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Zhou Q, Chang C, Wang Y, Gai X, Chen Y, Gao X, Liang Y, Sun Y. Comparative analysis of lysophospholipid metabolism profiles and clinical characteristics in patients with high vs. low C-reactive protein levels in acute exacerbations of chronic obstructive pulmonary disease. Clin Chim Acta 2024; 561:119816. [PMID: 38885755 DOI: 10.1016/j.cca.2024.119816] [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: 03/27/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND The precise role of lysophospholipids (LysoPLs) in the pathogenesis of acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) remains unclear. In this study, we sought to elucidate the differences in serum LysoPL metabolite profiles and their correlation with clinical features between patients with low versus high CRP levels. METHODS A total of 58 patients with AECOPD were enrolled in the study. Patients were classified into two groups: low CRP group (CRP < 20 mg/L, n = 34) and high CRP group (CRP ≥ 20 mg/L, n = 24). Clinical data were collected, and the LysoPL metabolite profiles were analyzed using Liquid Chromatography-Mass Spectrometry (LC-MS) and identified by matching with the LipidBlast library. RESULTS Nineteen differential LysoPLs were initially identified through Student's t-test (p < 0.05 and VIP > 1). Subsequently, four LysoPLs, LPC(16:0), LPE(18:2), LPC(22:0), and LPC(24:0), were identified by FDR adjustment (adjusted p < 0.05). These four lysoPLs had a significant negative correlation with CRP. Integrative analysis revealed that LPC (16:0) and LPC (22:0) correlated with less hypercapnic respiratory failure and ICU admission. CONCLUSION AECOPD patients with high CRP levels demonstrated a distinctive LysoPL metabolism profile, with LPC (16:0), LPE(18:2), LPC(22:0), and LPC(24:0) being the most significantly altered lipid molecules. These alterations were associated with poorer clinical outcomes.
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Affiliation(s)
- Qiqiang Zhou
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Chun Chang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Yating Wang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Xiaoyan Gai
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Yahong Chen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China.
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
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2
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McNicholas WT. Does Obstructive Sleep Apnea Lead to Progression of Chronic Obstructive Pulmonary Disease. Sleep Med Clin 2024; 19:253-260. [PMID: 38692750 DOI: 10.1016/j.jsmc.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have important bidirectional relationships that influence the pathophysiology of each disorder. The slim hyperinflated "pink puffer" phenotype of COPD protects against OSA, whereas the heavier "blue bloater" phenotype predisposes to OSA by fluid retention. OSA may aggravate COPD by promoting airway inflammation. COPD-OSA overlap patients have lower quality of life and are at higher risk of cardiovascular comorbidity than either disorder alone due to greater nocturnal oxygen desaturation and sympathetic activation. Management of OSA with positive airway pressure improves COPD outcomes that include lower exacerbation rates compared to untreated patients.
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Affiliation(s)
- Walter T McNicholas
- Department of Respiratory and Sleep Medicine, St. Vincent's Hospital Group, Dublin, Ireland; School of Medicine and the Conway Research Institute, University College, Dublin, Ireland.
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3
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Stock CJW, Bray WG, Kouranos V, Jacob J, Kokosi M, George PM, Chua F, Wells AU, Sestini P, Renzoni EA. Serum C-reactive protein is associated with earlier mortality across different interstitial lung diseases. Respirology 2024; 29:228-234. [PMID: 37779266 DOI: 10.1111/resp.14609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The acute-phase protein C-reactive protein (CRP) is known to be associated with poor outcomes in cancer and cardiovascular disease, but there is limited evidence of its prognostic implications in interstitial lung diseases (ILDs). We therefore set out to test whether baseline serum CRP levels are associated with mortality in four different ILDs. METHODS In this retrospective study, clinically measured CRP levels, as well as baseline demographics and lung function measures, were collected for ILD patients first presenting to the Royal Brompton Hospital between January 2010 and December 2019. Cox regression analysis was used to determine the relationship with 5-year mortality. RESULTS Patients included in the study were: idiopathic pulmonary fibrosis (IPF) n = 422, fibrotic hypersensitivity pneumonitis (fHP) n = 233, rheumatoid arthritis associated ILD (RA-ILD) n = 111 and Systemic Sclerosis associated ILD (SSc-ILD) n = 86. Patients with a recent history of infection were excluded. Higher CRP levels were associated with shorter 5-year survival in all four disease groups on both univariable analyses, and after adjusting for age, gender, smoking history, immunosuppressive therapy and baseline disease severity (IPF: HR (95% CI): 1.3 (1.1-1.5), p = 0.003, fHP: 1.5 (1.2-1.9), p = 0.001, RA-ILD: 1.4 (1.1-1.84), p = 0.01 and SSc-ILD: 2.7 (1.6-4.5), p < 0.001). CONCLUSION Higher CRP levels are independently associated with reduced 5-year survival in IPF, fHP, RA-ILD and SSc-ILD.
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Affiliation(s)
- Carmel J W Stock
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - William G Bray
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Vasilis Kouranos
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Joseph Jacob
- Satsuma Lab, Centre for Medical Image Computing, Department of Computer Science, UCL, London, UK
- UCL Respiratory, UCL, London, UK
| | - Maria Kokosi
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter M George
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Felix Chua
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Athol U Wells
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Elisabetta A Renzoni
- Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Margaret Turner Warwick Centre for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London, London, UK
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4
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Park C, Jang JH, Kim C, Lee Y, Lee E, Yang HM, Park RW, Park HS. Real-World Effectiveness of Statin Therapy in Adult Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:399-408.e6. [PMID: 37866433 DOI: 10.1016/j.jaip.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Blood lipids affect airway inflammation in asthma. Although several studies have suggested anti-inflammatory effects of statins on asthmatic airways, further studies are needed to clarify the long-term effectiveness of statins on asthma control and whether they are an effective treatment option. OBJECTIVE To evaluate the long-term effectiveness of statins in the chronic management of adult asthma in real-world practice. METHODS Electronic medical record data spanning 28 years, collected from the Ajou University Medical Center in Korea, were used to conduct a retrospective study. Clinical outcomes were compared between patients with asthma who had maintained statin use (the statin group) and those not taking statins, whose blood lipid tests were always normal (the non-statin group). We performed propensity score matching and calculated hazard ratios with 95% CIs using the Cox proportional hazards model. Severe asthma exacerbation was the primary outcome; asthma exacerbation, asthma-related hospitalization, and new-onset type 2 diabetes mellitus and hypertension were secondary outcomes. RESULTS After 1:1 propensity score matching, the statin and non-statin groups each included 545 adult patients with asthma. The risk of severe asthma exacerbations and asthma exacerbations was significantly lower in the statin group than in the non-statin group (hazard ratios [95% CI] = 0.57 [0.35-0.90] and 0.71 [0.52-0.96], respectively). There were no significant differences in the risk of asthma-related hospitalization or new-onset type 2 diabetes mellitus or hypertension between groups (0.76 [0.53-1.09], 2.33 [0.94-6.59], and 1.71 [0.95-3.17], respectively). CONCLUSION Statin use is associated with a lower risk of asthma exacerbation, with better clinical outcomes in adult asthma.
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Affiliation(s)
- ChulHyoung Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae-Hyuk Jang
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Chungsoo Kim
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Youngsoo Lee
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Eunyoung Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea; Office of Biostatistics, Medical Research Collaboration Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea
| | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea.
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea.
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Shakeel I, Ashraf A, Afzal M, Sohal SS, Islam A, Kazim SN, Hassan MI. The Molecular Blueprint for Chronic Obstructive Pulmonary Disease (COPD): A New Paradigm for Diagnosis and Therapeutics. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:2297559. [PMID: 38155869 PMCID: PMC10754640 DOI: 10.1155/2023/2297559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/28/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023]
Abstract
The global prevalence of chronic obstructive pulmonary disease (COPD) has increased over the last decade and has emerged as the third leading cause of death worldwide. It is characterized by emphysema with prolonged airflow limitation. COPD patients are more susceptible to COVID-19 and increase the disease severity about four times. The most used drugs to treat it show numerous side effects, including immune suppression and infection. This review discusses a narrative opinion and critical review of COPD. We present different aspects of the disease, from cellular and inflammatory responses to cigarette smoking in COPD and signaling pathways. In addition, we highlighted various risk factors for developing COPD apart from smoking, like occupational exposure, pollutants, genetic factors, gender, etc. After the recent elucidation of the underlying inflammatory signaling pathways in COPD, new molecular targeted drug candidates for COPD are signal-transmitting substances. We further summarize recent developments in biomarker discovery for COPD and its implications for disease diagnosis. In addition, we discuss novel drug targets for COPD that could be explored for drug development and subsequent clinical management of cardiovascular disease and COVID-19, commonly associated with COPD. Our extensive analysis of COPD cause, etiology, diagnosis, and therapeutic will provide a better understanding of the disease and the development of effective therapeutic options. In-depth knowledge of the underlying mechanism will offer deeper insights into identifying novel molecular targets for developing potent therapeutics and biomarkers of disease diagnosis.
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Affiliation(s)
- Ilma Shakeel
- Department of Zoology, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi 110025, India
| | - Anam Ashraf
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi 110025, India
| | - Mohammad Afzal
- Department of Zoology, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India
| | - Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania 7248, Australia
| | - Asimul Islam
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi 110025, India
| | - Syed Naqui Kazim
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi 110025, India
| | - Md. Imtaiyaz Hassan
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi 110025, India
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Tang L, Zhang L, Mei X, Yu J, Jiang G. Pulmonary infection is associated with an increased IL-6 in acute exacerbation chronic obstructive pulmonary disease. EUR J INFLAMM 2023. [DOI: 10.1177/1721727x221149534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective Acute Exacerbation Chronic Obstructive Pulmonary Disease (AECOPD) is associated with an acute worsening of respiratory symptoms that have effects on lung function, quality of life and health economic burden. In addition, the development of pulmonary infections is a common complication of Chronic Obstructive Pulmonary Disease (COPD). In the pathophysiology of AECOPD, interleukin (IL)-6 is a pleiotropic cytokine that can be produced by inflammatory and primary lung epithelial cells in response to a variety of different stimuli. We aim to investigate the correlation between serum cytokine levels and AECOPD with pulmonary infection. Methods 37 AECOPD patients diagnosed with pulmonary infection and 33 patients diagnosed with AECOPD only were selected. All COPD patients were diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Serum samples for C-reactive protein (CRP) and cytokines were obtained from the patients immediately after admission. Serum concentrations of cytokines were measured using a fluorescent bead immunoassay on a flow cytometer. Logistic regression was used to identify risk factors for AECOPD co-infection of the lungs. Results Serum characterization of our cohort showed patients with AECOPD and pulmonary infection had higher levels of IL-6 and IL-10 compared with the AECOPD group, and IL-6 was independently associated with AECOPD with pulmonary infection. ROC curve analysis showed that IL-6 was a useful predictor of the incidence of pulmonary infection in AECOPD patients. Conclusions Our findings highlight the role of IL-6 in the pathogenesis of AECOPD with pulmonary infection.
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Affiliation(s)
- Leilei Tang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Lingdi Zhang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xuan Mei
- Department of Hepatobiliary Internal Medicine, The 900th Hospital of PLA Joint Logistics Support Force, Fuzhou, China
| | - Jiawen Yu
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Guojun Jiang
- Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
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7
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Lin Y, Sang L, Wang J, Chen Y, Lai J, Zhu X, Yang Y, Zhang Z, Liu Y, Wen S, Zhang N, Zhao D. Analysis of Airway Thickening and Serum Cytokines in COPD Patients with Frequent Exacerbations: A Heart of the Matter. Int J Chron Obstruct Pulmon Dis 2023; 18:2353-2364. [PMID: 37928768 PMCID: PMC10624196 DOI: 10.2147/copd.s430650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023] Open
Abstract
Background Differences in lung function for Chronic Obstructive Pulmonary Disease (COPD) cause bias in the findings when identifying frequent exacerbator phenotype-related causes. The aim of this study was to determine whether computed tomographic (CT) biomarkers and circulating inflammatory biomarkers were associated with the COPD frequent exacerbator phenotype after eliminating the differences in lung function between a frequent exacerbator (FE) group and a non-frequent exacerbator (NFE) group. Methods A total of 212 patients with stable COPD were divided into a FE group (n=106) and a NFE group (n=106) according to their exacerbation history. These patients were assessed by spirometry, quantitative CT measurements and blood sample measurements during their stable phase. Univariate and multivariate logistic regression were used to assess the association between airway thickening or serum cytokines and the COPD frequent exacerbator phenotype. Receiver operating characteristic (ROC) curves were calculated for Pi10, WA%, IL-1β and IL-4 to identify frequent exacerbators. Results Compared with NFE group, FE group had a greater inner perimeter wall thickness of a 10 mm diameter bronchiole (Pi10), a greater airway wall area percentage (WA%) and higher concentrations of IL-1β and IL-4 (p<0.001). After adjusting for sex, age, BMI, FEV1%pred and smoking pack-years, Pi10, WA%, IL-β and IL-4 were independently associated with a frequent exacerbator phenotype (p<0.001). Additionally, there was an increase in the odds ratio of the frequent exacerbator phenotype with increasing Pi10, WA%, IL-4, and IL-1β (p for trend <0.001). The ROC curve demonstrated that IL-1β had a significantly larger calculated area under the curve (p < 0.05) than Pi10, WA% and IL-4. Conclusion Pi10, WA%, IL-4, and IL-1β were independently associated with the frequent exacerbator phenotype among patients with stable COPD, suggesting that chronic airway and systemic inflammation contribute to the frequent exacerbator phenotype. Trial Registration This trial was registered in Chinese Clinical Trial Registry (https://www.chictr.org.cn). Its registration number is ChiCTR2000038700, and date of registration is September 29, 2020.
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Affiliation(s)
- Yiqi Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Li Sang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Jiahe Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yating Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Jianxiong Lai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Xiaofeng Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yuhan Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Zhuofan Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yinghua Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Shenyu Wen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Nuofu Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Dongxing Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
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Muse VP, Aguayo-Orozco A, Balaganeshan SB, Brunak S. Population-wide analysis of hospital laboratory tests to assess seasonal variation and temporal reference interval modification. PATTERNS (NEW YORK, N.Y.) 2023; 4:100778. [PMID: 37602220 PMCID: PMC10435957 DOI: 10.1016/j.patter.2023.100778] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 08/22/2023]
Abstract
We identified mortality-, age-, and sex-associated differences in relation to reference intervals (RIs) for laboratory tests in population-wide data from nearly 2 million hospital patients in Denmark and comprising more than 300 million measurements. A low-parameter mathematical wave-based modification method was developed to adjust for dietary and environment influences during the year. The resulting mathematical fit allowed for improved association rates between re-classified abnormal laboratory tests, patient diagnoses, and mortality. The study highlights the need for seasonally modified RIs and presents an approach that has the potential to reduce over- and underdiagnosis, affecting both physician-patient interactions and electronic health record research as a whole.
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Affiliation(s)
- Victorine P. Muse
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Alejandro Aguayo-Orozco
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Sedrah B. Balaganeshan
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2200 Copenhagen, Denmark
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9
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Khedr L, Khedr NF, Werida RH. Functional capacity and inflammatory biomarkers as predictors for right atrial volume index in COPD patients. Int J Cardiovasc Imaging 2023; 39:1493-1504. [PMID: 37217717 PMCID: PMC10427529 DOI: 10.1007/s10554-023-02871-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and right-heart complications. So, this study aimed to evaluate the role of right atrial volume index (RAVI), inflammatory biomarkers and functional capacity in predicting poor outcomes for patients with COPD, classified by COPD assessment test (CAT) questionnaire, as early predictors of right heart diseases. METHODS 151 patients with COPD with ejection fraction (LVEF) > 55% were enrolled and classified according to CAT questionnaire into CAT ≥ 10 (group I) and CAT < 10 (group II). RAVI was calculated using Echocardiography. Assessment of RV systolic function was done by Doppler imaging. Functional capacity parameters were assessed by modified medical research council dyspnea scale (mMRC). IL-1β, adiponectin, hs-CRP and neopterin were evaluated by ELSA kits. RESULTS Group I (CAT ≥ 10) had higher RAVI (73.92 ± 21.20 ml/m2 vs 22.73 ± 6.24 ml/m2, p < 0.001), lower S`tri (0.05 ± 0.01 vs 0.13 ± 0.03 m/s, p < 0.001), lower tricuspid annular plane systolic excursion (TAPSE) (1.20 ± 0.17 cm vs 2.17 ± 0.48 cm, p < 0.001), higher RVSP (54.88 ± 7.97 vs 26.79 ± 9.84 mmHg, p < 0.001) compared with group II (CAT < 10). RAVI was good predictor of CAT (r = 0.954, p < 0.001) and strongly correlated with tricuspid S`tri, RVSP, tricuspid E/e' and Mitral E/e' (r = -0.737, r = 0.753, r = 0.817 and r = 0.515, respectively, p < 0.001). RAVI was correlated with TAPSE (r = -0.673, p < 0.001) and with tricuspid E/A ratio & LVEF (r = 0.628, r = -0.407, respectively, p < 0.001). Hs-CRP: 2.50 ± 1.43 vs 2.03 ± 1.19, IL-1β: 37.96 ± 14.35 vs 27.57 ± 8.06, neopterin: 91.37 ± 17.30 vs 76.90 ± 16.75, p < 0.05) were significantly higher besides lower adiponectin levels (3.19 ± 1.98 vs 5.32 ± 1.33 p < 0.05) in group I as compared to group II. CONCLUSION Functional capacity might be useful predictor for right heart diseases in COPD patients. Inflammatory biomarkers, low adiponectin and high Hs-CRP, IL-1β and neopterin levels, might not only be useful to monitor treatment response but may also help to discriminate patients with a worsen prognosis.
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Affiliation(s)
- Lamiaa Khedr
- Department of Cardiology, Faculty of Medicine, Tanta University Hospital, Tanta University, Tanta, Egypt.
| | - Naglaa F Khedr
- Biochemistry Department, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt.
| | - Rehab H Werida
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Damanhour, 22514, Egypt.
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10
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Gross EC, Putananickal N, Orsini AL, Schoenen J, Fischer D, Soto-Mota A. Defining metabolic migraine with a distinct subgroup of patients with suboptimal inflammatory and metabolic markers. Sci Rep 2023; 13:3787. [PMID: 36882474 PMCID: PMC9992685 DOI: 10.1038/s41598-023-28499-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 01/19/2023] [Indexed: 03/09/2023] Open
Abstract
Emerging evidence suggest migraine is a response to cerebral energy deficiency or oxidative stress in the brain. Beta-hydroxybutyrate (BHB) is likely able to circumvent some of the meta-bolic abnormalities reported in migraine. Exogenous BHB was given to test this assumption and, in this post-hoc analysis, multiple metabolic biomarkers were identified to predict clinical improvements. A randomized clinical trial, involving 41 patients with episodic migraine. Each treatment period was 12 weeks long, followed by eight weeks of washout phase / second run-in phase before entering the corresponding second treatment period. The primary endpoint was the number of migraine days in the last 4 weeks of treatment adjusted for baseline. BHB re-sponders were identified (those with at least a 3-day reduction in migraine days over placebo) and its predictors were evaluated using Akaike's Information Criterion (AIC) stepwise boot-strapped analysis and logistic regression. Responder analysis showed that metabolic markers could identify a "metabolic migraine" subgroup, which responded to BHB with a 5.7 migraine days reduction compared to the placebo. This analysis provides further support for a "metabolic migraine" subtype. Additionally, these analyses identified low-cost and easily accessible biomarkers that could guide recruitment in future research on this subgroup of patients.This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233.
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Affiliation(s)
- Elena C Gross
- Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
| | - Niveditha Putananickal
- Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Anna-Lena Orsini
- Division of Pediatric Neurology, University Children's Hospital Basel (UKBB) & Neurology Department, University Hospital Basel (USB), University of Basel, Basel, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology-Citadelle Hospital, University of Liège, Liège, Belgium
| | - Dirk Fischer
- Division of Pediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Adrian Soto-Mota
- Metabolic Diseases Research Unit, National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), Tlalpan, Mexico.,School of Medicine, Tecnologico de Monterrey, Mexico City, Mexico
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11
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Emam RM, Abdelfattah RA, Abdelghany EAE, Aziz MOA, Abdullah NM, Abdelaziz AO. Assessment of trace elements, systemic inflammation, and electrolytes in patients with chronic obstructive pulmonary disease. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2023. [DOI: 10.1186/s43168-023-00187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Abstract
Background
Systemic inflammation, electrolytes, and trace element derangements are thought to be involved, directly or indirectly, in chronic obstructive pulmonary diseases (COPD).
Aim
Our aim is to evaluate systemic inflammation and disturbance in serum electrolytes and trace elements in patients with COPD.
Methods
This study was conducted in the Chest Department, Cardiothoracic Minia University Hospital. One hundred COPD patients and 40 healthy controls were included in the study. Sixty patients were in a stable state, while 40 patients were in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Serum C-reactive protein (CRP), TNF-α, copper (Cu), zinc (Z), Na, K, and Mg levels were measured for all participants.
Results
CRP, TNF, Cu, and Z were significantly higher in the stable group than in the control group (p-value 0.0002*, 0.0018*, 0.04*, 0.034*, respectively) with significantly higher levels during exacerbation (8.47 ± 6.3, 24.36 ± 9.53, 201 ± 39.02, 192 ± 32.3). The Cu/Z ratio was significantly lower in the exacerbation group than in the stable group (p-value 0.042*). Serum levels of Na, K, and Mg were significantly lower in the patients group than in the control group (p-value 0.024*, 0.039*,0.044*, respectively), with more reduction observed in the exacerbation group (132 ± 5.45, 3.24 ± 0.52, 1.67 ± 0.38).
Conclusion
CRP, TNF-α, Cu, and Z levels were significantly higher in stable COPD patients, with higher levels during exacerbation. The Cu/Z ratio was lower in the exacerbation group than in the stable group. Na, K, and Mg levels were lower in patients than in the control group with more reduction during exacerbation.
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12
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O'Neill E, Ryan S, McNicholas WT. Chronic obstructive pulmonary disease and obstructive sleep apnoea overlap: co-existence, co-morbidity, or causality? Curr Opin Pulm Med 2022; 28:543-551. [PMID: 36124997 DOI: 10.1097/mcp.0000000000000922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The chronic obstructive pulmonary disease and obstructive sleep apnoea overlap syndrome is associated with higher morbidity and mortality rates than either disease alone. There is evidence of a bidirectional relationship between the two conditions, with the overlap syndrome encompassing a spectrum of clinical phenotypes. RECENT FINDINGS This review examines the evidence for the various factors that determine the overlap syndrome, the impact overlap syndrome has on co-morbidities, and implications for diagnosis and treatment. SUMMARY The accurate diagnosis of the overlap syndrome is critical given its implications for treatment optimisation and reduction in healthcare utilisation and costs.
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Affiliation(s)
- Emily O'Neill
- School of Medicine, University College Dublin, Department of Respiratory and Sleep Medicine, St. Vincent's University Hospital, Dublin, Ireland
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13
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Wang L, Pelgrim CE, Peralta Marzal LN, Korver S, van Ark I, Leusink-Muis T, van Helvoort A, Keshavarzian A, Kraneveld AD, Garssen J, Henricks PAJ, Folkerts G, Braber S. Changes in intestinal homeostasis and immunity in a cigarette smoke- and LPS-induced murine model for COPD: the lung-gut axis. Am J Physiol Lung Cell Mol Physiol 2022; 323:L266-L280. [PMID: 35699290 PMCID: PMC9423728 DOI: 10.1152/ajplung.00486.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/10/2022] [Accepted: 06/01/2022] [Indexed: 12/14/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is often associated with intestinal comorbidities. In this study, changes in intestinal homeostasis and immunity in a cigarette smoke (CS)- and lipopolysaccharide (LPS)-induced COPD model were investigated. Mice were exposed to cigarette smoke or air for 72 days, except days 42, 52, and 62 on which the mice were treated with saline or LPS via intratracheal instillation. Cigarette smoke exposure increased the airway inflammatory cell numbers, mucus production, and different inflammatory mediators, including C-reactive protein (CRP) and keratinocyte-derived chemokine (KC), in bronchoalveolar lavage (BAL) fluid and serum. LPS did not further impact airway inflammatory cell numbers or mucus production but decreased inflammatory mediator levels in BAL fluid. T helper (Th) 1 cells were enhanced in the spleen after cigarette smoke exposure; however, in combination with LPS, cigarette exposure caused an increase in Th1 and Th2 cells. Histomorphological changes were observed in the proximal small intestine after cigarette smoke exposure, and addition of LPS had no effect. Cigarette smoke activated the intestinal immune network for IgA production in the distal small intestine that was associated with increased fecal sIgA levels and enlargement of Peyer's patches. Cigarette smoke plus LPS decreased fecal sIgA levels and the size of Peyer's patches. In conclusion, cigarette smoke with or without LPS affects intestinal health as observed by changes in intestinal histomorphology and immune network for IgA production. Elevated systemic mediators might play a role in the lung-gut cross talk. These findings contribute to a better understanding of intestinal disorders related to COPD.
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Affiliation(s)
- Lei Wang
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Charlotte E Pelgrim
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Lucía N Peralta Marzal
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Stephanie Korver
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Ingrid van Ark
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Thea Leusink-Muis
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Ardy van Helvoort
- Danone Nutricia Research, Utrecht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ali Keshavarzian
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush Medical College, Rush University, Chicago, Illinois
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
- Danone Nutricia Research, Utrecht, The Netherlands
| | - Paul A J Henricks
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Gert Folkerts
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Saskia Braber
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
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14
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Tsutsumi T, Nakano D, Kawaguchi M, Hashida R, Yoshinaga S, Takahashi H, Anzai K, Kawaguchi T. MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men. Diabetol Metab Syndr 2022; 14:115. [PMID: 35974418 PMCID: PMC9380323 DOI: 10.1186/s13098-022-00887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM Metabolic dysfunction and associated systemic inflammation are risk factors for chronic obstructive pulmonary disease (COPD) and COPD is highly prevalent in men. We investigated the impact of metabolic-associated fatty liver disease (MAFLD) and MAFLD-related systemic inflammation on COPD in men. METHODS We enrolled 2,041 men with fatty liver. Patients were classified into the COPD (n = 420/2041) and non-COPD (n = 1621/2041) groups. COPD and its high-risk group were diagnosed using the Japanese Respiratory Society Disease statement. Systemic inflammation was evaluated using the C-reactive protein (CRP)/albumin ratio. Independent factors for COPD were investigated by multivariate analysis and decision-tree analysis. RESULTS The prevalence of MAFLD was significantly higher in the COPD group than in the non-COPD group. In multivariable analysis, in addition to heavy smoking and aging, MAFLD was identified as an independent factor for COPD (OR 1.46, 95% CI 1.020-2.101, P = 0.0385). Decision-tree analysis showed that MAFLD, rather than heavy smoking, was the most influential classifier for COPD in non-elderly men (14% in MAFLD vs 6% in non-MAFLD groups). MAFLD was also the second most influential factor in elderly men who were not heavy smokers. In both groups, the CRP/albumin ratio was the first classifier for COPD (16% in the high CRP/albumin ratio group vs 3% in the low CRP/albumin ratio group of non-elderly men). CONCLUSIONS MAFLD is an independent predictor of COPD in men. MAFLD had a significant impact on COPD through systemic inflammation in men of all ages who were not heavy smokers. MAFLD may be useful to broadly identify COPD in men.
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Affiliation(s)
- Tsubasa Tsutsumi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Dan Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Machiko Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan
| | - Shinobu Yoshinaga
- Medical Examination Section, Medical Examination Part Facilities, Public Utility Foundation Saga Prefectural Health Promotion Foundation, Saga, Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Keizo Anzai
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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15
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Yuenyongchaiwat K, Akekawatchai C. Systemic Inflammation in Sarcopenia Alter Functional Capacity in Thai Community-dwelling Older People: A Preliminary Observational Study. Curr Aging Sci 2022; 15:274-281. [PMID: 35570546 PMCID: PMC9720880 DOI: 10.2174/1874609815666220513141300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/19/2022] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sarcopenia is linked to the loss of muscle mass in older adults, leading to impaired functional capacity and quality of life. In addition, this finding was recognized as an agerelated chronic inflammatory process. We aimed to determine the relationship between sarcopenia, functional capacity, and inflammatory biomarkers and subsequent prediction of inflammatory biomarkers in older adults. METHODS A total of 126 women and men aged ≥ 60 years were enrolled. Participants were required to complete a handgrip dynamometer, 6-meter walk test, and bioimpedance analysis. Diagnosis was based on the definition of sarcopenia from the Asian Working Group for Sarcopenia 2019. Prior to performing a 6-minute walking test (i.e., functional capacity testing), blood samples were drawn for a C-reactive protein (CRP) test. RESULTS A total of 12.70% were categorized as having sarcopenia. Significant differences in CRP and functional capacity between the sarcopenia and non-sarcopenia groups were found (p <.05). Older people with high CRP levels had significantly reduced functional capacity and slow gait speed. CONCLUSIONS Poor functional capacity was associated with increased CRP levels, which might be due to the development of age-related inflammation. Older patients with sarcopenia may be at higher risk for functional decline.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, 12120, Thailand
- Research Unit for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Pathumthani, Thailand
| | - Chareeporn Akekawatchai
- Medical Technology Department, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
- Research Unit in Diagnostic Molecular Biology of Chronic Diseases Related to Cancer (DMB-CDC), Thammasat University, Pathumthani, Thailand
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16
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Sanders KJC, Wierts R, van Marken Lichtenbelt WD, de Vos-Geelen J, Plasqui G, Kelders MCJM, Schrauwen-Hinderling VB, Bucerius J, Dingemans AMC, Mottaghy FM, Schols AMWJ. Brown adipose tissue activation is not related to hypermetabolism in emphysematous chronic obstructive pulmonary disease patients. J Cachexia Sarcopenia Muscle 2022; 13:1329-1338. [PMID: 35166050 PMCID: PMC8978002 DOI: 10.1002/jcsm.12881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/27/2021] [Accepted: 11/01/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Brown adipose tissue (BAT) has been primarily researched as a potential target for mitigating obesity. However, the physiological significance of BAT in relation to cachexia remains poorly understood. The objective of this study was to investigate the putative contribution of BAT on different components of energy metabolism in emphysematous chronic obstructive pulmonary disease (COPD) patients. METHODS Twenty COPD patients (mean ± SD age 62 ± 6, 50% female, median [range] BMI 22.4 [15.1-32.5] kg/m2 and 85% low FFMI) were studied. Basal metabolic rate (BMR) was assessed by ventilated hood, total daily energy expenditure (TDEE) by doubly labelled water and physical activity by triaxial accelerometry. BMR was adjusted for fat-free mass (FFM) as assessed by deuterium dilution. Analysis of BAT and WAT was conducted in a subset of ten patients and six age-matched, gender-matched and BMI-matched healthy controls. BAT glucose uptake was assessed by means of cold-stimulated integrated [18F]FDG positron-emission tomography and magnetic resonance imaging. WAT was collected from subcutaneous abdominal biopsies to analyse metabolic and inflammatory gene expression levels. Lung function was assessed by spirometry and body plethysmography and systemic inflammation by high sensitivity C-reactive protein. RESULTS Mean TDEE was 2209 ± 394 kcal/day, and mean BMR was 1449 ± 214 kcal/day corresponding to 120% of predicted. FFM-adjusted BMR did not correlate with lung function or C-reactive protein. Upon cooling, energy expenditure increased, resulting in a non-shivering thermogenesis of (median [range]) 20.1% [3.3-41.3] in patients and controls. Mean BAT glucose uptake was comparable between COPD and controls (1.5 [0.1-6.2] vs. 1.1 [0.7-3.9]). In addition, no correlation was found between BMR adjusted for FFM and BAT activity or between cold-induced non-shivering energy expenditure and BAT activity. Gene expression levels of the brown adipocyte or beige markers were also comparable between the groups. No (serious) adverse events were reported. CONCLUSIONS Although COPD patients were hypermetabolic at rest, no correlation was found between BMR or TDEE and BAT activity. Furthermore, both BAT activity and gene expression levels of the brown adipocyte or beige markers were comparable between COPD patients and controls.
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Affiliation(s)
- Karin J C Sanders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wouter D van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marco C J M Kelders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Vera B Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, NUTRIM School for Nutrition and Translational Research in Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan Bucerius
- Department of Radiology and Nuclear Medicine and CARIM School for Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Medicine Göttingen, Georg-August-University Göttingen, Göttingen, Germany
| | | | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Nuclear Medicine and CIO ABCD, University Hospital RWTH Aachen University, Aachen, Germany
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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17
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Ono K, Tabusadani M, Yamane K, Takao S, Mori K, Matsumura Y, Kuroyama Y, Kawahara K, Omatsu S, Furuuchi K, Fujiwara K, Morimoto K, Kimura H, Senjyu H. Decreased incremental shuttle walk test distance characterized by fibrocavitary lesions in non-tuberculous mycobacterial pulmonary disease. Expert Rev Respir Med 2022; 16:469-475. [PMID: 35245168 DOI: 10.1080/17476348.2022.2049762] [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: 11/04/2022]
Abstract
BACKGROUND Patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD) have impaired exercise capacity, but the underlying factors are unknown. We investigated the characteristics of patients with NTM-PD and impaired exercise capacity. METHODS In total, 149 patients with NTM-PD participated in this study. Patients completed the incremental shuttle walk test (ISWT) to assess exercise capacity. Peripheral muscle strength and pulmonary function were also assessed. Radiological findings were classified into three phenotypes: non-cavitary nodular bronchiectatic (NC-NB) form, cavitary nodular bronchiectatic form, and fibrocavitary (FC) form. RESULTS The median ISWT distance (ISWD) and %ISWD were 450 meters and 88%. Participants were classified into three groups according to %ISWD, with %ISWD <60% as the severely decreased group, 60%-80% as the moderately decreased group, and >80% as the normal or mildly decreased group. In a comparison of %ISWD among phenotypes, FC form had significantly lower %ISWD than those with NC-NB form. In the severely decreased group, peripheral muscle strength and pulmonary function were significantly lower than the other two groups. From a radiological standpoint, significantly more patients had FC form in the group with severely decreased %ISWD. CONCLUSIONS Decreased ISWD is characterized by a deterioration in physical function and the presence of FC lesions in NTM-PD.
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Affiliation(s)
- Kazuki Ono
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Mitsuru Tabusadani
- Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Kazumasa Yamane
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan
| | - Satoshi Takao
- Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Kosuke Mori
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Yusuke Matsumura
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Yuku Kuroyama
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan
| | - Kazuma Kawahara
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Shunya Omatsu
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
| | - Koji Furuuchi
- Japan Anti-Tuberculosis Association, Respiratory Diseases Center, Fukujuji Hospital, Tokyo, Japan.,Department of Basic Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan
| | - Keiji Fujiwara
- Japan Anti-Tuberculosis Association, Respiratory Diseases Center, Fukujuji Hospital, Tokyo, Japan.,Department of Basic Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan
| | - Kozo Morimoto
- Japan Anti-Tuberculosis Association, Respiratory Diseases Center, Fukujuji Hospital, Tokyo, Japan.,Division of Clinical Research, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Tokyo, Japan
| | - Hiroshi Kimura
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Diseases Center, Fukujuji Hospital, Tokyo, Japan
| | - Hideaki Senjyu
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Tokyo, Japan.,Japan Anti-Tuberculosis Association, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Tokyo, Japan
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18
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Prognostic Value of Baseline Inflammation in Diabetic and Nondiabetic Patients Undergoing PCI. Can J Cardiol 2022; 38:792-800. [DOI: 10.1016/j.cjca.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/21/2022] Open
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19
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Yijin-Tang Attenuates Cigarette Smoke and Lipopolysaccharide-Induced Chronic Obstructive Pulmonary Disease in Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7902920. [PMID: 35035511 PMCID: PMC8754600 DOI: 10.1155/2022/7902920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/17/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) refers to a lung disorder associated with symptoms of dyspnea, cough, and sputum production. Traditionally, Yijin-tang (YJT), a mixture of Pinellia ternate, Poria cocos, ginger, Chinese liquorice, and tangerine peel, has been prescribed for the treatment of respiratory system diseases caused by dampness phlegm. This experiment investigated the therapeutic effect of YJT in a mouse model of cigarette smoke (CS)- and lipopolysaccharide (LPS)-induced COPD. METHODS COPD was induced by exposing mice to CS for 1 hour per day for 8 weeks, with intranasal delivery of LPS on weeks 1, 3, 5, and 7. YJT was administered at doses of 100 and 200 mg/kg 1 hour before CS exposure for the last 4 weeks. RESULTS YJT significantly suppressed CS- and LPS-induced increases in inflammatory cell counts and reduced interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) levels in bronchoalveolar lavage fluid (BALF) and lung tissue. In addition, YJT not only decreased airway wall thickness, average alveolar intercept, and lung fibrosis, but it also suppressed the expression of matrix metallopeptidase (MMP)-7, MMP-9, and transforming growth factor-B (TGF-β) and collagen deposition. Moreover, YJT suppressed phosphorylation of nuclear factor-kappa B (NF-κB) as well as expression of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS). CONCLUSION Collectively, our findings show that YJT attenuates respiratory inflammation and airway remodeling caused by CS and LPS exposure; therefore, therapeutic applications in COPD can be considered.
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20
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Yamazaki EM, Antler CA, Casale CE, MacMullen LE, Ecker AJ, Goel N. Cortisol and C-Reactive Protein Vary During Sleep Loss and Recovery but Are Not Markers of Neurobehavioral Resilience. Front Physiol 2021; 12:782860. [PMID: 34912243 PMCID: PMC8667577 DOI: 10.3389/fphys.2021.782860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022] Open
Abstract
Cortisol and C-reactive protein (CRP) typically change during total sleep deprivation (TSD) and psychological stress; however, it remains unknown whether these biological markers can differentiate robust individual differences in neurobehavioral performance and self-rated sleepiness resulting from these stressors. Additionally, little is known about cortisol and CRP recovery after TSD. In our study, 32 healthy adults (ages 27-53; mean ± SD, 35.1 ± 7.1 years; 14 females) participated in a highly controlled 5-day experiment in the Human Exploration Research Analog (HERA), a high-fidelity National Aeronautics and Space Administration (NASA) space analog isolation facility, consisting of two baseline nights, 39 h TSD, and two recovery nights. Psychological stress was induced by a modified Trier Social Stress Test (TSST) on the afternoon of TSD. Salivary cortisol and plasma CRP were obtained at six time points, before (pre-study), during [baseline, the morning of TSD (TSD AM), the afternoon of TSD (TSD PM), and recovery], and after (post-study) the experiment. A neurobehavioral test battery, including measures of behavioral attention and cognitive throughput, and a self-report measure of sleepiness, was administered 11 times. Resilient and vulnerable groups were defined by a median split on the average TSD performance or sleepiness score. Low and high pre-study cortisol and CRP were defined by a median split on respective values at pre-study. Cortisol and CRP both changed significantly across the study, with cortisol, but not CRP, increasing during TSD. During recovery, cortisol levels did not return to pre-TSD levels, whereas CRP levels did not differ from baseline. When sex was added as a between-subject factor, the time × sex interaction was significant for cortisol. Resilient and vulnerable groups did not differ in cortisol and CRP, and low and high pre-study cortisol/CRP groups did not differ on performance tasks or self-reported sleepiness. Thus, both cortisol and CRP reliably changed in a normal, healthy population as a result of sleep loss; however, cortisol and CRP were not markers of neurobehavioral resilience to TSD and stress in this study.
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Affiliation(s)
- Erika M. Yamazaki
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Caroline A. Antler
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Courtney E. Casale
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Laura E. MacMullen
- Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Adrian J. Ecker
- Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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21
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Baek EB, Rho JH, Jung E, Seo CS, Kim JH, Kwun HJ. Protective effect of Palmijihwanghwan in a mouse model of cigarette smoke and lipopolysaccharide-induced chronic obstructive pulmonary disease. BMC Complement Med Ther 2021; 21:281. [PMID: 34784929 PMCID: PMC8594196 DOI: 10.1186/s12906-021-03453-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/19/2021] [Indexed: 12/23/2022] Open
Abstract
Background Palmijihwanghwan (PJH) is a traditional medicine and eight constituents derived from PJH possess anti-inflammatory activities. However, the scientific evidence for its potential as a therapeutic agent for inflammatory lung disease has not yet been studied. In this study, we examined the protective effect of PJH in a mouse model of chronic obstructive pulmonary disease (COPD) induced by cigarette smoke (CS) with lipopolysaccharide (LPS). Methods Mice received CS exposure for 8 weeks and intranasal instillation of LPS on weeks 1, 3, 5 and 7. PJH (100 and 200 mg/kg) was administrated daily 1 h before CS treatment for the last 4 weeks. Results Compared with CS plus LPS-exposed mice, mice in the PJH-treated group showed significantly decreased inflammatory cells count and reduced inflammatory cytokines including interleukin-1 beta (IL-1β), IL-6 and tumor necrosis factor alpha (TNF-α) levels in broncho-alveolar lavage fluid (BALF) and lung tissue. PJH also suppressed the phosphorylation of nuclear factor kappa B (NF-κB) and extracellular signal-regulated kinase1/2 (ERK1/2) caused by CS plus LPS exposure. Furthermore, CS plus LPS induced increases in matrix metallopeptidase (MMP)-7, MMP-9, and transforming growth factor-β (TGF-β) expression and collagen deposition that were inhibited in PJH-treated mice. Conclusions This study demonstrates that PJH prevents respiratory inflammation and airway remodeling caused by CS with LPS exposure suggesting potential therapy for the treatment of COPD. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03453-5.
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Affiliation(s)
- Eun Bok Baek
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon, 34134, South Korea
| | - Jin-Hyung Rho
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon, 34134, South Korea
| | - Eunhye Jung
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon, 34134, South Korea
| | - Chang-Seob Seo
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, South Korea
| | - Jin-Hee Kim
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, South Korea
| | - Hyo-Jung Kwun
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon, 34134, South Korea.
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22
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Pleguezuelos E, Del Carmen A, Llorensi G, Carcole J, Casarramona P, Moreno E, Ortega P, Serra-Prat M, Palomera E, Miravitlles MM, Yebenes JC, Boixeda R, Campins L, Villelabeitia-Jaureguizar K, Garnacho-Castaño MV. Severe loss of mechanical efficiency in COVID-19 patients. J Cachexia Sarcopenia Muscle 2021; 12:1056-1063. [PMID: 34102017 PMCID: PMC8242734 DOI: 10.1002/jcsm.12739] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is limited information about the impact of coronavirus disease (COVID-19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID-19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG). METHODS A total of 60 participants were assigned to four experimental groups: COVID-19, COPD, IHD, and CG (n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO2 peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1. RESULTS A lower DE was detected in patients with COVID-19 and COPD compared with those in CG (P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases (P > 0.05). Lower VO2 peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG (P < 0.05). A higher VO2 , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold (P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID-19 and COPD groups (P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation (P < 0.001) was found between the VO2 peak and DE and between the peak power output and DE (P < 0.001). CONCLUSIONS Patients with COVID-19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID-19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO2 at each intensity. Resistance training should be considered during the early phase of rehabilitation.
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Affiliation(s)
- Eulogio Pleguezuelos
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain.,Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Amin Del Carmen
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Gemma Llorensi
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Jessica Carcole
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Paula Casarramona
- Physical Medicine and Rehabilitation Department, Hospital de Mataró, Mataró, Spain
| | - Eva Moreno
- Physical Medicine and Rehabilitation Department, Hospitalet General Hospital, L'Hospitalet de Llobregat, Spain
| | - Pilar Ortega
- Pneumology Department, Hospital de Mataró, Mataró, Spain
| | | | | | - Marc M Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | - Ramón Boixeda
- Department of Internal Medicine, Hospital de Mataró, CSDM, Mataró, Spain.,Grup d'Estudi al Maresme de la Pneumònia Adquirida en la Comunitat i la MPOC (GEMP@C), Mataró, Spain
| | - Lluis Campins
- Department of Pharmacy, Hospital de Mataró, CSdM, Mataró, Spain
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23
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Sanders K, Klooster K, Vanfleteren LEGW, Plasqui G, Dingemans AM, Slebos DJ, Schols AMWJ. Effect of Bronchoscopic Lung Volume Reduction in Advanced Emphysema on Energy Balance Regulation. Respiration 2021; 100:1-8. [PMID: 33550302 DOI: 10.1159/000511920] [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: 02/23/2020] [Accepted: 07/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypermetabolism and muscle wasting frequently occur in patients with severe emphysema. Improving respiratory mechanics by bronchoscopic lung volume reduction (BLVR) might contribute to muscle maintenance by decreasing energy requirements and alleviating eating-related dyspnoea. OBJECTIVE The goal was to assess the impact of BLVR on energy balance regulation. DESIGN Twenty emphysematous subjects participated in a controlled clinical experiment before and 6 months after BLVR. Energy requirements were assessed: basal metabolic rate (BMR) by ventilated hood, total daily energy expenditure (TDEE) by doubly labelled water, whole body fat-free mass (FFM) by deuterium dilution, and physical activity by accelerometry. Oxygen saturation, breathing rate, and heart rate were monitored before, during, and after a standardized meal via pulse oximetry and dyspnoea was rated. RESULTS Sixteen patients completed follow-up, and among those, 10 patients exceeded the minimal clinically important difference of residual volume (RV) reduction. RV was reduced with median (range) 1,285 mL (-2,430, -540). Before BLVR, 90% of patients was FFM-depleted despite a normal BMI (24.3 ± 4.3 kg/m2). BMR was elevated by 130%. TDEE/BMR was 1.4 ± 0.2 despite a very low median (range) daily step count of 2,188 (739, 7,110). Following BLVR, the components of energy metabolism did not change significantly after intervention compared to before intervention, but BLVR treatment decreased meal-related dyspnoea (4.1 vs. 1.7, p = 0.019). CONCLUSIONS Impaired respiratory mechanics in hyperinflated emphysematous patients did not explain hypermetabolism. Clinical Trial Registry Number: NCT02500004 at www.clinicaltrial.gov.
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Affiliation(s)
- Karin Sanders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Karin Klooster
- Department of Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lowie E G W Vanfleteren
- COPD Centre, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Guy Plasqui
- Department of Human Biology and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne-Marie Dingemans
- Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands,
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24
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Shin HJ, Kim TO, Kim YI, Kim SH, Kim HK, Kim YH, Byun MK, Jung KS, Yoo KH, Lee JS, Lim SC. The paradoxical response to short-acting bronchodilator administration in patients with chronic obstructive pulmonary disease. J Thorac Dis 2021; 13:511-520. [PMID: 33717524 PMCID: PMC7947541 DOI: 10.21037/jtd-20-985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background There are a few studies about paradoxical bronchodilator response (BDR), which means a decrease in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) after short-acting bronchodilator administration in patients with chronic obstructive pulmonary disease (COPD). We evaluated the effect of paradoxical BDR on the clinical outcomes of COPD patients in South Korea. Methods We analyzed the KOrea COpd Subgroup Study team (KOCOSS) cohort data in South Korea between January 2012 and December 2017. BDR was defined as at least a 12% and 200-mL reduction in FEV1 or FVC after bronchodilator administration. Results A total of 1,991 patients were included in this study. A paradoxical BDR was noted in 57 (2.9%) patients and was independently associated with worse dyspnea and poor quality of life. High C-reactive protein (CRP) levels were associated with a paradoxical BDR (OR, 1.05; 95% CI, 1.01-1.09; P=0.003). However, paradoxical BDR was not associated with severe acute exacerbations. Pre-bronchodilator FEV1 (L) showed a higher area under the curve (AUC) for predicting severe acute exacerbations than the post-bronchodilator FEV1 (L) in the paradoxical BDR group (0.788 vs. 0.752). Conclusion A paradoxical reduction of FEV1 or FVC after bronchodilator administration may be associated with chronic inflammation in the airway and independently associated with worse respiratory symptoms and poor quality of life.
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Affiliation(s)
- Hong-Joon Shin
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Kwangju, South Korea
| | - Tae-Ok Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Kwangju, South Korea
| | - Yu-Il Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Kwangju, South Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, South Korea
| | - Hyun Kuk Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Yong-Hyun Kim
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea
| | - Min Kwang Byun
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital, South Korea
| | - Ki-Suck Jung
- Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, South Korea
| | - Kwang-Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Jae Seung Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, South Korea
| | - Sung-Chul Lim
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Kwangju, South Korea
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25
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Zhang Y, Zhao X. Effects of the Health Belief Model-Based Intervention on Anxiety, Depression, and Quality of Life in Chronic Obstructive Pulmonary Disease. Neuroimmunomodulation 2021; 28:129-136. [PMID: 34062535 DOI: 10.1159/000512993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition. COPD causes a heavy burden on the patients through negative impacts on the quality of life and psychological health. The health belief model (HBM) is proposed and modified by several social psychologists and is confirmed to have benefits in the recovery of various diseases. This research aimed to explore the effects of the HBM-based intervention on anxiety, depression, and quality of life in COPD patients entering pulmonary rehabilitation (PR). METHODS This research was conducted at the Tianjin Rehabilitation Recuperate Center of Chinese PLA in 2019. A total of 136 COPD patients were randomized into the intervention group and the control group. In the control group, patients received the PR program. In the intervention group, patients received both PR program and the HBM-based intervention. Quality of life was measured by the COPD assessment test. The outcomes of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. RESULTS The HBM-based intervention decreased both anxiety and depression scores among COPD patients. The COPD assessment test score was declined by the HBM-based intervention, which also decreased the serum levels of interleukin-6 and C-reactive protein in COPD patients entering PR. CONCLUSION The HBM-based intervention alleviates anxiety and depression, enhances quality of life, and inhibits inflammation in COPD patients entering PR.
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Affiliation(s)
- Yating Zhang
- Department of Respiratory, Tianjin Chest Hospital, Tianjin, China
| | - Xiangfang Zhao
- Department of Geriatrics Ward, Tianjin Rehabilitation Recuperate Center of Chinese PLA, Tianjin, China
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26
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Kawagoshi A, Iwakura M, Furukawa Y, Sugawara K, Takahashi H, Shioya T. The association between systemic inflammation and the time spent in posture and movement during daytime in patients with chronic obstructive pulmonary disease and lower weight. J Phys Ther Sci 2020; 32:804-809. [PMID: 33362350 PMCID: PMC7758607 DOI: 10.1589/jpts.32.804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/09/2020] [Indexed: 12/01/2022] Open
Abstract
[Purpose] The effect of physical activity on systemic inflammation remains unclear and
might be negative in patients with chronic obstructive pulmonary disease (COPD) and lower
weight. We investigated the amount of physical activity as the time spent in posture and
movement and its association with systemic inflammation. [Participants and Methods] In
this retrospective cross-sectional pilot study, we evaluated 11 patients with COPD (age,
73 ± 7 years; body mass index, 18.9 ± 2.9 kg/m2). A recently developed triaxial
accelerometer was used to measure the time spent in posture and movement. We also
evaluated body composition, physiological indexes, and serum levels of inflammatory
cytokines. Single correlation coefficients were calculated as the association between
physical activity and other outcomes. [Results] The walking time was 36 ± 32 min/d, and
the standing time was 151 ± 118 min/d. The time spent walking significantly correlated
with the fat-free mass index (r=0.73) and interleukin (IL)-8 level
(r=0.76). The time spent standing significantly correlated with the
C-reactive protein (r=0.80) and IL-6 levels (r=0.74).
[Conclusion] These data indicate that increased physical activity is associated with
higher systematic inflammation. We should consider that the systemic inflammation may have
been affected by the increased physical activity of the patients with COPD and lower
weight in this study.
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Affiliation(s)
- Atsuyoshi Kawagoshi
- Department of Rehabilitation, Akita City Hospital: 4-30 Kawamoto Matsuoka-cho, Akita City, Akita 010-0933 Japan
| | - Masahiro Iwakura
- Department of Rehabilitation, Akita City Hospital: 4-30 Kawamoto Matsuoka-cho, Akita City, Akita 010-0933 Japan
| | - Yutaka Furukawa
- Department of Rehabilitation, Akita City Hospital: 4-30 Kawamoto Matsuoka-cho, Akita City, Akita 010-0933 Japan
| | - Keiyu Sugawara
- Department of Rehabilitation, Akita City Hospital: 4-30 Kawamoto Matsuoka-cho, Akita City, Akita 010-0933 Japan
| | - Hitomi Takahashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Takanobu Shioya
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Japan
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27
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Smole U, Kratzer B, Pickl WF. Soluble pattern recognition molecules: Guardians and regulators of homeostasis at airway mucosal surfaces. Eur J Immunol 2020; 50:624-642. [PMID: 32246830 PMCID: PMC7216992 DOI: 10.1002/eji.201847811] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/25/2020] [Accepted: 03/31/2020] [Indexed: 01/08/2023]
Abstract
Maintenance of homeostasis at body barriers that are constantly challenged by microbes, toxins and potentially bioactive (macro)molecules requires complex, highly orchestrated mechanisms of protection. Recent discoveries in respiratory research have shed light on the unprecedented role of airway epithelial cells (AEC), which, besides immune cells homing to the lung, also significantly contribute to host defence by expressing membrane‐bound and soluble pattern recognition receptors (sPRR). Recent evidence suggests that distinct, evolutionary ancient, sPRR secreted by AEC might become activated by usually innocuous proteins, commonly referred to as allergens. We here provide a systematic overview on sPRR detectable in the mucus lining of AEC. Some of them become actively produced and secreted by AECs (like the pentraxins C‐reactive protein and pentraxin 3; the collectins mannose binding protein and surfactant proteins A and D; H‐ficolin; serum amyloid A; and the complement components C3 and C5). Others are elaborated by innate and adaptive immune cells such as monocytes/macrophages and T cells (like the pentraxins C‐reactive protein and pentraxin 3; L‐ficolin; serum amyloid A; and the complement components C3 and C5). Herein we discuss how sPRRs may contribute to homeostasis but sometimes also to overt disease (e.g. airway hyperreactivity and asthma) at the alveolar–air interface.
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Affiliation(s)
- Ursula Smole
- Institute of ImmunologyCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaViennaAustria
| | - Bernhard Kratzer
- Institute of ImmunologyCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaViennaAustria
| | - Winfried F. Pickl
- Institute of ImmunologyCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaViennaAustria
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28
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Morikawa K, Tabira K, Takemura H, Inaba S, Kusuki H, Hashitsume Y, Suzuki Y, Tenpaku Y, Yasuma T, D’Alessandro-Gabazza CN, Gabazza E, Hataji O. A Prediction Equation to Assess Resting Energy Expenditure in Japanese Patients with COPD. J Clin Med 2020; 9:jcm9113455. [PMID: 33121107 PMCID: PMC7694151 DOI: 10.3390/jcm9113455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Medical nutrition therapy is important in the management of chronic obstructive pulmonary disease (COPD) patients. Determination of resting energy expenditure is essential to define therapeutic goals for medical nutrition. Previous studies proposed the use of equations to predict resting energy expenditure. No prediction equation is currently available for the Japanese population. The objective of this study was to develop an equation to predict resting energy expenditure in Japanese chronic obstructive pulmonary disease patients. To this end, we investigated clinical variables that correlate with the resting energy expenditure. Methods: This study included 102 COPD patients admitted at the Matsusaka Municipal Hospital Respiratory Center. We measured resting energy expenditure by indirect calorimetry and explored the relationship of resting energy expenditure with clinical variables by univariate and stepwise linear regression analysis. Results: The resting energy expenditure by indirect calorimetry was significantly correlated with fat-free mass, body weight, body mass index, height, gender, and pulmonary function test by univariate analysis. In the stepwise linear regression analysis, the fat-free mass, body weight, and age remained significantly correlated with indirect calorimetry’s resting energy expenditure. The fat-free mass, body weight, and age explained 50.5% of the resting energy expenditure variation. Conclusion: Fat-free mass, body weight, and age were significantly correlated with resting energy expenditure by stepwise linear regression analysis, and they were used to define a predictive equation for Japanese COPD patients.
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Affiliation(s)
- Keisuke Morikawa
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
- Department of Health of Science, Kio University Graduate School, Umamichu 4-2-2, Kitakatura-Gigunkoryocho, Nara 635-0832, Japan;
| | - Kazuyuki Tabira
- Department of Health of Science, Kio University Graduate School, Umamichu 4-2-2, Kitakatura-Gigunkoryocho, Nara 635-0832, Japan;
| | - Hiroyuki Takemura
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Shogo Inaba
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Haruka Kusuki
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Yu Hashitsume
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Yuta Suzuki
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Yosuke Tenpaku
- Department of Rehabilitation, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan; (K.M.); (H.T.); (S.I.); (H.K.); (Y.H.); (Y.S.); (Y.T.)
| | - Taro Yasuma
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan; (T.Y.); (C.N.D.-G.)
| | - Corina N. D’Alessandro-Gabazza
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan; (T.Y.); (C.N.D.-G.)
| | - Esteban Gabazza
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan; (T.Y.); (C.N.D.-G.)
- Correspondence: ; Tel.: +81-59-231-5017; Fax: +81-59-231-5225
| | - Osamu Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Tonomachi 1550, Matsusaka, Mie 515-8544, Japan;
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Andrade DR, Pinto KC, de Castro JS, Andaku DK, Lara VA, de Luca FA, Gun C, Mendes FAR, Oliveira MF, Medeiros WM. Oxygen supplementation increases the total work and muscle damage markers but reduces the inflammatory response in COPD patients. Respir Physiol Neurobiol 2020; 280:103475. [PMID: 32512234 DOI: 10.1016/j.resp.2020.103475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Oxygen supplementation (O2-Suppl) is recommended for pulmonary rehabilitation with higher exercise intensities. However, high-intensity exercise tends toward muscle damage and a greater inflammatory response. We aimed to investigate the effect of O2-Suppl during exercise test (EET) on CRP level and muscle damage (CPK, LDH, lactate) in non-hypoxemic COPD patients. METHODS Eleven non-depleted patients with COPD (FEV1 65.5 ± 4.3 %) performed two EET (room-air or O2-Suppl-100 %), through a blind, randomized, and placebo-controlled crossover design. CPK, LDH and CRP were measured before, immediately after and 24 h after EET. RESULTS Exercise time was higher with O2-Suppl (49.9 ± 37.3 %; p = 0.001) and increases in CPK and LDH were observed compared to basal values in the O2-Suppl (28.4UI/L and 28.3 UI/L). The O2-Suppl protocol resulted in a lower increase in CRP (92.1 ± 112.4 % vs. 400.1 ± 384.9 %; p = 0.003). CONCLUSIONS O2-Suppl increases exercise-tolerance, resulting in increased muscle injury markers in COPD. However, oxygen supplementation attenuates the inflammatory response, even upon increased physical exercise.
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Affiliation(s)
- Daniela Rodrigues Andrade
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Kelly Critine Pinto
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Julia Sampel de Castro
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Daniela Kuguimoto Andaku
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Viviani Aparecida Lara
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Fabio Augusto de Luca
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Carlos Gun
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil
| | | | - Mayron F Oliveira
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; VO2Care Research Group, Research Physiotherapy Coordinator of Vila Nova Star Hospital, São Paulo, SP, Brazil
| | - Wladimir Musetti Medeiros
- Laboratory of Exercise Physiology and Cardiac Rehabilitation (GERFE), Department of Medicine and Physiotherapy, Santo Amaro University (UNISA), São Paulo, Brazil; Department of Physiotherapy, Ibirapuera University (UNIB), São Paulo, Brazil; Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; HEART - Institute of Cardiology, Department of Education and Research, São Paulo, Brazil.
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The role of statins in chronic obstructive pulmonary disease: is cardiovascular disease the common denominator? Curr Opin Pulm Med 2020; 25:173-178. [PMID: 30418244 DOI: 10.1097/mcp.0000000000000551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW The pleiotropic anti-inflammatory effects of statins that have proven to improve outcomes in cardiovascular disease have also been of interest in the treatment of COPD, a disease with considerable morbidity and little available treatment that improves mortality. In-vitro and animal studies have supported biologic plausibility of statin therapy for lung health and function. Retrospective observational studies in humans have echoed this potential as well but confirmatory data from randomized studies are limited and somewhat disappointing. RECENT FINDINGS Despite discouraging clinical trial results, the possibility remains that statins can help patients with COPD characterized by systemic inflammation. At the same time, increasing recognition of the considerable cardiovascular disease burden and its suboptimal treatment in patients with COPD has also contributed to continued enthusiasm for statin use in COPD. SUMMARY When it comes to defining the role for statins as a disease-modifying therapy, the jury is still out; however, the importance of more careful cardiovascular risk stratification that includes assessing levels of inflammatory markers in patients with COPD and the benefit of statins in those with increased risk is gaining increasing recognition.
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Oxidative and inflammatory effects of pulmonary rehabilitation in patients with bronchiectasis. A prospective, randomized study. NUTR HOSP 2020; 37:6-13. [PMID: 31960695 DOI: 10.20960/nh.02763] [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: 11/02/2022] Open
Abstract
Introduction Background: systemic inflammation and oxidative stress are important factors in the pathogenesis of bronchiectasis. Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is no data about its effect on the inflammatory and REDOX status of these patients. Aims: to investigate the effect of PR in non-cystic-fibrosis bronchiectasis (NCFB) patients, and to compare it with the effect of PR plus a hyperproteic oral nutritional supplement (PRS) enriched with beta-hydroxy-beta-methylbutyrate (HMB) on serum inflammatory and oxidative biomarkers. Materials and methods: this was an open randomized, controlled trial. Thirty individuals (65 years old or younger with a body mass index over 18.5, older than 65 years with a body mass index over 20) were recruited from September 2013 to September 2014, and randomly assigned to receive PR or PRS. Total neutrophils, and inflammatory and oxidative biomarker levels were measured at baseline, and then at 3 and 6 months. Results: in the PRS group neutrophil levels were decreased from baseline at 6 months. A significantly different fold change was found between the PR and PRS groups. In the PR group, IL-6 and adiponectin were increased by the end of the study while TNFα levels were decreased from baseline at 6 months. REDOX biomarkers remained stable throughout the study except for 8-isoprostane levels, which were increased from baseline at 6 months in both groups of patients. Conclusions: a PR program induced a pro-oxidative effect accompanied by changes in circulating inflammatory cytokine levels in NCFB patients. Our results would also suggest a possible beneficial effect of the HMB enriched supplement on neutrophil level regulation in these patients. The information provided in this study could be useful for choosing the right therapeutic approach in the management of bronchiectasis.
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Holz O, DeLuca DS, Roepcke S, Illig T, Weinberger KM, Schudt C, Hohlfeld JM. Smokers with COPD Show a Shift in Energy and Nitrogen Metabolism at Rest and During Exercise. Int J Chron Obstruct Pulmon Dis 2020; 15:1-13. [PMID: 32021139 PMCID: PMC6956026 DOI: 10.2147/copd.s217474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose There is an ongoing demand for easily accessible biomarkers that reflect the physiological and pathophysiological mechanisms of COPD. To test if an exercise challenge could help to identify clinically relevant metabolic biomarkers in COPD. Patients and Methods We performed two constant-load exercise challenges separated by 4 weeks including smokers with COPD (n=23/19) and sex- and age-matched healthy smokers (n=23/20). Two hours after a standardized meal venous blood samples were obtained before, 5 mins after the start, at the end of submaximal exercise, and following a recovery of 20 mins. Data analysis was performed using mixed- effects model, with the metabolite level as a function of disease, time point and interaction terms and using each individual's resting level as reference. Results Exercise duration was longer in healthy smokers but lactate levels were comparable between groups at all four time points. Glucose levels were increased in COPD. Glutamine was lower, while glutamate and arginine were higher in COPD. Branched-chain amino acids showed a stronger decline during exercise in healthy smokers. Carnitine and the acyl-carnitines C16 and C18:1 were increased in COPD. These metabolite levels and changes were reproducible in the second challenge. Conclusion Higher serum glucose, evidence for impaired utilization of amino acids during exercise and a shift of energy metabolism to enhanced consumption of lipids could be early signs for a developing metabolic syndrome in COPD. In COPD patients, deviations of energy and nitrogen metabolism are amplified by an exercise challenge.
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Affiliation(s)
- Olaf Holz
- Fraunhofer ITEM, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - David S DeLuca
- Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - Stefan Roepcke
- Department of Biomarker Development, Takeda Pharmaceuticals International GmbH, Zürich, Switzerland
| | - Thomas Illig
- Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
| | - Klaus M Weinberger
- Biocrates Life Sciences AG, Innsbruck, Austria.,Research Group for Clinical Bioinformatics, Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.,sAnalytiCo Ltd, Belfast, Ireland
| | | | - Jens M Hohlfeld
- Fraunhofer ITEM, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany.,Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany
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Pandey S, Garg R, Kant S, Gaur P. Vitamin D, C-reactive protein, and oxidative stress markers in chronic obstructive pulmonary disease. Tzu Chi Med J 2019; 33:80-86. [PMID: 33505883 PMCID: PMC7821825 DOI: 10.4103/tcmj.tcmj_198_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/24/2019] [Accepted: 10/29/2019] [Indexed: 01/24/2023] Open
Abstract
Objective: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Systemic inflammation and oxidant/antioxidant imbalance has been seen to play a key role in pathogenesis of COPD. The present study investigated the levels of inflammatory and antioxidant/oxidative stress biomarker in COPD patients and healthy subjects. Materials and Methods: The present study enrolled seventy COPD patients and seventy healthy controls from Department of Respiratory Medicine at a tertiary care hospital. Vitamin D, C-reactive protein (CRP), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels were measured in both cases and control. GraphPad PRISM version 6.01 was used for analysis of data. Results: The levels of Vitamin D, SOD, Catalase, were found to be significantly lower among the COPD patients in comparison to healthy controls while levels of MDA and CRP were significantly higher (P = 0.0001). Conclusion: The results showed oxidant/antioxidant imbalance and Vitamin D deficiency in COPD patients. Higher levels of CRP and oxidative stress markers were observed in COPD patients in comparison to healthy controls. A biomarker based study testing the efficacy of novel antioxidant or other agents will be helpful that can modify the course of this disease.
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Affiliation(s)
- Sarika Pandey
- Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajiv Garg
- Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Priyanka Gaur
- Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Wang Y, Liao J, Zhong Y, Zhang C, Li X, Wang G. Predictive Value of Combining Inflammatory Biomarkers and Rapid Decline of FEV 1 for COPD in Chinese Population: A Prospective Cohort Study. Int J Chron Obstruct Pulmon Dis 2019; 14:2825-2833. [PMID: 31824147 PMCID: PMC6901061 DOI: 10.2147/copd.s223869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023] Open
Abstract
Background In China, the high prevalence and mortality rate of Chronic Obstructive Pulmonary Disease (COPD) and the poor intervention effect makes it into a heavy social burden. The main reason is that the current diagnosis of COPD mainly based on the static lung function, which is difficult for early intervention. Through matching a predictive model for high-risk groups of COPD that rewards FEV1 rapid decline as the core, we will establish the early warning model and prove its validity and socio-economic value. Methods This is a multi-center, prospective, cohort study. A total of 10,000 people aged 40∼75 without lung disease will be recruited and followed for 3 years. Some questionnaires such as St George’s Respiratory Questionnaire (SGRQ), income class, educational level, comorbidity, smoking habit, and biomass smoke exposure history will be collected. The baseline level of Interleukin 6 (IL-6), high-sensitivity C-reactive Protein (hs-CRP), microRNAs-23a (miR-23a) in peripheral blood and pH value in exhaled breath condensate (EBC) will be measured, lung spirometry will be tested in the first, second, and fourth years. Primary outcome is the incidence of COPD, multivariate regression analysis will be used to establish the predictive model for COPD in China. Discussion With the rapid decline of lung function as the core and the baseline inflammatory biomarkers in peripheral blood and pH of the exhaled breath condensate as affecting factors, a predictive model to achieve early detection of high-risk COPD groups will be established and promoted. Trial registration This study has been registered at www.ClinicalTrials.gov (registration identifier: NCT03532893) on 21 May 2018, https://register.clinicaltrials.gov.
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Affiliation(s)
- Yunxia Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Jiping Liao
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Yijue Zhong
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Xueying Li
- Department of Medical Statistics, Peking University First Hospital, Beijing, People's Republic of China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, People's Republic of China
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Daga MK, Chhoda A, Singh S, Mawari G, Kumar N, Mishra TK, Hira HS. Effect of Statin Supplementation on Pulmonary Function and Inflammatory Markers in Patients of Chronic Obstructive Pulmonary Disease. CURRENT RESPIRATORY MEDICINE REVIEWS 2019. [DOI: 10.2174/1573398x15666190614154338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
COPD being a systemic inflammatory disease is accompanied by alteration
of various inflammatory cytokines which affect the metabolic equilibrium of body. Some therapeutic
options, mainly statins via their wide range of pharmacologic actions alter the level of proinflammatory
cytokines hence, helpful in attenuating various extra-pulmonary consequences of
COPD. We did a randomised case-control study to study the effect of statin supplementation on
pulmonary function and inflammatory markers in patients of COPD.
Methods:
We included 40 stable COPD subjects & randomized them in two groups, Intervention &
Non-intervention. Intervention group received 40 mg atorvastatin once daily for 3 months in addition
to the conventional treatment of COPD similar to the prior one. We studied levels of IL-6 & CRP
and correlated them with disease severity before and after the aforementioned intervention.
Results:
We observed that CRP levels decreased in both the groups after a follow up of 3 months,
but neither of them was statistically significant (p=0.57 & 0.63 respectively) nor the mean of their
difference (p=0.969). IL-6 levels showed a persistent decline in intervention group but, was not
significant (p=0.91). In this study, we noticed statistically significant improvement in FEV1
(p=0.008) in the intervention group which was in contrast to non-intervention group. Similarly, the
exercise capacity also statistically increased in the intervention group (p=0.002). There was also
evident negative correlation between exercise capacity and IL-6 as well CRP levels. FEV1 also
showed statistically significant negative correlation with IL-6 levels (p=0.023).
Conclusion:
We can improve the disease outcome and alter its natural progression by altering the
levels of inflammatory markers with the aid of some additional pharmacological interventions i.e., in
this study was atorvastatin.
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Affiliation(s)
- Mradul K. Daga
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Ankit Chhoda
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Shashank Singh
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Govind Mawari
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Naresh Kumar
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Tarun K. Mishra
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
| | - Harmanjit S. Hira
- Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi-11002, India
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Sharma H, Kapur P, Jalali RK, Dubey K. Atherosclerosis risk assessment in patients with chronic obstructive pulmonary disease: a case-control study. Ther Clin Risk Manag 2019; 15:1061-1071. [PMID: 31695395 PMCID: PMC6718246 DOI: 10.2147/tcrm.s216180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/28/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose Chronic Obstructive Pulmonary Disease (COPD) is considered as a risk factor for atherosclerosis and a leading cause of mortality due to cardiovascular disease (CVD). The study assessed the association of COPD with atherosclerotic risk factors and compared the predictor role of various cardiovascular (CV) risk score calculators in Indian subjects with COPD. Patients and methods Forty subjects with stable COPD and forty age, gender and body mass index (BMI)-matched healthy controls were included in the case-control study conducted in a tertiary care hospital. Atherogenic indices were calculated by using the values of lipid parameters. CV risk calculators were utilized to assess the 10-year CV risk for the COPD group. Results The study subjects had a mean age of 60.83±12.40 years in COPD group and 57.73±9.49 years in control group (p=0.213). Gender distribution was similar in both the groups. The mean High sensitivity C-reactive protein (hs-CRP) levels were 3.70±2.37 mg/L in COPD group and 2.39±2.23 mg/L in control group. The hs-CRP levels were significantly higher in COPD than in control subjects (p=0.012). Using bivariate correlations, we found significant positive correlations between hs-CRP and atherogenesis indices-atherogenic index of plasma, cardiogenic risk ratio, atherogenic coefficient in COPD patients [(r=0.4265, p<0.006); (r=0.7034, p<0.001) and (r=0.7034, p<0.001), respectively]. Framingham risk score-cardiovascular disease (FRS-CVD) has identified maximum number of COPD subjects (45%) to be in high CVD risk category. Conclusion The study concluded that hs-CRP levels in COPD subjects were significantly higher than in control subjects. FRS-CVD was most useful for identifying high CV risk subjects in COPD subjects.
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Affiliation(s)
- Himanshu Sharma
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Prem Kapur
- Department of Medicine, Hamdard Institute of Medical Sciences and Research (HIMSR) and HAH-Centenary Hospital, Jamia Hamdard, New Delhi, India
| | | | - Kiran Dubey
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
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Diet-Induced Pulmonary Inflammation and Incipient Fibrosis in Mice: a Possible Role of Neutrophilic Inflammation. Inflammation 2019; 42:1886-1900. [DOI: 10.1007/s10753-019-01051-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Chen X, Dong T, Wei X, Yang Z, Matos Pires NM, Ren J, Jiang Z. Electrochemical methods for detection of biomarkers of Chronic Obstructive Pulmonary Disease in serum and saliva. Biosens Bioelectron 2019; 142:111453. [PMID: 31295711 DOI: 10.1016/j.bios.2019.111453] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/07/2019] [Accepted: 06/19/2019] [Indexed: 02/02/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death nowadays, and its underdiagnosis is still a great challenge. More effective diagnosis method is in urgent need since the traditional spirometry has many limitations in the practical application. The electrochemical (EC) detection methods have their unique advantages of high accuracy, short response time and easy integration of the system. In this review, recent works on the EC methods for COPD biomarkers including interleukin 6 (IL-6), interleukin 8 (IL-8) and C-reactive protein (CRP) are summarized. Five types of EC methods are highlighted in this study, as enzyme-labelled immunosensors, nanoparticle-labelled immunosensors, capacitive or impedimetric immunosensors, magnetoimmunosensors, and field effect transistor (FET) immunosensors. To date, EC immunosensors have been exhibiting high analytical performance with a detection limit that can achieve several pg/mL or even lower. The simplicity of EC immunosensors makes them a perfect solution for a future point-of-care device to use in settings for COPD diagnosis and follow-up. Nevertheless, more efforts need to be paid on the simultaneous detection of multiple biomarkers, a demand for the clinical diagnosis, and processes of assay simplification towards achieving one-step detection.
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Affiliation(s)
- Xuan Chen
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, School of Computer Science and Information Engineering, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China; Department of Microsystems (IMS), Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Postboks 235, 3603, Kongsberg, Norway
| | - Tao Dong
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, School of Computer Science and Information Engineering, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China; Department of Microsystems (IMS), Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Postboks 235, 3603, Kongsberg, Norway.
| | - Xueyong Wei
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Zhaochu Yang
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, School of Computer Science and Information Engineering, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China
| | - Nuno Miguel Matos Pires
- Chongqing Key Laboratory of Micro-Nano Systems and Smart Transduction, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, School of Computer Science and Information Engineering, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China
| | - Juan Ren
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Zhuangde Jiang
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
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Cordova-Rivera L, Gibson PG, Gardiner PA, Hiles SA, McDonald VM. Extrapulmonary associations of health status in severe asthma and bronchiectasis: Comorbidities and functional outcomes. Respir Med 2019; 154:93-101. [PMID: 31229944 DOI: 10.1016/j.rmed.2019.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/10/2019] [Accepted: 06/10/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Severe asthma and bronchiectasis are heterogeneous diseases that contribute to disability beyond the pulmonary system. The magnitude of the impact that these extrapulmonary features has on health-related quality of life (HRQoL) is unknown. METHODS We analysed the cross-sectional relationships between HRQoL (St. George's Respiratory Questionnaire; SGRQ) and extrapulmonary characteristics, including physical activity (steps/day), anxiety and depression, isometric leg strength, systemic inflammation, and several comorbidities in adults with severe asthma (n = 70) and bronchiectasis (n = 61). RESULTS Participants with severe asthma and bronchiectasis had similar SGRQ total scores (mean scores 43.7 and 37.8 for severe asthma and bronchiectasis; p > 0.05), and similar pulmonary and extrapulmonary characteristics. The associations between extrapulmonary variables and HRQoL did not differ according to diagnosis (all interactions p > 0.05). Greater anxiety and depressive symptoms, fewer steps/day and greater systemic inflammation were statistically associated with poorer HRQoL in both diseases (p < 0.05). Lower isometric leg strength in severe asthma, and greater Charlson Comorbidity Index in bronchiectasis were also associated with poorer HRQoL (p < 0.05). In the multivariable regression model performed in the combined disease groups, anxiety and depression, steps/day, systemic inflammation and isometric leg strength remained independently associated with HRQoL. Associations between extrapulmonary characteristics and SGRQ domains were stronger for the activity and impact domains, than symptoms. CONCLUSION In severe asthma and bronchiectasis, extrapulmonary features including physical activity and leg strength have a significant impact on HRQoL, especially within the activity and impact domains. These features should be considered as part of the assessment of these conditions, and they may represent additional treatment targets to improve HRQoL.
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Affiliation(s)
- Laura Cordova-Rivera
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia.
| | - Paul A Gardiner
- Centre for Health Services Research, The University of Queensland, Woolloongabba, Australia; Mater Research Institute, The University of Queensland, South Brisbane, Australia.
| | - Sarah A Hiles
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia.
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Ibrahim AA, Qamar B, Fituri S, Akbar ZA, Al-Abdi T, Shi Z. Association between Soft Drink Consumption and Asthma among Qatari Adults. Nutrients 2019; 11:nu11030606. [PMID: 30871131 PMCID: PMC6471171 DOI: 10.3390/nu11030606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/08/2019] [Accepted: 03/10/2019] [Indexed: 01/19/2023] Open
Abstract
We aimed to examine the association between soft drink consumption and asthma and lung function among Qatari adults. In the cross-sectional study, we used data from 986 Qatari participants aged 20 years and above attending the Qatar Biobank Study. Usual consumption of soft drink was assessed using a food frequency questionnaire. Lung function was measured by spirometry and asthma was based on self-report. The associations between soft drink consumption and asthma and lung function were assessed using multivariable logistic and linear regression, respectively. In total, 65 participants out of 986 (6.6%) reported having asthma. A clear dose-response relationship between soft drink consumption and asthma was found. High soft drink consumers (≥7 times/week) were 2.60 (95% CI 1.20–5.63) times more likely to have asthma as compared to non-consumers. The association was partly mediated by BMI and inflammation. Diet soft drink consumption was positively associated with asthma (OR 1.12 (95% CI 1.02–1.23)) but not with lung function. Regular soft drink consumption was inversely associated with FEV1, but not with FVC. In conclusion, soft drink consumption is positively associated with asthma in Qatari adults. The association is partly mediated by obesity and inflammation. Limiting soft drink consumption should be taken into consideration for asthma prevention.
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Affiliation(s)
- Amna Al Ibrahim
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
| | - Bushra Qamar
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
| | - Sundus Fituri
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
| | - Zoha Ali Akbar
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
| | - Tamara Al-Abdi
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
| | - Zumin Shi
- Human Nutrition Department, Qatar University, P.O. Box 2713 Doha, Qatar.
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Formiga MF, Vital I, Urdaneta G, Masters B, Herrera J, Campos MA, Cahalin LP. Higher serum levels of systemic inflammatory markers are linked to greater inspiratory muscle dysfunction in COPD. CLINICAL RESPIRATORY JOURNAL 2019; 13:247-255. [PMID: 30773817 DOI: 10.1111/crj.13006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/29/2019] [Accepted: 02/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with an inflammatory response that becomes more pronounced in acute exacerbations. Considerable attention has recently focused on the value of several inflammatory mediators in predicting worsening of COPD-related symptoms. Whereas respiratory muscle dysfunction is also widely present in this population, little is known about how systemic inflammation relates to inspiratory muscle dysfunction in COPD. METHODS Fifty-three males with mild-to-very severe airflow obstruction underwent blood sampling for 23 inflammatory markers, including acute-phase proteins, cytokines and adipokines. Inspiratory muscle performance was assessed via the test of incremental respiratory endurance, providing measures of maximal (MIP) and sustained maximal (SMIP) inspiratory pressures. RESULTS The mean ± SD MIP and SMIP were 75.32 ± 19.62 cmH2 O and 406.15 ± 124.55 PTU. MIP negatively correlated with CRP, SAA and cystatin C (r-values from -0.333 to -0.378, P < 0.02), while SMIP was inversely related to SAA and cystatin C (r = -0.534 and r = -0.396, P = 0.00). Significant differences in CRP, SAA, cystatin C and PARC were also found between subjects with and without inspiratory muscle weakness. No additional significant relationships were observed between either MIP or SMIP and other inflammatory markers in the study. CONCLUSIONS MIP and SMIP are markedly reduced with greater degrees of inflammation in COPD as expressed by higher levels of CRP, SAA and cystatin C. Future research is needed to further examine the above findings and determine the impact of systemic inflammation along with its underlying mechanisms on inspiratory muscle function in COPD.
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Affiliation(s)
- Magno F Formiga
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida.,CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.,Pulmonary Section, Miami Veterans Administration Medical Center, Miami, Florida
| | - Isabel Vital
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, Florida
| | - Gisel Urdaneta
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, Florida
| | | | | | - Michael A Campos
- Pulmonary Section, Miami Veterans Administration Medical Center, Miami, Florida.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida
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42
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Bowdish DM. The Aging Lung. Chest 2019; 155:391-400. [DOI: 10.1016/j.chest.2018.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/13/2018] [Accepted: 09/05/2018] [Indexed: 02/07/2023] Open
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Cornell K, Alam M, Lyden E, Wood L, LeVan TD, Nordgren TM, Bailey K, Hanson C. Saturated Fat Intake Is Associated with Lung Function in Individuals with Airflow Obstruction: Results from NHANES 2007⁻2012. Nutrients 2019; 11:nu11020317. [PMID: 30717299 PMCID: PMC6413158 DOI: 10.3390/nu11020317] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 01/14/2023] Open
Abstract
Nutritional status is a well-recognized prognostic indicator in chronic obstructive pulmonary disease (COPD); however, very little is known about the relationship between lung function and saturated fat intake. We used data from the cross-sectional National Health and Nutrition Examination Surveys (NHANES) to assess the relationship between saturated fatty acid (SFA) intake and lung function in the general US adult population. Adults in NHANES (2007⁻2012) with pre-bronchodilator spirometry measurements and dietary SFA intake were included. Primary outcomes were lung function including forced expiratory volume in one second (FEV₁), FEV₁, forced vital capacity (FVC), FEV₁/FVC ratio, percent predicted FEV₁ and percent predicted FVC. Multivariable regression models in the general population as well as those with spirometry-defined airflow obstruction were used to assess the relationship between lung function measurements and dietary SFA intake after adjustment for confounders. 11,180 eligible participants were included in this study. Univariate analysis revealed a statistically significant positive association between total SFA intake and lung function outcomes; however, these relationships were attenuated after adjustment for covariates. A secondary analysis of individuals with spirometry-defined airflow obstruction (FEV₁/FVC < 0.7) revealed that a lower intake of SFA was associated with reduced FEV1 (β = -126.4, p = 0.04 for quartile 1 vs. quartile 4), FVC (β = -165.8. p = 0.01 for quartile 1 vs. quartile 4), and percent predicted FVC (β = -3.3. p = 0.04 for quartile 1 vs. quartile 4), after adjustment for relevant confounders. No associations were observed for the FEV₁/FVC ratio and percent predicted FEV₁. It is possible that characteristics such as food source and fatty acid chain length may influence associations between saturated fatty acid intake and health outcomes.
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Affiliation(s)
- Kasey Cornell
- Internal Medicine Pulmonary, University of Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Morshed Alam
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Elizabeth Lyden
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Lisa Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle NSW 2308, Australia.
| | - Tricia D LeVan
- Internal Medicine Pulmonary, University of Nebraska Medical Center, Omaha, NE 68198, USA.
- College of Public Health Epidemiology, University of Nebraska, Omaha, NE 68198, USA.
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA.
| | - Tara M Nordgren
- Division of Biomedical Sciences, University of California Riverside, Riverside, CA 92521, USA.
| | - Kristina Bailey
- Internal Medicine Pulmonary, University of Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Corrine Hanson
- Medical Nutrition Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Metabolic Syndrome and Air Pollution: A Narrative Review of Their Cardiopulmonary Effects. TOXICS 2019; 7:toxics7010006. [PMID: 30704059 PMCID: PMC6468691 DOI: 10.3390/toxics7010006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 01/10/2023]
Abstract
Particulate matter (PM) exposure and metabolic syndrome (MetSyn) are both significant global health burdens. PM exposure has been implicated in the pathogenesis of MetSyn and cardiopulmonary diseases. Individuals with pre-existing MetSyn may be more susceptible to the detrimental effects of PM exposure. Our aim was to provide a narrative review of MetSyn/PM-induced systemic inflammation in cardiopulmonary disease, with a focus on prior studies of the World Trade Center (WTC)-exposed Fire Department of New York (FDNY). We included studies (1) published within the last 16-years; (2) described the epidemiology of MetSyn, obstructive airway disease (OAD), and vascular disease in PM-exposed individuals; (3) detailed the known mechanisms of PM-induced inflammation, MetSyn and cardiopulmonary disease; and (4) focused on the effects of PM exposure in WTC-exposed FDNY firefighters. Several investigations support that inhalation of PM elicits pulmonary and systemic inflammation resulting in MetSyn and cardiopulmonary disease. Furthermore, individuals with these preexisting conditions are more sensitive to PM exposure-related inflammation, which can exacerbate their conditions and increase their risk for hospitalization and chronic disease. Mechanistic research is required to elucidate biologically plausible therapeutic targets of MetSyn- and PM-induced cardiopulmonary disease.
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Garudadri S, Woodruff PG, Han MK, Curtis JL, Barr RG, Bleecker ER, Bowler RP, Comellas A, Cooper CB, Criner G, Dransfield MT, Hansel NN, Paine R, Krishnan JA, Peters SP, Hastie AT, Martinez FJ, O'Neal WK, Couper DJ, Alexis NE, Christenson SA. Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved Spirometry in SPIROMICS. Chest 2019; 155:908-917. [PMID: 30684474 DOI: 10.1016/j.chest.2018.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/09/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Chronic respiratory symptoms and exacerbation-like events are common among ever-smokers without airflow limitation on spirometry. The pathobiology of respiratory disease in this subgroup remains poorly defined, but may be due to underlying inflammation that overlaps with COPD or asthma. We hypothesized that symptoms, exacerbations, and functional measures of disease severity among smokers with preserved spirometry would be associated with markers of systemic inflammation, similar to what is reported in bone fide COPD, rather than elevated type 2 inflammation, which is often present in asthma. METHODS We measured inflammatory markers associated with COPD (C-reactive protein [CRP], fibrinogen, soluble tumor necrosis factor receptors [sTNFRSF1A and sTNFRSF1B], and blood/sputum neutrophils) and type 2 inflammation (IgE and blood/sputum eosinophils) in smokers with preserved spirometry (postbronchodilator FEV1/FVC ≥ 0.70) from the Subpopulations and Intermediate Outcome Measures In COPD Study (SPIROMICS). We evaluated the relationship of these markers with respiratory symptom burden (dichotomized by a COPD assessment test score cutoff of 10, diagnosis of chronic bronchitis), exacerbations, 6-minute walk distance, and lung function on the basis of FEV1. RESULTS CRP was associated with increased symptom burden (on the basis of COPD assessment test score and diagnosis of chronic bronchitis) and a greater number of exacerbations in the year before study enrollment. sTNFRSF1A was associated with symptom burden on the basis of COPD assessment test score. CRP and sTNFRSF1A levels negatively correlated with 6-minute walk distance. IgE and eosinophils were not associated with these outcomes. CONCLUSIONS Markers of inflammation including CRP and sTNFRSF1A are enriched among symptomatic smokers with preserved spirometry, suggesting an overlap with the underlying pathophysiology of COPD.
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Affiliation(s)
- Suresh Garudadri
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH; Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, San Francisco, CA.
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, San Francisco, CA
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI
| | - R Graham Barr
- Department of Medicine and Department of Epidemiology, Columbia University, New York, NY
| | | | | | | | | | - Gerard Criner
- School of Medicine, Medicine/Pulmonary and Critical Care, Temple University, Philadelphia, PA
| | - Mark T Dransfield
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama, Birmingham, Birmingham, AL
| | | | - Robert Paine
- Internal Medicine/Pulmonary and Critical Care, University of Utah, Salt Lake City, UT
| | - Jerry A Krishnan
- Pulmonary, Critical Care, Sleep and Allergy College of Medicine, University of Illinois, Chicago, Chicago, IL
| | - Stephen P Peters
- Section on Pulmonary, Critical Care, Allergy & Immunologic Diseases, Wake Forest University, Winston-Salem, NC
| | - Annette T Hastie
- Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, NC
| | | | - Wanda K O'Neal
- Marsico Lung Institute, University of North Carolina, Chapel Hill, NC
| | - David J Couper
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC
| | - Stephanie A Christenson
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, San Francisco, CA
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Arora S, Madan K, Mohan A, Kalaivani M, Guleria R. Serum inflammatory markers and nutritional status in patients with stable chronic obstructive pulmonary disease. Lung India 2019; 36:393-398. [PMID: 31464210 PMCID: PMC6710956 DOI: 10.4103/lungindia.lungindia_494_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease. We investigated whether serum inflammatory markers, C-reactive protein (CRP), leptin, and nutritional status (assessed by measurement of serum levels of prealbumin and anthropometry) correlated with COPD severity. Materials and Methods One-hundred and two COPD patients (mean age 56.94 ± 10.95 years) were recruited and classified into severity categories based on the GOLD guidelines. Serum concentrations of CRP, prealbumin, and leptin were measured. Anthropometry included body mass index (BMI), mid-upper arm circumference (MUAC), and sum of four skinfold thicknesses (triceps, biceps, suprailiac, and subscapular). Results Twenty-one patients had moderate, 44 had severe, and 37 had very severe COPD. Levels of CRP (mg/dl) (mean ± standard error [SE]) in moderate, severe, and very severe COPD were 0.60 ± 0.096, 2.16 ± 0.39, and 4.15 ± 0.463, respectively. Levels of prealbumin (mg/dl) (mean ± SE) in moderate, severe, and very severe COPD were 15.7 3 ± 0.92, 10.95 ± 0.85, and 11.15 ± 0.79 mg/dl, respectively. Levels of leptin (ng/ml) (mean ± SE) in moderate, severe, and very severe COPD were 13.81 ± 3.88, 8.45 ± 2.25, and 4.40 ± 1.06, respectively. BMI values in the three groups were 23.44 ± 1.16 kg/m2, 20.33 ± 0.62 kg/m2, and 18.86 ± 0.52 kg/m2, respectively. Sum of four skinfold thickness and MUAC was significantly reduced in very severe group as compared to moderate and severe group. Very severe COPD patients had a significantly lower leptin, BMI, and 6-min walk test. Serum CRP was significantly higher in very severe COPD. Conclusion Patients with increasing severity of COPD had a significantly greater serum inflammatory marker level and poorer nutritional status.
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Affiliation(s)
- Sneh Arora
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Terzikhan N, Lahousse L, Verhamme KMC, Franco OH, Ikram AM, Stricker BH, Brusselle GG. COPD is associated with an increased risk of peripheral artery disease and mortality. ERJ Open Res 2018; 4:00086-2018. [PMID: 30588480 PMCID: PMC6302209 DOI: 10.1183/23120541.00086-2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/23/2018] [Indexed: 11/21/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) commonly present with multimorbidity. We aimed to investigate the association between COPD and the development of peripheral arterial disease (PAD) in the general population, and how this might affect mortality among individuals with COPD. We included 3123 participants of the population-based Rotterdam Study without PAD at baseline (mean age 65 years; 57.4% female). The association between COPD at baseline and PAD during follow-up was studied using logistic regression (PAD being indicated by an ankle–brachial index (ABI) of 0.9 or less). Cox regression was used for mortality analysis and interaction terms were used to investigate mortality risk modification by PAD. The presence of COPD was associated with incident PAD (adjusted odds ratio 1.9, 95% CI 1.1–3.2). Mortality rates per 100 000 person-years were as follows: 10.0 in individuals without COPD or PAD, 18.4 in those with COPD only, 16.1 in those with PAD only and 30.1 in individuals with both COPD and PAD. No statistical interaction was found between PAD and COPD on risk of dying. Individuals with COPD have an almost doubled risk of developing PAD. Although PAD does not modify the association between COPD and mortality, people suffering from both diseases have substantially higher mortality rates. Individuals with COPD have an almost doubled risk of developing peripheral arterial disease (PAD). People suffering from both COPD and PAD have substantially higher mortality rates.http://ow.ly/IyOx30m0IBo
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Affiliation(s)
- Natalie Terzikhan
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lies Lahousse
- Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Katia M C Verhamme
- Dept of Medical Informatics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arfan M Ikram
- Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Guy G Brusselle
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
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Suzuki M, Muro S, Fukui M, Ishizaki N, Sato S, Shiota T, Endo K, Suzuki T, Mitsuma T, Mishima M, Hirai T. Effects of acupuncture on nutritional state of patients with stable chronic obstructive pulmonary disease (COPD): re-analysis of COPD acupuncture trial, a randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:287. [PMID: 30355325 PMCID: PMC6201549 DOI: 10.1186/s12906-018-2341-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/01/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND There are an increasing number of evidences that chronic obstructive pulmonary disease (COPD) is a systemic illness and that bodyweight loss is its prominent manifestation. We focused on the nutritional outcomes to find out the effectiveness of acupuncture on nutritional state of COPD patients and on their prognosis in our previous interventional study. METHODS The present study is re-analysis of our previous interventional study, COPD Acupuncture Trial (CAT) published in 2012. Data from CAT was re-analyzed in terms of nutritional status, inflammatory biomarkers, and prognostic index. Nutritional states were evaluated by the measurements of body weight, body composition, and muscle strength, and the nutritional hematological examination results (retinol-binding protein (RBP), prealbumin (PA), transferrin (Tf), and hemoglobin (Hb) in serum), and inflammation biomarkers such as carboxyhemoglobin (COHb), High sensitivity C-reactive protein (Hs-CRP), Tumor Necrosis Factor-alpha (TNF-α), Interleukin 6 (IL-6), and Serum Amyloid A (SAA) were measured. The BODE index was measured in terms of prognosis. These measurements were compared between the real acupuncture group (RAG) and the placebo acupuncture group (PAG). All data are presented as mean (SD) or mean (95% CI). The difference between baseline and final volumes was compared using analysis of covariance (ANCOVA). Moreover, correlations between nutritional hematological examination scores and inflammation biomarker parameters were assessed using Spearman's rank correlation coefficient. RESULTS After 12 weeks, the change in body weight was significantly greater in the RAG compared with the PAG (mean [SD] difference from baseline: 2.5 [0.4] in RAG vs - 0.5 [1.4] in PAG; mean difference between the groups: 3.00, 95% CI, 2.00 to 4.00 with ANCOVA). Patients in RAG also had improvements in the results of nutritional hematological examination (RBP, PA, Tf, Hb), Inflammation biomarkers (TNF-α, IL-6, SAA, Hs-CRP, COHb) and the BODE index. CONCLUSION This study demonstrated some clear evidences that acupuncture can be a useful adjunctive therapy to improve nutritional state of COPD patients. TRIAL REGISTRATION UMIN Clinical Trials Registry ( UMIN000001277 ). Retrospectively registered.
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Affiliation(s)
- Masao Suzuki
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University School of Medicine, 21-2 Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, Fukushima 969-3492 Japan
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480 Japan
| | - Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521 Japan
| | - Motonari Fukui
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480 Japan
| | - Naoto Ishizaki
- Course of Acupuncture and Moxibustion, Faculty of Health Sciences, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba, Ibaraki 305-8521 Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Yoshida, Konoe-cho, Sakyo-ku, Kyoto, 606-8501 Japan
| | - Tetsuhiro Shiota
- Department of Respiratory Medicine, Shiga General Hospital, 4-30 Moriyama-cho, Moriyama, Shiga 524-8524 Japan
| | - Kazuo Endo
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinanba-cho, Amagasaki, Hyogo 660-8550 Japan
| | - Tomoko Suzuki
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University School of Medicine, 21-2 Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, Fukushima 969-3492 Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University School of Medicine, 21-2 Maeda, Tanisawa, Kawahigashi, Aizuwakamatsu, Fukushima 969-3492 Japan
| | | | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Yoshida, Konoe-cho, Sakyo-ku, Kyoto, 606-8501 Japan
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Aggarwal T, Wadhwa R, Thapliyal N, Sharma K, Rani V, Maurya PK. Oxidative, inflammatory, genetic, and epigenetic biomarkers associated with chronic obstructive pulmonary disorder. J Cell Physiol 2018; 234:2067-2082. [DOI: 10.1002/jcp.27181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Taru Aggarwal
- Amity Institute of Biotechnology, Amity UniversityNoida India
| | - Ridhima Wadhwa
- Amity Institute of Biotechnology, Amity UniversityNoida India
| | | | - Kanishka Sharma
- Amity Education GroupOakdale, Long Island (Suffolk) New York
| | - Varsha Rani
- Amity Education GroupOakdale, Long Island (Suffolk) New York
| | - Pawan K. Maurya
- Amity Institute of Biotechnology, Amity UniversityNoida India
- Amity Education GroupOakdale, Long Island (Suffolk) New York
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of PsychiatryFederal University of São PauloSão Paulo Brazil
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50
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De Benedetto F, Pastorelli R, Ferrario M, de Blasio F, Marinari S, Brunelli L, Wouters EFM, Polverino F, Celli BR. Supplementation with Qter ® and Creatine improves functional performance in COPD patients on long term oxygen therapy. Respir Med 2018; 142:86-93. [PMID: 30170808 DOI: 10.1016/j.rmed.2018.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPD patients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPD patients on long-term O2 therapy. METHODS One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
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Affiliation(s)
| | - Roberta Pastorelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | | | | | - Laura Brunelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Bartolome R Celli
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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