Higher Plasma Myostatin Levels in Cor Pulmonale Secondary to Chronic Obstructive Pulmonary Disease

Equine Asthma Does Not Affect Circulating Myostatin Concentrations in Horses

(1) Background: The number of horses suffering from chronic respiratory diseases, resembling human asthma, is increasing but there is still a lack of reliable and accurate methods to detect these disorders. Numerous studies have found elevated plasma concentrations of one of the myokines, namely, myostatin (MSTN), in people suffering from severe asthma. MSTN normally inhibits myoblast proliferation and differentiation through autocrine or paracrine signals. Therefore, given the pathogenesis of asthma, we hypothesize that MSTN could be a useful biomarker of equine asthma. Thus, this study aimed to compare the concentration of MSTN in the blood plasma of fully healthy and asthmatic horses. (2) Methods: A total of 61 horses were clinically examined to confirm or exclude the occurrence of equine asthma, including bronchoalveolar lavage (BAL) fluid cytology performed on 49 horses. This study included three groups of horses, two of which were clinically healthy, and one of which was asthmatic. (3) Results: The mean circulatory MSTN concentration determined using the ELISA method in asthmatic horses was significantly higher than that in clinically healthy young Thoroughbred racehorses (p < 0.05), but it did not differ as compared to the group of healthy, adult leisure horses. (4) Conclusions: The obtained results did not unambiguously support our original hypothesis that MSTM may be a reliable marker for the early diagnosis of equine asthma. To the best of the authors' knowledge, this is the first study to analyze the plasma MSTN concentration in equine asthma patients, and therefore further studies are needed to confirm our novel findings.

Role of nutrition in patients with coexisting chronic obstructive pulmonary disease and sarcopenia

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in the elderly population and is characterized by persistent respiratory symptoms and airflow obstruction. During COPD progression, a variety of pulmonary and extrapulmonary complications develop, with sarcopenia being one of the most common extrapulmonary complications. Factors that contribute to the pathogenesis of coexisting COPD and sarcopenia include systemic inflammation, hypoxia, hypercapnia, oxidative stress, protein metabolic imbalance, and myocyte mitochondrial dysfunction. These factors, individually or in concert, affect muscle function, resulting in decreased muscle mass and strength. The occurrence of sarcopenia severely affects the quality of life of patients with COPD, resulting in increased readmission rates, longer hospital admission, and higher mortality. In recent years, studies have found that oral supplementation with protein, micronutrients, fat, or a combination of nutritional supplements can improve the muscle strength and physical performance of these patients; some studies have also elucidated the possible underlying mechanisms. This review aimed to elucidate the role of nutrition among patients with coexisting COPD and sarcopenia.

A Prospective Case-Control Study Examining the Relationship Between Frailty and Serum Myostatin in Older Persons with Chronic Heart Failure

Background

Frailty affects the prognosis and management of patients with heart failure, and is often related with sarcopenia. Also, the serum myostatin (MSTN) involved in the development of sarcopenia and frailty. This study aimed to determine the connection between MSTN level and frailty in older adults with chronic heart failure (CHF).

Methods

This prospective case-control study enrolled older adult patients with CHF between May 2019 and May 2021, and analyzed their clinical data.

Results

In this study 75 older adults with CHF were included, 29 of whom were frail. The B-type natriuretic peptide (BNP) levels were significantly higher in frail older adults with CHF than in older adults with CHF who were not frail (316.82 ± 235.64 pg/mL vs 198.61 ± 112.58 pg/mL; P = 0.016). The MSTN levels were significantly higher in frail participants than in participants who were not frail (2.93 ± 1.35 ng/mL vs 2.24 ± 0.84 ng/mL; P = 0.018). Based on multivariable analysis the BNP (odds ratio [OR] = 1.004, 95% confidence interval [CI] = 1 0.001-1.008; P = 0.018) and MSTN (OR = 1.772, 95% CI = 1.079-2.912; P =0 0.024) levels were independently associated with frailty in older adults with CHF.

Conclusion

MSTN is a promising biomarker of frailty in elderly patients with CHF.

"Yiqi Huayu, Wenyang Lishui" Prescription (YHWLP) Improves the Symptoms of Chronic Obstructive Pulmonary Disease-Induced Chronic Pulmonary Heart Disease by Inhibiting the RhoA/ROCK Signaling Pathway

Background

Chronic pulmonary heart disease (CPHD) is a common type of heart disease. In China, chronic obstructive pulmonary disease (COPD) is one of the main causes of CPHD. At present, there is no specific therapy for COPD-induced CPHD, so it is of great importance to identify a new therapy for CPHD.

Objective

The purpose of this study was to explore the effects of "Yiqi Huayu, Wenyang Lishui" prescription (YHWLP) on CPHD symptoms.

Methods

Eighty patients with COPD-induced CPHD were randomly divided into the control group and the YHWLP group, both involving treatment for 3 months. Both groups were treated with Western medicine, and the YHWLP group was also treated with YHWLP. The changes (relative to baseline) in the symptoms, pulmonary arterial pressure, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen (Fbg), D-dimer (D-D), and ratio of phosphorylated (p)-myosin-binding subunit (MBS)/total (t)-MBS in peripheral blood (which indirectly indicates the activation/inhibition of RhoA/ROCK signaling) were compared between the two groups.

Results

YHWLP plus Western medicine was superior to Western medicine alone at reducing symptoms, pulmonary arterial pressure, PT, aPTT, Fbg, D-D, and p-MBS/t-MBS.

Conclusion

YHWLP can relieve CPHD by inhibiting the RhoA/ROCK signaling pathway, which means YHWLP is a potential treatment for CPHD.

Characteristics of length of stay and cardiovascular pharmacotherapy advice among chronic obstructive pulmonary disease patients

Chronic obstructive pulmonary disease (COPD) increases the global disease burden due to its diverse adverse health effects on the respiratory and cardiovascular systems. This study aimed to elucidate the potential indicators of length of stay (LOS) and pharmacotherapy advice among COPD patients. Thereafter, hospitalized COPD patients with clinical records and respiratory and cardiovascular pharmacotherapy advice were retrospectively collected from a tertiary hospital between April 2017 and September 2020, and the determinants of LOS and cardiovascular pharmacotherapy advice were explored using regression analyses. Overall, 475 patients with COPD were recruited and stratified according to exacerbation and presence of Cor pulmonale (CP). The extended LOS, increased B-type natriuretic peptides (BNP), and a higher percentage of cardiovascular pharmacotherapy advice were observed in COPD with CP regardless of exacerbation, although the percentage of respiratory prescriptions was comparable. The presence of CP indicated a longer LOS (B = 1.850, p < 0.001) for COPD regardless of exacerbation. Meanwhile, elevated BNP levels indicated cardiovascular pharmacotherapy advise for both COPD in exacerbation (OR = 1.003, p = 0.012) and absence of exacerbation (OR = 1.006, p = 0.015). Moreover, advice for trimetazidine use for COPD in exacerbation (OR = 1.005, p = 0.002) has been suggested. Therefore, CP appears to be an important comorbidity resulting in extended LOS for COPD, which is likely to be advised with cardiovascular pharmacotherapy, which might be guided through BNP monitoring.

Myostatin as a Biomarker of Muscle Wasting and other Pathologies-State of the Art and Knowledge Gaps

Sarcopenia is a geriatric syndrome with a significant impact on older patients’ quality of life, morbidity and mortality. Despite the new available criteria, its early diagnosis remains difficult, highlighting the necessity of looking for a valid muscle wasting biomarker. Myostatin, a muscle mass negative regulator, is one of the potential candidates. The aim of this work is to point out various factors affecting the potential of myostatin as a biomarker of muscle wasting. Based on the literature review, we can say that recent studies produced conflicting results and revealed a number of potential confounding factors influencing their use in sarcopenia diagnosing. These factors include physiological variables (such as age, sex and physical activity) as well as a variety of disorders (including heart failure, metabolic syndrome, kidney failure and inflammatory diseases) and differences in laboratory measurement methodology. Our conclusion is that although myostatin alone might not prove to be a feasible biomarker, it could become an important part of a recently proposed panel of muscle wasting biomarkers. However, a thorough understanding of the interrelationship of these markers, as well as establishing a valid measurement methodology for myostatin and revising current research data in the light of new criteria of sarcopenia, is needed.

Salidroside mitigates skeletal muscle atrophy in rats with cigarette smoke-induced COPD by up-regulating myogenin and down-regulating myostatin expression

OBJECTIVES

The present study aimed at investigating the therapeutic effect of Salidroside on skeletal muscle atrophy in a rat model of cigarette smoking-induced chronic obstructive pulmonary disease (COPD) and its potential mechanisms.

METHODS

Male Wistar rats were randomized, and treated intraperitoneally (IP) with vehicle (injectable water) or a low, medium or high dose of Salidroside, followed by exposure to cigarette smoking daily for 16 weeks. A healthy control received vehicle injection and air exposure. Their lung function, body weights and gastrocnemius (GN) weights, grip strength and cross-section area (CSA) of individual muscular fibers in the GN were measured. The levels of TNF-α, IL-6, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) in serum and GN tissues as well as myostatin and myogenin expression in GN tissues were measured.

RESULTS

In comparison with that in the healthy control, long-term cigarette smoking induced emphysema, significantly impaired lung function, reduced body and GN weights and CSA values in rats, accompanied by significantly increased levels of TNF-α, IL-6 and MDA, but decreased levels of SOD and GSH in serum and GN tissues. Furthermore, cigarette smoking significantly up-regulated myostatin expression, but down-regulated myogenin expression in GN tissues. Salidroside treatment decreased emphysema, significantly ameliorated lung function, increased antioxidant, but reduced MDA, IL-6 and TNF-α levels in serum and GN tissues of rats, accompanied by decreased myostain, but increased myogenin expression in GN tissues.

CONCLUSION

Salidroside mitigates the long-term cigarette smoking-induced emphysema and skeletal muscle atrophy in rats by inhibiting oxidative stress and inflammatory responses and regulating muscle-specific transcription factor expression.