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Enríquez-Rodríguez CJ, Casadevall C, Faner R, Pascual-Guardia S, Castro-Acosta A, López-Campos JL, Peces-Barba G, Seijo L, Caguana-Vélez OA, Monsó E, Rodríguez-Chiaradia D, Barreiro E, Cosío BG, Agustí A, Gea J, On Behalf Of The Biomepoc Group. A Pilot Study on Proteomic Predictors of Mortality in Stable COPD. Cells 2024; 13:1351. [PMID: 39195241 DOI: 10.3390/cells13161351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 08/29/2024] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of global mortality. Despite clinical predictors (age, severity, comorbidities, etc.) being established, proteomics offers comprehensive biological profiling to obtain deeper insights into COPD pathophysiology and survival prognoses. This pilot study aimed to identify proteomic footprints that could be potentially useful in predicting mortality in stable COPD patients. Plasma samples from 40 patients were subjected to both blind (liquid chromatography-mass spectrometry) and hypothesis-driven (multiplex immunoassays) proteomic analyses supported by artificial intelligence (AI) before a 4-year clinical follow-up. Among the 34 patients whose survival status was confirmed (mean age 69 ± 9 years, 29.5% women, FEV1 42 ± 15.3% ref.), 32% were dead in the fourth year. The analysis identified 363 proteins/peptides, with 31 showing significant differences between the survivors and non-survivors. These proteins predominantly belonged to different aspects of the immune response (12 proteins), hemostasis (9), and proinflammatory cytokines (5). The predictive modeling achieved excellent accuracy for mortality (90%) but a weaker performance for days of survival (Q2 0.18), improving mildly with AI-mediated blind selection of proteins (accuracy of 95%, Q2 of 0.52). Further stratification by protein groups highlighted the predictive value for mortality of either hemostasis or pro-inflammatory markers alone (accuracies of 95 and 89%, respectively). Therefore, stable COPD patients' proteomic footprints can effectively forecast 4-year mortality, emphasizing the role of inflammatory, immune, and cardiovascular events. Future applications may enhance the prognostic precision and guide preventive interventions.
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Affiliation(s)
- Cesar Jessé Enríquez-Rodríguez
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carme Casadevall
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa Faner
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servei de Pneumologia (Institut Clínic de Respiratori), Hospital Clínic-Fundació Clínic per la Recerca Biomèdica, Universitat de Barcelona, 08907 Barcelona, Spain
| | - Sergi Pascual-Guardia
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ady Castro-Acosta
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Respiratory Medicine Department, Hospital 12 de Octubre, 28041 Madrid, Spain
| | - José Luis López-Campos
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, 41012 Sevilla, Spain
| | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Respiratory Medicine Department, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Luis Seijo
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Respiratory Medicine Department, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Respiratory Medicine Department, Clínica Universidad de Navarra, 31008 Madrid, Spain
| | - Oswaldo Antonio Caguana-Vélez
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eduard Monsó
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, 08193 Sabadell, Spain
| | - Diego Rodríguez-Chiaradia
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Esther Barreiro
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Borja G Cosío
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Respiratory Medicine Department, Hospital Son Espases-Instituto de Investigación Sanitaria de Palma (IdISBa), Universitat de les Illes Balears, 07120 Palma de Mallorca, Spain
| | - Alvar Agustí
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servei de Pneumologia (Institut Clínic de Respiratori), Hospital Clínic-Fundació Clínic per la Recerca Biomèdica, Universitat de Barcelona, 08907 Barcelona, Spain
| | - Joaquim Gea
- Hospital del Mar Research Institute, Respiratory Medicine Department, Hospital del Mar. Medicine and Life Sciences Department, Universitat Pompeu Fabra (UPF), BRN, 08018 Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Chang HC, Liu SF. Impact of Smoking Cessation and Charlson Comorbidity Index on Influenza Vaccination Efficacy in COPD Patients. Microorganisms 2024; 12:1437. [PMID: 39065205 PMCID: PMC11278861 DOI: 10.3390/microorganisms12071437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) patients are particularly susceptible to respiratory infections like influenza, which exacerbate symptoms and increase healthcare utilization. While smoking cessation and influenza vaccination are recommended preventive measures, their combined impact on healthcare resource utilization is underexplored. The Charlson Comorbidity Index (CCI) assesses comorbidity burden in COPD patients and may influence healthcare outcomes. We conducted a retrospective analysis of 357 COPD patients, evaluating smoking cessation success over one year and influenza vaccination receipt, stratifying patients by CCI scores. Healthcare utilization outcomes included emergency room visits, hospitalizations, and medical expenses. Results showed that 51.82% of patients quit smoking and 59.66% received influenza vaccination, with higher comorbidity prevalence in advanced COPD stages (p = 0.002). Both smoking cessation and influenza vaccination independently correlated with decreased emergency room visits, hospital admissions, days, and costs. Patients who both quit smoking and received influenza vaccination exhibited the lowest healthcare utilization rates. In conclusion, smoking cessation and influenza vaccination significantly reduce healthcare resource utilization in COPD patients, with the combination yielding synergistic benefits, particularly in those with lower CCI scores. Integrating these interventions and comorbidity management in COPD strategies is essential for optimizing patient outcomes and healthcare efficiency.
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Affiliation(s)
- Hui-Chuan Chang
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Shih-Feng Liu
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, #123, Ta-Pei Road, Niaosong District, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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Klandorf H, Dartigue V. Oxidative stress and plasma ceramides in broiler chickens. Front Physiol 2024; 15:1411332. [PMID: 39077757 PMCID: PMC11284268 DOI: 10.3389/fphys.2024.1411332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/19/2024] [Indexed: 07/31/2024] Open
Abstract
The selection for rapid growth in chickens has rendered meat-type (broiler) chickens susceptible to develop metabolic syndrome and thus inflammation. The sphingolipid ceramide has been linked as a marker of oxidative stress in mammals, however, the relationship between sphingolipid ceramide supply and oxidative stress in broiler chickens has not been investigated. Therefore, we employed a lipidomic approach to investigate the changes in circulating sphingolipid ceramides in context of allopurinol-induced oxidative stress in birds. Day zero hatched chicks (n = 60) were equally divided into six groups; an unsupplemented control, an allopurinol group (25 mg/kg body weight), a conjugated linoleic acid (CLA) group where half of the oil used in the control diet was substituted for a CLA oil mixture, a CLA and an allopurinol group utilizing the same dose of CLA and allopurinol, a berberine (BRB) group consisting of berberine supplementation (200 mg/kg feed), and a BRB and allopurinol group, utilizing the same dose of BRB and allopurinol. Conjugated linoleic acid and berberine were utilized to potentially enhance antioxidant activity and suppress the oxidative stress induced by allopurinol treatment. Body weight, plasma uric acid, nonesterified fatty acids (NEFA) and sphingolipid ceramides were quantified. Allopurinol induced an inflammatory state as measured by a significant reduction in plasma uric acid - an antioxidant in birds as well as a metabolic waste product. Results showed that both total and saturated sphingolipid ceramides declined (p < 0.05) with age in unsupplemented chicks, although plasma ceramides C16:0 and 18:0 increased in concentration over the study period. Simple total and saturated sphingolipid ceremide's were further decreased (p < 0.05) with allopurinol supplementation, however, this may be an indirect consequence of inducing an inflammatory state. Neither CLA or BRB were able to significantly attenuate the decline. The administration of allopurinol specifically targets the liver which in birds, is the primary organ for fatty acids synthesis. For this reason, sphingolipid ceramide production might have been unwittingly affected by the addition of allopurinol.
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Mou K, Chan SMH, Vlahos R. Musculoskeletal crosstalk in chronic obstructive pulmonary disease and comorbidities: Emerging roles and therapeutic potentials. Pharmacol Ther 2024; 257:108635. [PMID: 38508342 DOI: 10.1016/j.pharmthera.2024.108635] [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: 11/06/2023] [Revised: 02/13/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a multifaceted respiratory disorder characterized by progressive airflow limitation and systemic implications. It has become increasingly apparent that COPD exerts its influence far beyond the respiratory system, extending its impact to various organ systems. Among these, the musculoskeletal system emerges as a central player in both the pathogenesis and management of COPD and its associated comorbidities. Muscle dysfunction and osteoporosis are prevalent musculoskeletal disorders in COPD patients, leading to a substantial decline in exercise capacity and overall health. These manifestations are influenced by systemic inflammation, oxidative stress, and hormonal imbalances, all hallmarks of COPD. Recent research has uncovered an intricate interplay between COPD and musculoskeletal comorbidities, suggesting that muscle and bone tissues may cross-communicate through the release of signalling molecules, known as "myokines" and "osteokines". We explored this dynamic relationship, with a particular focus on the role of the immune system in mediating the cross-communication between muscle and bone in COPD. Moreover, we delved into existing and emerging therapeutic strategies for managing musculoskeletal disorders in COPD. It underscores the development of personalized treatment approaches that target both the respiratory and musculoskeletal aspects of COPD, offering the promise of improved well-being and quality of life for individuals grappling with this complex condition. This comprehensive review underscores the significance of recognizing the profound impact of COPD on the musculoskeletal system and its comorbidities. By unravelling the intricate connections between these systems and exploring innovative treatment avenues, we can aspire to enhance the overall care and outcomes for COPD patients, ultimately offering hope for improved health and well-being.
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Affiliation(s)
- Kevin Mou
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Stanley M H Chan
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Ross Vlahos
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
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Yu X, Cheng X, Lv L, Wang N, Li M, Ji W, Liu T, Wang G, Hu T, Shi Z. The association between chronic obstructive pulmonary disease and autoimmune diseases: a bidirectional Mendelian randomization study. Front Med (Lausanne) 2024; 11:1331111. [PMID: 38504914 PMCID: PMC10949139 DOI: 10.3389/fmed.2024.1331111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Objective Observational studies have reported that chronic obstructive pulmonary disease (COPD) is often accompanied by autoimmune diseases, but the causal relationships between them remain uncertain. In this Mendelian study, we aimed to investigate the potential causal relationship between COPD and four common autoimmune diseases. Methods We conducted an analysis of summary data on COPD and autoimmune disease using publicly available genome-wide association studies (GWAS) summary data. We initially employed the inverse- variance weighted method as the primary approach to establish the causal impact of COPD on autoimmune diseases in the sample and conducted additional sensitivity analyses to examine the robustness of the results. Subsequently, we performed reverse Mendelian randomization (MR) analyses for the four autoimmune diseases. Finally, the potential for bidirectional causal relationships was assessed. Results Our MR analysis revealed no significant causal relationship between COPD and any of the studied autoimmune diseases. However, reverse MR results indicated a significant association between rheumatoid arthritis (RA), osteoarthritis (OA) and the risk of developing COPD, with respective odds ratios (OR) of 377.313 (95% CI, 6.625-21487.932, P = 0.004) for RA and 11.097 (95% CI, 1.583-77.796, P = 0.015) for OA. Sensitivity analyses confirmed the robustness of the results. Conclusion Our findings support a potential causal relationship between autoimmune diseases and COPD, highlighting the importance of considering comorbidities in clinical management of COPD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Zhihong Shi
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Alwadani FA, Wheeler K, Pittaway H, Turner AM. Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Patients with Underlying Alpha-1 Antitrypsin Deficiency: A Systematic Review and Practical Recommendations. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2024; 11:121-132. [PMID: 37813825 PMCID: PMC10913928 DOI: 10.15326/jcopdf.2023.0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Abstract
Background Alpha-1 antitrypsin deficiency (AATD) is an often-overlooked genetic condition that makes individuals susceptible to early onset of chronic obstructive pulmonary disease (COPD). The established benefits of exercise-based pulmonary rehabilitation (PR) for usual COPD patients are unclear for those with underlying AATD, especially given potentially differing muscle adaptations to exercise. This review seeks to compare PR outcomes between AATD and usual COPD patients and to consolidate current knowledge on exercise intervention outcomes for the AATD population. Methods A thorough search of 4 databases (Ovid, Medline, CINAHL, CENTRAL) was conducted based on 3 search concepts: (1) alpha-1 antitrypsin deficiency, (2) pulmonary rehabilitation OR exercise, and (3) muscle morphology. A dual review process and quality assessment were independently implemented throughout all stages of the review. Results Four studies highlighted modest exercise capacity and quality of life in AATD patients undergoing PR. However, one study reported unique muscle and mitochondrial responses compared to usual COPD patients. Additionally, a moderate exercise session did not alter pro-inflammatory cytokine levels in AATD patients, despite higher levels of tumor necrosis factor-α levels in muscle biopsies compared to usual COPD patients. Conclusions The current literature base insufficiently addresses the efficacy of PR on AATD, with indications that exercise adaptation may deviate from that of usual COPD patients. Further research is needed to optimize PR, particularly in identifying the most suitable exercise intensity, and delivery setting, and addressing specific educational needs for individuals with AATD.
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Affiliation(s)
- Fawaz A. Alwadani
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Department of Physical Therapy, Jazan University, Jazan, Saudi Arabia
| | | | - Harriet Pittaway
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Alice M. Turner
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Saad E, Maamoun B, Nimer A. Increased Red Blood Cell Distribution Predicts Severity of Chronic Obstructive Pulmonary Disease Exacerbation. J Pers Med 2023; 13:jpm13050843. [PMID: 37241013 DOI: 10.3390/jpm13050843] [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: 03/08/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Increased red blood cell distribution width (RDW) has been reported to be related to underlying chronic inflammation. Our aim is to investigate the relationship of different complete blood count (CBC) parameters such as hemoglobin level, mean corpuscular volume (MCV), mean platelet volume (MPV) or RDW with COPD exacerbation severity. METHODS In the present retrospective analysis, consecutive patients admitted with the diagnosis of "COPD Exacerbation" between 1 January 2012 and 31 December 2015 were evaluated. RESULTS The study population included 804 patients with COPD exacerbation. The maximal partial pressure of carbon dioxide in the arterial blood (PaCO2) during hospital stay was significantly higher in patients with high MCV (p < 0.001), and in patients with a high RDW (p < 0.001). The hospitalization duration was significantly longer in patients with high RDW (p < 0.001) and in patients with elevated C-reactive protein (CRP) levels (p < 0.001). CRP levels strongly correlated to RDW (p = 0.001). CONCLUSIONS Our study demonstrated that different CBC parameters, such as MCV and RDW, are in correlation with the severity of acute exacerbation of COPD reflected by the PaCO2 level and the duration of hospitalization. Furthermore, we also found a positive correlation between RDW and CRP levels. This finding supports the hypothesis that RDW is a good biomarker of acute inflammation.
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Affiliation(s)
- Elias Saad
- Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel
- Department of Medicine, Galilee Medical Center, Nahariya 2210001, Israel
| | - Basheer Maamoun
- Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel
- Department of Medicine, Galilee Medical Center, Nahariya 2210001, Israel
| | - Assy Nimer
- Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel
- Department of Medicine, Galilee Medical Center, Nahariya 2210001, Israel
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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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Dey D, Mondal P, Moitra S, Saha GK, Podder S. Association of Interleukin 6 and Interleukin 8 genes polymorphisms with house dust mite-induced nasal-bronchial allergy in a sample of Indian patients. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00348-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Genetic background of nasal-bronchial allergy (NBA) is well documented. House Dust Mites (HDMs) are reported to elicit NBA symptoms. Susceptibility to HDM sensitization varies considerably from person to person. Interleukin 6 (IL 6) and Interleukin 8 (IL 8) are studied previously for genetic association with several diseases. To the best of our knowledge, the genetic association of HDM-induced NBA has not been largely reported from India. The aim of our present study was to evaluate any possible association of IL 6 and IL 8 gene polymorphisms with HDM-induced NBA in an Indian population.
Methods
IL 6 (− 572G/C, − 597G/A) and IL 8 polymorphisms (− 251A/T, + 781C/T) were analyzed in a HDM-sensitized group (N = 372) and a control group (N = 110). Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR–RFLP) based genotyping was done. Chi-square test and Fisher’s exact tests were applied for statistical analysis.
Results
IL 6 − 597G/A and IL 8 + 781C/T were not associated with HDM-sensitization, while IL 6 − 72G/C and IL 8 − 51A/T showed significant associations in terms of both genotype and allele frequencies. For both the SNPs, minor allele frequencies were significantly higher in the patients compared to the control. Moreover, IL 6 -572G/C and IL 8 -251A/T were found to be strongly linked with HDM sensitization and severity.
Conclusion
This is probably the pioneer study to describe the association of IL 6 and IL 8 polymorphisms with HDM sensitization in any Indian population. The results suggested that IL 6 -572G/C and IL 8 -251A/T may exert a risk of HDM sensitization leading to NBA.
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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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11
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Xu Z, Wang W, Liu Q, Li Z, Lei L, Ren L, Deng F, Guo X, Wu S. Association between gaseous air pollutants and biomarkers of systemic inflammation: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118336. [PMID: 34634403 DOI: 10.1016/j.envpol.2021.118336] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Studies have linked gaseous air pollutants to multiple health effects via inflammatory pathways. Several major inflammatory biomarkers, including C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) have also been considered as predictors of cardiovascular disease. However, there has been no meta-analysis to evaluate the associations between gaseous air pollutants and these typical biomarkers of inflammation to date. OBJECTIVES To evaluate the overall associations between short-term and long-term exposures to ambient ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon dioxide (CO) and major inflammatory biomarkers including CRP, fibrinogen, IL-6 and TNF-α. METHODS A meta-analysis was conducted for publications from PubMed, Web of Science, Scopus and EMBASE databases up to Feb 1st, 2021. RESULTS The meta-analysis included 38 studies conducted among 210,438 participants. Generally, we only observed significant positive associations between short-term exposures to gaseous air pollutants and inflammatory biomarkers. For a 10 μg/m3 increase in short-term exposure to O3, NO2, and SO2, there were significant increases of 1.05% (95%CI: 0.09%, 2.02%), 1.60% (95%CI: 0.49%, 2.72%), and 10.44% (95%CI: 4.20%, 17.05%) in CRP, respectively. Meanwhile, a 10 μg/m3 increase in NO2 was also associated with a 4.85% (95%CI: 1.10%, 8.73%) increase in TNF-α. Long-term exposures to gaseous air pollutants were not statistically associated with these biomarkers, but the study numbers were relatively small. Subgroup analyses found more apparent associations in studies with better study design, higher quality, and smaller sample size. Meanwhile, the associations also varied across studies conducted in different geographical regions. CONCLUSION Short-term exposure to gaseous air pollutants is associated with increased levels of circulating inflammatory biomarkers, suggesting that a systemic inflammatory state is activated upon exposure. More studies on long-term exposure to gaseous air pollutants and inflammatory biomarkers are warranted to verify the associations.
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Affiliation(s)
- Zhouyang Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Zichuan Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Lei Lei
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Lihua Ren
- Division of Maternal and Child Nursing, School of Nursing, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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12
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Abe Y, Suzuki M, Shima H, Shiraishi Y, Tanabe N, Sato S, Shimizu K, Kimura H, Makita H, Hirai T, Konno S, Nishimura M. Annual Body Weight Change and Prognosis in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:3243-3253. [PMID: 34876811 PMCID: PMC8643147 DOI: 10.2147/copd.s338908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose Low body mass index (BMI) has been reported to be associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). In contrast, a detailed analysis of the association between body weight change over time and prognosis is not sufficient, particularly in Japanese patients with COPD who have been reported to be much thinner compared to Westerners. This study aimed to investigate the relationship between annual body weight change and long-term prognosis in Japanese patients with COPD in two independent cohorts. Patients and Methods We analyzed 279 patients with COPD who participated in the Hokkaido COPD cohort study as a discovery cohort. We divided participants into three groups according to quartiles of annual body weight change calculated by the data from the first 5 years: weight loss group (<-0.17 kg/year), no change group (−0.17 to ≤0.20 kg/year), and weight gain group (>0.20 kg/year). The association between annual body weight change and prognosis was replicated in the Kyoto University cohort (n = 247). Results In the Hokkaido COPD cohort study, the weight loss group had significantly worse mortality than the other groups, whereas there was no difference in BMI at baseline. In the multivariate analysis, annual body weight change was an independent risk factor for all-cause mortality, which was confirmed in the Kyoto University cohort. Conclusion Annual body weight loss is associated with poor prognosis in Japanese patients with COPD, independent of baseline BMI. Longitudinal assessment of body weight is important for the management of COPD.
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Affiliation(s)
- Yuki Abe
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan
| | - Hiroshi Shima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yusuke Shiraishi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan
| | - Hironi Makita
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan.,Hokkaido Medical Research Institute for Respiratory Diseases, Chuo-ku, Sapporo, 060-0063, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan.,Hokkaido Medical Research Institute for Respiratory Diseases, Chuo-ku, Sapporo, 060-0063, Japan
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13
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Wouters EFM. Nutritional Status and Body Composition in Patients Suffering From Chronic Respiratory Diseases and Its Correlation With Pulmonary Rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:725534. [PMID: 36188872 PMCID: PMC9397774 DOI: 10.3389/fresc.2021.725534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/08/2021] [Indexed: 11/13/2022]
Abstract
As part of an individualized intervention to improve the physical, emotional, and social functioning of patients with chronic respiratory diseases in general and chronic obstructive pulmonary disease in particular, awareness of the presence and consequences of changes in body composition increased enormously during the last decades, and nutritional intervention is considered as an essential component in the comprehensive approach of these patients. This review describes the prevalence and the clinical impact of body composition changes and also provides an update of current intervention strategies. It is argued that body composition, preferentially a three-component evaluation of fat, lean, and bone mass, must become part of a thorough assessment of every patient, admitted for pulmonary rehabilitation.
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Affiliation(s)
- Emiel F. M. Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
- *Correspondence: Emiel F. M. Wouters
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14
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Ilari S, Vitiello L, Russo P, Proietti S, Milić M, Muscoli C, Cardaci V, Tomino C, Bonassi G, Bonassi S. Daily Vegetables Intake and Response to COPD Rehabilitation. The Role of Oxidative Stress, Inflammation and DNA Damage. Nutrients 2021; 13:nu13082787. [PMID: 34444947 PMCID: PMC8398833 DOI: 10.3390/nu13082787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 02/01/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disease associated with airways inflammation and lung parenchyma fibrosis. The primary goals of COPD treatment are to reduce symptoms and risk of exacerbations, therefore pulmonary rehabilitation is considered the key component of managing COPD patients. Oxidative airway damage, inflammation and reduction of endogenous antioxidant enzymes are known to play a crucial role in the pathogenesis of COPD. Recently, also natural antioxidants have been considered as they play an important role in metabolism, DNA repair and fighting the effects of oxidative stress. In this paper we evaluated the response of 105 elderly COPD patients to pulmonary rehabilitation (PR), based on high or low vegetable consumption, by analyzing clinical parameters and biological measurements at baseline and after completion of the three weeks PR. We found that daily vegetable intake in normal diet, without any specific intervention, can increase the probability to successfully respond to rehabilitation (65.4% of responders ate vegetables daily vs. 40.0% of non-responders, p = 0.033). The association was especially evident in subjects ≥ 80 year of age (OR = 17.0; p < 0.019). Three weeks of pulmonary rehabilitation are probably too short to reveal a reduction of the oxidative stress and DNA damage, but are enough to show an improvement in the patient’s inflammatory state.
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Affiliation(s)
- Sara Ilari
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), University “Magna Graecia” of Catanzaro, 88201 Catanzaro, Italy; (S.I.); (C.M.)
| | - Laura Vitiello
- Laboratory of Flow Cytometry, IRCCS San Raffaele Roma, 00166 Rome, Italy;
| | - Patrizia Russo
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, 00166 Rome, Italy; (S.P.); (S.B.)
- Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy
- Correspondence: ; Tel.: +39-06-5225-3409
| | - Stefania Proietti
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, 00166 Rome, Italy; (S.P.); (S.B.)
| | - Mirta Milić
- Mutagenesis Unit, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia;
| | - Carolina Muscoli
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), University “Magna Graecia” of Catanzaro, 88201 Catanzaro, Italy; (S.I.); (C.M.)
| | - Vittorio Cardaci
- Pulmonary Rehabilitation Unit, IRCCS San Raffaele Roma, 00166 Rome, Italy;
| | - Carlo Tomino
- Scientific Direction, IRCCS San Raffaele Roma, 00166 Rome, Italy;
| | - Gaia Bonassi
- S.C. Medicina Fisica e Riabilitazione Ospedaliera, ASL4, Azienda Sanitaria Locale Chiavarese, 16034 Chiavari, Italy;
| | - Stefano Bonassi
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, 00166 Rome, Italy; (S.P.); (S.B.)
- Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy
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15
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Inflammatory Biomarkers Interleukin 1 Beta (IL-1β) and Tumour Necrosis Factor Alpha (TNF-α) Are Differentially Elevated in Tobacco Smoke Associated COPD and Biomass Smoke Associated COPD. TOXICS 2021; 9:toxics9040072. [PMID: 33915841 PMCID: PMC8066753 DOI: 10.3390/toxics9040072] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 12/03/2022]
Abstract
Chronic obstructive pulmonary disease (COPD), the leading cause of mortality and morbidity worldwide, is characterized by abnormal activation of inflammatory cells. The increased pro-inflammatory cytokines, such as tumour necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β), further amplify the inflammation. We evaluated the dose response relationship of IL-1β and TNF-α levels and severity of airflow limitation, and differential responses in IL-1β and TNF-α between biomass COPD (BMS-COPD) and tobacco smoke COPD (TS-COPD) using a case control design in 160 subjects. Patients with COPD had higher serum levels of both IL-1β and TNF-α compared to healthy controls. A large difference in TNF-α was observed between TS-COPD and BMS-COPD, where TS-COPD patients had much higher levels. Serum IL-1β levels were higher in BMS-COPD. Levels of IL-1β correlated better with severity of airflow limitation than TNF-α levels. Both TNF-α and IL-1β levels had a negative linear relationship with Forced Expiratory Volume in 1st second (FEV1) and six-minute walk distance. The correlations were stronger with FEV1 than six-minute walk distance. The correlations of TNF-α and IL-1β with St George Respiratory Questionnaire (SGRQ) scores and body mass index (BMI) were not significant. In conclusion, the levels of pro-inflammatory cytokines TNF-α and IL-1β are differently elevated in TS-COPD and BMS-COPD, respectively.
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16
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Yangui F, Touil A, Antit S, Zakhama L, Charfi MR. COPD prevalence in smokers with stable ischemic heart disease: A cross-sectional study in Tunisia. Respir Med 2021; 179:106335. [PMID: 33621707 DOI: 10.1016/j.rmed.2021.106335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) are common causes of mortality worldwide, with shared risk factors. COPD continues to be largely underdiagnosed and undertreated, especially in patients with IHD. OBJECTIVE To investigate the prevalence of COPD in smokers with confirmed IHD and to compare IHD characteristics between COPD patients and those without COPD. METHODS It was a cross-sectional study, conducted between August and December 2017, including patients over 40 years of age, current or former smokers, with stable and confirmed IHD. Spirometry was undertaken for all participants, and COPD was defined according to GOLD criteria. RESULTS A total of 122 patients, with mean age of 59.3 years and mean pack-year of 52.3, were enrolled. Spirometry was normal in 63.2% of patients and airflow limitation was the most frequent ventilatory disorder (20.5%). COPD was diagnosed in 19.7% of patients. Of the 24 COPD patients, 17 (70.8%) were previously undiagnosed. Airflow limitation severity in COPD patients was classified mild, moderate, severe and very severe in 25%, 62.5%, 8.3% and 4.2% of patients. Comparison between COPD patients and non-COPD patients showed that comorbidities, respiratory symptoms, chest x-ray abnormalities, life-threatening lesions, three vessel disease, pulmonary hypertension and right ventricle dysfunction were significantly more frequent in COPD patients. CONCLUSIONS There was a high prevalence of COPD among smoking patients with IHD, and most were undiagnosed despite being symptomatic. Smokers with IHD, especially if having respiratory symptoms, radiological or ultrasound abnormalities or life-threatening coronary lesions should be evaluated for airflow limitation.
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Affiliation(s)
- Ferdaous Yangui
- University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Pneumology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia.
| | - Amany Touil
- University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Pneumology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia
| | - Saoussen Antit
- University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Cardiology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia
| | - Lilia Zakhama
- University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Cardiology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia
| | - Mohamed Ridha Charfi
- University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Pneumology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia
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17
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Testa C, DI Lorenzo A, Parlato A, D'Ambrosio G, Merolla A, Pacileo M, Iannuzzo G, Gentile M, Nugara C, Sarullo FM, DE Gregorio C, D'Andrea A, Vigorito C, Venturini E, Giallauria F. Exercise for slowing the progression of atherosclerotic process: effects on inflammatory markers. Panminerva Med 2021; 63:122-132. [PMID: 33565757 DOI: 10.23736/s0031-0808.21.04266-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Atherosclerosis is a dynamic process driven by all cardiovascular risk factors that can be briefly divided into an early and a late phase. Inflammation is one of the fundamental substrates that initiates the atherosclerotic process in the early stages and promotes and maintains it in the final stages. In the last decades, clinical and experimental data have shown that inflammation is supported by mediators that respond to physical activity. The present review aimed at investigating the effect of physical exercise on inflammatory mediators, both the positive ones that have a proinflammatory effect (interleukin 6, c-reactive protein and tumor necrosis factor α, interferon γ, high-mobility group box-1), and the negative ones which have an anti-inflammatory effect (interleukin 10). Pooled data support the evidence that physical exercise can directly modulate the activity of inflammatory cytokines slowing down or preventing the formation of the atherosclerotic stage.
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Affiliation(s)
- Crescenzo Testa
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Anna DI Lorenzo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Alessandro Parlato
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giuseppe D'Ambrosio
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Aurora Merolla
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Mario Pacileo
- Unit of Cardiology and Intensive Care, "Umberto I" Hospital, Nocera Inferiore, Salerno, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Cinzia Nugara
- Unit of Cardiovascular Rehabilitation, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy
| | - Filippo M Sarullo
- Unit of Cardiovascular Rehabilitation, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy
| | - Cesare DE Gregorio
- Unit of Cardiology, Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.,Post-graduate Residency School in Cardiovascular Diseases, Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Antonello D'Andrea
- Unit of Cardiology and Intensive Care, "Umberto I" Hospital, Nocera Inferiore, Salerno, Italy
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Elio Venturini
- Cardiac Rehabilitation Unit, AUSL Toscana Nord-Ovest, Cecina Civil Hospital, Cecina, Livorno, Italy
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy - .,Faculty of Sciences and Technology, University of New England, Armidale, Australia
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18
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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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19
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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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Müller M, Hermes GDA, Emanuel E. C, Holst JJ, Zoetendal EG, Smidt H, Troost F, Schaap FG, Damink SO, Jocken JWE, Lenaerts K, Masclee AAM, Blaak EE. Effect of wheat bran derived prebiotic supplementation on gastrointestinal transit, gut microbiota, and metabolic health: a randomized controlled trial in healthy adults with a slow gut transit. Gut Microbes 2020; 12:1704141. [PMID: 31983281 PMCID: PMC7524158 DOI: 10.1080/19490976.2019.1704141] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Acute intake of the wheat bran extract Arabinoxylan-Oligosaccharide (AXOS) modulates the gut microbiota, improves stool characteristics and postprandial glycemia in healthy humans. Yet, little is known on how long-term AXOS intake influences gastrointestinal (GI) functioning, gut microbiota, and metabolic health. In this randomized, placebo-controlled, double-blind study, we evaluated the effects of AXOS intake on GI function and metabolic health in adults with slow GI transit without constipation. Forty-eight normoglycemic adults were included with whole-gut transit time (WGTT) of >35 h receiving either 15 g/day AXOS or placebo (maltodextrin) for 12-wks. The primary outcome was WGTT, and secondary outcomes included stool parameters, gut permeability, short-chain fatty acids (SCFA), microbiota composition, energy expenditure, substrate oxidation, glucose, insulin, lipids, gut hormones, and adipose tissue (AT) function. WGTT was unchanged, but stool consistency softened after AXOS. 12-wks of AXOS intake significantly changed the microbiota by increasing Bifidobacterium and decreasing microbial alpha-diversity. With a good classification accuracy, overall microbiota composition classified responders with decreased WGTT after AXOS. The incretin hormone Glucagon-like protein 1 was reduced after AXOS compared to placebo. Energy expenditure, plasma metabolites, AT parameters, SCFA, and gut permeability were unchanged. In conclusion, intake of wheat bran extract increases fecal Bifidobacterium and softens stool consistency without major effects on energy metabolism in healthy humans with a slow GI transit. We show that overall gut microbiota classified responders with decreased WGTT after AXOS highlighting that GI transit and change thereof were associated with gut microbiota independent of Bifidobacterium. NCT02491125.
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Affiliation(s)
- Mattea Müller
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Gerben D. A. Hermes
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Canfora Emanuel E.
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Jens J. Holst
- NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Erwin G. Zoetendal
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Hauke Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Freddy Troost
- Division of Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands,Food Innovation and Health Research, Centre for Healthy Eating and Food Innovation, Maastricht University, Venlo, The Netherlands
| | - Frank G. Schaap
- Division of Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Steven Olde Damink
- Division of Gastroenterology-Hepatology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Johan W. E. Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kaatje Lenaerts
- Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ad A. M. Masclee
- Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ellen E. Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands,CONTACT Ellen E. Blaak Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, P.O. Box 616, Maastricht6200, The Netherlands
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Terrosu P. Relapse of chronic obstructive pulmonary disease and myocardial infarction: what is the connection? Eur Heart J Suppl 2020; 22:L151-L154. [PMID: 33239991 PMCID: PMC7673614 DOI: 10.1093/eurheartj/suaa156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Albeit largely underappreciated, chronic obstructive pulmonary disease (COPD) constitutes a major risk factor for cardiovascular diseases in general and for coronary disease in particular. The incidence of myocardial infarction, in fact increases rapidly, after relapse of COPD, with a peak event rate during the first week in the worst forms (those requiring hospitalization). Even though the precise mechanism is not completely defined, it is likely derived from two pathogenetic causes: (i) mismatch between myocardial demand and offer of O2 (not fully demonstrated and limited to few cases); (ii) acute coronary thrombosis, probably due to a systemic inflammatory reaction, brought upon by multiple interaction between the infective agent and the host immune system.
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Abstract
Frailty is a clinical state of vulnerability to stressors resulting from cumulative alterations in multiple physiological and molecular systems. Frailty assessment in patients with chronic disease is useful for identifying those who are at increased risk for poor clinical and patient reported outcomes. Due to biobehavioral changes purported to cause both frailty and certain chronic lung diseases, patients with lung disease appear susceptible to frailty and prone to developing it decades earlier than community dwelling healthy populations. Herein, we review the literature and potential pathobiological mechanisms underpinning associations between frailty in lung disease and age, sex, comorbidity and symptom burden, severity of lung disease, inflammatory biomarkers, various clinical parameters, body composition measures, and physical activity levels. We also propose a multipronged program of future research focused on improving the accuracy and precision of frailty measurement in lung disease, identifying blood-based biomarkers and measures of body composition for frailty, determining whether subphenotypes of frailty with distinct pathobiology exist, and developing personalized interventions that target the specific underlying mechanisms causing frailty.
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Recio Iglesias J, Díez-Manglano J, López García F, Díaz Peromingo JA, Almagro P, Varela Aguilar JM. Management of the COPD Patient with Comorbidities: An Experts Recommendation Document. Int J Chron Obstruct Pulmon Dis 2020; 15:1015-1037. [PMID: 32440113 PMCID: PMC7217705 DOI: 10.2147/copd.s242009] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/10/2020] [Indexed: 12/11/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, which impact negatively on patients and are often underdiagnosed, thus lacking a proper management due to the absence of clear guidelines. Purpose To elaborate expert recommendations aimed to help healthcare professionals to provide the right care for treating COPD patients with comorbidities. Methods A modified RAND-UCLA appropriateness method consisting of nominal groups to draw up consensus recommendations (6 Spanish experts) and 2-Delphi rounds to validate them (23 Spanish experts) was performed. Results A panel of Spanish internal medicine experts reached consensus on 73 recommendations and 81 conclusions on the clinical consequences of the presence of comorbidities. In general, the experts reached consensus on the issues raised with regard to cardiovascular comorbidity and metabolic disorders. Consensus was reached on the use of selective serotonin reuptake inhibitors in cases of depression and the usefulness of referring patients with anxiety to respiratory rehabilitation programmes. The results also showed consensus on the usefulness of investigating the quality of sleep, the treatment of pain with opioids and the evaluation of osteoporosis by lateral chest radiography. Conclusion This study provides conclusions and recommendations that are intended to improve the management of the complexity of patients with COPD and important comorbidities, usually excluded from clinical trials.
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Affiliation(s)
- Jesús Recio Iglesias
- Internal Medicine Department, Quironsalud Valencia Hospital, Valencia, Valencian Community, Spain
| | - Jesús Díez-Manglano
- Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Aragon, Spain
| | - Francisco López García
- Internal Medicine Department General University Hospital of Elche, Alicante, Valencian Community, Spain
| | - José Antonio Díaz Peromingo
- Internal Medicine Department, University Clinical Hospital of Santiago de Compostela, a Coruña, Galicia, Spain
| | - Pere Almagro
- Internal Medicine Department, Mútua Terrassa University Hospital, Terrassa, Barcelona, Catalonia, Spain
| | - José Manuel Varela Aguilar
- Internal Medicine Department, University Hospital Virgen del Rocío, Seville, Andalusia, Spain
- CIBER of Epidemiology and Public Health, Madrid, Community of Madrid, Spain
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Samarghandi A, Ioachimescu OC, Qayyum R. Association between peak inspiratory flow rate and hand grip muscle strength in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease. PLoS One 2020; 15:e0227737. [PMID: 32004333 PMCID: PMC6994102 DOI: 10.1371/journal.pone.0227737] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/27/2019] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Ineffective peak inspiratory flow rate (PIFR) generation in patients using inhalers results in insufficient drug delivery to the lungs and poor clinical outcomes. Low inspiratory muscle strength is associated with suboptimal PIFR. OBJECTIVE To examine in a prospective study the relationship between PIFR and skeletal muscle strength using hand grip strength (HGS) as a surrogate. METHODS Adult patients admitted with acute exacerbation of chronic obstructive pulmonary disease (COPD) were enrolled. PIFR was measured within 48 hours before discharge. PIFR below 60L/min was considered suboptimal. HGS was measured using a handheld dynamometer. Any readmissions and emergency department visit data were collected. The associations between PIFR, HGS, 30 and 90-day COPD and all-cause readmissions were examined, without and with adjustment for age, race and gender. RESULTS Of the 75 enrolled patients, 56% had suboptimal PIFR; they were older (63.9±9.7 vs. 58.2±7.7 years) and had significantly lower HGS (24.2±11.1 vs. 30.9±10.9 Kg) compared to those with optimal PIFR. There were no significant differences between the two PIFR groups by gender, race, history of coronary artery disease, congestive heart failure, hypertension or functional scores. Each kilogram increase in HGS was associated with 0.50 (95%CI 0.18-0.89, p = 0.003) L/min increase in PIFR. We did not observe an association between PIFR and 30 or 90-day readmission rates. CONCLUSION We found a significant association between HGS and PIFR in hospitalized patients with acute exacerbations of COPD. Whether interventions aimed at increasing skeletal muscle strength also result in improvement in PIFR remains unclear and need further study.
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Affiliation(s)
- Arash Samarghandi
- Division of Pulmonary, Allergy, Emory University School of Medicine, Critical Care and Sleep Medicine, Atlanta, Georgia
| | - Octavian C. Ioachimescu
- Division of Pulmonary, Allergy, Emory University School of Medicine, Critical Care and Sleep Medicine, Atlanta, Georgia
| | - Rehan Qayyum
- Division of Hospital Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, United States of America
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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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26
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Circulating but not faecal short-chain fatty acids are related to insulin sensitivity, lipolysis and GLP-1 concentrations in humans. Sci Rep 2019; 9:12515. [PMID: 31467327 PMCID: PMC6715624 DOI: 10.1038/s41598-019-48775-0] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/07/2019] [Indexed: 12/27/2022] Open
Abstract
Microbial-derived short-chain fatty acids (SCFA) acetate, propionate and butyrate may provide a link between gut microbiota and whole-body insulin sensitivity (IS). In this cross-sectional study (160 participants, 64% male, BMI: 19.2–41.0 kg/m2, normal or impaired glucose metabolism), associations between SCFA (faecal and fasting circulating) and circulating metabolites, substrate oxidation and IS were investigated. In a subgroup (n = 93), IS was determined using a hyperinsulinemic-euglycemic clamp. Data were analyzed using multiple linear regression analysis adjusted for sex, age and BMI. Fasting circulating acetate, propionate and butyrate concentrations were positively associated with fasting GLP-1 concentrations. Additionally, circulating SCFA were negatively related to whole-body lipolysis (glycerol), triacylglycerols and free fatty acids levels (standardized (std) β adjusted (adj) −0.190, P = 0.023; std β adj −0.202, P = 0.010; std β adj −0.306, P = 0.001, respectively). Circulating acetate and propionate were, respectively, negatively and positively correlated with IS (M-value: std β adj −0.294, P < 0.001; std β adj 0.161, P = 0.033, respectively). We show that circulating rather than faecal SCFA were associated with GLP-1 concentrations, whole-body lipolysis and peripheral IS in humans. Therefore, circulating SCFA are more directly linked to metabolic health, which indicates the need to measure circulating SCFA in human prebiotic/probiotic intervention studies as a biomarker/mediator of effects on host metabolism.
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27
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Arslan S, Yildiz G, Özdemir L, Kaysoydu E, Özdemir B. Association between blood pressure, inflammation and spirometry parameters in chronic obstructive pulmonary disease. Korean J Intern Med 2019; 34:108-115. [PMID: 30428648 PMCID: PMC6325439 DOI: 10.3904/kjim.2017.284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/19/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. METHODS We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. RESULTS In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24- hour pulse per minute values were also associated with all the parameters except FEV1%. CONCLUSION In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.
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Affiliation(s)
- Sulhattin Arslan
- Department of Chest Diseases, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Gürsel Yildiz
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Okan University, Istanbul, Turkey
- Correspondence to Gürsel Yildiz, M.D. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Okan University, İçmeler Mah., Aydınlı Yolu Cad., Aydemir Sk. No. 2, Istanbul 34947, Turkey Tel: +90-5055422909 Fax: +90-5055422909 E-mail:
| | - Levent Özdemir
- Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Erdal Kaysoydu
- Department of Chest Diseases, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Bülent Özdemir
- Department of Cardiology, Faculty of Medicine, Uludag University, Bursa, Turkey
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28
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Futtrup J, Nordentoft M, Elfving B, Krogh J. The association between norepinephrine and metabolism in patients with major depression. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.npbr.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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29
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Lozo Vukovac E, Miše K, Gudelj I, Perić I, Duplančić D, Vuković I, Vučinović Z, Lozo M. Bronchoalveolar pH and inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease. J Int Med Res 2018; 47:791-802. [PMID: 30488761 PMCID: PMC6381468 DOI: 10.1177/0300060518811560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods We performed an observational, analytical case–control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing. Results The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels. Conclusions AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.
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Affiliation(s)
- Emilija Lozo Vukovac
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Kornelija Miše
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Ivan Gudelj
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Irena Perić
- 1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.,2 University of Split School of Medicine, Split, Croatia
| | - Darko Duplančić
- 2 University of Split School of Medicine, Split, Croatia.,3 Department of Cardiology, University Hospital Center Split, Split, Croatia
| | - Ivica Vuković
- 2 University of Split School of Medicine, Split, Croatia.,3 Department of Cardiology, University Hospital Center Split, Split, Croatia
| | - Zoran Vučinović
- 4 Department of Endocrinology, University Hospital Center Split, Split, Croatia
| | - Mislav Lozo
- 3 Department of Cardiology, University Hospital Center Split, Split, Croatia
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Bottiger BA, Nicoara A, Snyder LD, Wischmeyer PE, Schroder JN, Patel CB, Daneshmand MA, Sladen RN, Ghadimi K. Frailty in the End-Stage Lung Disease or Heart Failure Patient: Implications for the Perioperative Transplant Clinician. J Cardiothorac Vasc Anesth 2018; 33:1382-1392. [PMID: 30193783 DOI: 10.1053/j.jvca.2018.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Indexed: 12/13/2022]
Abstract
The syndrome of frailty for patients undergoing heart or lung transplantation has been a recent focus for perioperative clinicians because of its association with postoperative complications and poor outcomes. Patients with end-stage cardiac or pulmonary failure may be under consideration for heart or lung transplantation along with bridging therapies such as ventricular assist device implantation or venovenous extracorporeal membrane oxygenation, respectively. Early identification of frail patients in an attempt to modify the risk of postoperative morbidity and mortality has become an important area of study over the last decade. Many quantification tools and risk prediction models for frailty have been developed but have not been evaluated extensively or standardized in the cardiothoracic transplant candidate population. Heightened awareness of frailty, coupled with a better understanding of distinct cellular mechanisms and biomarkers apart from end-stage organ disease, may play an important role in potentially reversing frailty related to organ failure. Furthermore, the clinical management of these critically ill patients may be enhanced by waitlist and postoperative physical rehabilitation and nutritional optimization.
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Affiliation(s)
- Brandi A Bottiger
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology & Critical Care, Duke University, Durham, NC
| | - Alina Nicoara
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology & Critical Care, Duke University, Durham, NC
| | - Laurie D Snyder
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University, Durham, NC
| | - Paul E Wischmeyer
- Division of Critical Care Medicine, Department of Anesthesiology & Critical Care, Duke University, Durham, NC; Duke Clinical Research Institute, Durham, NC
| | - Jacob N Schroder
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University, Durham, NC
| | - Chetan B Patel
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC
| | - Mani A Daneshmand
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University, Durham, NC
| | - Robert N Sladen
- Department of Anesthesiology, Columbia University, New York, NY
| | - Kamrouz Ghadimi
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology & Critical Care, Duke University, Durham, NC; Division of Critical Care Medicine, Department of Anesthesiology & Critical Care, Duke University, Durham, NC.
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Tanner A, Vassallo M, Kwan J, Allen SC. The pulmonary rehabilitation regimen: a treatment for frailty and 'inflammaging'? Br J Hosp Med (Lond) 2018; 79:432-437. [PMID: 30070944 DOI: 10.12968/hmed.2018.79.8.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary rehabilitation is an exercise-based intervention that improves walking endurance, strength, functional independence, wellbeing and the risk of re-admission to hospital. It was developed for patients recovering from acute exacerbations of chronic obstructive pulmonary disease, and sometimes other long-term inflammatory lung diseases. Many other conditions have a chronic inflammatory component, including type 2 diabetes, obesity, osteoarthritis and old age. Such background inflammation is linked to a range of adverse outcomes, including all-cause mortality, sarcopenia and other markers of frailty. Exercise, including pulmonary rehabilitation, has an anti-inflammatory effect on innate immune chemistry, and improves outcomes in a variety of conditions, although for most diagnostic groups there is no consistent structured programme similar to pulmonary rehabilitation. The authors contend that the pulmonary rehabilitation model could be used generically to treat other chronic and post-acute inflammatory states and thereby reduce the risk of frailty and other adverse outcomes.
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Affiliation(s)
- A Tanner
- Foundation Doctor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset
| | - M Vassallo
- Consultant Physician and Visiting Professor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset
| | - Jsk Kwan
- Clinical Associate Professor and Honorary Consultant Physician, Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S C Allen
- Consultant Physician and Visiting Professor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset BH7 7DW and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset
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32
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Acanfora D, Scicchitano P, Carone M, Acanfora C, Piscosquito G, Maestri R, Zito A, Dentamaro I, Longobardi M, Casucci G, Antonelli-Incalzi R, Ciccone MM. Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD. BMC Pulm Med 2018; 18:116. [PMID: 30005642 PMCID: PMC6045885 DOI: 10.1186/s12890-018-0685-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prognostic stratification of elderly patients with chronic obstructive pulmonary disease (COPD) is difficult due to the wide inter-individual variability in the course of the disease. No marker can exactly stratify the evolution and natural history of COPD patients. Studies have shown that leukocyte count is associated with increased risk of mortality in COPD patients. The aim of this study was to evaluate the possible role of relative lymphocyte count as a risk marker for mortality in elderly patients with COPD. METHODS AND RESULTS This is a3-year prospective study. A total of 218patients, mean age 75.2±7 years, with moderate to severe COPD and free from conditions affecting lymphocyte count were enrolled. The population was divided into two groups according to the relative lymphocyte count, with a cut-off of 20%. Eighty-five patients (39%) had a relative lymphocyte count ≤20%. Three-year mortality rates from any cause in patients with relative lymphocyte count ≤ or > 20% were 68 and 51%, respectively (p = 0.0012). Survival curve analysis showed higher mortality in patients with relative lymphocyte count ≤20% (p = 0.0005). After adjustment for age and sex, the hazard ratio for mortality risk according to lymphocyte count was 1.79 (95% confidence interval [CI]: 1.26-2.57, p = 0.0013), even in the analysis limited to the 171 patients without congestive heart failure (1.63; 95% CI: 1.03-2.58, p = 0.038). CONCLUSIONS Low relative lymphocyte count was associated with higher mortality in elderly patients with severe COPD.
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Affiliation(s)
- Domenico Acanfora
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of TeleseTerme, Benevento, Italy
| | - Pietro Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy.
| | - Mauro Carone
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of TeleseTerme, Benevento, Italy
| | - Chiara Acanfora
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of TeleseTerme, Benevento, Italy
| | - Giuseppe Piscosquito
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of TeleseTerme, Benevento, Italy
| | - Roberto Maestri
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Montescano, Pavia, Italy
| | - Annapaola Zito
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
| | - Ilaria Dentamaro
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
| | - Marialaura Longobardi
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of TeleseTerme, Benevento, Italy
| | | | | | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy
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Nogueira L, Trisko BM, Lima‐Rosa FL, Jackson J, Lund‐Palau H, Yamaguchi M, Breen EC. Cigarette smoke directly impairs skeletal muscle function through capillary regression and altered myofibre calcium kinetics in mice. J Physiol 2018; 596:2901-2916. [PMID: 29797443 PMCID: PMC6046067 DOI: 10.1113/jp275888] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/18/2018] [Indexed: 12/21/2022] Open
Abstract
KEY POINTS Cigarette smoke components directly alter muscle fatigue resistance and intracellular muscle fibre Ca2+ handling independent of a change in lung structure. Changes in muscle vascular structure are associated with a depletion of satellite cells. Sarcoplasmic reticulum Ca2+ uptake is substantially impaired in myofibres during fatiguing contractions in mice treated with cigarette smoke extract. ABSTRACT Cigarette smokers exhibit exercise intolerance before a decline in respiratory function. In the present study, the direct effects of cigarette smoke on limb muscle function were tested by comparing cigarette smoke delivered to mice by weekly injections of cigarette smoke extract (CSE), or nose-only exposure (CS) 5 days each week, for 8 weeks. Cigarette smoke delivered by either route did not alter pulmonary airspace size. Muscle fatigue measured in situ was 50% lower in the CSE and CS groups than in control. This was accompanied by 34% and 22% decreases in soleus capillary-to-fibre ratio of the CSE and CS groups, respectively, and a trend for fewer skeletal muscle actin-positive arterioles (P = 0.07). In addition, fewer quiescent satellite cells (Nes+Pax7+) were associated with soleus fibres in mice with skeletal myofibre VEGF gene deletion (decreased 47%) and CS exposed (decreased 73%) than with control fibres. Contractile properties of isolated extensor digitorum longus and soleus muscles were impaired. In flexor digitorum brevis myofibres isolated from CSE mice, fatigue resistance was diminished by 43% compared to control and CS myofibres, and this was accompanied by a pronounced slowing in relaxation, an increase in intracellular Ca2+ accumulation, and a slowing in sarcoplasmic reticulum Ca2+ uptake. These data suggest that cigarette smoke components may impair hindlimb muscle vascular structure, fatigue resistance and myofibre calcium handling, and these changes ultimately affect contractile efficiency of locomotor muscles independent of a change in lung function.
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Affiliation(s)
- Leonardo Nogueira
- Department of MedicineUniversity of California, San DiegoLa JollaCAUSA
- Instituto de Bioquímica Médica Leopoldo de Meis (IBqM‐LDM)Universidade Federal do Rio de JaneiroRio de JaneiroRJBrazil
| | - Breanna M. Trisko
- Department of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Frederico L. Lima‐Rosa
- Instituto de Bioquímica Médica Leopoldo de Meis (IBqM‐LDM)Universidade Federal do Rio de JaneiroRio de JaneiroRJBrazil
| | - Jason Jackson
- Department of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Helena Lund‐Palau
- Department of MedicineUniversity of California, San DiegoLa JollaCAUSA
| | - Masahiro Yamaguchi
- Department of Physiology, Kochi Medical SchoolKochi UniversityKochiJapan
| | - Ellen C. Breen
- Department of MedicineUniversity of California, San DiegoLa JollaCAUSA
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Dubé BP, Laveneziana P. Effects of aging and comorbidities on nutritional status and muscle dysfunction in patients with COPD. J Thorac Dis 2018; 10:S1355-S1366. [PMID: 29928518 DOI: 10.21037/jtd.2018.02.20] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent, complex and debilitating disease which imposes a formidable burden on patients and the healthcare system. The recognition that COPD is a multifaceted disease is not new, and increasing evidence have outlined the importance of its extra-pulmonary manifestations and its relation to other comorbid conditions in the clinical course of the disease and its societal cost. The relationship between aging, COPD and its comorbidities on skeletal muscle function and nutritional status is complex, multidirectional and incompletely understood. Despite this, the current body of knowledge allows the identification of various, seemingly partially independent factors related both to the normal aging process and to the independent deleterious effects of chronic diseases on muscle function and body composition. There is a dire need of studies evaluating the relative contribution of each of these factors, and their potential synergistic effects in patients with COPD and advanced age/comorbid conditions, in order to delineate the best course of therapeutic action in this increasingly prevalent population.
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Affiliation(s)
- Bruno-Pierre Dubé
- Département de Médecine, Service de Pneumologie, Centre Hospitalier de l'Université de Montréal (CHUM) Montréal, Québec, Canada.,Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) - Carrefour de l'Innovation et de l'Évaluation en Santé, Montréal, Québec, Canada
| | - Pierantonio Laveneziana
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée du Département R3S, Paris, France
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Wshah A, Guilcher SJ, Goldstein R, Brooks D. Prevalence of osteoarthritis in individuals with COPD: a systematic review. Int J Chron Obstruct Pulmon Dis 2018; 13:1207-1216. [PMID: 29713154 PMCID: PMC5909783 DOI: 10.2147/copd.s158614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The objective of this review was to examine the prevalence of osteoarthritis (OA) in individuals with COPD. A computer-based literature search of CINAHL, Medline, PsycINFO and Embase databases was performed. Studies reporting the prevalence of OA among a cohort of individuals with COPD were included. The sample size varied across the studies from 27 to 52,643 with a total number of 101,399 individuals with COPD recruited from different countries. The mean age ranged from 59 to 76 years. The prevalence rates of OA among individuals with COPD were calculated as weighted means. A total of 14 studies met the inclusion criteria with a prevalence ranging from 12% to 74% and an overall weighted mean of 35.5%. Our findings suggest that the prevalence of OA is high among individuals with COPD and should be considered when developing and applying interventions in this population.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Sara Jt Guilcher
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Hangelbroek RWJ, Knuiman P, Tieland M, de Groot LCPGM. Attenuated strength gains during prolonged resistance exercise training in older adults with high inflammatory status. Exp Gerontol 2018; 106:154-158. [PMID: 29474863 DOI: 10.1016/j.exger.2018.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/05/2018] [Accepted: 02/07/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Chronic systemic low grade inflammation is associated with the age-related loss of muscle mass. Resistance exercise has been suggested to reduce or lower chronic systemic low grade inflammation. However, systemic chronic low-grade inflammation may adversely affect the adaptive response to exercise training. We investigated the effect of resistance exercise training on systemic chronic low-grade inflammation in older adults. In addition, we studied the association between systemic chronic low-grade inflammation and the adaptive response to exercise training. DESIGN/SETTING/PARTICIPANTS Frail and pre-frail older adults (61 subjects) performed 24 weeks of progressive resistance exercise training. Frailty was assessed using the Fried frailty criteria. MEASUREMENTS Lean body mass (DXA), strength (1RM), circulating levels of IL-1β, IL-6, IL-8 and TNF-α were measured prior to exercise training, after 12 weeks of training, and after 24 weeks of training. RESULTS Prolonged progressive resistance exercise training did not affect circulating levels of IL-6, IL-8 and TNF-α. However, exercise training led to a small but significant increase of 0.052 pg/mL in IL-1β. Higher circulating levels of TNF-α, IL-8 and IL-6 during the training period were negatively associated with strength gains for the leg press. A doubling of plasma TNF-α, IL-8 or IL-6 resulted in reduced strength gains for leg press with coefficients of -3.52, -3.42 and -1.54 respectively. High levels of circulating TNF-α were also associated with decreased strength gains for the leg extension (coefficient -1.50). Inflammatory cytokines did not appear to have an effect on gains in lean mass. CONCLUSION Our findings suggest that increased levels of plasma cytokines (TNF-α, IL-6 and IL-8) are associated with lower strength gains during resistance exercise training.
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Affiliation(s)
- Roland W J Hangelbroek
- Top Institute Food and Nutrition, Wageningen, The Netherlands; Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Pim Knuiman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | - Michael Tieland
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Lisette C P G M de Groot
- Top Institute Food and Nutrition, Wageningen, The Netherlands; Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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Kim SW, Cho IH, Lim GS, Park GN, Paek SH. Biochemical-immunological hybrid biosensor based on two-dimensional chromatography for on-site sepsis diagnosis. Biosens Bioelectron 2017. [DOI: 10.1016/j.bios.2017.06.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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Hashash JG, Binion DG. Exercise and Inflammatory Bowel Disease: Insights into Etiopathogenesis and Modification of Clinical Course. Gastroenterol Clin North Am 2017; 46:895-905. [PMID: 29173530 DOI: 10.1016/j.gtc.2017.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There is sparse information regarding exercise and inflammatory bowel disease (IBD). Furthermore, the importance of regular exercise in the optimal management of IBD has not received attention in guidelines and is often overlooked by practitioners. This article summarizes evidence regarding health benefits of exercise, guidelines regarding exercise in the general population and chronic inflammatory disorder populations, limitations regarding exercise capacity in patients with IBD, the association of lack of exercise with IBD pathogenesis, the role of exercise in beneficially modulating IBD clinical course, and extraintestinal benefits of exercise in patients with IBD.
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Affiliation(s)
- Jana G Hashash
- Division of Gastroenterology, Hepatology and Nutrition, UPMC Presbyterian Hospital, University of Pittsburgh School of Medicine, University of Pittsburgh, 200 Lothrop Street, Mezzanine Level C Wing PUH, Pittsburgh, PA 15213, USA; American University of Beirut, Box 11-0236 Riad El-Solh, Beirut 1107 2020, Lebanon
| | - David G Binion
- Division of Gastroenterology, Hepatology and Nutrition, UPMC Presbyterian Hospital, University of Pittsburgh School of Medicine, University of Pittsburgh, 200 Lothrop Street, Mezzanine Level C Wing PUH, Pittsburgh, PA 15213, USA.
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Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D, Tutkun L. C-Reactive Protein Concentrations Among Crop and Dairy Farmers with Stable Chronic Obstructive Pulmonary Disease. Open Access Maced J Med Sci 2017; 5:724-729. [PMID: 29104680 PMCID: PMC5661709 DOI: 10.3889/oamjms.2017.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 01/18/2023] Open
Abstract
AIM To assess the mean serum C-reactive protein concentrations among farmers and office controls, and further examined its relation to exposure duration, smoking habit, as well as presence or absence of COPD. METHODS A cross-sectional survey was performed including examined group (EG), composed of agricultural workers (87 crop - EG1 and 83 dairy farmers - EG2), and control group (CG) composed by 80 office workers. Evaluation of subjects included a questionnaire on chronic respiratory symptoms, lung function tests, COPD diagnostics, and measurement of CRP serum concentrations. RESULTS Serum CRP concentrations were raised in stable COPD patients independent of smoking habit or exposure duration. The mean CRP serum concentrations were higher in the subjects of EG1 and EG2 compared with those in CG, but without statistical significance. This count for mean CRP serum concentrations in subjects of EG1 and EG2 exposed more than 20 years and for those in smokers in all three groups as well. The mean CRP serum concentrations were significantly higher in subjects with COPD within EG1 (P=0.049) and EG2 (P=0.040), while those in CG were not. CONCLUSION Data obtained suggest that systemic inflammation is present in farmers with COPD and CRP is an important biomarker in COPD in means of reflecting disease severity and prognosis of exposed farmers.
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Affiliation(s)
- Saso Stoleski
- Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
| | - Jordan Minov
- Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
| | - Jovanka Karadzinska-Bislimovska
- Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
| | - Dragan Mijakoski
- Institute for Occupational Health of Republic of Macedonia - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
| | - Lütfiye Tutkun
- Department of Medical Biochemistry, Yozgat, Bozok University, Faculty of Medicine, Bozok, Turkey
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40
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Sciriha A, Lungaro-Mifsud S, Bonello A, Agius T, Scerri J, Ellul B, Fenech A, Camilleri L, Montefort S. Systemic inflammation in COPD is not influenced by pulmonary rehabilitation. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1332682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Anabel Sciriha
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | | | | | - Tonio Agius
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Josianne Scerri
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Bridget Ellul
- Department of Medicine, University of Malta, Msida, Malta
| | - Anthony Fenech
- Department of Medicine, University of Malta, Msida, Malta
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Huang D, Ma Z, He Y, Xiao Y, Luo H, Liang Q, Zhong X, Bai J, He Z. Long-term cigarette smoke exposure inhibits histone deacetylase 2 expression and enhances the nuclear factor-κB activation in skeletal muscle of mice. Oncotarget 2017; 8:56726-56736. [PMID: 28915625 PMCID: PMC5593596 DOI: 10.18632/oncotarget.18089] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/27/2017] [Indexed: 01/21/2023] Open
Abstract
Long-term cigarette smoke induces lung inflammatory injury and chronic obstructive pulmonary disease (COPD), associated with skeletal muscle inflammation. This study aimed at investigating how cigarette smoke promotes skeletal muscle inflammation and its molecular pathogenesis. Mice were exposed to air or cigarette smoke for 12 or 24 weeks, and C2C12 cells were stimulated with cigarette smoke extract (CSE). The mass and function, myotube formation, inflammatory cytokine production, histone deacetylase 2 (HDAC2) and nuclear factor-κB (NF-κB) p65 expression were detected in the gastrocnemius muscles of mice and C2C12 cells. In comparison with the control mice, cigarette smoke significantly damaged the lung and reduced the gastrocnemius muscle mass and body weights in mice. Cigarette smoke significantly down-regulated myosin heavy chain (MHC)-IIβ and HDAC2 expression, but enhanced NF-κBp65, keratinocyte chemoattractant (KC) and tumor necrosis factor (TNF)-α expression in the gastrocnemius muscles. CSE stimulation significantly inhibited the myotube formation, MyoD and HDAC2 expression, but enhanced NF-κBp65 expression, KC and TNF-α production in C2C12 cells, which were enhanced by HDAC2 knockdown and abrogated by a NF-κB inhibitor. CSE significantly inhibited the interaction of HDAC2 with NF-κBp65, and increased the levels of acetyl-NF-κBp65 in C2C12 cells. These data indicated that cigarette smoke inhibited HDAC2 expression and its interaction with NF-κBp65 to stimulate inflammation, contributing to the pathogenesis of COPD-related skeletal muscle atrophy in mice.
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Affiliation(s)
- Dongmei Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Zhiying Ma
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Yili He
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Ying Xiao
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Honglin Luo
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Qiuli Liang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Xiaoning Zhong
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Jing Bai
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Zhiyi He
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
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Loi ALT, Hoonhorst S, van Aalst C, Langereis J, Kamp V, Sluis-Eising S, ten Hacken N, Lammers JW, Koenderman L. Proteomic profiling of peripheral blood neutrophils identifies two inflammatory phenotypes in stable COPD patients. Respir Res 2017; 18:100. [PMID: 28532454 PMCID: PMC5440930 DOI: 10.1186/s12931-017-0586-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/16/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND COPD is a heterogeneous chronic inflammatory disease of the airways and it is well accepted that the GOLD classification does not fully represent the complex clinical manifestations of COPD and this classification therefore is not well suited for phenotyping of individual patients with COPD. Besides the chronic inflammation in the lung compartment, there is also a systemic inflammation present in COPD patients. This systemic inflammation is associated with elevated levels of cytokines in the peripheral blood, but the precise composition is unknown. Therefore, differences in phenotype of peripheral blood neutrophils in vivo could be used as a read out for the overall systemic inflammation in COPD. METHOD Our aim was to utilize an unsupervised method to assess the proteomic profile of peripheral neutrophils of stable COPD patients and healthy age matched controls to find potential differences in these profiles as read-out of inflammatory phenotypes. We performed fluorescence two-dimensional difference gel electrophoresis with the lysates of peripheral neutrophils of controls and stable COPD patients. RESULTS We identified two groups of COPD patients based on the differentially regulated proteins and hierarchical clustering whereas there was no difference in lung function between these two COPD groups. The neutrophils from one of the COPD groups were less responsive to bacterial peptide N-formyl-methionyl-leucyl-phenylalanine (fMLF). CONCLUSION This illustrates that systemic inflammatory signals do not necessarily correlate with the GOLD classification and that inflammatory phenotyping can significantly add in an improved diagnosis of single COPD patients. TRIAL REGISTRATION Clinicaltrials.gov: NCT00807469 registered December 11th 2008.
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Affiliation(s)
- Adèle Lo Tam Loi
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Susan Hoonhorst
- Departments of Respiratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Corneli van Aalst
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Langereis
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vera Kamp
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Simone Sluis-Eising
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick ten Hacken
- Departments of Respiratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan-Willem Lammers
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leo Koenderman
- Departments of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Department Respiratory Medicine and Laboratory of Translational Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3583CX Utrecht, The Netherlands
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Hobbins S, Chapple IL, Sapey E, Stockley RA. Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors? Int J Chron Obstruct Pulmon Dis 2017; 12:1339-1349. [PMID: 28496317 PMCID: PMC5422335 DOI: 10.2147/copd.s127802] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
COPD is recognized as having a series of comorbidities potentially related to common inflammatory processes. Periodontitis is one of the most common human inflammatory diseases and has previously been associated with COPD in numerous observational studies. As periodontitis and COPD are both chronic, progressive conditions characterized by neutrophilic inflammation with subsequent proteolytic destruction of connective tissue, it has been proposed that they share common pathophysiological processes. The mechanisms proposed to link COPD and periodontitis include mechanical aspiration of oral contents into the respiratory tree, overspill of locally produced inflammatory mediators into the systemic circulation or oral or lung-derived bacteremia activating an acute-phase response and also reactive oxygen species (ROS) and cytokine release by systemic neutrophils at distant sites. Studies of systemic neutrophils in COPD and chronic periodontitis describe altered cellular functions that would predispose to inflammation and tissue destruction both in the lung and in the mouth, again potentially connecting these conditions. However, COPD and periodontitis also share risk factors such as age, chronic tobacco smoke exposure, and social deprivation that are not always considered in observational and interventional studies. Furthermore, studies reporting associations have often utilized differing definitions of both COPD and periodontitis. This article reviews the current available evidence supporting the hypothesis that COPD and inflammatory periodontal disease (periodontitis) could be pathologically associated, including a review of shared inflammatory mechanisms. It highlights the potential limitations of previous studies, in particular, the lack of uniformly applied case definitions for both COPD and periodontitis and poor recognition of shared risk factors. Understanding associations between these conditions may inform why patients with COPD suffer such a burden of comorbid illness and new therapeutic strategies for both the diseases. However, further research is needed to clarify factors that may be directly causal as opposed to confounding relationships.
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Affiliation(s)
| | | | - Elizabeth Sapey
- Institute of Inflammation and Aging.,Centre for Translational Inflammation Research, Institute of Inflammation and Aging, Queen Elizabeth Hospital
| | - Robert A Stockley
- University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
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Byun MK, Cho EN, Chang J, Ahn CM, Kim HJ. Sarcopenia correlates with systemic inflammation in COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:669-675. [PMID: 28255238 PMCID: PMC5325093 DOI: 10.2147/copd.s130790] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Muscle wasting and chronic inflammation are predominant features of patients with COPD. Systemic inflammation is associated with an accelerated decline in lung function. In this study, the prevalence of sarcopenia and the relationships between sarcopenia and systemic inflammations in patients with stable COPD were investigated. Materials and methods In a cross-sectional design, muscle strength and muscle mass were measured by handgrip strength (HGS) and bioelectrical impedance analysis in 80 patients with stable COPD. Patients (≥40 years old) diagnosed with COPD were recruited from outpatient clinics, and then COPD stages were classified. Sarcopenia was defined as the presence of both low muscle strength (by HGS) and low muscle mass (skeletal muscle mass index [SMMI]). Levels of circulating inflammatory biomarkers (IL-6 and high-sensitivity TNFα [hsTNFα]) were measured. Results Sarcopenia was prevalent in 20 (25%) patients. Patients with sarcopenia were older, had lower body mass index, and a higher percentage of cardiovascular diseases. In addition, they had significantly higher modified Medical Research Council scores and lower 6-minute walk distance than those without sarcopenia. HGS was significantly correlated with age, modified Medical Research Council score, and COPD Assessment Test scores. Both HGS and SMMI had associations with IL-6 and hsTNFα (HGS, r=−0.35, P=0.002; SMMI, r=−0.246, P=0.044) level. In multivariate analysis, old age, lower body mass index, presence of cardiovascular comorbidities, and higher hsTNFα levels were significant determinants for sarcopenia in patients with stable COPD. Conclusion Sarcopenia is very common in patients with stable COPD, and is associated with more severe dyspnea-scale scores and lower exercise tolerance. Systemic inflammation could be an important contributor to sarcopenia in the stable COPD population.
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Affiliation(s)
- Min Kwang Byun
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital
| | - Eun Na Cho
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital
| | - Joon Chang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Min Ahn
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital
| | - Hyung Jung Kim
- Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital
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Matsumoto N, Tsubouchi H, Imazu Y, Arimura Y, Yanagi S, Iiboshi H, Nakazato M. Clinical application of ghrelin for chronic respiratory failure. Endocr J 2017; 64:S1-S3. [PMID: 28652535 DOI: 10.1507/endocrj.64.s1] [Citation(s) in RCA: 5] [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] [Indexed: 11/23/2022] Open
Abstract
Chronic respiratory failure, which is often caused by chronic obstructive pulmonary disease, chronic lower respiratory tract infection, or interstitial pneumonia, often leads to cachexia with disease progression. Patients who have chronic respiratory failure with cachexia exhibit increased morbidity. Although cachectic status is an important clinical problem, there are no effective therapies for cachexia. Ghrelin has various effects, including increasing food intake, attenuating sympathetic nerve activity, inhibiting inflammation, increasing cardiac output, and controlling fat utilization. These effects of ghrelin are ideal targets for the treatment of severely wasting chronic respiratory disease. In a few clinical studies, including a small randomized controlled trial, ghrelin administration to cachectic patients with chronic respiratory failure improved exercise tolerance, dyspnea, and appetite. The patients in these studies gained muscle mass and weight. In another study of chronic lower respiratory tract infection with cachexia, ghrelin suppressed airway inflammation by decreasing neutrophil accumulation in the airway, resulting in improvements in oxygenation and exercise tolerance. Although further clinical investigations are needed to clarify its usefulness, ghrelin is expected to become a novel therapy for cachectic patients with chronic respiratory failure.
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Affiliation(s)
- Nobuhiro Matsumoto
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hironobu Tsubouchi
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yoshifumi Imazu
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yasuji Arimura
- Division of Data Management, Department of Social Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shigehisa Yanagi
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hirotoshi Iiboshi
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Masamitsu Nakazato
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
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Quantitative Assessment of Erector Spinae Muscles in Patients with Chronic Obstructive Pulmonary Disease. Novel Chest Computed Tomography-derived Index for Prognosis. Ann Am Thorac Soc 2016; 13:334-41. [PMID: 26700501 DOI: 10.1513/annalsats.201507-446oc] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Loss of skeletal muscle mass and physical inactivity are important manifestations of chronic obstructive pulmonary disease (COPD), and both are closely related to poor prognoses in patients with COPD. Antigravity muscles are involved in maintaining normal posture and are prone to atrophy with inactivity. The erector spinae muscles (ESM) are one of the antigravity muscle groups, and they can be assessed by chest computed tomography (CT). OBJECTIVES We hypothesized that the cross-sectional area of ESM (ESMCSA) visualized on chest CT images may serve as a predictor of mortality in patients with COPD. METHODS This study was part of the prospective observational study undertaken at Kyoto University Hospital. ESMCSA was measured on a single-slice axial CT image at the level of the 12th thoracic vertebra in patients with COPD. The cross-sectional area of the pectoralis muscles (PMCSA) was also measured. We evaluated the relationship between ESMCSA and clinical parameters, including mortality, in patients with COPD. Age- and height-matched smoking control subjects were also evaluated. MEASUREMENTS AND MAIN RESULTS In total, 130 male patients and 20 smoking control males were enrolled in this study. ESMCSA was significantly lower in patients with COPD than in the smoking control subjects and was significantly correlated with disease severity. There was a significant but only moderate correlation between ESMCSA and PMCSA. ESMCSA was significantly correlated with previously reported prognostic factors, such as body mass index, dyspnea (modified Medical Research Council dyspnea scale score), FEV1 percent predicted value, inspiratory capacity to total lung capacity ratio, and emphysema severity (percentage of the lung field occupied by low attenuation area). Compared with PMCSA, ESMCSA was more strongly associated with mortality in patients with COPD. Stepwise multivariate Cox proportional hazards analysis revealed that, among these known prognostic factors, ESMCSA was the strongest risk factor for mortality (hazard ratio, 0.85; 95% confidence interval, 0.79-0.92; P < 0.001) and mMRC dyspnea scale score was an additional factor (hazard ratio, 2.35; 95% confidence interval, 1.51-3.65; P < 0.001). CONCLUSIONS ESMCSA assessed by chest CT may be a valuable clinical parameter, as ESACSA correlates significantly with physiological parameters, symptoms, and disease prognosis.
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Khan NA, Daga MK, Ahmad I, Mawari G, Kumar S, Kumar N, Husain SA. Evaluation of BODE index and its relationship with systemic inflammation mediated by proinflammatory biomarkers in patients with COPD. J Inflamm Res 2016; 9:187-198. [PMID: 27920567 PMCID: PMC5123728 DOI: 10.2147/jir.s108783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction BODE index, a multidimensional grading system which is based on Body mass index, airway Obstruction, Dyspnea scale, and Exercise capacity, has been increasingly used for the evaluation of chronic obstructive pulmonary disease (COPD). Many of the systemic manifestations of COPD are shown to be mediated by elevated levels of proinflammatory biomarkers. Objective We aimed to investigate the relationship between the BODE index, its components, disease severity, and proinflammatory biomarkers like C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-6. Materials and methods A cross-sectional study which included 290 clinically stable COPD patients and 80 smoker controls was conducted. Medical history, body mass index, pulmonary function tests, 6-minute walking test, and modified scale of Medical Research Council dyspnea scale were evaluated. BODE scores were determined. Systemic inflammation was evaluated with the measurement of CRP, TNF-α, and IL-6 in the serum samples of all studied subjects. The correlation between inflammatory biomarkers and BODE index was assessed in COPD patients. Results We found a significant relationship between COPD stages and BODE index. Our analysis showed significant association between systemic biomarkers and components of the BODE index. Both TNF-α and CRP levels exhibited weak but significant correlation with BODE index. Serum IL-6 concentrations exhibited significant correlation with 6-minute walking test, modified scale of Medical Research Council, and BODE index (r=0.201, P=0.004; r=0.068, P=0.001; and r=0.530, P=0.001, respectively). Also, an inverse and significant correlation was observed between BODE index and FEV1 (r=0.567, P=0.001). IL-6 exhibited a highly significant and inverse correlation with FEV1 (r=−0.580, P=0.001). Conclusion BODE index should be considered for evaluating patients with COPD. Also, IL-6 seems to be a potential biomarker that may enable determination of the severity and prediction of the course of the disease.
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Affiliation(s)
- Naushad Ahmad Khan
- Department of Medicine, Maulana Azad Medical College; Department of Biosciences, Jamia Millia Islamia
| | | | - Istaq Ahmad
- Department of Biosciences, Jamia Millia Islamia
| | - Govind Mawari
- Department of Medicine, Maulana Azad Medical College
| | - Suman Kumar
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
| | - Naresh Kumar
- Department of Medicine, Maulana Azad Medical College
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Ushiki A, Nozawa S, Yasuo M, Urushihata K, Yamamoto H, Hanaoka M, Fujimoto K. Associations between the distance covered in the incremental shuttle walk test and lung function and health status in patients with chronic obstructive pulmonary disease. Respir Investig 2016; 55:33-38. [PMID: 28012491 DOI: 10.1016/j.resinv.2016.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 07/27/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Field walk tests such as the incremental shuttle walk test (ISWT) are simple tests for assessing the degree of disability in individuals with chronic obstructive pulmonary disease (COPD). In the present study, the correlations between exercise performance in the ISWT, lung function, and health status were examined in patients with COPD of varying severities. METHODS A retrospective examination of 277 COPD patients was performed using the ISWT and lung function tests along with assessment of health status using St. George׳s Respiratory Questionnaire (SGRQ). In addition, we assessed the correlations between the walking distance, lung function parameters, and SGRQ scores. RESULTS ISWT distances were poorly correlated with lung function parameters and SGRQ scores in mild COPD patients. In contrast, ISWT distances were significantly correlated with pulmonary function parameters, such as vital capacity (%predicted) and forced expiratory volume in one second, and SGRQ scores in moderate and severe COPD patients. CONCLUSIONS The ISWT is more independent of health status and pulmonary function in patients with mild COPD compared to moderate or severe cases. Therefore, the exercise capacity of patients with mild COPD should be estimated by the ISWT.
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Affiliation(s)
- Atsuhito Ushiki
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Shuhei Nozawa
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Masanori Yasuo
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Kazuhisa Urushihata
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Hiroshi Yamamoto
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan.
| | - Keisaku Fujimoto
- Department of Clinical Laboratory Sciences, Shinshu University School of Health Sciences, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
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McKeough ZJ, Alison JA, Bye PTP. Reduction in resting energy expenditure following lung volume reduction surgery in subjects with chronic obstructive pulmonary disease. Chron Respir Dis 2016; 1:197-202. [PMID: 16281646 DOI: 10.1191/1479972304cd043xx] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Study objectives: Some subjects with COPD have an elevated resting energy expenditure (REE)which may be related to an increased work of breathing at rest. The purpose of this study was to examine the effect of lung volume reduction surgery (LVRS) on REE and body weight. Design: Ten subjects with COPD were recruited (mean age + SD = 61.4 + 6.1 years). At baseline (which was following preoperative pulmonary rehabilitation) and four months following LVRS (combined with postoperative pulmonary rehabilitation), each subject had tests of lung function, REE via indirect calorimetry using a canopy system, six minute walk distance (6MWD) and quality of life (QoL) using the St George's Hospital Respiratory Questionnaire (SGRQ). Measurements: The FEV, (% predicted) increased from 27.7 + 5.8% (mean + SD) at baseline to 33.9 + 7.8% following LVRS (P < 0.05). REE (% predicted) was 110 + 9.8% at baseline and decreased to 106 + 6.7% following LVRS (P = 0.04). Body mass index (BMI) following LVRS was unchanged (P = 0.67). No correlation between the change in BMI and change in REE was shown (r2 = 0.3, P = 0.1). Therewas a significant improvement in QoL following LVRS (P < 0.001). 6MWD also significantly increased from 354 + 83 m to 412 + 82 m following LVRS (P = 0.001). Conclusion: Whilst there was an increase in lung function and a reduction in REE following LVRS, there was no corresponding change to body weight. The improvement in REE following LVRS may be related to an improvement in work of breathing.
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Affiliation(s)
- Z J McKeough
- School of Physiotherapy, Faculty of Health Sciences, Sydney University, Australia.
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50
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Singer JP, Lederer DJ, Baldwin MR. Frailty in Pulmonary and Critical Care Medicine. Ann Am Thorac Soc 2016; 13:1394-404. [PMID: 27104873 PMCID: PMC5021078 DOI: 10.1513/annalsats.201512-833fr] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/22/2016] [Indexed: 02/07/2023] Open
Abstract
Conceptualized first in the field of geriatrics, frailty is a syndrome characterized by a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems. This accumulation of deficits results in poorer functional status and disability. Frailty is a "state of risk" for subsequent disproportionate declines in health status following new exposure to a physiologic stressor. Two predominant models have emerged to operationalize the measurement of frailty. The phenotype model defines frailty as a distinct clinical syndrome that includes conceptual domains such as strength, activity, wasting, and mobility. The cumulative deficit model defines frailty by enumerating the number of age-related things wrong with a person. The biological pathways driving frailty include chronic systemic inflammation, sarcopenia, and neuroendocrine dysregulation, among others. In adults with chronic lung disease, frailty is independently associated with more frequent exacerbations of lung disease, all-cause hospitalization, declines in functional status, and all-cause mortality. In addition, frail adults who become critically ill are more likely develop chronic critical illness or severe disability and have higher in-hospital and long-term mortality rates. The evaluation of frailty appears to provide important prognostic information above and beyond routinely collected measures in adults with chronic lung disease and the critically ill. The study of frailty in these populations, however, requires multipronged efforts aimed at refining clinical assessments, understanding the mechanisms, and developing therapeutic interventions.
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Affiliation(s)
- Jonathan P. Singer
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - David J. Lederer
- Department of Medicine and
- Department of Epidemiology, Columbia University Medical Center, New York, New York; and
| | - Matthew R. Baldwin
- Department of Medicine, Columbia University Medical Center, New York, New York
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