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Tang D, Wu S, Kong M, Liu Z, Li Z, Han Y, Gong Y, Hu J. A Fluorescent Lateral Flow Immunoassay for the Detection of Skeletal Muscle Troponin I in Serum for Muscle Injury Monitoring at the Point of Care. BIOSENSORS 2024; 14:381. [PMID: 39194610 DOI: 10.3390/bios14080381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/02/2024] [Accepted: 08/04/2024] [Indexed: 08/29/2024]
Abstract
Exercise-induced muscle injury is one of the most common types of sports injuries. Skeletal muscle troponin I (skTnI) serves as an ideal biomarker in assessing such injuries, facilitating timely detection and evaluation. In this study, we develop a fluorescent sandwich lateral flow immunoassay (LFIA) combined with a desktop analyzer for rapid detection of skTnI. Through optimizing the reaction system, the assay achieves a satisfying detection performance, reaching a limit of detection (LOD) of 0.5 ng/mL with a turnaround time of 15 min. The proposed detection platform offers portability, ease of use, and high sensitivity, which facilitates the monitoring of exercise-induced muscle injuries at the point of care. This feature is particularly advantageous for end users, enabling timely detection of sports-related injuries and ultimately enhancing prognosis and sports life.
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Affiliation(s)
- Deding Tang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, China
- Public Teaching Department, Maanshan Teacher's College, Maanshan 243041, China
| | - Shuang Wu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, China
| | - Mengqi Kong
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, China
- Suzhou Diyinan Biotech Company, Suzhou 215129, China
| | - Zhaonan Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, China
- Suzhou Diyinan Biotech Company, Suzhou 215129, China
| | - Zonghao Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, China
- Suzhou Diyinan Biotech Company, Suzhou 215129, China
| | - Ying Han
- School of Chemistry and Life Sciences, Suzhou University of Science and Technology, Suzhou 215009, China
| | - Yan Gong
- School of Chemistry and Life Sciences, Suzhou University of Science and Technology, Suzhou 215009, China
| | - Jie Hu
- Suzhou Diyinan Biotech Company, Suzhou 215129, China
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Iqbal M, Hassan K, Bliss E, Whiteside EJ, Hoffman B, Mills DE. The effects of inspiratory muscle training on biomarkers of muscle damage in recovered COVID-19 patients after weaning from mechanical ventilation. Chron Respir Dis 2024; 21:14799731241289423. [PMID: 39365635 PMCID: PMC11457248 DOI: 10.1177/14799731241289423] [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: 02/25/2024] [Accepted: 09/13/2024] [Indexed: 10/05/2024] Open
Abstract
Background: COVID-19 patients experience respiratory muscle damage, leading to reduced respiratory function and functional capacity often requiring mechanical ventilation which further increases susceptibility to muscle weakness. Inspiratory muscle training (IMT) may help mitigate this damage and improve respiratory function and functional capacity. Methods: We studied the effects of IMT on muscle damage biomarkers, respiratory function, and functional capacity in COVID-19 recovered young adults, successfully weaned from mechanical ventilation. Participants were randomly allocated to either an IMT (n = 11) or control (CON; n = 11) intervention for 4 weeks. The IMT group performed 30 dynamic inspiratory efforts twice daily, at 50% of their maximal inspiratory mouth pressure (PMmax) while the CON group performed 60 inspiratory efforts at 10% of pMmax daily. Serum was collected at baseline, week two, and week four to measure creatine kinase muscle-type (CKM), fast skeletal troponin-I (sTnI) and slow sTnI. Results: Time × group interaction effects were observed for CKM and slow sTnI, but not for fast sTnI. Both were lower at two and 4 weeks for the IMT compared to the CON group, respectively. Time × group interaction effects were observed for forced expiratory volume in 1s, forced vital capacity, PMmax and right- and left-hand grip strength. These were higher for the IMT compared to the CON group. Conclusion: Four weeks of IMT decreased muscle damage biomarkers and increased respiratory function and grip strength in recovered COVID-19 patients after weaning from mechanical ventilation.
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Affiliation(s)
- Muneeb Iqbal
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
| | - Kumail Hassan
- Department of Physiotherapy, University of Lahore Teaching Hospital, Lahore, Pakistan
| | - Edward Bliss
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
| | - Eliza J Whiteside
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Future Materials, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Ben Hoffman
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
| | - Dean E Mills
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
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Kowalski T, Kasiak PS, Rebis K, Klusiewicz A, Granda D, Wiecha S. Respiratory muscle training induces additional stress and training load in well-trained triathletes-randomized controlled trial. Front Physiol 2023; 14:1264265. [PMID: 37841319 PMCID: PMC10576561 DOI: 10.3389/fphys.2023.1264265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Background: Respiratory muscle training (RMT) has been investigated in the context of improved athletic performance and pulmonary function. However, psychophysiological costs of RMT remain understudied. Voluntary isocapnic hyperpnoea (VIH) and inspiratory pressure threshold loading (IPTL) are widely applied RMT methods. The main purposes of this study were to assess whether RMT induces additional load on well-trained triathletes and determine differences in RMT-induced load between sexes and applied methods. Materials and Methods: 16 well-trained triathletes (n = 16, 56% males) underwent 6 weeks of VIH or IPTL program with progressive overload. Blood markers, subjective measures, cardiac indices, near-infrared spectroscopy indices, inspiratory muscle fatigue, and RMT-induced training load were monitored pre-, in and post-sessions. We used multiple ANOVA to investigate effects of sex, training method, and time on measured parameters. Results: There were significant interactions for acid-base balance (p = 0.04 for sex, p < 0.001 for method), partial carbon dioxide pressure (p = 0.03 for sex, p < 0.001 for method), bicarbonate (p = 0.01 for method), lactate (p < 0.001 for method), RMT-induced training load (p = 0.001 for method for single session, p = 0.03 for method per week), average heart rate (p = 0.03 for sex), maximum heart rate (p = 0.02 for sex), intercostales muscle oxygenation (p = 0.007 for testing week), and intercostales muscle oxygenation recovery (p = 0.003 for testing week and p = 0.007 for method). Conclusion: We found that RMT induced additional load in well-trained triathletes. Elicited changes in monitored variables depend on sex and training method. VIH significantly increased subjective training load measures. IPTL was associated with disbalance in blood gasometry, increase in lactate, and reports of headaches and dizziness. Both methods should be applied with consideration in high-performance settings.
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Affiliation(s)
- Tomasz Kowalski
- Department of Physiology, Institute of Sport—National Research Institute, Warsaw, Poland
| | | | - Kinga Rebis
- Department of Physiology, Institute of Sport—National Research Institute, Warsaw, Poland
| | - Andrzej Klusiewicz
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
| | - Dominika Granda
- Department of Nutrition Physiology and Dietetics, Institute of Sport—National Research Institute, Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, Biala Podlaska, Poland
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Damiani LF, Engelberts D, Bastia L, Osada K, Katira BH, Otulakowski G, Goligher EC, Reid WD, Dubo S, Bruhn A, Post M, Kavanagh BP, Brochard LJ. Impact of Reverse Triggering Dyssynchrony During Lung-Protective Ventilation on Diaphragm Function: An Experimental Model. Am J Respir Crit Care Med 2021; 205:663-673. [PMID: 34941477 DOI: 10.1164/rccm.202105-1089oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Reverse triggering is a patient-ventilator interaction where a respiratory muscle contraction is triggered by a passive mechanical insufflation. Its impact on diaphragm structure and function is unknown. OBJECTIVE To establish an animal model of reverse triggering with lung injury receiving lung-protective ventilation and to assess its impact on structure and function of the diaphragm. METHODS Lung injury was induced by surfactant depletion and high stress ventilation in 32 ventilated pigs. Animals were allocated to receive passive mechanical ventilation or a lung-protective strategy with adjustments facilitating the occurrence of reverse triggering for 3 hours. Diaphragm function (transdiaphragmatic pressure (Pdi) during phrenic nerve stimulation [Force/frequency curve]) and structure (biopsies) were assessed. The impact of reverse triggering on diaphragm function was analyzed according to the breathing effort. RESULTS Compared to passive ventilation, the protective ventilation group with reverse triggering received significantly lower tidal volume (7 vs 10 ml/kg) and higher respiratory rate (45 vs 31 bpm). An entrainment pattern of 1:1 was frequent. Breathing effort induced by reverse triggering was highly variable across animals. Reverse triggering with the lowest tercile of breathing effort was associated with 23% higher twitch Pdi compared to passive ventilation, whereas reverse triggering with high breathing effort was associated with a 10% lower twitch Pdi and a higher proportion of abnormal muscle fibers. CONCLUSION In a reproducible animal model of reverse triggering with variable levels of breathing effort and entrainment patterns, reverse triggering with high effort is associated with impaired diaphragm function whereas reverse triggering with low effort is associated with preserved diaphragm force.
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Affiliation(s)
- L Felipe Damiani
- Pontificia Universidad Católica de Chile - Facultad de Medicina, Departamento de Ciencias de la Salud, Santiago, Chile
| | - Doreen Engelberts
- Hospital for Sick Children, 7979, Physiology & Experimental Medicine, Toronto, Ontario, Canada
| | - Luca Bastia
- SickKids, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Milan-Bicocca, 9305, Medicine, Milano, Lombardia, Italy
| | - Kohei Osada
- SickKids, 7979, Translational Medicine, Toronto, Ontario, Canada
| | - Bhushan H Katira
- Hospital for Sick Children, 7979, Paediatric Critical Care Medicine, Toronto, Ontario, Canada
| | - Gail Otulakowski
- Hospital for Sick Children Research Institute, Lung Biology, Toronto, Ontario, Canada
| | - Ewan C Goligher
- University Health Network, 7989, Department of Medicine, Division of Respirology, Critical Care Program, Toronto, Ontario, Canada.,University of Toronto, 7938, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
| | - W Darlene Reid
- University of Toronto, Department of Physical Therapy, Toronto, Ontario, Canada
| | - Sebastián Dubo
- Universidad de Concepcion, 28056, Departamento de Kinesiología, Facultad de Medicina, Concepcion, Chile
| | - Alejandro Bruhn
- Pontificia Universidad Católica de Chile - Facultad de Medicina, Departamento de Medicina Intensiva, Santiago, Chile
| | - Martin Post
- Hospital for Sick Children, Lung Biology, Toronto, Ontario, Canada
| | - Brian P Kavanagh
- Hospital Sick Children, Department of Critical Care Medicine, Toronto, Ontario, Canada
| | - Laurent J Brochard
- St Michael's Hospital in Toronto, Li Ka Shing Knowledge Institute, Keenan Research Centre, Toronto, Ontario, Canada.,University of Toronto, 7938, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada;
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Spadaro S, Dalla Corte F, Scaramuzzo G, Grasso S, Cinnella G, Rosta V, Chiavieri V, Alvisi V, Di Mussi R, Volta CA, Bellini T, Trentini A. Circulating Skeletal Troponin During Weaning From Mechanical Ventilation and Their Association to Diaphragmatic Function: A Pilot Study. Front Med (Lausanne) 2021; 8:770408. [PMID: 35004739 PMCID: PMC8727747 DOI: 10.3389/fmed.2021.770408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Patients with acute respiratory failure (ARF) may need mechanical ventilation (MV), which can lead to diaphragmatic dysfunction and muscle wasting, thus making difficult the weaning from the ventilator. Currently, there are no biomarkers specific for respiratory muscle and their function can only be assessed trough ultrasound or other invasive methods. Previously, the fast and slow isoform of the skeletal troponin I (fsTnI and ssTnI, respectively) have shown to be specific markers of muscle damage in healthy volunteers. We aimed therefore at describing the trend of skeletal troponin in mixed population of ICU patients undergoing weaning from mechanical ventilation and compared the value of fsTnI and ssTnI with diaphragmatic ultrasound derived parameters. Methods: In this prospective observational study we enrolled consecutive patients recovering from acute hypoxemic respiratory failure (AHRF) within 24 h from the start of weaning. Every day an arterial blood sample was collected to measure fsTnI, ssTnI, and global markers of muscle damage, such as ALT, AST, and CPK. Moreover, thickening fraction (TF) and diaphragmatic displacement (DE) were assessed by diaphragmatic ultrasound. The trend of fsTnI and ssTnI was evaluated during the first 3 days of weaning. Results: We enrolled 62 consecutive patients in the study, with a mean age of 67 ± 13 years and 43 of them (69%) were male. We did not find significant variations in the ssTnI trend (p = 0.623), but fsTnI significantly decreased over time by 30% from Day 1 to Day 2 and by 20% from Day 2 to Day 3 (p < 0.05). There was a significant interaction effect between baseline ssTnI and DE [F(2) = 4.396, p = 0.015], with high basal levels of ssTnI being associated to a higher decrease in DE. On the contrary, the high basal levels of fsTnI at day 1 were characterized by significant higher DE at each time point. Conclusions: Skeletal muscle proteins have a distinctive pattern of variation during weaning from mechanical ventilation. At day 1, a high basal value of ssTnI were associated to a higher decrease over time of diaphragmatic function while high values of fsTnI were associated to a higher displacement at each time point.
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Affiliation(s)
- Savino Spadaro
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
- *Correspondence: Savino Spadaro
| | - Francesca Dalla Corte
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
- Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Gaetano Scaramuzzo
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
| | - Salvatore Grasso
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Gilda Cinnella
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Valentina Rosta
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Valentina Chiavieri
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
| | - Valentina Alvisi
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
| | - Rosa Di Mussi
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Carlo Alberto Volta
- Department of Translational Medicine, Anesthesia and Intensive Care, University of Ferrara, Ferrara, Italy
| | - Tiziana Bellini
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Trentini
- Section of Medical Biochemistry, Molecular Biology and Genetics, Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
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Mañas-García L, Denhard C, Mateu J, Duran X, Gea J, Barreiro E. Beneficial Effects of Resveratrol in Mouse Gastrocnemius: A Hint to Muscle Phenotype and Proteolysis. Cells 2021; 10:cells10092436. [PMID: 34572085 PMCID: PMC8469306 DOI: 10.3390/cells10092436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022] Open
Abstract
We hypothesized that the phenolic compound resveratrol mitigates muscle protein degradation and loss and improves muscle fiber cross-sectional area (CSA) in gastrocnemius of mice exposed to unloading (7dI). In gastrocnemius of mice (female C57BL/6J, 10 weeks) exposed to a seven-day period of hindlimb immobilization with/without resveratrol treatment, markers of muscle proteolysis (tyrosine release, systemic troponin-I), atrophy signaling pathways, and muscle phenotypic features and function were analyzed. In gastrocnemius of unloaded mice treated with resveratrol, body and muscle weight and function were attenuated, whereas muscle proteolysis (tyrosine release), proteolytic and apoptotic markers, atrophy signaling pathways, and myofiber CSA significantly improved. Resveratrol treatment of mice exposed to a seven-day period of unloading prevented body and muscle weight and limb strength loss, while an improvement in muscle proteolysis, proteolytic markers, atrophy signaling pathways, apoptosis, and muscle fiber CSA was observed in the gastrocnemius muscle. These findings may have potential therapeutic implications in the management of disuse muscle atrophy in clinical settings.
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Affiliation(s)
- Laura Mañas-García
- Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Pulmonology Department, IMIM—Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (L.M.-G.); (C.D.); (J.G.)
- Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Charlotte Denhard
- Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Pulmonology Department, IMIM—Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (L.M.-G.); (C.D.); (J.G.)
- Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Javier Mateu
- Department of Pharmacy, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain;
| | - Xavier Duran
- Scientific and Technical Department, Hospital del Mar-IMIM, 08003 Barcelona, Spain;
| | - Joaquim Gea
- Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Pulmonology Department, IMIM—Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (L.M.-G.); (C.D.); (J.G.)
- Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Esther Barreiro
- Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Pulmonology Department, IMIM—Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (L.M.-G.); (C.D.); (J.G.)
- Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-316-0385; Fax: +34-93-316-0410
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7
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Bamberg K, Mehtälä L, Arola O, Laitinen S, Nordling P, Strandberg M, Strandberg N, Paltta J, Mali M, Espinosa-Ortega F, Pirilä L, Lundberg IE, Savukoski T, Pettersson K. Evaluation of a New Skeletal Troponin I Assay in Patients with Idiopathic Inflammatory Myopathies. J Appl Lab Med 2021; 5:320-331. [PMID: 32445386 DOI: 10.1093/jalm/jfz016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/01/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND The current biomarkers for diagnosis and monitoring of injured and diseased skeletal muscles, such as creatine kinase (CK), have limited tissue specificity and incapability to differentiate between pathological and physiological changes. Thus, new biomarkers with improved diagnostic accuracy are needed. Our aim was to develop and validate a novel assay for skeletal troponin I (skTnI), and to assess its clinical performance in patients with idiopathic inflammatory myopathies (IIM). METHODS A two-step fluoroimmunoassay was used to analyze samples from healthy reference individuals (n = 140), patients with trauma (n = 151), and patients with IIM (n = 61). RESULTS The limit of detection was 1.2 ng/mL, and the upper reference limit (90th percentile) was 5.2 ng/mL. The median skTnI concentrations were <limit of detection (LoD), 2.7 ng/mL, and 8.6 ng/mL in reference, trauma, and IIM cohorts, respectively. Differences in measured skTnI levels were statistically significant between all three study cohorts (Kruskal-Wallis P < 0.001; Mann-Whitney P < 0.001 for all). skTnI and CK had a strong positive correlation (Spearman's r = 0.771, P < 0.001), and the longitudinal changes in skTnI mirrored those observed with CK. CONCLUSIONS With the skTnI assay, patients with IIM were identified from healthy individuals and from patients with traumatic muscular injuries. When compared to CK, skTnI appeared to be more accurate in managing patients with low-grade IIM disease activities. The developed assay serves as a reliable analytical tool for the assessment of diagnostic accuracy of skTnI in the diagnosis and monitoring of myopathies.
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Affiliation(s)
- Katriina Bamberg
- Department of Biochemistry/Biotechnology, University of Turku, Turku, Finland
| | - Laura Mehtälä
- Department of Biochemistry/Biotechnology, University of Turku, Turku, Finland
| | - Olli Arola
- Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland
| | | | | | | | - Niko Strandberg
- Department of Orthopaedic Surgery, Turku University Hospital, Turku, Finland
| | - Johanna Paltta
- Department of Rheumatology, Turku University Hospital, Turku, Finland
| | - Markku Mali
- Department of Rheumatology, Turku University Hospital, Turku, Finland
| | - Fabricio Espinosa-Ortega
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Laura Pirilä
- Department of Rheumatology, Turku University Hospital, Turku, Finland
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tanja Savukoski
- Department of Biochemistry/Biotechnology, University of Turku, Turku, Finland
| | - Kim Pettersson
- Department of Biochemistry/Biotechnology, University of Turku, Turku, Finland
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Mañas-García L, Penedo-Vázquez A, López-Postigo A, Deschrevel J, Durán X, Barreiro E. Prolonged Immobilization Exacerbates the Loss of Muscle Mass and Function Induced by Cancer-Associated Cachexia through Enhanced Proteolysis in Mice. Int J Mol Sci 2020; 21:E8167. [PMID: 33142912 PMCID: PMC7663403 DOI: 10.3390/ijms21218167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 12/11/2022] Open
Abstract
We hypothesized that in mice with lung cancer (LC)-induced cachexia, periods of immobilization of the hindlimb (7 and 15 days) may further aggravate the process of muscle mass loss and function. Mice were divided into seven groups (n = 10/group): (1) non-immobilized control mice, (2) 7-day unloaded mice (7-day I), (3) 15-day unloaded mice (15-day I), (4) 21-day LC-cachexia group (LC 21-days), (5) 30-day LC-cachexia group (LC 30-days), (6) 21-day LC-cachexia group besides 7 days of unloading (LC 21-days + 7-day I), (7) 30-day LC-cachexia group besides 15 days of unloading (LC 30-days + 15-day I). Physiological parameters, body weight, muscle and tumor weights, phenotype and morphometry, muscle damage (including troponin I), proteolytic and autophagy markers, and muscle regeneration markers were identified in gastrocnemius muscle. In LC-induced cachexia mice exposed to hindlimb unloading, gastrocnemius weight, limb strength, fast-twitch myofiber cross-sectional area, and muscle regeneration markers significantly decreased, while tumor weight and area, muscle damage (troponin), and proteolytic and autophagy markers increased. In gastrocnemius of cancer-cachectic mice exposed to unloading, severe muscle atrophy and impaired function was observed along with increased muscle proteolysis and autophagy, muscle damage, and impaired muscle regeneration.
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Affiliation(s)
- Laura Mañas-García
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain; (L.M.-G.); (A.P.-V.); (A.L.-P.); (J.D.)
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Antonio Penedo-Vázquez
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain; (L.M.-G.); (A.P.-V.); (A.L.-P.); (J.D.)
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Adrián López-Postigo
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain; (L.M.-G.); (A.P.-V.); (A.L.-P.); (J.D.)
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
| | - Jorieke Deschrevel
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain; (L.M.-G.); (A.P.-V.); (A.L.-P.); (J.D.)
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
- Laboratory of Respiratory diseases and Thoracic Surgery, Department Chrometa, Catholic University of Leuven, B-3000 Leuven, Belgium
| | - Xavier Durán
- Scientific and Technical Department, Hospital del Mar-IMIM, 08003 Barcelona, Spain;
| | - Esther Barreiro
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain; (L.M.-G.); (A.P.-V.); (A.L.-P.); (J.D.)
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 08003 Barcelona, Spain
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9
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Muscle Phenotype, Proteolysis, and Atrophy Signaling During Reloading in Mice: Effects of Curcumin on the Gastrocnemius. Nutrients 2020; 12:nu12020388. [PMID: 32024036 PMCID: PMC7071295 DOI: 10.3390/nu12020388] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/24/2019] [Accepted: 01/24/2020] [Indexed: 12/31/2022] Open
Abstract
We hypothesized that curcumin may mitigate muscle protein degradation and loss through attenuation of proteolytic activity in limb muscles of mice exposed to reloading (7dR) following immobilization (7dI). In gastrocnemius of mice (female C57BL/6J, 10 weeks) exposed to recovery following a seven-day period of hindlimb immobilization with/without curcumin treatment, markers of muscle proteolysis (systemic troponin-I), atrophy signaling pathways and histone deacetylases, protein synthesis, and muscle phenotypic characteristics and function were analyzed. In gastrocnemius of reloading mice compared to unloaded, muscle function, structure, sirtuin-1, and protein synthesis improved, while proteolytic and signaling markers (FoxO1/3) declined. In gastrocnemius of unloaded and reloaded mice treated with curcumin, proteolytic and signaling markers (NF-kB p50) decreased and sirtuin-1 activity and hybrid fibers size increased (reloaded muscle), while no significant improvement was seen in muscle function. Treatment with curcumin elicited a rise in sirtuin-1 activity, while attenuating proteolysis in gastrocnemius of mice during reloading following a period of unloading. Curcumin attenuated muscle proteolysis probably via activation of histone deacetylase sirtuin-1, which also led to decreased levels of atrophy signaling pathways. These findings offer an avenue of research in the design of therapeutic strategies in clinical settings of patients exposed to periods of disuse muscle atrophy.
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10
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Inspiratory Muscle Training in Patients with Prolonged Mechanical Ventilation: Narrative Review. Cardiopulm Phys Ther J 2019; 30:44-50. [PMID: 31105474 DOI: 10.1097/cpt.0000000000000092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Patients with impending respiratory failure often require mechanical ventilation to optimize gas exchange. Although this form of assisted ventilation is required for survival, its persistent use results in diaphragm weakness and muscle fiber atrophy. There is strong evidence that mechanical ventilation alters the structure and function of the diaphragm, resulting in prolonged dependence on assisted ventilation and long-term consequences such as a delayed functional recovery, reduced quality of life and increased risk of mortality. This review summarizes the mechanisms underlying diaphragm dysfunction due to prolonged mechanical ventilation, highlights the role of inspiratory muscle exercise as a strategy to counter diaphragm weakness, and identifies the parameters of an evidence-supported exercise prescription for difficult to wean patients.
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11
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Dominelli PB, McNeil CJ, Vermeulen TD, Stuckless TJR, Brown CV, Dominelli GS, Swenson ER, Teppema LJ, Foster GE. Effect of acetazolamide and methazolamide on diaphragm and dorsiflexor fatigue: a randomized controlled trial. J Appl Physiol (1985) 2018; 125:770-779. [PMID: 29792554 DOI: 10.1152/japplphysiol.00256.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Acetazolamide, a carbonic anhydrase (CA) inhibitor used clinically and to prevent acute mountain sickness, worsens skeletal muscle fatigue in animals and humans. In animals, methazolamide, a methylated analog of acetazolamide and an equally potent CA inhibitor, reportedly exacerbates fatigue less than acetazolamide. Accordingly, we sought to determine, in humans, if methazolamide would attenuate diaphragm and dorsiflexor fatigue compared with acetazolamide. Healthy men (dorsiflexor: n = 12; diaphragm: n = 7) performed fatiguing exercise on three occasions, after ingesting acetazolamide (250 mg three times a day) and then in random order, methazolamide (100 mg twice a day) or placebo for 48 h. For both muscles, subjects exercised at a fixed intensity until exhaustion on acetazolamide, with subsequent iso-time and -workload trials. Diaphragm exercise was performed using a threshold-loading device, while dorsiflexor exercise was isometric. Neuromuscular function was determined pre- and postexercise by potentiated transdiaphragmatic twitch pressure and dorsiflexor torque in response to stimulation of the phrenic and fibular nerve, respectively. Diaphragm contractility 3-10 min postexercise was impaired more for acetazolamide than methazolamide or placebo (82 ± 10, 87 ± 9, and 91 ± 8% of pre-exercise value; P < 0.05). Similarly, dorsiflexor fatigue was greater for acetazolamide than methazolamide (mean twitch torque of 61 ± 11 vs. 57 ± 13% of baseline, P < 0.05). In normoxia, methazolamide leads to less neuromuscular fatigue than acetazolamide, indicating a possible benefit for clinical use or in the prophylaxis of acute mountain sickness. NEW & NOTEWORTHY Acetazolamide, a carbonic anhydrase inhibitor, may worsen diaphragm and locomotor muscle fatigue after exercise; whereas, in animals, methazolamide does not impair diaphragm function. Compared with both methazolamide and the placebo, acetazolamide significantly compromised dorsiflexor function at rest and after exhaustive exercise. Similarly, diaphragm function was most compromised on acetazolamide followed by methazolamide and placebo. Methazolamide may be preferable over acetazolamide for clinical use and altitude illness prophylaxis to avoid skeletal muscle dysfunction.
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Affiliation(s)
- Paolo B Dominelli
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Chris J McNeil
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Tyler D Vermeulen
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Troy J R Stuckless
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Courtney V Brown
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
| | - Giulio S Dominelli
- Southern Medical Program, University of British Columbia, Kelowna, Canada
| | - Erik R Swenson
- Division of Pulmonary & Critical Care Medicine, VA Puget Sound Health Care System, University of Washington , Seattle, Washington
| | - Lucas J Teppema
- Department of Anesthesiology, Leiden University Medical Center , Leiden , The Netherlands
| | - Glen E Foster
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia , Kelowna , Canada
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12
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Recruitment and Deoxygenation of Selected Respiratory and Skeletal Muscles During Incremental Loading in Stable COPD Patients. J Cardiopulm Rehabil Prev 2017; 36:279-87. [PMID: 27337606 DOI: 10.1097/hcr.0000000000000185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To evaluate changes in oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) of the sternocleidomastoid (SCM), parasternal (PS), biceps (BC), and tibialis anterior (TA) using near-infrared spectroscopy during incremental loading of the inspiratory muscles and the elbow flexors in people with stable chronic obstructive pulmonary disease. METHODS Fifteen participants with obstructive pulmonary disease were recruited in a repeated-measures crossover design. Near-infrared spectroscopy optodes were applied over the SCM, PS, BC, and TA to measure O2Hb, HHb, and tHb. Participants were randomly assigned to perform incremental inspiratory threshold loading or elbow flexor loading that imposed higher loads every 2 minutes until task failure. At least 1 week later, participants performed the other test. Arterial oxygen saturation (SpO2) was monitored continuously. RESULTS O2Hb of the main agonist muscles, SCM and BC, decreased compared with the other muscles during inspiratory threshold loading and elbow flexor loading, respectively. SCM O2Hb and BC O2Hb decreased at higher loads compared with baseline. SCM tHb and HHb increased, whereas TA tHb decreased during inspiratory threshold loading. tHb did not change among any muscles during elbow flexor loading. SpO2 did not change from baseline to task failure. CONCLUSIONS Our data suggest that the SCM was recruited progressively during incremental inspiratory threshold loading; however, O2Hb was not maintained in this muscle. Similarly, O2Hb was not maintained in the biceps during elbow flexor loading. This regional deoxygenation in SCM and BC during incremental loading protocols was not reflected by a decrease in SpO2.
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13
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Chacon-Cabrera A, Lund-Palau H, Gea J, Barreiro E. Time-Course of Muscle Mass Loss, Damage, and Proteolysis in Gastrocnemius following Unloading and Reloading: Implications in Chronic Diseases. PLoS One 2016; 11:e0164951. [PMID: 27792730 PMCID: PMC5085049 DOI: 10.1371/journal.pone.0164951] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/04/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Disuse muscle atrophy is a major comorbidity in patients with chronic diseases including cancer. We sought to explore the kinetics of molecular mechanisms shown to be involved in muscle mass loss throughout time in a mouse model of disuse muscle atrophy and recovery following immobilization. METHODS Body and muscle weights, grip strength, muscle phenotype (fiber type composition and morphometry and muscle structural alterations), proteolysis, contractile proteins, systemic troponin I, and mitochondrial content were assessed in gastrocnemius of mice exposed to periods (1, 2, 3, 7, 15 and 30 days) of non-invasive hindlimb immobilization (plastic splint, I cohorts) and in those exposed to reloading for different time-points (1, 3, 7, 15, and 30 days, R cohorts) following a seven-day period of immobilization. Groups of control animals were also used. RESULTS Compared to non-exposed controls, muscle weight, limb strength, slow- and fast-twitch cross-sectional areas, mtDNA/nDNA, and myosin content were decreased in mice of I cohorts, whereas tyrosine release, ubiquitin-proteasome activity, muscle injury and systemic troponin I levels were increased. Gastrocnemius reloading following splint removal improved muscle mass loss, strength, fiber atrophy, injury, myosin content, and mtDNA/nDNA, while reducing ubiquitin-proteasome activity and proteolysis. CONCLUSIONS A consistent program of molecular and cellular events leading to reduced gastrocnemius muscle mass and mitochondrial content and reduced strength, enhanced proteolysis, and injury, was seen in this non-invasive mouse model of disuse muscle atrophy. Unloading of the muscle following removal of the splint significantly improved the alterations seen during unloading, characterized by a specific kinetic profile of molecular events involved in muscle regeneration. These findings have implications in patients with chronic diseases including cancer in whom physical activity may be severely compromised.
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Affiliation(s)
- Alba Chacon-Cabrera
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), C/ Dr. Aiguader, 88, Barcelona, E-08003 Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Helena Lund-Palau
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), C/ Dr. Aiguader, 88, Barcelona, E-08003 Spain
| | - Joaquim Gea
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), C/ Dr. Aiguader, 88, Barcelona, E-08003 Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Esther Barreiro
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research group, IMIM-Hospital del Mar, Parc de Salut Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), C/ Dr. Aiguader, 88, Barcelona, E-08003 Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
- * E-mail:
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14
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Dot I, Pérez-Teran P, Samper MA, Masclans JR. Diaphragm Dysfunction in Mechanically Ventilated Patients. Arch Bronconeumol 2016; 53:150-156. [PMID: 27553431 DOI: 10.1016/j.arbres.2016.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/04/2016] [Accepted: 07/17/2016] [Indexed: 12/14/2022]
Abstract
Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure. Although the specific etiology of process is unknown, the muscle presents oxidative stress and mitochondrial changes. These cause changes in protein turnover, resulting in atrophy and impaired contractility, and leading to impaired functionality. The term 'ventilator-induced diaphragm dysfunction' was first coined by Vassilakopoulos et al. in 2004, and this phenomenon, along with injury cause by over-distention of the lung and barotrauma, represents a challenge in the daily life of ventilated patients. Diaphragmatic dysfunction affects prognosis by delaying extubation, prolonging hospital stay, and impairing the quality of life of these patients in the years following hospital discharge. Ultrasound, a non-invasive technique that is readily available in most ICUs, could be used to diagnose this condition promptly, thus preventing delays in starting rehabilitation and positively influencing prognosis in these patients.
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Affiliation(s)
- Irene Dot
- Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar de Barcelona, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM)-GREPAC, Barcelona, España
| | - Purificación Pérez-Teran
- Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar de Barcelona, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM)-GREPAC, Barcelona, España
| | - Manuel-Andrés Samper
- Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar de Barcelona, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM)-GREPAC, Barcelona, España
| | - Joan-Ramon Masclans
- Servicio de Medicina Intensiva, Hospital del Mar-Parc de Salut Mar de Barcelona, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM)-GREPAC, Barcelona, España; Universitat Pompeu Fabra, Barcelona, España; CIBERES, España.
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15
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Burch PM, Greg Hall D, Walker EG, Bracken W, Giovanelli R, Goldstein R, Higgs RE, King NMP, Lane P, Sauer JM, Michna L, Muniappa N, Pritt ML, Vlasakova K, Watson DE, Wescott D, Zabka TS, Glaab WE. Evaluation of the Relative Performance of Drug-Induced Skeletal Muscle Injury Biomarkers in Rats. Toxicol Sci 2015; 150:247-56. [DOI: 10.1093/toxsci/kfv328] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Doorduin J, van Hees HWH, van der Hoeven JG, Heunks LMA. Monitoring of the respiratory muscles in the critically ill. Am J Respir Crit Care Med 2012; 187:20-7. [PMID: 23103733 DOI: 10.1164/rccm.201206-1117cp] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence has accumulated that respiratory muscle dysfunction develops in critically ill patients and contributes to prolonged weaning from mechanical ventilation. Accordingly, it seems highly appropriate to monitor the respiratory muscles in these patients. Today, we are only at the beginning of routinely monitoring respiratory muscle function. Indeed, most clinicians do not evaluate respiratory muscle function in critically ill patients at all. In our opinion, however, practical issues and the absence of sound scientific data for clinical benefit should not discourage clinicians from having a closer look at respiratory muscle function in critically ill patients. This perspective discusses the latest developments in the field of respiratory muscle monitoring and possible implications of monitoring respiratory muscle function in critically ill patients.
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Affiliation(s)
- Jonne Doorduin
- Department of Critical Care Medicine, Radboud University Nijmegen Medical Centre, The Netherlands
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