001), with Cluster 1 (C1; n = 29) overall displaying a more pronounced change in marker expression than Cluster 2 (C2; n = 16). General baseline characteristics did not differ between clusters. Following PR, both 6 min walking distance (+26.5 ± 8.3 m, P = 0.003) and peak load on the cycle ergometer test (+9.7 ± 1.9 W, P < 0.001) were improved. However, the functional improvement was more pronounced in C1, as a higher percentage of patients exceeded the minimal clinically important difference in peak workload (61 vs. 21%, P = 0.022) and both peak workload and 6 min walking test (52 vs. 8%, P = 0.008) upon PR. CONCLUSIONS We identified patient groups with distinct skeletal muscle molecular responses to rehabilitation, associated with differences in functional improvements upon PR.
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Affiliation(s)
- Anita E M Kneppers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Roy A M Haast
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Maastricht Centre for Systems Biology, Maastricht University, Maastricht, The Netherlands
| | - Ramon C J Langen
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Lex B Verdijk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Pieter A Leermakers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Harry R Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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