Fish oil supplementation in chronic obstructive pulmonary disease: feasibility of conducting a randomised controlled trial

Effect of Macronutrients or Micronutrients Supplementation on Nutritional Status, Physical Functional Capacity and Quality of Life in Patients with COPD: A Systematic Review and Meta-Analysis

Given the importance that a correct and balanced nutrition has on patients with chronic obstructive pulmonary disease (COPD), supplementation of macro and micronutrients has been proposed, but the results of previous meta-analyses are contrasting. We performed an update of the latest evidence through a systematic review and meta-analysis of studies to assess the role of nutritional supplements in improving nutritional status, pulmonary function, physical performance, and quality of life of these patients.We included randomized controlled trials (RCTs) published between 01-01-2010 and 11-01-2023 evaluating the effectiveness of nutritional support in patients affected by stable COPD with an intervention of at least 2 weeks. Primary outcomes were changes in body mass index (BMI) and fat free mass index (FFMI). Secondary outcomes were exercise tolerance (6-min walking test, 6MWT), quality of life (St George's Respiratory Questionnaire, SGRQ) and respiratory function (FEV1). According with supplements type (macronutrients or micronutrients), we calculated the pooled adjusted mean difference (MD) and 95% confidence intervals (95%CIs) of the selected outcomes, using random-effects models in presence of high heterogeneity (I2>50%) or fixed-effects models otherwise. The risk of publication bias was evaluated with the trim and fill method.From 967 articles, 20 RCTs were included. Macronutrients supplementation improved BMI (MD 1.0 kg/m2, 95%CI 0.21-1.79), FFMI (MD 0.77 Kg/m2, 95%CI 0.48-1.06), 6MQT (MD 68.39 m, 95%CI 40.07-96.71), and SGRQ (MD -5.14, 95% CI -7.31-2.97), while it does not ameliorate respiratory function (MD 0.26% 95%CI -1.87-2.40). Micronutrients supplementation alone did not improve any of the considered outcomes.

The association between polyunsaturated fatty acids and chronic obstructive pulmonary disease: a meta-analysis

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease, and its development and prognosis are influenced by many nutrients. However, the relationship between polyunsaturated fatty acids (PUFAs) and COPD remains unclear. Methods: This study searched all literature reports on PUFAs and COPD based on electronic databases from their inception up to October 2023. Meta-analysis was conducted to evaluate the differences in PUFAs between COPD patients and controls, the risk of COPD in subjects with different levels of PUFA concentrations, and the effect of PUFA supplementation on COPD. Results: A total of nineteen studies met our inclusion criteria, which included 155 636 subjects. Our meta-analysis results showed that the daily dietary intake of PUFAs was lower in COPD patients than in controls (SMD = -0.80 g, 95% CI: -1.28, -0.31 g, I2 = 98.6%, P < 0.001). Meanwhile, the lower n-3 PUFA levels and higher n-6 PUFA levels were associated with an increased risk of COPD (effect size n-3 = 0.87, 95% CI: 0.77, 0.98, I2 = 52.2%, P = 0.018; effect size n-6 = 1.23, 95% CI: 1.05, 1.43, I2 = 75.2%, P < 0.001). Furthermore, the content of low-density lipoprotein cholesterol in the PUFA supplementation group was higher than that in the control group (SMD = 0.63 mg dL-1, 95% CI: 0.15, 1.12 mg dL-1, I2 = 0.0%, P = 0.697). Conclusions: Our meta-analysis indicated a potential relationship between PUFAs and COPD. More large-scale prospective cohort studies and clinical trials are necessary to validate this relationship.

Continued post-retraction citation of a fraudulent clinical trial report, 11 years after it was retracted for falsifying data

This paper presents a case study of long-term post-retraction citation to falsified clinical trial data (Matsuyama et al. in Chest 128(6):3817–3827, 2005. 10.1378/chest.128.6.3817), demonstrating problems with how the current digital library environment communicates retraction status. Eleven years after its retraction, the paper continues to be cited positively and uncritically to support a medical nutrition intervention, without mention of its 2008 retraction for falsifying data. To date no high quality clinical trials reporting on the efficacy of omega-3 fatty acids on reducing inflammatory markers have been published. Our paper uses network analysis, citation context analysis, and retraction status visibility analysis to illustrate the potential for extended propagation of misinformation over a citation network, updating and extending a case study of the first 6 years of post-retraction citation (Fulton et al. in Publications 3(1):7–26, 2015. 10.3390/publications3010017). The current study covers 148 direct citations from 2006 through 2019 and their 2542 second-generation citations and assesses retraction status visibility of the case study paper and its retraction notice on 12 digital platforms as of 2020. The retraction is not mentioned in 96% (107/112) of direct post-retraction citations for which we were able to conduct citation context analysis. Over 41% (44/107) of direct post-retraction citations that do not mention the retraction describe the case study paper in detail, giving a risk of diffusing misinformation from the case paper. We analyze 152 second-generation citations to the most recent 35 direct citations (2010–2019) that do not mention the retraction but do mention methods or results of the case paper, finding 23 possible diffusions of misinformation from these non-direct citations to the case paper. Link resolving errors from databases show a significant challenge in a reader reaching the retraction notice via a database search. Only 1/8 databases (and 1/9 database records) consistently resolved the retraction notice to its full-text correctly in our tests. Although limited to evaluation of a single case (N = 1), this work demonstrates how retracted research can continue to spread and how the current information environment contributes to this problem.

Probiotics in pregnancy: protocol of a double-blind randomized controlled pilot trial for pregnant women with depression and anxiety (PIP pilot trial)

Background

Maternal prenatal depressive or anxiety symptoms are associated with adverse maternal and infant health outcomes. With prevalence rates of maternal prenatal depression and anxiety ranging between 10 and 20%, attempts to identify effective interventions to reduce symptoms are priority. There are indications that probiotics can reduce symptoms of maternal depression or anxiety. Probiotics ingested by the mother may thus offer a promising and accessible intervention to complement existing treatments.

Methods

The Probiotics in Pregnancy (PIP) pilot trial is a double-blind, placebo-controlled, randomized pilot trial. While one group orally consumes a probiotic mixture (Ecologic® Barrier; 2,5 × 109 colony forming units/g; 2 g; daily), the other group consumes a placebo, from between 26 and 30 weeks gestation until delivery. Subjects are randomly allocated (1:1) to the intervention or placebo group. Forty healthy pregnant women with symptoms of depression or anxiety and uncomplicated pregnancies at randomization will be included. The primary aim is to determine the feasibility and acceptability of a probiotic trial to reduce symptoms of maternal depression or anxiety in pregnancy. The secondary aim is to exploratorily compare the potential effect of probiotics, compared to placebo, on depressive and/or anxiety symptoms, maternal stress (i.e. reported/hair cortisol), maternal vaginal and intestinal microbiota, and by possibly affecting maternal mood and microbiota, maternal bonding to offspring, infant microbiota and infant crying.

Discussion

Results of this pilot trial will help determine whether or not to proceed with a full trial after the pilot trial, and if so, whether revisions should be made to the study protocol and procedures before conducting a full randomized controlled trial. Additionally, they are expected to provide insights into whether changes in psychological, behavioral and biological parameters can be attributed to the probiotic intervention.

Trial registration

Netherlands Trial Register, NTR6219. Registered on 28 February 2017.

Electronic supplementary material

The online version of this article (10.1186/s13063-019-3389-1) contains supplementary material, which is available to authorized users.

Quenching the fires: Pro-resolving mediators, air pollution, and smoking

Exposure to air pollution and other environmental inhalation hazards, such as occupational exposures to dusts and fumes, aeroallergens, and tobacco smoke, is a significant cause of chronic lung inflammation leading to respiratory disease. It is now recognized that resolution of inflammation is an active process controlled by a novel family of small lipid mediators termed "specialized pro-resolving mediators" or SPMs, derived mainly from dietary omega-3 polyunsaturated fatty acids. Chronic inflammation results from an imbalance between pro-inflammatory and pro-resolution pathways. Research is ongoing to develop SPMs, and the pro-resolution pathway more generally, as a novel therapeutic approach to diseases characterized by chronic inflammation. Here, we will review evidence that the resolution pathway is dysregulated in chronic lung inflammatory diseases, and that SPMs and related molecules have exciting therapeutic potential to reverse or prevent chronic lung inflammation, with a focus on lung inflammation due to inhalation of environmental hazards including urban particulate matter, organic dusts and tobacco smoke.