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d'Humières T, Bouvarel A, Boyer L, Savale L, Guillet H, Alassaad L, de Luna G, Berti E, Iles S, Pham Hung d'Alexandry d'Orengiani AL, Audureau E, Troupe MJ, Schlatter RC, Lamadieu A, Galactéros F, Derumeaux G, Messonnier LA, Bartolucci P. Cardiac diastolic maladaptation is associated with the severity of exercise intolerance in sickle cell anemia patients. Sci Rep 2024; 14:11095. [PMID: 38750085 PMCID: PMC11096405 DOI: 10.1038/s41598-024-61689-w] [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] [Received: 07/12/2023] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
This pilot study focusing on Sickle Cell Anemia (SCA) patients offers a comprehensive and integrative evaluation of respiratory, cardiovascular, hemodynamic, and metabolic variables during exercise. Knowing that diastolic dysfunction is frequent in this population, we hypothesize that a lack of cardiac adaptation through exercise might lead to premature increase in blood lactate concentrations in SCA patients, a potential trigger for acute disease complication. SCA patients were prospectively included in PHYSIO-EXDRE study and underwent a comprehensive stress test with a standardized incremental exercise protocol up to 4 mmol L-1 blood lactate concentration (BL4). Gas exchange, capillary lactate concentration and echocardiography were performed at baseline, during stress test (at ∼ 2 mmol L-1) and BL4. The population was divided into two groups and compared according to the median value of percentage of theoretical peak oxygen uptake (%V ˙ O 2 p e a k t h ) at BL4. Twenty-nine patients were included (42 ± 12 years old, 48% of women). Most patients reached BL4 at low-intensity exercise [median value of predicted power output (W) was 37%], which corresponds to daily life activities. The median value of %V ˙ O 2 p e a k t h at BL4 was 39%. Interestingly, diastolic maladaptation using echocardiography during stress test along with hemoglobin concentration were independently associated to early occurrence of BL4. As BL4 occurs for low-intensity exercises, SCA patients may be subject to acidosis-related complications even during their daily life activities. Beyond assessing physical capacities, our study underlines that diastolic maladaptation during exercise is associated with an early increase in blood lactate concentration.
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Affiliation(s)
- Thomas d'Humières
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
- Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.
| | - Antoine Bouvarel
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Laurent Boyer
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Laurent Savale
- Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Henri Guillet
- Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
- Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France
| | - Lara Alassaad
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Gonzalo de Luna
- Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
- Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France
| | - Enora Berti
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Sihem Iles
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | | | - Etienne Audureau
- Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- CEpiA IMRB U955, FHU SENEC, Université Paris Est (UPEC), Créteil, France
| | - Marie-Joelle Troupe
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Reine-Claude Schlatter
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Anaïs Lamadieu
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Frédéric Galactéros
- Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
- Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France
| | - Geneviève Derumeaux
- Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
- INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Laurent A Messonnier
- Inter-University Laboratory of Human Movement Sciences EA 7424, Université Savoie Mont Blanc, Chambéry, France
| | - Pablo Bartolucci
- Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
- Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France
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2
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Antonelli Rossi DA, De Araujo Junior JA, Luvizutto GJ, Bazan R, Salmazo PS, Modolo GP, Hueb JC, Nunes HRDC, Hokama NK, Minicucci MF, Roscani MG, Zanati Bazan SG. Effect of a Physical Exercise Program on the Inflammatory Response, Cardiac Functions, Functional Capacity, and Quality of Life in Patients with Sickle Cell Disease. J Clin Med 2023; 12:3952. [PMID: 37373647 DOI: 10.3390/jcm12123952] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/13/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. METHODS A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1-Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2-Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. STATISTICAL ANALYSIS Comparisons between groups were made using Student's t-test, Mann-Whitney test, chi-square test, or Fisher's exact test. Spearman's correlation coefficient was calculated. The significance level was set at p < 0.05. RESULTS There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient -0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient -0.480; p = 0.013) in SCD patients in both groups. CONCLUSIONS The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.
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Affiliation(s)
| | - Jonas Alves De Araujo Junior
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba 38065-430, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil
| | - Péricles Sidnei Salmazo
- Department of Medicine, Faculty of Medical and Health Sciences, Pontifical Catholic University of São Paulo, Sorocaba 18052-490, Brazil
| | - Gabriel Pinheiro Modolo
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil
| | - João Carlos Hueb
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | | | - Newton Key Hokama
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Marcos Ferreira Minicucci
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos-UFSCar, São Carlos 13565-251, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil
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Januel L, Merlet AN, He Z, Hourdé C, Bartolucci P, Gellen B, Galactéros F, Messonnier LA, Féasson L. Skeletal Muscle Satellite Cells in Sickle Cell Disease Patients and Their Responses to a Moderate-intensity Endurance Exercise Training Program. J Histochem Cytochem 2022; 70:415-426. [PMID: 35642249 DOI: 10.1369/00221554221103905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We previously demonstrated that 8 weeks of moderate-intensity endurance training is safe and improves muscle function and characteristics of sickle cell disease (SCD) patients. Here, we investigated skeletal muscle satellite cells (SCs) in SCD patients and their responses to a training program. Fifteen patients followed the training program while 18 control patients maintained a normal lifestyle. Biopsies of the vastus lateralis muscle were performed before and after training. After training, the cross-sectional area and myonuclear content in type I fibers were slightly increased in the training patients compared to non-training patients. The SC pool was unchanged in type I fibers while it was slightly decreased in type II fibers in the training patients compared to non-training patients. No necrotic fibers were detected in patients before or after training. Therefore, the slight myonuclear accretion in type I fibers in trained SCD patients may highlight the contribution of SCs to training-induced slight type I fiber hypertrophy without expansion of the SC pool. The low training intensity and the short duration of training sessions could explain the low SC response to the training program. However, the lack of necrotic fibers suggests that the training program seemed to be safe for patients' muscle tissue.
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Affiliation(s)
- Léa Januel
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Priest en Jarez, France
| | - Angèle N Merlet
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France.,Unité de Myologie, Service de Physiologie Clinique et de l'Exercice, Hôpital Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Zhiguo He
- Biologie, Ingénierie et Imagerie de la Greffe de Cornée, Université de Lyon and Université Jean Monnet, Saint-Etienne, France
| | - Christophe Hourdé
- Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Chambéry, France
| | - Pablo Bartolucci
- Service de Médecine Interne, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France.,Service de Santé Publique, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Barnabas Gellen
- Service de Réhabilitation Cardiaque, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Frédéric Galactéros
- Service de Médecine Interne, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France.,Service de Santé Publique, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Laurent A Messonnier
- Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Chambéry, France
| | - Léonard Féasson
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France.,Unité de Myologie, Service de Physiologie Clinique et de l'Exercice, Hôpital Universitaire de Saint-Etienne, Saint-Etienne, France
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4
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Saraf SL, Derebail VK, Zhang X, Machado RF, Gordeuk VR, Lash JP, Little J. Hyperkalemia and Metabolic Acidosis Occur at a Higher eGFR in Sickle Cell Disease. KIDNEY360 2022; 3:608-614. [PMID: 35721605 DOI: 10.34067/kid.0006802021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Abstract
Background People with sickle cell disease (SCD) have an elevated estimated glomerular filtration rate (eGFR) compared with the general population, and this may alter the usual creatinine-based eGFR cutoffs for which physiologic evidence of kidney dysfunction is apparent. This study aimed to identify eGFR thresholds for hyperkalemia and metabolic acidosis in patients with SCD. Methods This was a cross-sectional analysis of 733 patients with severe (hemoglobin SS or Sβ 0-thalassemia) SCD genotype, 238 patients with moderate (hemoglobin SC or Sβ +-thalassemia) SCD genotype, and 1333 age- and sex-matched African Americans from the National Health and Nutrition Examination Survey (NHANES). The prevalence rates of hyperkalemia and metabolic acidosis were compared by eGFR category. Cutoffs for hyperkalemia and metabolic acidosis were determined using generalized additive models. Results Hyperkalemia and metabolic acidosis were more common in those with severe SCD genotype (13% and 21%, respectively) compared with the NHANES (0.3% and 5%, respectively); the prevalence rates in the moderate SCD genotype were intermediate for hyperkalemia (3%) and metabolic acidosis (11%). The proportion of patients with hyperkalemia and metabolic acidosis progressively increased with lower eGFR category in both SCD genotype groups. The eGFR thresholds for hyperkalemia and metabolic acidosis were higher in the severe (85 and 91 ml/min per 1.73 m2, respectively) and moderate (52 and 102 ml/min per 1.73 m2, respectively) SCD genotypes compared with the NHANES (34 and 46 ml/min per 1.73 m2). Conclusions We demonstrate that hyperkalemia and metabolic acidosis are more common and occur at higher eGFR values in patients with SCD compared with age- and sex-matched African Americans, including in eGFR ranges considered to be normal. Future studies using redefined creatinine-based eGFR thresholds for abnormal kidney function may identify high-risk patients for earlier intervention strategies and referral for specialized renal care in SCD.
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Affiliation(s)
- Santosh L Saraf
- Department of Medicine, Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, Illinois
| | - Vimal K Derebail
- Department of Medicine, Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Xu Zhang
- Department of Medicine, Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, Illinois
| | - Roberto F Machado
- Department of Medicine, Division of Pulmonary Medicine, University of Indiana, Indianapolis, Indiana
| | - Victor R Gordeuk
- Department of Medicine, Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, Illinois
| | - James P Lash
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, Illinois
| | - Jane Little
- Department of Medicine, Division of Hematology & Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Messonnier LA, Riccetti M, Chatel B, Galactéros F, Gellen B, Rupp T, Féasson L, Bartolucci P. How to implement endurance exercise training in sickle cell disease. Haematologica 2021; 106:1476-1479. [PMID: 32855281 PMCID: PMC8094104 DOI: 10.3324/haematol.2020.267047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Laurent A Messonnier
- Interuniversity Laboratory of Human Movement Biology, University Savoie Mont Blanc, Chambery, France
| | - Manon Riccetti
- Interuniversity Laboratory of Human Movement Biology, University Savoie Mont Blanc, Chambery, France
| | | | - Frédéric Galactéros
- Sickle Cell Referral Center, UMGGR, Henri-Mondor University Hospital (AP-HP), Creteil, France
| | - Barnabas Gellen
- Department of Cardiac Rehabilitation, Henri-Mondor University Hospital, AP-HP, Creteil, France
| | - Thomas Rupp
- Interuniversity Laboratory of Human Movement Biology, University Savoie Mont Blanc, Chambery, France
| | - Léonard Féasson
- Interuniversity Laboratory of Human Movement Biology, Myology Unit, University Hospital Saint-Etienne, Saint-Etienne, France
| | - Pablo Bartolucci
- Sickle Cell Referral Center, UMGGR, Henri-Mondor University Hospital (AP-HP), Creteil, France
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Messonnier LA, Bartolucci P, d'Humières T, Dalmais E, Lacour JR, Freund H, Galactéros F, Féasson L. Preventive measures for the critical postexercise period in sickle cell trait and disease. J Appl Physiol (1985) 2021; 130:485-490. [PMID: 33270510 DOI: 10.1152/japplphysiol.00855.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The immediate postexercise/physical activity period is critical for sickle cell trait (SCT) carriers and disease (SCD) patients. Exercise-related blood acidosis is known to trigger the cascade of HbS deoxygenation and polymerization, leading to red blood cell sickling and subsequent complications. Unfortunately, two facts worsen exercise-related blood acidosis during the initial postexercise period: First, blood lactate and H+ concentrations continue to increase for several minutes after exercise completion, exacerbating blood acidosis. Second, blood lactate concentration remains elevated and pH altered for 20-45 min during inactivity after intense exercise, keeping acid/base balance disturbed for a long period after exercise. Therefore, the risk of complications (including vasoocclusive crises and even sudden death) persists and even worsens several minutes after intense exercise completion in SCT carriers or SCD patients. Light physical activity following intense exercise (namely, active recovery) may, by accelerating lactate removal and acid/base balance restoration, reduce the risk of complications. Scientific evidence suggests that light exercise at or below the first lactate threshold is an appropriate strategy.
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Affiliation(s)
- Laurent A Messonnier
- Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université Savoie Mont Blanc, Chambéry, France
| | - Pablo Bartolucci
- INSERM U955, Equipe 2 Transfusion et maladies du globule rouge, Laboratoire d'Excellence GRex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC) Faculté de Médecine, Créteil, France.,Reference Center for Sickle Cell Disease, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Thomas d'Humières
- Service de Physiologie Cardiovasculaire, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Etienne Dalmais
- Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université Savoie Mont Blanc, Chambéry, France.,Centre d'Evaluation et de Prévention Articulaire, Challes-les-Eaux, France
| | - Jean-René Lacour
- Laboratoire de Physiologie de l'Exercice, Faculté de Médecine Lyon-Sud, Université de Lyon, Université Claude Bernard Lyon 1, Oullins, France
| | - Hubert Freund
- Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université Savoie Mont Blanc, Chambéry, France
| | - Frédéric Galactéros
- Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC) Faculté de Médecine, Créteil, France.,Reference Center for Sickle Cell Disease, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Léonard Féasson
- University Hospital of Saint-Etienne, Myology Unit, Department of Clinical and Exercise Physiology, Referent Center of Neuromuscular Diseases, Euro-NmD, Saint-Etienne, France.,Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
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7
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Chatel B, Bernit E, Vilmen C, Michel C, Bendahan D, Messonnier LA. In vivo muscle function and energetics in women with sickle cell anemia or trait: a 31P-magnetic resonance spectroscopy study. J Appl Physiol (1985) 2020; 130:737-745. [PMID: 33300856 DOI: 10.1152/japplphysiol.00790.2020] [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] [Indexed: 11/22/2022] Open
Abstract
Sickle cell anemia (SCA) is a genetic hemoglobinopathy associated with an impaired oxygen delivery to skeletal muscle that could alter ATP production processes and increase intramuscular acidosis. These alterations have been already reported in the Townes mouse model of SCA but the corresponding changes in humans have not been documented. In the present study, we used 31-phosphorus magnetic resonance spectroscopy to investigate in vivo the metabolic changes induced by a moderate-intensity exercise in twelve SCA patients, eight sickle cell trait (SCT) carriers, and twelve controls women. The rest-exercise-recovery protocol disclosed slight differences regarding phosphocreatine (PCr) consumption and lactate accumulation between SCA patients and controls but these differences did not reach a statistical significance. On that basis, the in vivo metabolic changes associated with a moderate-intensity muscle exercise were slightly altered in SCA patients and SCT carriers but within a normal range. The present results strongly support the fact that a moderate-intensity exercise is safe and could be recommended in stable SCA patients and SCT subjects.NEW & NOTEWORTHY The main finding of the present study was that the metabolic changes associated with a moderate-intensity muscle exercise were slightly modified in stable sickle cell anemia patients and sickle cell trait carriers as compared to controls but still in the normal range. The present results strongly support the safety of a moderate-intensity exercise for stable sickle cell anemia patients and sickle cell trait carriers.
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Affiliation(s)
- Benjamin Chatel
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France.,CellMade, Le-Bourget-du-Lac, France
| | - Emmanuelle Bernit
- Service de Médecine Interne, Hôpital de la Timone, APHM, Marseille, France.,Centre de référence Antilles-Guyane pour la Drépanocytose, les Thalassémies et les maladies constitutives du Globule Rouge et de l'Erythropoïèse, Pointe à Pitre, Guadeloupe
| | | | | | - David Bendahan
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France
| | - Laurent A Messonnier
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France.,Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité EA7424, Chambéry, France
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8
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Merlet AN, Féasson L, Bartolucci P, Hourdé C, Schwalm C, Gellen B, Galactéros F, Deldicque L, Francaux M, Messonnier LA. Muscle structural, energetic and functional benefits of endurance exercise training in sickle cell disease. Am J Hematol 2020; 95:1257-1268. [PMID: 32681734 DOI: 10.1002/ajh.25936] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
Sickle cell disease (SCD) patients display skeletal muscle hypotrophy, altered oxidative capacity, exercise intolerance and poor quality of life. We previously demonstrated that moderate-intensity endurance training is beneficial for improving muscle function and quality of life of patients. The present study evaluated the effects of this moderate-intensity endurance training program on skeletal muscle structural and metabolic properties. Of the 40 randomized SCD patients, complete data sets were obtained from 33. The training group (n = 15) followed a personalized moderate-intensity endurance training program, while the non-training (n = 18) group maintained a normal lifestyle. Biopsies of the vastus lateralis muscle and submaximal incremental cycling tests were performed before and after the training program. Endurance training increased type I muscle fiber surface area (P = .038), oxidative enzyme activity [citrate synthase, P < .001; β-hydroxyacyl-CoA dehydrogenase, P = .009; type-I fiber cytochrome c oxidase, P = .042; respiratory chain complex IV, P = .017] and contents of respiratory chain complexes I (P = .049), III (P = .005), IV (P = .003) and V (P = .002). Respiratory frequency, respiratory exchange ratio, blood lactate concentration and rating of perceived exertion were all lower at a given submaximal power output after training vs non-training group (all P < .05). The muscle content of proteins involved in glucose transport and pH regulation were unchanged in the training group relative to the non-training group. The moderate-intensity endurance exercise program improved exercise capacity and muscle structural and oxidative properties. This trial was registered at www.clinicaltrials.gov as #NCT02571088.
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Affiliation(s)
- Angèle N. Merlet
- Laboratoire Interuniversitaire de Biologie de la Motricité Université de Lyon, Université Jean Monnet Saint‐Etienne France
| | - Léonard Féasson
- Laboratoire Interuniversitaire de Biologie de la Motricité Université de Lyon, Université Jean Monnet Saint‐Etienne France
- Unité de Myologie, Service de Physiologie Clinique et de l'Exercice Hôpital Universitaire de Saint‐Etienne Saint‐Etienne France
| | - Pablo Bartolucci
- Service de Médecine Interne Hôpital Henri‐Mondor (AP‐HP), Université Paris‐Est Créteil (UPEC) Créteil France
- Service de Santé Publique Hôpital Henri‐Mondor (AP‐HP), Université Paris‐Est Créteil Créteil France
| | - Christophe Hourdé
- Laboratoire Interuniversitaire de Biologie de la Motricité Université Savoie Mont Blanc Chambéry France
| | - Céline Schwalm
- Institute of Neuroscience Université Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Barnabas Gellen
- Service de Réhabilitation Cardiaque Hôpital Henri‐Mondor (Assistance Publique–Hôpitaux de Paris [APHP]) Créteil France
| | - Frédéric Galactéros
- Service de Santé Publique Hôpital Henri‐Mondor (AP‐HP), Université Paris‐Est Créteil Créteil France
- Laboratoire Interuniversitaire de Biologie de la Motricité Université Savoie Mont Blanc Chambéry France
| | - Louise Deldicque
- Institute of Neuroscience Université Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Marc Francaux
- Institute of Neuroscience Université Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Laurent A. Messonnier
- Laboratoire Interuniversitaire de Biologie de la Motricité Université Savoie Mont Blanc Chambéry France
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9
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Kozłowska L, Mizera O, Gromadzińska J, Janasik B, Mikołajewska K, Mróz A, Wąsowicz W. Changes in Oxidative Stress, Inflammation, and Muscle Damage Markers Following Diet and Beetroot Juice Supplementation in Elite Fencers. Antioxidants (Basel) 2020; 9:antiox9070571. [PMID: 32630279 PMCID: PMC7402086 DOI: 10.3390/antiox9070571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to assess the impact of diet and active substances in beetroot juice on the parameters of oxidative stress, inflammation, and muscle damage as well as on the maximum rate of oxygen uptake (VO2max) in elite fencers (10 women, 10 men). Athletes during four weeks realized dietary recommendations (ID) and, after that, diet with freeze-dried beetroot juice supplementation (ID&BEET). At baseline and after each stage, fasting antioxidants, biomarkers of oxidative stress, inflammation, and skeletal muscle damage were measured, and a VO2max test was performed. Only after ID&BEET was a significant increase of VO2max observed, and changes of this parameter were negatively related with changes of serum lactate dehydrogenase (∆LDH) activity, as well as with serum ∆β-carotene and malondialdehyde concentration (∆MDA). Additionally, positive relationships were observed between ∆β-carotene versus changes of the serum concentration of advanced oxidation protein products (∆AOPP), changes of serum glutathione peroxidase activity (∆GPx3) versus both changes of physical activity level and ∆LDH, as well as erythrocyte glutathione peroxidase activity (∆GPx1) versus ∆LDH. To summarize, we showed that long-term beetroot juice supplementation increases lipid peroxidation, and improvement of VO2max after ID&BEET seems to be dependent on LDH activity, as well as on the serum concentration of MDA and β-carotene.
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Affiliation(s)
- Lucyna Kozłowska
- Department of Dietetics, Warsaw University of Life Sciences, Institute of Human Nutrition Sciences, Nowoursynowska 15c, 02-776 Warsaw, Poland;
| | - Olga Mizera
- Department of Dietetics, Warsaw University of Life Sciences, Institute of Human Nutrition Sciences, Nowoursynowska 15c, 02-776 Warsaw, Poland;
- Correspondence:
| | - Jolanta Gromadzińska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Beata Janasik
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Karolina Mikołajewska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Anna Mróz
- Department of Physiology and Sport Medicine, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland;
| | - Wojciech Wąsowicz
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
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10
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Messonnier LA, Gellen B, Lacroix R, Peyrot S, Rupp T, Mira J, Peyrard A, Berkenou J, Galactéros F, Bartolucci P, Féasson L. Physiological Evaluation for Endurance Exercise Prescription in Sickle Cell Disease. Med Sci Sports Exerc 2020; 51:1795-1801. [PMID: 30920486 DOI: 10.1249/mss.0000000000001993] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Although strenuous exercise may expose sickle cell disease (SCD) patients to risks of vaso-occlusive crisis, evidence suggests that regular endurance exercise may be beneficial. This study aimed to test (i) the safety and usefulness of a submaximal incremental exercise in evaluating physical ability of SCD patients and identify a marker for the management of endurance exercise and (ii) the feasibility of endurance exercise sessions in SCD patients. METHODS Twenty adults with SCD (12 men and 8 women) performed a submaximal incremental exercise used to determine the first lactate threshold (LT1) and stopped as soon as blood lactate concentration ([lactate]b) reached ≥4 mmol·L. Fifteen of those patients (8 men and 7 women) also performed three 30-min endurance exercise sessions at ~2.5 mmol·L of [lactate]b on separate occasions. RESULTS LT1 occurred at 47 ± 3 and 33 ± 3 W for men and women, respectively, demonstrating the extreme deconditioning and, thus, low physical ability of adult SCD patients. During endurance exercise, peripheral oxygen saturation and [lactate]b most often remained stable and within acceptable ranges. CONCLUSIONS The proposed strategy of submaximal incremental exercise allowed safe determination of LT1, an important parameter of patients' physical ability. The study also demonstrated the feasibility and safety of individually tailored endurance exercises at ~2.5 mmol·L of [lactate]b. These latter results suggest that endurance training programs may be considered for adult SCD patients and that the method proposed here may be helpful in that regard.
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Affiliation(s)
- Laurent A Messonnier
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Barnabas Gellen
- Department of Cardiac Rehabilitation, Henri-Mondor University Hospital, AP-HP, Creteil, FRANCE.,ELSAN, Polyclinique de Poitiers, Poitiers, FRANCE
| | - Roxane Lacroix
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Sandrine Peyrot
- Department of Cardiac Rehabilitation, Henri-Mondor University Hospital, AP-HP, Creteil, FRANCE
| | - Thomas Rupp
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - José Mira
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Arthur Peyrard
- University Savoie Mont Blanc, Inter-university Laboratory of Human Movement Sciences, Chambéry EA7424, FRANCE
| | - Jugurtha Berkenou
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE
| | - Frédéric Galactéros
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE.,IMRB, Henri-Mondor Hospital-UPEC, GRex, Créteil, FRANCE
| | - Pablo Bartolucci
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital-UPEC, AP-HP, Créteil, FRANCE.,IMRB, Henri-Mondor Hospital-UPEC, GRex, Créteil, FRANCE
| | - Léonard Féasson
- Inter-university Laboratory of Human Movement Sciences, University of Lyon, UJM-Saint-Etienne, EA7424, Saint-Etienne, FRANCE.,Myology Unit, Referent Center of Rare Neuromuscular Diseases, Euro-NmD, University Hospital of Saint-Etienne, Saint-Etienne, FRANCE
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11
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Cazenave M, Audard V, Bertocchio JP, Habibi A, Baron S, Prot-Bertoye C, Berkenou J, Maruani G, Stehlé T, Cornière N, Ayari H, Friedlander G, Galacteros F, Houillier P, Bartolucci P, Courbebaisse M. Tubular Acidification Defect in Adults with Sickle Cell Disease. Clin J Am Soc Nephrol 2020; 15:16-24. [PMID: 31822527 PMCID: PMC6946065 DOI: 10.2215/cjn.07830719] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/29/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Metabolic acidosis is a frequent manifestation of sickle cell disease but the mechanisms and determinants of this disorder are unknown. Our aim was to characterize urinary acidification capacity in adults with sickle cell disease and to identify potential factors associated with decreased capacity to acidify urine. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Among 25 adults with sickle cell disease and an eGFR of ≥60 ml/min per 1.73 m2 from a single center in France, we performed an acute acidification test after simultaneous administration of furosemide and fludrocortisone. A normal response was defined as a decrease in urinary pH <5.3 and an increase in urinary ammonium excretion ≥33 µEq/min at one or more of the six time points after furosemide and fludrocortisone administration. RESULTS Of the participants (median [interquartile range] age of 36 [24-43] years old, 17 women), 12 had a normal and 13 had an abnormal response to the test. Among these 13 participants, nine had normal baseline plasma bicarbonate concentration. Plasma aldosterone was within the normal range for all 13 participants with an abnormal response, making the diagnosis of type 4 tubular acidosis unlikely. The participants with an abnormal response to the test were significantly older, more frequently treated with oral bicarbonate, had a higher plasma uric acid concentration, higher hemolysis activity, lower eGFR, lower baseline plasma bicarbonate concentration, higher urine pH, lower urine ammonium ion excretion, and lower fasting urine osmolality than those with a normal response. Considering both groups, the maximum urinary ammonium ion excretion was positively correlated with fasting urine osmolality (r 2=0.34, P=0.002), suggesting that participants with sickle cell disease and lower urine concentration capacity have lower urine acidification capacity. CONCLUSIONS Among adults with sickle cell disease, impaired urinary acidification capacity attributable to distal tubular dysfunction is common and associated with the severity of hyposthenuria. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_12_10_CJN07830719.mp3.
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Affiliation(s)
- Maud Cazenave
- Nephrology and Renal Transplantation Department, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Henri Mondor Hospital, AP-HP, Paris Est Créteil University, Créteil, France
| | - Jean-Philippe Bertocchio
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, INSERM U1138, Centre National de la Recherche Scientifique (CNRS) ERL8228, Paris, France
| | - Anoosha Habibi
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB team 2, UPEC, Labex GRex, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Stéphanie Baron
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, INSERM U1138, Centre National de la Recherche Scientifique (CNRS) ERL8228, Paris, France
| | - Caroline Prot-Bertoye
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, INSERM U1138, Centre National de la Recherche Scientifique (CNRS) ERL8228, Paris, France
| | - Jugurtha Berkenou
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB team 2, UPEC, Labex GRex, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Gérard Maruani
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, Necker-Enfants Malades Institute, INSERM U1151-CNRS UMR8253, Paris, France; and
| | - Thomas Stehlé
- Nephrology and Renal Transplantation Department, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Henri Mondor Hospital, AP-HP, Paris Est Créteil University, Créteil, France
| | - Nicolas Cornière
- Nephrology Department, Felix Guyon Hospital, Saint-Denis, Réunion Island, France
| | - Hamza Ayari
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, INSERM U1138, Centre National de la Recherche Scientifique (CNRS) ERL8228, Paris, France
| | - Gérard Friedlander
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, Necker-Enfants Malades Institute, INSERM U1151-CNRS UMR8253, Paris, France; and
| | - Frédéric Galacteros
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB team 2, UPEC, Labex GRex, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Pascal Houillier
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, INSERM U1138, Centre National de la Recherche Scientifique (CNRS) ERL8228, Paris, France
| | - Pablo Bartolucci
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB team 2, UPEC, Labex GRex, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Marie Courbebaisse
- Physiology Department, European Georges Pompidou University Hospital, AP-HP, Paris Descartes University, Necker-Enfants Malades Institute, INSERM U1151-CNRS UMR8253, Paris, France; and
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12
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Chatel B, Messonnier LA, Vilmen C, Bernard M, Pialoux V, Bendahan D. Ischaemia-induced muscle metabolic abnormalities are poorly alleviated by endurance training in a mouse model of sickle cell disease. Exp Physiol 2019; 104:398-406. [PMID: 30578584 DOI: 10.1113/ep087430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/17/2018] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? The aim of this study was to evaluate the potential beneficial effects of endurance training during an ischaemia-reperfusion protocol in a mouse model of sickle cell disease (SCD). What is the main finding and its importance? Endurance training did not reverse the metabolic defects induced by a simulated vaso-occlusive crisis in SCD mice, with regard to intramuscular acidosis, mitochondrial dysfunction or anatomical properties. Our results suggest that endurance training would reduce the number of vaso-occlusive crises rather than the complications related to vaso-occlusive crises. ABSTRACT The aim of this study was to investigate whether endurance training could limit the abnormalities described in a mouse model of sickle cell disease (SCD) in response to an ischaemia-reperfusion (I/R) protocol. Ten sedentary (HbSS-SED) and nine endurance-trained (HbSS-END) SCD mice were submitted to a standardized protocol of I/R of the leg, during which ATP, phosphocreatine and inorganic phosphate concentrations and intramuscular pH were measured using magnetic resonance spectroscopy. Forty-eight hours later, skeletal muscles were harvested. Oxidative stress markers were then measured. Although the time course of protons accumulation was slightly different between trained and sedentary mice (P < 0.05), the extent of acidosis was similar at the end of the ischaemic period. The initial rate of phosphocreatine resynthesis measured at blood flow restoration, illustrating mitochondrial function, was not altered in trained mice compared with sedentary mice. Although several oxidative stress markers were not different between groups (P > 0.05), the I/R-related increase of uric acid concentration observed in sedentary SCD mice (P < 0.05) was not present in the trained group. The spleen weight, generally used as a marker of the severity of the disease, was not different between groups (P > 0.05). In conclusion, endurance training did not limit the metabolic consequences of an I/R protocol in skeletal muscle of SCD mice, suggesting that the reduction in the severity of the disease previously demonstrated in the basal state would be attributable to a reduction of the occurrence of vaso-occlusive crises rather than a decrease of the deleterious effects of vaso-occlusive crises.
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Affiliation(s)
| | - Laurent A Messonnier
- Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-73000, Chambéry, France
| | | | | | - Vincent Pialoux
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Villeurbanne, France
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