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Mougin L, Riccetti M, Merlet AN, Bartolucci P, Gellen B, Blervaque L, D'Humières T, Galactéros F, Emhoff CAW, Féasson L, Messonnier LA. Endurance training improves oxygen uptake/demand mismatch, metabolic flexibility and recovery in patients with sickle cell disease. Haematologica 2024. [PMID: 38572551 DOI: 10.3324/haematol.2023.284474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Indexed: 04/05/2024] Open
Abstract
Patients with sickle cell disease (SCD) display lower slope coefficients of the oxygen uptake (V_O2) vs. work rate (W) relationship (delineating an O2 uptake/demand mismatch) and a poor metabolic flexibility. Because endurance training (ET) increases the microvascular network and oxidative enzymes activity including one involved in lipid oxidation, ET might improve the slope coefficient of the V_O2 vs. W curve and the metabolic flexibility of SCD patients. ET may also contribute to improve patient post-exercise cardiopulmonary and metabolic recovery. Fifteen patients with SCD performed a submaximal incremental test on a cycle ergometer before (SIT1) and after (SIT2) 8 weeks of ET. Minute ventilation, ventilation rate (VR), heart rate (HR), V_O2, CO2 production, respiratory exchange ratio, carbohydrate/lipid utilization and partitioning (including %Lipidox) and blood lactate concentration ([lactate]b) were measured during and after SIT1 and SIT2. At baseline, the slope coefficient of the V_O2 vs. W curve positively correlated with total hemoglobin, mean corpuscular hemoglobin and percentage of HbF. After training, the slope coefficient of the V_O2 vs. W curve was significantly higher and the [lactate]b increase was delayed. If patients' energy metabolism apparently relied largely on carbohydrate sources during SIT1, %Lipidox tended to increase at low exercise intensities during SIT2, supporting a training-induced improvement of metabolic flexibility in patients with SCD. Post-exercise recovery of VR, V_E/V_CO2, HR and [lactate]b was faster after training. We concluded that ET in patients with SCD i) ameliorated the oxygen uptake/demand mismatch, ii) blunted the metabolic inflexibility, and iii) improved post-exercise cardiopulmonary and metabolic responses.
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Affiliation(s)
- Loïs Mougin
- Inter-university Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry
| | - Manon Riccetti
- Inter-university Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry
| | - Angèle N Merlet
- Inter-university Laboratory of Human Movement Sciences, University Jean Monnet, Saint-Etienne, France; Myology Unit, Department of Clinical Physiology and Exercise, Saint-Etienne University Hospital, Saint-Etienne
| | - Pablo Bartolucci
- Department of Internal Medicine, Henri-Mondor Hospital (AP-HP), University Paris-Est Créteil (UPEC), Créteil, France; Sickle Cell Referral Centre - UMGGR, Great Paris East Rare Diseases Expertise Platform, UPEC, FHU SENEC, Henri-Mondor Hospital (AP-HP), Créteil
| | - Barnabas Gellen
- Department of Cardiac Rehabilitation, Henri-Mondor Hospital (AP-HP), Créteil
| | - Léo Blervaque
- Inter-university Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry
| | - Thomas D'Humières
- Sickle Cell Referral Centre - UMGGR, Great Paris East Rare Diseases Expertise Platform, UPEC, FHU SENEC, Henri-Mondor Hospital (AP-HP), Créteil, France; Department of Physiology, FHU SENEC, Henri-Mondor Hospital (AP-HP), Créteil, France; INSERM IMRB U955, Team 8, University Paris Est (UPEC), Créteil
| | - Frédéric Galactéros
- Department of Internal Medicine, Henri-Mondor Hospital (AP-HP), University Paris-Est Créteil (UPEC), Créteil, France; Sickle Cell Referral Centre - UMGGR, Great Paris East Rare Diseases Expertise Platform, UPEC, FHU SENEC, Henri-Mondor Hospital (AP-HP), Créteil
| | - Chi-An W Emhoff
- Inter-university Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry, France; Department of Kinesiology, Saint Mary's College of California, Moraga, California
| | - Léonard Féasson
- Inter-university Laboratory of Human Movement Sciences, University Jean Monnet, Saint-Etienne, France; Myology Unit, Department of Clinical Physiology and Exercise, Saint-Etienne University Hospital, Saint-Etienne
| | - Laurent A Messonnier
- Inter-university Laboratory of Human Movement Sciences, University Savoie Mont Blanc, Chambéry, France; Institut universitaire de France (IUF).
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Henrot P, Dupin I, Schilfarth P, Esteves P, Blervaque L, Zysman M, Gouzi F, Hayot M, Pomiès P, Berger P. Main Pathogenic Mechanisms and Recent Advances in COPD Peripheral Skeletal Muscle Wasting. Int J Mol Sci 2023; 24:ijms24076454. [PMID: 37047427 PMCID: PMC10095391 DOI: 10.3390/ijms24076454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a worldwide prevalent respiratory disease mainly caused by tobacco smoke exposure. COPD is now considered as a systemic disease with several comorbidities. Among them, skeletal muscle dysfunction affects around 20% of COPD patients and is associated with higher morbidity and mortality. Although the histological alterations are well characterized, including myofiber atrophy, a decreased proportion of slow-twitch myofibers, and a decreased capillarization and oxidative phosphorylation capacity, the molecular basis for muscle atrophy is complex and remains partly unknown. Major difficulties lie in patient heterogeneity, accessing patients' samples, and complex multifactorial process including extrinsic mechanisms, such as tobacco smoke or disuse, and intrinsic mechanisms, such as oxidative stress, hypoxia, or systemic inflammation. Muscle wasting is also a highly dynamic process whose investigation is hampered by the differential protein regulation according to the stage of atrophy. In this review, we report and discuss recent data regarding the molecular alterations in COPD leading to impaired muscle mass, including inflammation, hypoxia and hypercapnia, mitochondrial dysfunction, diverse metabolic changes such as oxidative and nitrosative stress and genetic and epigenetic modifications, all leading to an impaired anabolic/catabolic balance in the myocyte. We recapitulate data concerning skeletal muscle dysfunction obtained in the different rodent models of COPD. Finally, we propose several pathways that should be investigated in COPD skeletal muscle dysfunction in the future.
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Affiliation(s)
- Pauline Henrot
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Isabelle Dupin
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
| | - Pierre Schilfarth
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Pauline Esteves
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
| | - Léo Blervaque
- PhyMedExp, INSERM-CNRS-Montpellier University, F-34090 Montpellier, France
| | - Maéva Zysman
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
| | - Fares Gouzi
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, F-34090 Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, F-34090 Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM-CNRS-Montpellier University, F-34090 Montpellier, France
| | - Patrick Berger
- Centre de Recherche Cardio-Thoracique de Bordeaux, Univ. Bordeaux, U1045, F-33604 Pessac, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33604 Pessac, France
- CHU de Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Service de Pneumologie, F-33604 Pessac, France
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Henrot P, Blervaque L, Dupin I, Zysman M, Esteves P, Gouzi F, Hayot M, Pomiès P, Berger P. Cellular interplay in skeletal muscle regeneration and wasting: insights from animal models. J Cachexia Sarcopenia Muscle 2023; 14:745-757. [PMID: 36811134 PMCID: PMC10067506 DOI: 10.1002/jcsm.13103] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 02/24/2023] Open
Abstract
Skeletal muscle wasting, whether related to physiological ageing, muscle disuse or to an underlying chronic disease, is a key determinant to quality of life and mortality. However, cellular basis responsible for increased catabolism in myocytes often remains unclear. Although myocytes represent the vast majority of skeletal muscle cellular population, they are surrounded by numerous cells with various functions. Animal models, mostly rodents, can help to decipher the mechanisms behind this highly dynamic process, by allowing access to every muscle as well as time-course studies. Satellite cells (SCs) play a crucial role in muscle regeneration, within a niche also composed of fibroblasts and vascular and immune cells. Their proliferation and differentiation is altered in several models of muscle wasting such as cancer, chronic kidney disease or chronic obstructive pulmonary disease (COPD). Fibro-adipogenic progenitor cells are also responsible for functional muscle growth and repair and are associated in disease to muscle fibrosis such as in chronic kidney disease. Other cells have recently proven to have direct myogenic potential, such as pericytes. Outside their role in angiogenesis, endothelial cells and pericytes also participate to healthy muscle homoeostasis by promoting SC pool maintenance (so-called myogenesis-angiogenesis coupling). Their role in chronic diseases muscle wasting has been less studied. Immune cells are pivotal for muscle repair after injury: Macrophages undergo a transition from the M1 to the M2 state along with the transition between the inflammatory and resolutive phase of muscle repair. T regulatory lymphocytes promote and regulate this transition and are also able to activate SC proliferation and differentiation. Neural cells such as terminal Schwann cells, motor neurons and kranocytes are notably implicated in age-related sarcopenia. Last, newly identified cells in skeletal muscle, such as telocytes or interstitial tenocytes could play a role in tissular homoeostasis. We also put a special focus on cellular alterations occurring in COPD, a chronic and highly prevalent respiratory disease mainly linked to tobacco smoke exposure, where muscle wasting is strongly associated with increased mortality, and discuss the pros and cons of animal models versus human studies in this context. Finally, we discuss resident cells metabolism and present future promising leads for research, including the use of muscle organoids.
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Affiliation(s)
- Pauline Henrot
- Centre de Recherche Cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, Pessac, France.,CHU de Bordeaux, Service d'exploration fonctionnelle respiratoire, Pessac, France
| | - Léo Blervaque
- PhyMedExp, INSERM-CNRS-Montpellier University, Montpellier, France
| | - Isabelle Dupin
- Centre de Recherche Cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, Pessac, France
| | - Maéva Zysman
- Centre de Recherche Cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, Pessac, France.,CHU de Bordeaux, Service d'exploration fonctionnelle respiratoire, Pessac, France
| | - Pauline Esteves
- Centre de Recherche Cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, Pessac, France
| | - Fares Gouzi
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM-CNRS-Montpellier University, CHRU Montpellier, Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM-CNRS-Montpellier University, Montpellier, France
| | - Patrick Berger
- Centre de Recherche Cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, Pessac, France.,CHU de Bordeaux, Service d'exploration fonctionnelle respiratoire, Pessac, France
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Desplanche E, Blervaque L, Günther S, Gruest M, Philippe A, Rancic J, Gendron N, Hédon C, Heraud N, Perez-Martin A, Virsolvy A, Cazorla O, Condurache G, Plouvier N, Proust A, Dauvilliers Y, Hayot M, Rossi E, Bourdin A, Gouzi F, Smadja D. Défaut de mobilisation par l’exercice des cellules souches/progénitrices endothéliales chez les patients BPCO et réponse vasculaire à la réhabilitation respiratoire. Rev Mal Respir 2023. [DOI: 10.1016/j.rmr.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Blervaque L, Bowen M, Chatel B, Corbex E, Dalmais E, Messonnier LA. Is the Energy Cost of Rowing a Determinant Factor of Performance in Elite Oarsmen? Front Physiol 2022; 13:827932. [PMID: 35431985 PMCID: PMC9005883 DOI: 10.3389/fphys.2022.827932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/03/2022] [Indexed: 12/04/2022] Open
Abstract
In elite oarsmen, the rowing ergometer is a valuable tool for both training and studying rowing performance determinants. However, the energy cost of rowing, often reported as a determinant of performance, has never been described for ergometer rowing. Therefore, this study aimed to characterize the energy cost of ergometer rowing (ECR) in elite oarsmen, its contribution to 2,000 m performance, and its determinants. This study was conducted on 21 elite oarsmen from the French national team. It included an incremental exercise test up to exhaustion and an all-out performance test over 2,000 m, both conducted on a rowing ergometer. Gas exchange analysis was performed to calculate oxygen uptake and substrate utilization rate. Whole blood lactate concentrations during the incremental test were obtained from the earlobe. During the incremental test, ECR displayed a significant linear increase up to a plateau that reached a mean rowing speed of 5.23 ± 0.02 m⋅s–1. The ECR values at 300, 350, and 400 W were positively correlated with performance expressed as the time required to perform the 2,000 m distance on the rowing ergometer. The same ECR values were found to be significantly related to fat oxidation (expressed in percentage of total energy supply) and blood lactate concentrations. This study provides the first description of ECR and of its relationship to exercise intensity on the rowing ergometer in elite oarsmen. ECR appeared to be a factor of performance and interestingly was related to energy supply from fat and blood lactate concentrations.
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Messonnier LA, Chatel B, Emhoff CAW, Blervaque L, Oyono-Enguéllé S. Delayed Rebound of Glycemia During Recovery Following Short-Duration High-Intensity Exercise: Are There Lactate and Glucose Metabolism Interactions? Front Nutr 2021; 8:734152. [PMID: 34859027 PMCID: PMC8632521 DOI: 10.3389/fnut.2021.734152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022] Open
Abstract
Lactate constitutes the primary gluconeogenic precursor in healthy humans at rest and during low-intensity exercise. Data on the interactions between lactate and glucose metabolisms during recovery after short-duration high-intensity exercise are sparse. The aim of the present study was to describe blood glucose ([glucose]b) and lactate ([lactate]b) concentration curves during recovery following short-duration high-intensity exercise. Fifteen healthy Cameroonian subjects took part in the study and performed successively (i) an incremental exercise to exhaustion to determine maximal work rate (Pmax) and (ii) a 2-min 110% Pmax exercise after which blood lactate and glucose concentrations were measured during the 80-min passive recovery. In response to the 2-min 110% Pmax exercise, [glucose]b remained stable (from 4.93 ± 1.13 to 4.65 ± 0.74 mmol.L−1, NS) while [lactate]b increased (from 1.35 ± 0.36 to 7.87 ± 1.66 mmol.L−1, p < 0.0001). During recovery, blood lactate concentrations displayed the classic biphasic curve while blood glucose concentrations displayed a singular shape including a delayed and transitory rebound of glycemia. This rebound began at 27.7 ± 6.2 min and peaked at 6.78 ± 0.53 mmol.L−1 at 56.3 ± 9.7 min into recovery. The area under the curve (AUC) of [lactate]b during the rebound of glycemia was positively correlated with the peak value of glycemia and the AUC of [glucose]b during the rebound. In conclusion, the delayed rebound of glycemia observed in the present study was associated with lactate availability during this period.
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Affiliation(s)
- Laurent A Messonnier
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Savoie Mont Blanc, Chambéry, France
| | | | - Chi-An W Emhoff
- Department of Kinesiology, Saint Mary's College of California, Moraga, CA, United States
| | - Léo Blervaque
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Savoie Mont Blanc, Chambéry, France
| | - Samuel Oyono-Enguéllé
- Laboratoire de Physiologie de la Faculté de Médecine, Université Yaoundé 1, Yaoundé, Cameroon
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Catteau M, Passerieux E, Blervaque L, Gouzi F, Ayoub B, Hayot M, Pomiès P. Response to Electrostimulation Is Impaired in Muscle Cells from Patients with Chronic Obstructive Pulmonary Disease. Cells 2021; 10:3002. [PMID: 34831227 PMCID: PMC8616440 DOI: 10.3390/cells10113002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 11/16/2022] Open
Abstract
Among the comorbidities associated with chronic obstructive pulmonary disease (COPD), skeletal muscle weakness and atrophy are known to affect patient survival rate. In addition to muscle deconditioning, various systemic and intrinsic factors have been implicated in COPD muscle dysfunction but an impaired COPD muscle adaptation to contraction has never been extensively studied. We submitted cultured myotubes from nine healthy subjects and nine patients with COPD to an endurance-type protocol of electrical pulse stimulation (EPS). EPS induced a decrease in the diameter, covered surface and expression of MHC1 in COPD myotubes. Although the expression of protein degradation markers was not affected, expression of the protein synthesis marker mTOR was not induced in COPD compared to healthy myotubes after EPS. The expression of the differentiation markers p16INK4a and p21 was impaired, while expression of Myf5 and MyoD tended to be affected in COPD muscle cells in response to EPS. The expression of mitochondrial biogenesis markers PGC1α and MFN2 was affected and expression of TFAM and COX1 tended to be reduced in COPD compared to healthy myotubes upon EPS. Lipid peroxidation was increased and the expression of the antioxidant enzymes SOD2 and GPx4 was affected in COPD compared to healthy myotubes in response to EPS. Thus, we provide evidence of an impaired response of COPD muscle cells to contraction, which might be involved in the muscle weakness observed in patients with COPD.
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Affiliation(s)
- Matthias Catteau
- PhyMedExp, University of Montpellier—INSERM—CNRS, 34295 Montpellier, France; (M.C.); (E.P.); (L.B.)
| | - Emilie Passerieux
- PhyMedExp, University of Montpellier—INSERM—CNRS, 34295 Montpellier, France; (M.C.); (E.P.); (L.B.)
| | - Léo Blervaque
- PhyMedExp, University of Montpellier—INSERM—CNRS, 34295 Montpellier, France; (M.C.); (E.P.); (L.B.)
| | - Farés Gouzi
- PhyMedExp, University of Montpellier—INSERM—CNRS—CHRU Montpellier, 34295 Montpellier, France; (F.G.); (B.A.); (M.H.)
| | - Bronia Ayoub
- PhyMedExp, University of Montpellier—INSERM—CNRS—CHRU Montpellier, 34295 Montpellier, France; (F.G.); (B.A.); (M.H.)
| | - Maurice Hayot
- PhyMedExp, University of Montpellier—INSERM—CNRS—CHRU Montpellier, 34295 Montpellier, France; (F.G.); (B.A.); (M.H.)
| | - Pascal Pomiès
- PhyMedExp, University of Montpellier—INSERM—CNRS, 34295 Montpellier, France; (M.C.); (E.P.); (L.B.)
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Blervaque L, Préfaut C, Forthin H, Maffre F, Bourrelier M, Héraud N, Catteau M, Pomiès P, Jaffuel D, Molinari N, Hayot M, Gouzi F. Efficacy of a long-term pulmonary rehabilitation maintenance program for COPD patients in a real-life setting: a 5-year cohort study. Respir Res 2021; 22:79. [PMID: 33691702 PMCID: PMC7948332 DOI: 10.1186/s12931-021-01674-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/01/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) improves exercise capacity, health-related quality of life (HRQoL) and dyspnea in chronic obstructive pulmonary disease (COPD) patients. Maintenance programs can sustain the benefits for 12 to 24 months. Yet, the long-term effects (> 12 months) of pragmatic maintenance programs in real-life settings remain unknown. This prospective cohort study assessed the yearly evolution in the outcomes [6-min walking distance (6MWD), HRQoL, dyspnea] of a supervised self-help PR maintenance program for COPD patients followed for 5 years. The aim was to assess the change in the outcomes and survival probability for 1 to 5 years after PR program discharge in COPD patients following a PR maintenance program supported by supervised self-help associations. METHODS Data were prospectively collected from 144 COPD patients who followed a pragmatic multidisciplinary PR maintenance program for 1 to 5 years. They were assessed yearly for 6MWD, HRQol (VQ11) and dyspnea (MRC). The 5-year survival probability was compared to that of a control PR group without a maintenance program. A trajectory-based cluster analysis identified the determinants of long-term response. RESULTS Maintenance program patients showed significant PR benefits at 4 years for 6MWD and VQ11 and 5 years for MRC. The 5-year survival probability was higher than for PR patients without PR maintenance. Two clusters of response to long-term PR were identified, with responders being the less severe COPD patients. CONCLUSIONS This study provides evidence of the efficacy of a pragmatic PR maintenance program in a real-life setting for more than 3 years. In contrast to short-term PR, long-term PR maintenance appeared more beneficial in less severe COPD patients.
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Affiliation(s)
- Léo Blervaque
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University, Montpellier, France
| | | | | | | | | | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé - KORIAN SANTE, 34700, Lodève, France
| | - Matthias Catteau
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University, Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University, Montpellier, France
| | - Dany Jaffuel
- Department of Pneumology, Montpellier University Hospital, Montpellier, France
| | - Nicolas Molinari
- IMAG, CNRS, Montpellier University, Montpellier University Hospital, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France.
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Blervaque L, Pomiès P, Rossi E, Catteau M, Blandinières A, Passerieux E, Blaquière M, Ayoub B, Molinari N, Mercier J, Perez-Martin A, Marchi N, Smadja DM, Hayot M, Gouzi F. COPD is deleterious for pericytes: implications during training-induced angiogenesis in skeletal muscle. Am J Physiol Heart Circ Physiol 2020; 319:H1142-H1151. [PMID: 32986960 DOI: 10.1152/ajpheart.00306.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Improvements in skeletal muscle endurance and oxygen uptake are blunted in patients with chronic obstructive pulmonary disease (COPD), possibly because of a limitation in the muscle capillary oxygen supply. Pericytes are critical for capillary blood flow adaptation during angiogenesis but may be impaired by COPD systemic effects, which are mediated by circulating factors. This study compared the pericyte coverage of muscle capillaries in response to 10 wk of exercise training in patients with COPD and sedentary healthy subjects (SHS). Fourteen patients with COPD were compared with seven matched SHS. SHS trained at moderate intensity corresponding to an individualized moderate-intensity patient with COPD trained at the same relative (%V̇o2: COPD-RI) or absolute (mL·min-1·kg-1: COPD-AI) intensity as SHS. Capillary-to-fiber ratio (C/F) and NG2+ pericyte coverage were assessed from vastus lateralis muscle biopsies, before and after 5 and 10 wk of training. We also tested in vitro the effect of COPD and SHS serum on pericyte morphology and mesenchymal stem cell (MSC) differentiation into pericytes. SHS showed greater improvement in aerobic capacity (V̇o2VT) than both patients with COPD-RI and patients with COPD-AI (Group × Time: P = 0.004). Despite a preserved increase in the C/F ratio, NG2+ pericyte coverage did not increase in patients with COPD in response to training, contrary to SHS (Group × Time: P = 0.011). Conversely to SHS serum, COPD serum altered pericyte morphology (P < 0.001) and drastically reduced MSC differentiation into pericytes (P < 0.001). Both functional capacities and pericyte coverage responses to exercise training are blunted in patients with COPD. We also provide direct evidence of the deleterious effect of COPD circulating factors on pericyte morphology and differentiation.NEW & NOTEWORTHY This work confirms the previously reported impairment in the functional response to exercise training of patients with COPD compared with SHS. Moreover, it shows for the first time that pericyte coverage of the skeletal capillaries is drastically reduced in patients with COPD compared with SHS during training-induced angiogenesis. Finally, it provides experimental evidence that circulating factors are involved in the impaired pericyte coverage of patients with COPD.
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Affiliation(s)
- Léo Blervaque
- PhyMedExp, INSERM-CNRS-Montpellier University, Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM-CNRS-Montpellier University, Montpellier, France
| | - Elisa Rossi
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
| | - Matthias Catteau
- PhyMedExp, INSERM-CNRS-Montpellier University, Montpellier, France
| | - Adeline Blandinières
- Service d'Hématologie et Laboratoire de Recherches Biochirugicales (Fondation Carpentier), AH-HP, Georges Pompidou European Hospital, Paris, France
| | | | - Marine Blaquière
- Cerebrovascular and Glia Research, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U1191 INSERM, University of Montpellier), Montpellier, France
| | - Bronia Ayoub
- PhyMedExp, INSERM-CNRS-Montpellier University, CHU Montpellier, Montpellier, France
| | - Nicolas Molinari
- IMAG, CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, INSERM-CNRS-Montpellier University, CHU Montpellier, Montpellier, France
| | - Antonia Perez-Martin
- Vascular Medicine Department and Laboratory, CHU Nîmes and EA2992 Research Unit, Montpellier University, Nimes, France
| | - Nicola Marchi
- Cerebrovascular and Glia Research, Department of Neuroscience, Institute of Functional Genomics (UMR 5203 CNRS-U1191 INSERM, University of Montpellier), Montpellier, France
| | - David M Smadja
- Service d'Hématologie et Laboratoire de Recherches Biochirugicales (Fondation Carpentier), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Maurice Hayot
- PhyMedExp, INSERM-CNRS-Montpellier University, CHU Montpellier, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, INSERM-CNRS-Montpellier University, CHU Montpellier, Montpellier, France
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Catteau M, Gouzi F, Blervaque L, Passerieux E, Blaquière M, Ayoub B, Bughin F, Mercier J, Hayot M, Pomiès P. Effects of a human microenvironment on the differentiation of human myoblasts. Biochem Biophys Res Commun 2020; 525:968-973. [DOI: 10.1016/j.bbrc.2020.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
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Vanfleteren LE, Blervaque L, Franssen FM, Daines L, Kocks JW, Honkoop PJ, Poberezhets V. ERS International Congress, Madrid, 2019: highlights from the General Pneumology Assembly. ERJ Open Res 2020; 6:00323-2019. [PMID: 32154290 PMCID: PMC7049709 DOI: 10.1183/23120541.00323-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/20/2020] [Indexed: 11/05/2022] Open
Abstract
This article contains highlights and a selection of the scientific advances from the European Respiratory Society's General Pneumology Assembly that were presented at the 2019 European Respiratory Society International Congress in Madrid, Spain. The most relevant topics from the different groups will be discussed, covering a wide range of areas including rehabilitation and chronic care, general practice and primary care and M-health and E-health. In this review, the newest research and actual data as well as award-winning abstracts and highlight sessions will be discussed.
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Affiliation(s)
- Lowie E.G.W. Vanfleteren
- COPD Center, Sahlgrenska University Hospital and Institute of Medicine, Gothenburg University, Gothenburg, Sweden
| | - Léo Blervaque
- PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
| | - Frits M.E. Franssen
- CIRO, Horn, The Netherlands
- Dept of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Luke Daines
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Janwillem W.H. Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- Observational and Pragmatic Research Institute, Singapore
| | - Persijn J. Honkoop
- Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Dept of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Vitalii Poberezhets
- Dept of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
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12
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Blervaque L, Passerieux E, Pomiès P, Catteau M, Héraud N, Blaquière M, Bughin F, Ayoub B, Molinari N, Cristol JP, Perez-Martin A, Mercier J, Hayot M, Gouzi F. Impaired training-induced angiogenesis process with loss of pericyte-endothelium interactions is associated with an abnormal capillary remodelling in the skeletal muscle of COPD patients. Respir Res 2019; 20:278. [PMID: 31806021 PMCID: PMC6896673 DOI: 10.1186/s12931-019-1240-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/13/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract Chronic obstructive pulmonary disease (COPD) is associated with exercise intolerance and limits the functional gains in response to exercise training in patients compared to sedentary healthy subjects (SHS). The blunted skeletal muscle angiogenesis previously observed in COPD patients has been linked to these limited functional improvements, but its underlying mechanisms, as well as the potential role of oxidative stress, remain poorly understood. Therefore, we compared ultrastructural indexes of angiogenic process and capillary remodelling by transmission electron microscopy in 9 COPD patients and 7 SHS after 6 weeks of individualized moderate-intensity endurance training. We also assessed oxidative stress by plasma-free and esterified isoprostane (F2-IsoP) levels in both groups. We observed a capillary basement membrane thickening in COPD patients only (p = 0.008) and abnormal variations of endothelial nucleus density in response to exercise training in these patients when compared to SHS (p = 0.042). COPD patients had significantly fewer occurrences of pericyte/endothelium interdigitations, a morphologic marker of capillary maturation, than SHS (p = 0.014), and significantly higher levels of F2-IsoP (p = 0.048). Last, the changes in pericyte/endothelium interdigitations and F2-IsoP levels in response to exercise training were negatively correlated (r = − 0.62, p = 0.025). This study is the first to show abnormal capillary remodelling and to reveal impairments during the whole process of angiogenesis (capillary creation and maturation) in COPD patients. Trial registration NCT01183039 & NCT01183052, both registered 7 August 2010 (retrospectively registered).
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Affiliation(s)
- Léo Blervaque
- Physiologie & médecine expérimentale du Cœur et des Muscles (PhyMedExp), INSERM - CNRS - Montpellier University. CHU Arnaud De Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France.
| | - Emilie Passerieux
- Physiologie & médecine expérimentale du Cœur et des Muscles (PhyMedExp), INSERM - CNRS - Montpellier University. CHU Arnaud De Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France
| | - Pascal Pomiès
- Physiologie & médecine expérimentale du Cœur et des Muscles (PhyMedExp), INSERM - CNRS - Montpellier University. CHU Arnaud De Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France
| | - Matthias Catteau
- Physiologie & médecine expérimentale du Cœur et des Muscles (PhyMedExp), INSERM - CNRS - Montpellier University. CHU Arnaud De Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France
| | - Nelly Héraud
- Les Cliniques du Souffle®, Groupe 5 Santé, Lodève, France
| | - Marine Blaquière
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - François Bughin
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Bronia Ayoub
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Nicolas Molinari
- IMAG, CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Antonia Perez-Martin
- Vascular Medicine Department and Laboratory, CHU Nîmes and EA2992 Research Unit, Montpellier University, Nimes, France
| | - Jacques Mercier
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, INSERM - CNRS, Montpellier University, CHU Montpellier, Montpellier, France
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Gouzi F, Hédon C, Blervaque L, Passerieux E, Kuster N, Pujol T, Mercier J, Hayot M. Interactive whiteboard use in clinical reasoning sessions to teach diagnostic test ordering and interpretation to undergraduate medical students. BMC Med Educ 2019; 19:424. [PMID: 31729989 PMCID: PMC6858719 DOI: 10.1186/s12909-019-1834-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Over-testing of patients is a significant problem in clinical medicine that can be tackled by education. Clinical reasoning learning (CRL) is a potentially relevant method for teaching test ordering and interpretation. The feasibility might be improved by using an interactive whiteboard (IWB) during the CRL sessions to enhance student perceptions and behaviours around diagnostic tests. Overall, IWB/CRL could improve their skills. METHODS Third-year undergraduate medical students enrolled in a vertically integrated curriculum were randomized into two groups before clinical placement in either a respiratory disease or respiratory physiology unit: IWB-based CRL plus clinical mentoring (IWB/CRL + CM: n = 40) or clinical mentoring only (CM-only: n = 40). Feasibility and learning outcomes were assessed. In addition, feedback via questionnaire of the IWB students and their classmates (n = 233) was compared. RESULTS Analyses of the IWB/CRL sessions (n = 40, 27 paperboards) revealed that they met validated learning objectives. Students perceived IWB as useful and easy to use. After the IWB/CRL + CM sessions, students mentioned more hypothesis-based indications in a test ordering file (p < 0.001) and looked for more nonclinical signs directly on raw data tests (p < 0.01) compared with students in the CM-only group. Last, among students who attended pre- and post-assessments (n = 23), the number of diagnostic tests ordered did not change in the IWB/CRL + CM group (+ 7%; p = N.S), whereas it increased among CM-only students (+ 30%; p < 0.001). Test interpretability increased significantly in the IWB/CRL + CM group (from 4.7 to 37.2%; p < 0.01) but not significantly in the CM-only group (from 2.4 to 9.8%; p = 0.36). CONCLUSIONS Integrating IWB into CRL sessions is feasible to teach test ordering and interpretation to undergraduate students. Moreover, student feedback and prospective assessment suggested a positive impact of IWB/CRL sessions on students' learning.
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Affiliation(s)
- Fares Gouzi
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France.
- French College of University Teachers in Health, (College Français des Enseignants Universitaires de Physiologie en Santé - CFEUPS), Montpellier, France.
| | - Christophe Hédon
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
- French College of University Teachers in Health, (College Français des Enseignants Universitaires de Physiologie en Santé - CFEUPS), Montpellier, France
| | - Léo Blervaque
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
| | - Emilie Passerieux
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
| | - Nils Kuster
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
- Laboratoire d'Innovation Pédagogique et de Création d'Outils Multimédia (LIPCOM), Montpellier University, Montpellier, France
| | - Thierry Pujol
- Laboratoire d'Innovation Pédagogique et de Création d'Outils Multimédia (LIPCOM), Montpellier University, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
- French College of University Teachers in Health, (College Français des Enseignants Universitaires de Physiologie en Santé - CFEUPS), Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University HospitalMontpellier University, F-34295, Montpellier, France
- French College of University Teachers in Health, (College Français des Enseignants Universitaires de Physiologie en Santé - CFEUPS), Montpellier, France
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Blervaque L, Passerieux E, Catteau M, Pomiès P, Héraud N, Pérez-Martin A, Blaquière M, Bughin F, Ayoub B, Molinari N, Mercier J, Hayot M, Gouzi F. Défaut de maturation capillaire au cours du réentraînement à l’effort chez le patient BPCO – étude de l’ultrastructure capillaire musculaire. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Blervaque L, Pomiès P, Catteau M, Passerieux E, Ayoub B, Blaquière M, Ducros L, Bughin F, Molinari N, Mercier J, Hayot M, Gouzi F. Défaut de couverture péricytaire capillaire au cours de l’angiogenèse musculaire induite par le réentraînement à l’effort chez le patient BPCO. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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