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Toïgo M, Marc J, Hayot M, Moulis L, Carbonnel F. Quality Assessment of Smartphone Medication Management Apps in France: Systematic Search. JMIR Mhealth Uhealth 2024; 12:e54866. [PMID: 38498042 PMCID: PMC10985613 DOI: 10.2196/54866] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/28/2024] [Accepted: 02/06/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Adherence to medication is estimated to be around 50% for chronically ill patients in high-income countries. Improving the effectiveness of adherence interventions could have a far greater impact on population health than any improvement in specific medical treatments. Mobile health (mHealth) is one of the most effective solutions for helping patients improve their medication intake, notably through the use of mobile apps with reminder systems. With more than 327,000 apps available in the mHealth field, it is difficult for health care professionals and patients alike to choose which apps to recommend and use. OBJECTIVE We aim to carry out a systematic search of medication management smartphone apps available in France that send reminders to patients and assess their quality using a validated scale. METHODS Mobile apps were identified in October and November 2022 after a systematic keyword search on the 2 main app download platforms: App Store (Apple Inc) and Google Play Store. Inclusion criteria were free availability, date of last update, and availability in French. Next, 2 health care professionals independently evaluated the included apps using the French version of the Mobile App Rating Scale (MARS-F), an objective scoring system validated for assessing the overall quality of apps in the mHealth field. An intraclass correlation coefficient was calculated to determine interrater reliability. RESULTS In total, 960 apps were identified and 49 were selected (25 from the App Store and 24 from the Google Play Store). Interrater reliability was excellent (intraclass correlation coefficient 0.92; 95% CI 0.87-0.95; P<.001). The average MARS-F score was 3.56 (SD 0.49) for apps on the App Store and 3.51 (SD 0.46) for those on the Google Play Store, with 10 apps scoring above 4 out of 5. Further, 2 apps were tested in at least one randomized controlled trial and showed positive results. The 2 apps with the highest ratings were Mediteo rappel de médicaments (Mediteo GmbH) and TOM rappel medicaments, pilule (Innovation6 GmbH), available on both platforms. Each app's MARS-F score was weakly correlated with user ratings on the App Store and moderately correlated on the Google Play Store. CONCLUSIONS To our knowledge, this is the first study that used a validated scoring system to evaluate medication management apps that send medication reminders. The quality of the apps was heterogeneous, with only 2 having been studied in a randomized controlled trial with positive results. The evaluation of apps in real-life conditions by patients is necessary to determine their acceptability and effectiveness. Certification of apps is also essential to help health care professionals and patients identify validated apps.
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Affiliation(s)
- Mickael Toïgo
- Department of General Practice, Univ Montpellier, Montpellier, France
| | - Julie Marc
- Department of General Practice, Univ Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | - Lionel Moulis
- Clinical Research and Epidemiology Unit, Department of Public Health, Univ Montpellier, CHU Montpellier, Montpellier, France
- Pathogenesis and Control of Chronic and Emerging Infections, Univ Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | - Francois Carbonnel
- Department of General Practice, Univ Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
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Latrille C, Hayot M, Bosselut G, Bughin F, Boiché J. Determinants of physical activity in newly diagnosed obstructive sleep apnea patients: testing the health action process approach. J Behav Med 2024:10.1007/s10865-024-00474-6. [PMID: 38413452 DOI: 10.1007/s10865-024-00474-6] [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: 04/15/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France.
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France.
| | - Maurice Hayot
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Grégoire Bosselut
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
| | - François Bughin
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
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Moulinié J, Hayot M, Gouzi F. [The FEV 1/VC ratio to define bronchial obstruction: Should we use a fixed ratio or the lower limit of normal?]. Rev Mal Respir 2023; 40:564-571. [PMID: 37407298 DOI: 10.1016/j.rmr.2023.06.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 06/07/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION While the screening of chronic obstructive lung diseases (COPD, asthma, etc.) constitutes a major public health issue in France and worldwide, simple spirometry appears currently as the key to meeting the challenge. Since description of the forced expiratory maneuver by Robert Tiffeneau in 1947, it has been admitted that the FEV1/VC ratio permits diagnosis obstructive pulmonary diseases. However, the diagnostic criteria for this ratio remain uncertain. The long-lasting debate between advocates of a 0.7 "fixed ratio" (FR) of 0.7 and advocates of the "lower limit of normal" (LLN) remains relevant. STATE OF THE ARTS In this general review, we describe the respective advantages of the FR and LLN criteria according to the most recently published studies, and characterize the conditions associated with discrepancies between these criteria. PERSPECTIVES AND CONCLUSIONS FR and LLN appear not to share similar diagnosis values and the use of both criteria facilitates proposal of an up-to-date interpretation and diagnosis strategy in the context of first-line spirometry, particularly for patients with FEV1/VC ratio in the "grey zone".
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Affiliation(s)
- J Moulinié
- Département de physiologie clinique, CHU de Montpellier, 34295 Montpellier, France; PhyMedExp, Inserm, CNRS, université de Montpellier, CHRU de Montpellier, Montpellier, France.
| | - M Hayot
- PhyMedExp, Inserm, CNRS, université de Montpellier, CHRU de Montpellier, Montpellier, France
| | - F Gouzi
- PhyMedExp, Inserm, CNRS, université de Montpellier, CHRU de Montpellier, Montpellier, France
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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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Latrille C, Chapel B, Héraud N, Bughin F, Hayot M, Boiché J. An individualized mobile health intervention to promote physical activity in adults with obstructive sleep apnea: An intervention mapping approach. Digit Health 2023; 9:20552076221150744. [PMID: 36776408 PMCID: PMC9909081 DOI: 10.1177/20552076221150744] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023] Open
Abstract
Objective Combining continuous positive airway pressure with physical activity (PA) might be a promising strategy to treat obstructive sleep apnea (OSA). This article describes how intervention mapping (IM) can guide the development, content, and mechanisms of action of a mobile application to promote PA in adults with OSA. Methods To develop the program, the IM approach was followed. This article presents the first three steps of IM to develop a mixed intervention (with interventionists and a digital application) aiming to: (1) assess patients' health problems and needs in a literature review to determine their expectations and perceived facilitators and barriers to PA behavior change and thus select the determinants of behavior; (2) formulate the expected intervention outcomes and objectives to be met to achieve the overall program goals; and (3) select and implement the behavior change techniques (BCTs) to achieve the change objectives. Results The literature review identified the relevant determinants (e.g., self-efficacy, coping, planning, and habit) of PA behavior using the health action process approach and multiprocess action control. These results were used to specify the program outcomes for PA adapted to physical, psychological, and social parameters. Overall, 11 performance objectives and 30 change objectives were defined. Lastly, BCTs and practical applications were identified. Conclusions The study provides a theoretical and methodological basis for researchers and practitioners given the current paucity of evidence-based PA interventions for adults with OSA. It addresses the lack of BCTs (framing and prompts/cue techniques) and meaningful behavioral determinants (identity and habit) in most interventions.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France,Christophe Latrille, University of Montpellier, 700 avenue du Pic Saint-Loup, Montpellier 34090, France.
| | - Blandine Chapel
- Montpellier Research of Management MRM, University of Montpellier, Montpellier, France
| | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
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Gouzi F, Dubois-Gamez AS, Lacoude P, Abdellaoui A, Hédon C, Charriot J, Boissin C, Vachier I, Hayot M, Molinari N, Bourdin A. Feasibility of a nasal breathing training during pulmonary rehabilitation. A pilot randomized controlled study. Respir Physiol Neurobiol 2023; 308:103987. [PMID: 36372120 DOI: 10.1016/j.resp.2022.103987] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Hyperventilation syndrome (HVS) is a common source of dyspnea and disability. While pulmonary rehabilitation (PR) including breathing exercises is indicated, randomized controlled trial are warranted to recommend one type of breathing exercise than another. We aimed to compare during PR, the effect of 5 sessions of nasal ventilation exercise (NV+PR) versus voluntary hypoventilation (vHV+PR) on exercise dyspnea (primary outcome) and capacity and health-related quality of life in patients. In this open label randomized controlled trial, 19 HVS patients (age=48.3 ± 15.2 y.o, female/male=18/1, Nijmegen score=33 ± 7.7) were randomized in a NV+PR (n = 9) or vHV+PR (n = 10) group. Modified Medical Research Council (mMRC) dyspnea, 6-minute walking distance (6MWD) with nasal/oral ventilation were assessed before and after 3 months of PR, and questionnaires (Nijmegen, VQ-11). There was a significant effect of PR of but no significant difference between groups in the improvements of dyspnea@max exercise (time effect (T): p < 0.01; group (G): p = 0.63; group*time interaction (G*T): p = 0.49), mMRC dyspnea (T: p < 0.01; G: p = 0.45; G*T: p = 0.62), 6MWD (T: p < 0.05; G: p = 0.36; G*T: p = 0.31), VQ-11 (T: p < 0.001; G: p = 0.16; G*T: p = 0.09) and plasma HCO3- (T: p < 0.05; G: p = 0.93; G*T; p = 0.36), Yet, Nijmegen score (T: p < 0.01; G: p = 0.32; G*T: p < 0.05) improvement was larger in NV+PR group. The exercise oronasal breathing shift during the 6MWT was significantly delayed in all patients (T: p < 0.05; G: p = 0.30; G*T: p = 0.32) and positively correlated with plasma HCO3-(r = 0.42; p < 0.05). Nasal exercise was not superior versus voluntary hypoventilation during PR in HVS patients. Yet, nasal exercise appeared feasible, leading to acquisition of a nasal breathing pattern during walking, improvement of PR outcomes and ventilatory alkalosis. The link between nasal breathing and hyperventilation is discussed in the light of the nasal ventilation rhythm in the limbic system and its role on the limbic emotional and ventilatory functions.
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Affiliation(s)
- F Gouzi
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France.
| | - A S Dubois-Gamez
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France
| | - P Lacoude
- Institut de Formation en Masso-Kinésithérapie de Montpellier (IFMK), France
| | - A Abdellaoui
- Institut de Formation en Masso-Kinésithérapie de Montpellier (IFMK), France
| | - C Hédon
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France
| | - J Charriot
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France
| | - C Boissin
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France
| | - I Vachier
- Institut Desbrest de Santé Publique (IDESP) INSERM - Université de Montpellier. Département d'informatique Médicale, CHRU Montpellier, France
| | - M Hayot
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, France
| | - N Molinari
- Institut Desbrest de Santé Publique (IDESP) INSERM - Université de Montpellier. Département d'informatique Médicale, CHRU Montpellier, France
| | - A Bourdin
- PhyMedExp, INSERM - CNRS - Montpellier University, CHRU Montpellier, Montpellier, 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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Berger M, Daubin D, Charriot J, Klouche K, Le Moing V, Morquin D, Halimi L, Jaussent A, Taourel P, Hayot M, Cristol JP, Nagot N, Fesler P, Roubille C. Mid-Term Sequelae of Surviving Patients Hospitalized in Intensive Care Unit for COVID-19 Infection: The REHCOVER Study. J Clin Med 2023; 12:jcm12031000. [PMID: 36769648 PMCID: PMC9917891 DOI: 10.3390/jcm12031000] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES The objective of this prospective, single-center study was to explore the mid-term outcomes 6 to 9 months after hospitalization in an Intensive Care Unit (ICU) for severe COVID-19 infection. METHODS Patients systematically underwent biological tests, pulmonary function tests, chest computed tomography (CT) scan, and psychological tests. RESULTS Among 86 patients, including 71 (82.6%) men, median age of 65.8 years (56.7; 72.4), 57 (71.3%) patients presented post-COVID-19 asthenia, 39 (48.1%) muscle weakness, and 30 (36.6%) arthralgia. Fifty-two (64.2%) patients had a decreased diffusion capacity for carbon monoxide (DLCO) <80% and 16 (19.8%) had DLCO <60%. Chest CT-scans showed ground glass opacities in 35 (40.7%) patients, and reticular changes in 28 patients (33.7%), including fibrosis-like changes in 18 (21.7%) patients. Reticular changes and DLCO <60% were associated with length of stay in ICU, and reticular changes with higher maximal CRP level. The psychological questionnaires found 37.7% suffered from depression, 23.5% from anxiety, 42.4% from insomnia, and 9.4% from post-traumatic stress. Being female was associated with a higher frequency of depression and anxiety, with depression scores being associated with obesity. CONCLUSIONS Many patients hospitalized in ICU for severe COVID-19 infection have mid-term sequelae. Additional studies on the prognostic factors seem necessary.
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Affiliation(s)
- Marie Berger
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
| | - Delphine Daubin
- Critical Care Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Jeremy Charriot
- Department of Respiratory Diseases, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
| | - Kada Klouche
- Critical Care Unit, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
| | - Vincent Le Moing
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Infectious Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - Laurence Halimi
- Department of Respiratory Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - Audrey Jaussent
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Patrice Taourel
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Medical Imaging, Montpellier University Hospital, 34090 Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Clinical Physiology, University Hospital of Montpellier, 34090 Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Biochemistry and Hormonology, University Hospital of Montpellier, 34090 Montpellier, France
| | - Nicolas Nagot
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Pierre Fesler
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Correspondence: ; Tel.: +33(0)-4-6733-8443; Fax: +33(0)-4-6733-8453
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10
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Bughin F, Mendelson M, Jaffuel D, Pépin JL, Gagnadoux F, Goutorbe F, Abril B, Ayoub B, Aranda A, Alagha K, Pomiès P, Roubille F, Mercier J, Molinari N, Dauvilliers Y, Héraud N, Hayot M. Impact of a telerehabilitation programme combined with continuous positive airway pressure on symptoms and cardiometabolic risk factors in obstructive sleep apnea patients. Digit Health 2023; 9:20552076231167009. [PMID: 37051564 PMCID: PMC10084579 DOI: 10.1177/20552076231167009] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/15/2023] [Indexed: 04/14/2023] Open
Abstract
Background Obstructive sleep apnea syndrome is a common sleep-breathing disorder associated with adverse health outcomes including excessive daytime sleepiness, impaired quality of life and is well-established as a cardiovascular risk factor. Continuous positive airway pressure is the reference treatment, but its cardiovascular and metabolic benefits are still debated. Combined interventions aiming at improving patient's lifestyle behaviours are recommended in guidelines management of obstructive sleep apnea syndrome but adherence decreases over time and access to rehabilitation programmes is limited. Telerehabilitation is a promising approach to address these issues, but data are scarce on obstructive sleep apnea syndrome. Methods The aim of this study is to assess the potential benefits of a telerehabilitation programme implemented at continuous positive airway pressure initiation, compared to continuous positive airway pressure alone and usual care, on symptoms and cardiometabolic risk factors of obstructive sleep apnea syndrome. This study is a 6-months multicentre randomized, parallel controlled trial during which 180 obese patients with severe obstructive sleep apnea syndrome will be included. We will use a sequential hierarchical criterion for major endpoints including sleepiness, quality of life, nocturnal systolic blood pressure and inflammation biological parameters. Discussion m-Rehab obstructive sleep apnea syndrome is the first multicentre randomized controlled trial to examine the effectiveness of a telerehabilitation lifestyle programme in obstructive sleep apnea syndrome. We hypothesize that a telerehabilitation lifestyle intervention associated with continuous positive airway pressure for 6 months will be more efficient than continuous positive airway pressure alone on symptoms, quality of life and cardiometabolic risk profile. Main secondary outcomes include continuous positive airway pressure adherence, usability and satisfaction with the telerehabilitation platform and medico-economic evaluation. Trial registration Clinicaltrials.gov Identifier: NCT05049928. Registration data: 20 September 2021.
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Affiliation(s)
- François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
- Clinique du Millénaire, Montpellier, France
- François Bughin, Clinique du Millénaire, Montpellier, France.
| | - Monique Mendelson
- Grenoble Alpes University, INSERM, University hospital Grenoble Alpes, HP2, Grenoble, France
| | - Dany Jaffuel
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
- Department of Pneumology, Arnaud de Villeneuve, Regional University Hospital of Montpellier, Montpellier, France
| | - Jean-Louis Pépin
- Grenoble Alpes University, INSERM, University hospital Grenoble Alpes, HP2, Grenoble, France
| | - Frédéric Gagnadoux
- Department of Respiratory, University of Angers, Sleep Medicine, University Hospital of Angers, Angers, France
| | | | - Beatriz Abril
- Service des troubles du sommeil, CHU Nîmes, Nimes, France
| | - Bronia Ayoub
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
| | | | | | - Pascal Pomiès
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
| | - François Roubille
- Cardiology Department, INI-CRT, CHU Montpellier, PhyMedExp,, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
| | - Nicolas Molinari
- IDESP, INRIA, INSERM, University of Montpellier, CHU Montpellier, Montpellier, France
| | - Yves Dauvilliers
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
| | - Nelly Héraud
- Direction de La Recherche Clinique et de L'innovation en Santé - Korian, Lodève, France; GCS CIPS, Lodève, France
| | - M Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHU, Montpellier, France
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11
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De Brandt J, Derave W, Vandenabeele F, Pomiès P, Blancquaert L, Keytsman C, Barusso-Grüninger MS, de Lima FF, Hayot M, Spruit MA, Burtin C. Efficacy of 12 weeks oral beta-alanine supplementation in patients with chronic obstructive pulmonary disease: a double-blind, randomized, placebo-controlled trial. J Cachexia Sarcopenia Muscle 2022; 13:2361-2372. [PMID: 35977911 PMCID: PMC9530565 DOI: 10.1002/jcsm.13048] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/28/2022] [Accepted: 06/14/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Beta-alanine (BA) supplementation increases muscle carnosine, an abundant endogenous antioxidant and pH buffer in skeletal muscle. Carnosine loading promotes exercise capacity in healthy older adults. As patients with chronic obstructive pulmonary disease (COPD) suffer from elevated exercise-induced muscle oxidative/carbonyl stress and acidosis, and from reduced muscle carnosine stores, it was investigated whether BA supplementation augments muscle carnosine and induces beneficial changes in exercise capacity, quadriceps function, and muscle oxidative/carbonyl stress in patients with COPD. METHODS In this double-blind, randomized, placebo (PL)-controlled trial (clinicaltrials.gov identifier: NCT02770417), 40 patients (75% male) with COPD (mean ± standard deviation: age 65 ± 6 years; FEV1 % predicted 55 ± 14%) were assigned to 12 weeks oral BA or PL supplementation (3.2 g/day). The primary outcome, i.e. muscle carnosine, was quantified from m. vastus lateralis biopsies obtained before and after intervention. Co-primary outcomes, i.e. incremental and constant work rate cycle capacity, were also assessed. Linear mixed model analyses were performed. Compliance with and side effects of supplement intake and secondary outcomes (quadriceps strength and endurance, and muscle oxidative/carbonyl stress) were also assessed. RESULTS Beta-alanine supplementation increased muscle carnosine in comparison with PL in patients with COPD (mean difference [95% confidence interval]; +2.82 [1.49-4.14] mmol/kg wet weight; P < 0.001). Maximal incremental cycling capacity (VO2 peak: +0.5 [-0.7 to 1.7] mL/kg/min; P = 0.384, Wpeak: +5 [-1 to 11] W; P = 0.103) and time to exhaustion on the constant work rate cycle test (+28 [-179 to 236] s; P = 0.782) did not change significantly. Compliance with supplement intake was similar in BA (median (quartile 1-quartile 3); 100 (98-100)%) and PL (98 (96-100)%) (P = 0.294) groups, and patients did not report side effects possibly related to supplement intake. No change was observed in secondary outcomes. CONCLUSIONS Beta-alanine supplementation is efficacious in augmenting muscle carnosine (+54% from mean baseline value) without side effects in patients with COPD in comparison with PL. However, accompanied beneficial changes in exercise capacity, quadriceps function, and muscle oxidative/carbonyl stress were not observed.
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Affiliation(s)
- Jana De Brandt
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.,BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Wim Derave
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Frank Vandenabeele
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Pascal Pomiès
- PhyMedExp, University of Montpellier - INSERM - CNRS - CHRU Montpellier, Montpellier, France
| | - Laura Blancquaert
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Charly Keytsman
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.,BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Marina S Barusso-Grüninger
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.,LEFiR - Spirometry and Respiratory Laboratory, São Carlos Federal University - UFSCar, São Carlos, São Paulo, Brazil
| | - Fabiano F de Lima
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.,Faculty of Science and Technology, Department of Physical Therapy, Postgraduate Program in Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
| | - Maurice Hayot
- PhyMedExp, University of Montpellier - INSERM - CNRS - CHRU Montpellier, Montpellier, France
| | - Martijn A Spruit
- Department of Research and Education, CIRO+, Horn, The Netherlands.,Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chris Burtin
- Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.,BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
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12
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Chapel B, Alexandre F, Heraud N, Ologeanu-Taddei R, Cases AS, Bughin F, Hayot M. Standardization of the assessment process within telerehabilitation in chronic diseases: a scoping meta-review. BMC Health Serv Res 2022; 22:984. [PMID: 35918690 PMCID: PMC9344755 DOI: 10.1186/s12913-022-08370-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background Telerehabilitation (TR) interventions are receiving increasing attention. They have been evaluated in various scientific areas through systematic reviews. However, there is a lack of data on how to standardize assessment and report on their domains to guide researchers across studies and bring together the best evidence to assess TR for chronic diseases. Aims and objectives The aim of this study was to identify domains of assessment in TR and to qualitatively and quantitatively analyze how and when they are examined to gain an overview of assessment in chronic disease. Methods A scoping meta-review was carried out on 9 databases and gray literature from 2009 to 2019. The keyword search strategy was based on "telerehabilitation", “evaluation", “chronic disease" and their synonyms. All articles were subjected to qualitative analysis using the Health Technology Assessment (HTA) Core Model prior to further analysis and narrative synthesis. Results Among the 7412 identified articles, 80 studies met the inclusion criteria and addressed at least one of the noncommunicable diseases (NCD) categories of cardiovascular disease (cardiovascular accidents), cancer, chronic respiratory disease, diabetes, and obesity. Regarding the domains of assessment, the most frequently occurring were “social aspect” (n = 63, 79%) (e.g., effects on behavioral changes) and “clinical efficacy” (n = 53, 66%), and the least frequently occurring was “safety aspects” (n = 2, 3%). We also identified the phases of TR in which the assessment was conducted and found that it most commonly occurred in the pilot study and randomized trial phases and least commonly occurred in the design, pretest, and post-implementation phases. Conclusions Through the HTA model, this scoping meta-review highlighted 10 assessment domains which have not been studied with the same degree of interest in the recent literature. We showed that each of these assessment domains could appear at different phases of TR development and proposed a new cross-disciplinary and comprehensive method for assessing TR interventions. Future studies will benefit from approaches that leverage the best evidence regarding the assessment of TR, and it will be interesting to extend this assessment framework to other chronic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08370-y.
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Affiliation(s)
- Blandine Chapel
- University of Montpellier, Montpellier Research of Management, Montpellier, France.
| | - François Alexandre
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | - Nelly Heraud
- Direction de La Recherche Clinique Et de L'Innovation en Santé, Korian ; GCS CIPS, 800 Avenue Joseph Vallot, Lodève, France
| | | | - Anne-Sophie Cases
- University of Montpellier, Montpellier Research of Management, Montpellier, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU Montpellier, Montpellier, France
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De La Villeon G, Gavotto A, Ledong N, Bredy C, Guillaumont S, Man J, Gouzi F, Hayot M, Mura T, Amedro P, Matecki S. Double gas transfer factors (DLCO-DLNO) at rest in patients with congenital heart diseases correlates with their ventilatory response during maximal exercise. International Journal of Cardiology Congenital Heart Disease 2022. [DOI: 10.1016/j.ijcchd.2022.100346] [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: 10/19/2022] Open
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Berger M, Daubin D, Charriot J, Klouche K, Le Moing V, Arnaud B, Morquin D, Jaussent A, Taourel P, Hayot M, Nagot N, Fesler P, Roubille C. Devenir des patients hospitalisés en soins critiques pour infection à SARS-COV2 : évaluation standardisée des séquelles à 6–9 mois. Rev Med Interne 2022. [PMCID: PMC9212689 DOI: 10.1016/j.revmed.2022.03.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Identifié en Chine en décembre 2019, le Severe Acute Respiratory SyndromeCoronavirus 2 (SARS-COV2) s’est rapidement propagé au niveau mondial. Si les études se sont initialement concentrées sur la prise en charge de la phase aiguë de la COrona VIrus Disease (COVID), l’objectif de ce travail est de s’intéresser aux conséquences à distance d’une hospitalisation pour COVID sévère. Patients et méthodes Nous avons réalisé une étude prospective, monocentrique, incluant des patients 6 à 9 mois après leur hospitalisation en soins critiques (soins intensifs ou réanimation) pour une infection confirmée à SARS-COV2. Les patients étaient évalués au cours d’une hospitalisation de jour en médecine interne. L’entretien débutait par un recueil des antécédents du patient, des évènements et des symptômes post-COVID. L’examinateur procédait ensuite à un examen clinique détaillé et un test de marche des 6 minutes (TM6). Les patients réalisaient de manière systématique des explorations fonctionnelles respiratoires (EFR), une tomodensitométrie (TDM) thoracique non injectée, une échographie cardiaque trans-thoracique (ETT), et un bilan biologique complet. Une batterie de tests était réalisée, explorant la qualité de vie et les séquelles psychologiques. Résultats Quatre-vingt-six patients, dont 71 (82,6 %) hommes, d’âge médian 65,8 ans (56,7;72,4), ont été évalués dans un délai moyen de 7 mois (min 3,4; max 14,9). L’hypertension artérielle (46,5 %), le diabète (34,9 %) et la dyslipidémie (39,5 %) étaient les antécédents médicaux les plus représentés. Douze (14,0 %) patients avaient une pathologie pulmonaire sous-jacente, principalement une broncho-pneumopathie chronique obstructive (BPCO). L’indice de comorbidités de Charlson médian était de 1 (0,0; 2,0). La durée médiane du séjour en soins critiques était de 10,0 (6,0;17,0) jours. Cinquante-quatre (62,8 %) patients ont eu une ventilation invasive et 67 (77,9 %) patients ont reçu un traitement par corticothérapie. Cinquante-sept (71,3 %) patients ont présenté une asthénie post-COVID, 39 (48,1 %) une faiblesse musculaire, 30 (36,6 %) des arthralgies. Quinze patients ont développé un déséquilibre du diabète et 9 un déséquilibre de la pression artérielle. Dix-sept (21,3 %) patients avaient une distance au TM6 < 80 % de la théorique. Quarante-six patients53,5 %) avaient un score de dyspnée Medical Reaserch Council (MRC) de 0 et 24 (27,9 %) avaient un score MRC de 1. Treize (15,5 %) patients avaient une auscultation anormale à type de crépitants secs des bases. Cinquante-deux (64,2 %) patients ont présenté un déficit de la diffusion du CO défini par une DLCO < 80 % et 16 (19,8 %) avaient une DLCO < 60 %. Le scanner thoracique montrait chez 35 (40,7 %) patients des lésions de verre dépoli et 18 (21,7 %) de la fibrose. Trente-deux patients (37,6 %) avaient un score PHQ-9 significatif pour une dépression, 20 (23,5 %) un score GAD-7 significatif pour un trouble anxieux et 8 (9,4 %) patients avaient un score PCL5 supérieur au seuil évoquant un état de stress post-traumatique. Le niveau de qualité de vie à distance de l’épisode aigu était satisfaisant avec une médiane de l’EQ-5D-3L à 0,89 (0,64;1,00). En analyse univariée, la fibrose sur le scanner de réévaluation et une DLCO < 60 % étaient associées à la durée du séjour en soins critiques et au niveau maximal de CRP pendant l’épisode aigu. En analyse multivariée, la fibrose et la DLCO étaient associées à la durée de séjour. En analyse uni et multivariée, le PHQ-9 et le GAD-7 étaient associés au sexe féminin. Discussion À ce jour, rares sont les études qui ont étudié de manière systématisée les séquelles somatiques et psychologiques à long terme de la COVID chez les patients qui ont été pris en charge en soins critiques. Conformément à la littérature, la diminution de la DLCO est l’anomalie la plus fréquemment retrouvée aux EFR, les plages de verre dépoli persistent sur le scanner et des lésions fibrotiques sont retrouvées chez plus d’un patient sur 5 [1], [2]. Ces anomalies contrastent avec une plainte respiratoire modérée et un examen clinique rassurant. Les symptômes généraux (asthénie, faiblesse musculaire et arthralgies) sont au cœur de la plainte fonctionnelle. Les déséquilibres de la tension artérielle et du diabète observés justifient un suivi accru des pathologies chroniques au décours de l’épisode aigu. Enfin, nous avons noté une prévalence plus importante des troubles psychologiques que celles relevées rétrospectivement (dossier informatisé) dans une autre étude [3], renforçant, selon nous, la nécessité d’un dépistage systématique des troubles psychiatriques. Conclusion De nombreux patients présentent des séquelles à distance d’une COVID sévère nous incitant à un dépistage systématique afin de proposer une prise en charge adaptée.
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Alexandre F, Molinier V, Hayot M, Chevance G, Moullec G, Varray A, Héraud N. Association between long-term oxygen therapy provided outside the guidelines and mortality in patients with COPD. BMJ Open 2022; 12:e049115. [PMID: 35017234 PMCID: PMC8753397 DOI: 10.1136/bmjopen-2021-049115] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Hypoxaemia is a frequent complication of chronic obstructive pulmonary disease (COPD). To prevent its consequences, supplemental oxygen therapy is recommended by international respiratory societies. However, despite clear recommendations, some patients receive long-term oxygen therapy (LTOT), while they do not meet prescription criteria. While evidence suggests that acute oxygen supply at high oxygenation targets increases COPD mortality, its chronic effects on COPD mortality remain unclear. Thus, the study will aim to evaluate through a systematic review and individual patient data meta-analysis (IPD-MA), the association of LTOT prescription outside the guidelines on survival over time in COPD. METHODS Systematic review and IPD-MA will be conducted according to Preferred Reporting Items for a Systematic Review and Meta-Analyses IPD guidelines. Electronic databases (PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, OpenGrey and BioRxiv/MedRxix) will be scanned to identify relevant studies (cohort of stable COPD with arterial oxygen tension data available, with indication of LTOT filled out at the moment of the study and with a survival follow-up). The anticipated search dates are January-February 2022. The main outcome will be the association between LTOT and time to all-cause mortality according to hypoxaemia severity, after controlling for potential covariates and all available clinical characteristics. Quantitative data at the level of the individual patient will be used in a one-step approach to develop and validate a prognostic model with a Cox regression analysis. The one-step IPD-MA will be conducted to study the association and the moderators of association between supplemental oxygen therapy and mortality. Multilevel survival analyses using Cox-mixed effects models will be performed. ETHICS AND DISSEMINATION As a protocol for a systematic review, a formal ethics committee review is not required. Only studies with institutional approval from an ethics committee and anonymised IPD will be included. Results will be disseminated through peer-reviewed publications and presentations in conferences. PROSPERO REGISTRATION NUMBER CRD42020209823.
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Affiliation(s)
- Francois Alexandre
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - Virginie Molinier
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - Maurice Hayot
- PhyMedExp, Université de Montpellier, INSERM, CNRS, CHRU de Montpellier, Montpellier, France
| | | | - Gregory Moullec
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Alain Varray
- EuroMov Digital Health in Motion, IMT Mines Ales, University of Montpellier, Montpellier, France
| | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
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Hayot M, Saey D, Costes F, Bughin F, Chambellan A. [Respiratory telerehabilitation in cases of COPD]. Rev Mal Respir 2022; 39:140-151. [PMID: 35000811 DOI: 10.1016/j.rmr.2021.12.005] [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: 05/02/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
Abstract
Telerehabilitation brings together a set of rehabilitation practices applied remotely by means of information and communication technologies. Even though it has been taking on increasing importance in many health fields over 10 years, telerehabilitation had yet to find its place in pulmonary rehabilitation before 2020, when the pandemic situation impelled numerous teams to put it to work. Pilot studies on respiratory diseases, primarily COPD, along with recent data from randomized or non-randomized studies, have enhanced our understanding of "remote" practice. In this review of the literature, we will show that pulmonary telerehabilitation is feasible, safe and likely to yield short-term (and possibly longer term) effects generally similar to those achieved in the pulmonary rehabilitation programs of specialized centers, especially as regards some indicators of exercise tolerance, dyspnea or patient quality of life. However, the number of studies and patients included in these programs remains too limited in terms of modalities, duration, long-term effects, or adaptations in case of exacerbation to be the subject of recommendations. The potential of respiratory telerehabilitation justifies continuing clinical trials and experiments, which need to be coordinated with the interventions characterizing a conventional program.
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Affiliation(s)
- M Hayot
- PhyMedExp, INSERM-CNRS - Université de Montpellier, CHRU Montpellier, Montpellier, France.
| | - D Saey
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada; Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - F Costes
- Université Clermont Auvergne, INRAE, UNH, CHU de Clermont Ferrand, Groupe de travail Alvéole SPLF, Clermont Ferrand, France
| | - F Bughin
- PhyMedExp, INSERM-CNRS - Université de Montpellier, CHRU Montpellier, Montpellier, France
| | - A Chambellan
- Service de Pneumologie, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Faculté de Médecine & Maïeutique, Université Catholique de Lille, France
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Bughin F, Bui G, Ayoub B, Blervaque L, Saey D, Avignon A, Brun JF, Molinari N, Pomies P, Mercier J, Gouzi F, Hayot M. Impact of a Mobile Telerehabilitation Solution on Metabolic Health Outcomes and Rehabilitation Adherence in Patients With Obesity: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e28242. [PMID: 34874887 PMCID: PMC8691412 DOI: 10.2196/28242] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/10/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
Background Obesity is a major public health issue. Combining exercise training, nutrition, and therapeutic education in metabolic rehabilitation (MR) is recommended for obesity management. However, evidence from randomized controlled studies is lacking. In addition, MR is associated with poor patient adherence. Mobile health devices improve access to MR components. Objective The aim of this study is to compare the changes in body composition, anthropometric parameters, exercise capacity, and quality of life (QOL) within 12 weeks of patients in the telerehabilitation (TR) program to those of usual care patients with obesity. Methods This was a parallel-design randomized controlled study. In total, 50 patients with obesity (BMI>30 kg/m²) were included in a TR group (TRG) or a usual care group (UCG) for 12 weeks. Patients underwent biometric impedance analyses, metabolic exercise tests, actimetry, and QOL and satisfaction questionnaires. The primary outcome was the change in fat mass at 12 weeks from baseline. Secondary outcomes were changes in body weight, metabolic parameters, exercise capacity, QOL, patients’ adhesion, and satisfaction. Results A total of 49 patients completed the study. No significant group × time interaction was found for fat mass (TRG: mean 1.7 kg, SD 2.6 kg; UCG: mean 1.2 kg, SD 2.4 kg; P=.48). Compared with the UCG, TRG patients tended to significantly improve their waist to hip ratios (TRG: −0.01 kg, SD 0.04; UCG: +0.01 kg, SD 0.06; P=.07) and improved QOL physical impact (TRG: +21.8, SD 43.6; UCG: −1.2, SD 15.4; P=.005). Significant time effects were observed for body composition, 6-minute walk test distance, exercise metabolism, sedentary time, and QOL. Adherence (95%) and satisfaction in the TRG were good. Conclusions In adults with obesity, the TR program was not superior to usual care for improving body composition. However, TR was able to deliver full multidisciplinary rehabilitation to patients with obesity and improve some health outcomes. Given the patients’ adherence and satisfaction, pragmatic programs should consider mobile health devices to improve access to MR. Further studies are warranted to further establish the benefits that TR has over usual care. Trial Registration ClinicalTrials.gov NCT03396666; http://clinicaltrials.gov/ct2/show/NCT03396666
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Affiliation(s)
- François Bughin
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Gaspard Bui
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Bronia Ayoub
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Leo Blervaque
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Didier Saey
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Antoine Avignon
- Institut Desbrest de Santé Publique, University of Montpellier, Institut national de la santé et de la recherche médicale, Montpellier, France.,Endocrinologie-Diabétologie-Nutrition, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France
| | - Jean Frédéric Brun
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Nicolas Molinari
- Institut Montpelliérain Alexander Grothendieck, University of Montpellier, Centre national de la recherche scientifique, Montpellier, France.,Department of Medical Statistics and Epidemiology, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Montpellier, France
| | - Pascal Pomies
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Montpellier, France
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18
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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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19
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Souweine JS, Gouzi F, Badia É, Pomies P, Garrigue V, Morena M, Hayot M, Mercier J, Ayoub B, Quintrec ML, Raynaud F, Cristol JP. Skeletal Muscle Phenotype in Patients Undergoing Long-Term Hemodialysis Awaiting Kidney Transplantation. Clin J Am Soc Nephrol 2021; 16:1676-1685. [PMID: 34750160 PMCID: PMC8729424 DOI: 10.2215/cjn.02390221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/16/2021] [Accepted: 09/08/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Age and comorbidity-related sarcopenia represent a main cause of muscle dysfunction in patients on long-term hemodialysis. However, recent findings suggest muscle abnormalities that are not associated with sarcopenia. The aim of this study was to isolate functional and cellular muscle abnormalities independently of other major confounding factors, including malnutrition, age, comorbidity, or sedentary lifestyle, which are common in patients on maintenance hemodialysis. To overcome these confounding factors, alterations in skeletal muscle were analyzed in highly selected patients on long-term hemodialysis undergoing kidney transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In total, 22 patients on long-term hemodialysis scheduled for kidney transplantation with few comorbidities, but with a long-term uremic milieu exposure, and 22 age, sex, and physical activity level frequency-matched control participants were recruited. We compared biochemical, functional, and molecular characteristics of the skeletal muscle using maximal voluntary force and endurance of the quadriceps, 6-minute walking test, and muscle biopsy of vastus lateralis. For statistical analysis, mean comparison and multiple regression tests were used. RESULTS In patients on long-term hemodialysis, muscle endurance was lower, whereas maximal voluntary force was not significantly different. We observed a transition from type I (oxidative) to type II (glycolytic) muscle fibers, and an alteration of mitochondrial structure (swelling) without changes in DNA content, genome replication (peroxisome proliferator activator receptor γ coactivator-1α and mitochondrial transcription factor A), regulation of fusion (mitofusin and optic atrophy 1), or fission (dynamin-related protein 1). Notably, there were autophagosome structures containing glycogen along with mitochondrial debris, with a higher expression of light chain 3 (LC3) protein, indicating phagophore formation. This was associated with a greater conversion of LC3-I to LC3-II and the expression of Gabaralp1 and Bnip3l genes involved in mitophagy. CONCLUSIONS In this highly selected long-term hemodialysis population, a low oxidative phenotype could be defined by a poor endurance, a fiber-type switch, and an alteration of mitochondria structure, without evidence of sarcopenia. This phenotype could be related to uremia through the activation of autophagy/mitophagy. CLINICAL TRIAL REGISTRATION NUMBERS NCT02794142 and NCT02040363.
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Affiliation(s)
- Jean-Sébastien Souweine
- Department of Biochemistry, University Hospital of Montpellier and Department of Biochemistry and Hormonology, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, University of Montpellier, INSERM, Montpellier, France,Department of Physiology, University Hospital of Montpellier, Montpellier, France
| | - Éric Badia
- Department of Biochemistry, University Hospital of Montpellier and Department of Biochemistry and Hormonology, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, Montpellier, France
| | - Pascal Pomies
- Department of Physiology, University Hospital of Montpellier, Montpellier, France
| | - Valérie Garrigue
- Department of Nephrology, University Hospital of Montpellier, Montpellier, France
| | - Marion Morena
- Department of Biochemistry, University Hospital of Montpellier and Department of Biochemistry and Hormonology, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, Montpellier, France,Department of Physiology, University Hospital of Montpellier, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, University of Montpellier, INSERM, Montpellier, France,Department of Physiology, University Hospital of Montpellier, Montpellier, France
| | - Bronia Ayoub
- PhyMedExp, University of Montpellier, INSERM, Montpellier, France,Department of Physiology, University Hospital of Montpellier, Montpellier, France
| | - Moglie Le Quintrec
- Department of Nephrology, University Hospital of Montpellier, Montpellier, France
| | - Fabrice Raynaud
- Department of Biochemistry, University Hospital of Montpellier and Department of Biochemistry and Hormonology, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, Montpellier, France
| | - Jean-Paul Cristol
- Department of Biochemistry, University Hospital of Montpellier and Department of Biochemistry and Hormonology, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, Montpellier, France
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20
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Souweine JS, Pasquier G, Kuster N, Rodriguez A, Patrier L, Morena M, Badia E, Raynaud F, Chalabi L, Raynal N, Ohresser I, Hayot M, Mercier J, Quintrec ML, Gouzi F, Cristol JP. Dynapaenia and sarcopaenia in chronic haemodialysis patients: do muscle weakness and atrophy similarly influence poor outcome? Nephrol Dial Transplant 2021; 36:1908-1918. [PMID: 33306128 DOI: 10.1093/ndt/gfaa353] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 07/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Sarcopaenia, defined as a decline in both muscle mass and function, has been recognized as a major determinant of poor outcome in haemodialysis (HD) patients. It is generally assumed that sarcopaenia is driven by muscle atrophy related to protein-energy wasting. However, dynapaenia, defined as weakness without atrophy, has been characterized by a different disease phenotype from sarcopaenia. The aim of this study was to compare the characteristics and prognosis of sarcopaenic and dynapaenic patients among a prospective cohort of chronic HD (CHD) patients. METHODS Two hundred and thirty-two CHD patients were enrolled from January to July 2016 and then followed prospectively until December 2018. At inclusion, weakness and atrophy were, respectively, evaluated by maximal voluntary force (MVF) and creatinine index (CI). Sarcopaenia was defined as the association of weakness and atrophy (MVF and CI below the median) while dynapaenia was defined as weakness not related to atrophy (MVF below the median, and CI above the median). RESULTS From a total of 187 prevalent CHD patients [65% of men, age 65.3 (49.7-82.0) years], 44 died during the follow-up period of 23.7 (12.4-34.9) months. Sarcopaenia and dynapaenia were observed in 33.7 and 16% of the patients, respectively. Compared with patients with sarcopaenia, patients with dynapaenia were younger and with a lower Charlson score. In contrast, mortality rate was similar in both groups (38 and 27%, respectively). After adjustment for age, sex, lean tissue index, serum albumin, high-sensitivity C-reactive protein (hs-CRP), haemoglobin (Hb), normalized protein catabolic rate (nPCR), dialysis vintage and Charlson score, only patients with dynapaenia were at increased risk of death [hazard ratio (HR) = 2.99, confidence interval 1.18-7.61; P = 0.02]. CONCLUSIONS Screening for muscle functionality is highly warranted to identify patients with muscle functional impairment without muscle atrophy. In contrast to sarcopaenia, dynapaenia should appear as a phenotype induced by uraemic milieu, characterized by young patients with low Charlson score and poor prognosis outcome independently of serum albumin, hs-CRP, Hb, nPCR and dialysis vintage.
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Affiliation(s)
- Jean-Sébastien Souweine
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Grégoire Pasquier
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Nils Kuster
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | | | | | - Marion Morena
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Eric Badia
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Fabrice Raynaud
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | | | | | | | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Moglie Le Quintrec
- Department of Nephrology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
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21
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De Brandt J, Burtin C, Pomiès P, Vandenabeele F, Verboven K, Aumann J, Blancquaert L, Everaert I, Van Ryckeghem L, Cops J, Hayot M, Spruit MA, Derave W. Carnosine, oxidative and carbonyl stress, antioxidants and muscle fiber characteristics of quadriceps muscle of patients with COPD. J Appl Physiol (1985) 2021; 131:1230-1240. [PMID: 34323590 DOI: 10.1152/japplphysiol.00200.2021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Oxidative/carbonyl stress is elevated in lower-limb muscles of patients with Chronic Obstructive Pulmonary Disease (COPD). Carnosine is a skeletal muscle antioxidant particularly present in fast-twitch fibers. AIMS To compare muscle carnosine, oxidative/carbonyl stress, antioxidants and fiber characteristics between patients with COPD and healthy controls (HCs), and between patients after stratification for airflow limitation (mild/moderate vs. severe/very-severe). To investigate correlates of carnosine in patients with COPD. METHODS A vastus lateralis muscle biopsy was obtained from 40 patients with stable COPD and 20 age/sex matched HCs. Carnosine, oxidative/carbonyl stress, antioxidants, fiber characteristics, quadriceps strength and endurance (QE), VO2peak (incremental cycle test) and physical activity (PA) were determined. RESULTS Patients with COPD had a similar carnosine concentration (4.16 mmol/kg wet weight (WW) (SD 1.93)) to HCs (4.64 mmol/kgWW (SD 1.71)) and significantly higher percentage of fast-twitch fibers and lower QE, VO2peak and PA vs. HCs. Patients with severe/very-severe COPD had a 30% lower carnosine concentration (3.24 mmol/kgWW (SD 1.79); n=15) vs. patients with mild/moderate COPD (4.71 mmol/kgWW (SD 1.83); n=25; P=0.02) and significantly lower VO2peak and PA vs. patients with mild/moderate COPD. Carnosine correlated significantly with QE (rs=0.427), VO2peak (rs=0.334), PA (rs=0.379) and lung function parameters in patients with COPD. CONCLUSION Despite having the highest proportion of fast-twitch fibers, patients with severe/very-severe COPD displayed a 30% lower muscle carnosine concentration compared to patients with mild/moderate COPD. As no oxidative/carbonyl stress markers, nor antioxidants were affected, the observed carnosine deficiency is thought to be a possible first sign of muscle redox balance abnormalities.
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Affiliation(s)
- Jana De Brandt
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.,Hasselt University, BIOMED - Biomedical Research Institute, Diepenbeek, Belgium
| | - Chris Burtin
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.,Hasselt University, BIOMED - Biomedical Research Institute, Diepenbeek, Belgium
| | - Pascal Pomiès
- PhyMedExp, University of Montpellier - INSERM - CNRS - CHRU Montpellier, Montpellier, France
| | - Frank Vandenabeele
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium
| | - Kenneth Verboven
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.,Hasselt University, BIOMED - Biomedical Research Institute, Diepenbeek, Belgium
| | - Joseph Aumann
- Department of Respiratory Medicine, Jessa Hospital, Hasselt, Belgium
| | - Laura Blancquaert
- Ghent University, Department of Movement and Sports Sciences, Ghent, Belgium
| | - Inge Everaert
- Ghent University, Department of Movement and Sports Sciences, Ghent, Belgium
| | - Lisa Van Ryckeghem
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.,Hasselt University, BIOMED - Biomedical Research Institute, Diepenbeek, Belgium
| | - Jirka Cops
- Hasselt University, Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Diepenbeek, Belgium.,Hasselt University, BIOMED - Biomedical Research Institute, Diepenbeek, Belgium
| | - Maurice Hayot
- PhyMedExp, University of Montpellier - INSERM - CNRS - CHRU Montpellier, Montpellier, France
| | - Martijn A Spruit
- CIRO, Department of Research and Development, Horn, The Netherlands.,Maastricht University Medical Centre, Department of Respiratory Medicine, Faculty of Health, Medicine and Life Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Wim Derave
- Ghent University, Department of Movement and Sports Sciences, Ghent, Belgium
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22
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Richalet JP, Pillard F, LE Moal D, Rivière D, Oriol P, Poussel M, Chenuel B, Doutreleau S, Vergès S, Demanez S, Vergnion M, Boulet JM, Douard H, Dupré M, Mesland O, Remetter R, Lonsdorfer-Wolf E, Frey A, Vilcoq L, Nedelec Jaffuel A, Debeaumont D, Duperrex G, Lecoq F, Hédon C, Hayot M, Giardini G, Lhuissier FJ. Validation of a Score for the Detection of Subjects with High Risk for Severe High-Altitude Illness. Med Sci Sports Exerc 2021; 53:1294-1302. [PMID: 33433150 DOI: 10.1249/mss.0000000000002586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE A decision tree based on a clinicophysiological score (severe high-altitude illness (SHAI) score) has been developed to detect subjects susceptible to SHAI. We aimed to validate this decision tree, to rationalize the prescription of acetazolamide (ACZ), and to specify the rule for a progressive acclimatization. METHODS Data were obtained from 641 subjects in 15 European medical centers before and during a sojourn at high altitude. Depending on the value of the SHAI score, advice was given and ACZ was eventually prescribed. The outcome was the occurrence of SHAI at high altitude as a function of the SHAI score, ACZ prescription, and use and fulfillment of the acclimatization rule. RESULTS The occurrence of SHAI was 22.6%, similar to what was observed 18 yr before (23.7%), whereas life-threatening forms of SHAI (high-altitude pulmonary and cerebral edema) were less frequent (2.6%-0.8%, P = 0.007). The negative predictive value of the decision tree based was 81%, suggesting that the procedure is efficient to detect subjects who will not suffer from SHAI, therefore limiting the use of ACZ. The maximal daily altitude gain that limits the occurrence of SHAI was established at 400 m. The occurrence of SHAI was reduced from 27% to 12% when the recommendations for ACZ use and 400-m daily altitude gain were respected (P < 0.001). CONCLUSIONS This multicenter study confirmed the interest of the SHAI score in predicting the individual risk for SHAI. The conditions for an optimized acclimatization (400-m rule) were also specified, and we proposed a rational decision tree for the prescription of ACZ, adapted to each individual tolerance to hypoxia.
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Affiliation(s)
| | - Fabien Pillard
- Université Paul Sabatier III, Faculté de Médecine Purpan, UMR INSERM U1048 Institut des maladies métaboliques et cardiovasculaires, Hôpital Pierre Paul Riquet, Unité de Médecine du Sport, Toulouse, FRANCE
| | - David LE Moal
- Université Sorbonne Paris Nord, UMR INSERM 1272 Hypoxie et poumon, Bobigny, FRANCE
| | - Daniel Rivière
- Université Paul Sabatier III, Faculté de Médecine Purpan, UMR INSERM U1048 Institut des maladies métaboliques et cardiovasculaires, Hôpital Pierre Paul Riquet, Unité de Médecine du Sport, Toulouse, FRANCE
| | - Philippe Oriol
- Institut Régional de Médecine et d'Ingénierie de Sport, Médecine du sport et Myologie, CHU Saint-Etienne, Saint-Etienne, FRANCE
| | - Mathias Poussel
- Centre Hospitalier Régional Universitaire de Nancy, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, Service des Explorations de la Fonction Respiratoire, Université de Lorraine, EA 3450 Développement, Adaptation et Handicap, Nancy, FRANCE
| | - Bruno Chenuel
- Centre Hospitalier Régional Universitaire de Nancy, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, Service des Explorations de la Fonction Respiratoire, Université de Lorraine, EA 3450 Développement, Adaptation et Handicap, Nancy, FRANCE
| | | | | | - Sophie Demanez
- Centre de physiologie de l'effort-CB Move Herve-Julémont, BELGIUM
| | - Michel Vergnion
- Centre de physiologie de l'effort-CB Move Herve-Julémont, BELGIUM
| | - Jean-Michel Boulet
- Hôpital cardiologique, Service maladies coronaires, tests d'effort et readaptation, Pessac, FRANCE
| | - Hervé Douard
- Hôpital cardiologique, Service maladies coronaires, tests d'effort et readaptation, Pessac, FRANCE
| | - Maryse Dupré
- Institut Régional de Médecine du Sport, CHU Nantes, PHU 10, Hôpital Saint Jacques, Nantes, FRANCE
| | - Olivier Mesland
- Institut Régional de Médecine du Sport, CHU Nantes, PHU 10, Hôpital Saint Jacques, Nantes, FRANCE
| | - Romain Remetter
- Centre Hospitalier Universitaire de Strasbourg, Service de Physiologie et EFR, Nouvel Hôpital Civil, Strasbourg, FRANCE
| | - Evelyne Lonsdorfer-Wolf
- Centre Hospitalier Universitaire de Strasbourg, Service de Physiologie et EFR, Nouvel Hôpital Civil, Strasbourg, FRANCE
| | - Alain Frey
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - Louis Vilcoq
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - Anne Nedelec Jaffuel
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - David Debeaumont
- Centre Hospitalo-Universitaire de Rouen, Hôpital Charles Nicolle, CIC-CRB 1404, Unité de physiologie respiratoire et de l'exercice, Rouen, FRANCE
| | - Guy Duperrex
- Hôpitaux du Pays du Mont Blanc, Consultation de Médecine et Traumatologie du Sport, Montagne, Sallanches, FRANCE
| | - François Lecoq
- Hôpitaux du Pays du Mont Blanc, Consultation de Médecine et Traumatologie du Sport, Montagne, Sallanches, FRANCE
| | - Christophe Hédon
- UMR INSERM U1046-CNRS 9214-PhyMedExp, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier, FRANCE
| | - Maurice Hayot
- UMR INSERM U1046-CNRS 9214-PhyMedExp, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier, FRANCE
| | - Guido Giardini
- Ospedale U. Parini-Azienda USL della Valle d'Aosta, Centro di Medicina e Neurologia di Montagna, Aosta, ITALY
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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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24
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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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Meys R, Stoffels AAF, de Brandt J, van Hees HWH, Franssen FME, Sillen MJH, Wouters EFM, Burtin C, Klijn P, Bij de Vaate E, van den Borst B, Otker JM, Donkers J, Schleich FN, Hayot M, Pomiès P, Everaert I, Derave W, Spruit MA. Beta-alanine supplementation in patients with COPD receiving non-linear periodised exercise training or neuromuscular electrical stimulation: protocol of two randomised, double-blind, placebo-controlled trials. BMJ Open 2020; 10:e038836. [PMID: 32928863 PMCID: PMC7488791 DOI: 10.1136/bmjopen-2020-038836] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Exercise intolerance is common in patients with chronic obstructive pulmonary disease (COPD) and, although multifactorial, it is largely caused by lower-limb muscle dysfunction. Research has shown that patients with severe to very severe COPD have significantly lower levels of muscle carnosine, which acts as a pH buffer and antioxidant. Beta-alanine (BA) supplementation has been shown to consistently elevate muscle carnosine in a variety of populations and may therefore improve exercise tolerance and lower-limb muscle function. The primary objective of the current studies is to assess the beneficial effects of BA supplementation in enhancing exercise tolerance on top of two types of exercise training (non-linear periodised exercise (NLPE) training or neuromuscular electrical stimulation (NMES)) in patients with COPD. METHODS AND ANALYSIS Two randomised, double-blind, placebo-controlled trials have been designed. Patients will routinely receive either NLPE (BASE-TRAIN trial) or NMES (BASE-ELECTRIC trial) as part of standard exercise-based care during their 8-to-10 week pulmonary rehabilitation (PR) programme. A total of 222 patients with COPD (2×77 = 154 patients in the BASE-TRAIN trial and 2×34 = 68 patients in the BASE-ELECTRIC trial) will be recruited from two specialised PR centres in The Netherlands. For study purposes, patients will receive 3.2 g of oral BA supplementation or placebo per day. Exercise tolerance is the primary outcome, which will be assessed using the endurance shuttle walk test (BASE-TRAIN) or the constant work rate cycle test (BASE-ELECTRIC). Furthermore, quadriceps muscle strength and endurance, cognitive function, carnosine levels (in muscle), BA levels (in blood and muscle), markers of oxidative stress and inflammation (in blood, muscles and lungs), physical activity and quality of life will be measured. ETHICS AND DISSEMINATION Both trials were approved by CMO Regio Arnhem-Nijmegen, The Netherlands (NL70781.091.19. and NL68757.091.19). TRIAL REGISTRATION NUMBER NTR8427 (BASE-TRAIN) and NTR8419 (BASE-ELECTRIC).
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Affiliation(s)
- Roy Meys
- Department of Research and Development, CIRO, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Anouk A F Stoffels
- Department of Research and Development, CIRO, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- Department of Pulmonary Diseases, Radboud UMC Dekkerswald, Nijmegen, The Netherlands
| | - Jana de Brandt
- Reval Rehabilitation Research, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, DIepenbeek, Belgium
| | | | - Frits M E Franssen
- Department of Research and Development, CIRO, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | | | - Emiel F M Wouters
- Department of Research and Development, CIRO, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Chris Burtin
- Reval Rehabilitation Research, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, DIepenbeek, Belgium
| | - Peter Klijn
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Eline Bij de Vaate
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
| | - Bram van den Borst
- Department of Pulmonary Diseases, Radboud UMC Dekkerswald, Nijmegen, The Netherlands
| | - Jacqueline M Otker
- Patient Advisory Council, Lung Foundation Netherlands, Amersfoort, The Netherlands
- Client Council, CIRO, Horn, The Netherlands
| | | | - Florence N Schleich
- Department of Respiratory Medicine, CHU Sart-Tilman Liege, GIGA I3, Liege, Belgium
| | - Maurice Hayot
- PhyMedExp, INSERM - CNRS, University of Montpellier - Montpellier CHU, Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, INSERM - CNRS, University of Montpellier - Montpellier CHU, Montpellier, France
| | - Inge Everaert
- Department of Movement and Sport Sciences, University Ghent, Ghent, Belgium
| | - Wim Derave
- Department of Movement and Sport Sciences, University Ghent, Ghent, Belgium
| | - Martijn A Spruit
- Department of Research and Development, CIRO, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- Reval Rehabilitation Research, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, DIepenbeek, Belgium
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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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27
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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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Hayot M, Ologeanu-Taddei R, Bouaynaya W, Ayoub B, Bughin F. Assessment by Patients of a Connected System for Telerehabilitation: Lessons Learned from a Randomized Qualitative Study. Stud Health Technol Inform 2019; 264:1931-1932. [PMID: 31438413 DOI: 10.3233/shti190719] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This poster presents the design of a connected system for telerehabilitation for patients with obesity and the assessment of the system through a randomized qualitative study on a sample of 15 patients. The patients expressed positive motivation but negatively assessed (as a deficiency) the system operation. All patients found that the system was neither intuitive nor easy to use.
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Affiliation(s)
- Maurice Hayot
- Department of Clinical Physiology and PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | | | | | - Bronia Ayoub
- Department of Clinical Physiology and PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | - François Bughin
- Department of Clinical Physiology and PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, 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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Souweine JS, Kuster N, Chenine L, Rodriguez A, Patrier L, Morena M, Badia E, Chalabi L, Raynal N, Ohresser I, Leray-Moragues H, Mercier J, Hayot M, Le Quintrec M, Gouzi F, Cristol JP. Physical inactivity and protein energy wasting play independent roles in muscle weakness in maintenance haemodialysis patients. PLoS One 2018; 13:e0200061. [PMID: 30067754 PMCID: PMC6070183 DOI: 10.1371/journal.pone.0200061] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/12/2018] [Indexed: 01/10/2023] Open
Abstract
Background Muscle weakness is associated with increased mortality risk in chronic haemodialysis (CHD) patients. Protein energy wasting (PEW) and low physical activity could impair muscle quality and contribute to muscle weakness beyond muscle wasting in these patients. Aim of this study was to assess clinical and biological parameters involved in the reduction of muscle strength of CHD patients. Methods One hundred and twenty-three CHD patients (80 males, 43 females; 68,8 [57.9–78.8] y.o.) were included in this study. Maximal voluntary force (MVF) of quadriceps was assessed using a belt-stabilized hand-held dynamometer. Muscle quality was evaluated by muscle specific torque, defined as the strength per unit of muscle mass. Muscle mass was estimated using lean tissue index (LTI), skeletal muscle mass (SMM) assessed by bioelectrical impedance analysis and creatinine index (CI). Voorrips questionnaire was used to estimate physical activity. Criteria for the diagnosis of PEW were serum albumin, body mass index < 23 kg/m2, creatinine index < 18.82 mg/kg/d and low dietary protein intake estimated by nPCR < 0.80g/kg/d. Results MVF was 76.1 [58.2–111.7] N.m. and was associated with CI (β = 5.3 [2.2–8.4], p = 0.001), LTI (β = 2.8 [0.6–5.1], p = 0.013), Voorrips score (β = 17.4 [2.9–31.9], p = 0.02) and serum albumin (β = 1.9 [0.5–3.2], p = 0.006). Only serum albumin (β = 0.09 [0.03–0.15], p = 0.003), Voorrips score (β = 0.8 [0.2–1.5], p = 0.005) and CI (β = 0.2 [0.1–0.3], p<0.001) remained associated with muscle specific torque. Thirty patients have dynapenia defined as impaired MVF with maintained SMM and were younger with high hs-CRP (p = 0.001), PEW criteria (p<0.001) and low Voorrips score (p = 0.001), and reduced dialysis vintage (p<0.046). Conclusions Beyond atrophy, physical inactivity and PEW conspire to impair muscle strength and specific torque in CHD patients and could be related to muscle quality. Trial registration ClinicalTrials.gov NCT02806089
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Affiliation(s)
- Jean-Sébastien Souweine
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Biochimie et Hormonologie, CHU Montpellier, Montpellier, France
- Département de Néphrologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Nils Kuster
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Biochimie et Hormonologie, CHU Montpellier, Montpellier, France
| | - Leila Chenine
- Département de Néphrologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Annie Rodriguez
- Département de Biochimie et Hormonologie, CHU Montpellier, Univ Montpellier, Montpellier, France
- AIDER, Montpellier, France
| | | | - Marion Morena
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Biochimie et Hormonologie, CHU Montpellier, Montpellier, France
| | - Eric Badia
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Biochimie et Hormonologie, CHU Montpellier, Montpellier, France
| | | | | | | | | | - Jacques Mercier
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Physiologie, CHU Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Physiologie, CHU Montpellier, Montpellier, France
| | - Moglie Le Quintrec
- Département de Néphrologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Physiologie, CHU Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, INSERM, CNRS, Univ Montpellier, Département de Biochimie et Hormonologie, CHU Montpellier, Montpellier, France
- * E-mail:
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Gouzi F, Blaquière M, Catteau M, Bughin F, Maury J, Passerieux E, Ayoub B, Mercier J, Hayot M, Pomiès P. Oxidative stress regulates autophagy in cultured muscle cells of patients with chronic obstructive pulmonary disease. J Cell Physiol 2018; 233:9629-9639. [PMID: 29943813 DOI: 10.1002/jcp.26868] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 09/27/2017] [Accepted: 05/23/2018] [Indexed: 12/21/2022]
Abstract
The proteolytic autophagy pathway is enhanced in the lower limb muscles of patients with chronic obstructive pulmonary disease (COPD). Reactive oxygen species (ROS) have been shown to regulate autophagy in the skeletal muscles, but the role of oxidative stress in the muscle autophagy of patients with COPD is unknown. We used cultured myoblasts and myotubes from the quadriceps of eight healthy subjects and twelve patients with COPD (FEV1% predicted: 102.0% and 32.0%, respectively; p < 0.0001). We compared the autophagosome formation, the expression of autophagy markers, and the autophagic flux in healthy subjects and the patients with COPD, and we evaluated the effects of the 3-methyladenine (3-MA) autophagy inhibitor on the atrophy of COPD myotubes. Autophagy was also assessed in COPD myotubes treated with an antioxidant molecule, ascorbic acid. Autophagosome formation was increased in COPD myoblasts and myotubes (p = 0.011; p < 0.001), and the LC3 2/LC3 1 ratio (p = 0.002), SQSTM1 mRNA and protein expression (p = 0.023; p = 0.007), BNIP3 expression (p = 0.031), and autophagic flux (p = 0.002) were higher in COPD myoblasts. Inhibition of autophagy with 3-MA increased the COPD myotube diameter (p < 0.001) to a level similar to the diameter of healthy subject myotubes. Treatment of COPD myotubes with ascorbic acid decreased ROS concentration (p < 0.001), ROS-induced protein carbonylation (p = 0.019), the LC3 2/LC3 1 ratio (p = 0.037), the expression of SQSTM1 (p < 0.001) and BNIP3 (p < 0.001), and increased the COPD myotube diameter (p < 0.001). Thus, autophagy signaling is enhanced in cultured COPD muscle cells. Furthermore, the oxidative stress level contributes to the regulation of autophagy, which is involved in the atrophy of COPD myotubes in vitro.
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Affiliation(s)
- Fares Gouzi
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Marine Blaquière
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Matthias Catteau
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Jonathan Maury
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Clinique du Souffle "La Solane," Fontalvie/5-Santé Group, Osséja, France
| | - Emilie Passerieux
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Bronia Ayoub
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Department of Clinical Physiology, CHRU of Montpellier, Montpellier, France
| | - Pascal Pomiès
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
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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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El Amrani L, Oude Engberink A, Ninot G, Hayot M, Carbonnel F. Connected Health Devices for Health Care in French General Medicine Practice: Cross-Sectional Study. JMIR Mhealth Uhealth 2017; 5:e193. [PMID: 29269336 PMCID: PMC5754567 DOI: 10.2196/mhealth.7427] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 09/16/2017] [Accepted: 09/17/2017] [Indexed: 01/04/2023] Open
Abstract
Background The integration of Connected Health Devices (CHDs) is growing within mobile health (mHealth) and telemedicine, encouraged by institutions and industries. The idea is to improve lifestyle habits and health behaviors as a preventive goal in an aging population with fewer physicians available. However, their ill-defined place in health care does not promote their use in current medical practice. Objective The primary objective of this study was to quantify CHDs’ use rate by general practitioners (GPs). A secondary objective was to evaluate their benefits and limitations in usual care. Methods A cross-sectional study through an Internet-based survey was addressed to French GPs via regional medical unions and continuous education agencies, supplemented with an informative website, from March 2015 to July 2015. Surveys where either the form was insufficiently filled or the main question was left unanswered were excluded from the study. Results A total of 1084 answers were analyzed, of which 19.46% (211/1084, 95% CI 17.1-21.8) GPs used CHDs, and 10.15% (110/1084, 95% CI 8.5-12.1) prescribed a CHD. CHD users statistically prescribed more CHDs (7.38% [80/1084] in the user group vs 2.86% [31/1084] in nonusers; P<.001) and were more likely to use them in the future. Major interests in their utilization were in patient monitoring for 84.96% (921/1084) and patient education for 75.83% (822/1084), especially for diabetes (89.67%, 972/1084) and hypertension (84.13%, 912/1084). Generated data had to be managed securely by the patient primarily for 85.79% (930/1084) of the GPs. CHDs had to not constrain GPs outside clinical consultation, nor restrain their time for 75.83% (822/1084). Additional actors in patient care were not desired for 79.98% (867/1084) of the GPs. Questions about data management issues and technical difficulties were raised. Conclusions CHDs are little used by French GPs and even less prescribed to their patients, as only a few GPs use these tools. Their benefits as tools of patient empowerment, although expected, remain to be demonstrated in real-life setups.
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Affiliation(s)
- Leila El Amrani
- UFR Medecine site Nord, Department of General Practice, University of Montpellier, Montpellier, France.,Centre Hospitalier de Carcassonne, Department of Emergency Medicine, Carcassonne, France
| | - Agnes Oude Engberink
- UFR Medecine site Nord, Department of General Practice, University of Montpellier, Montpellier, France.,CEPS Platform, Universities of Montpellier, Montpellier, France.,Research Unit EA4556 Epsylon, University of Montpellier Paul Valery, University of Montpellier, Montpellier, France.,Avicenne Multiprofessional Health Center, Cabestany, France
| | - Gregory Ninot
- CEPS Platform, Universities of Montpellier, Montpellier, France.,Research Unit EA4556 Epsylon, University of Montpellier Paul Valery, University of Montpellier, Montpellier, France.,Institut du Cancer Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | - François Carbonnel
- UFR Medecine site Nord, Department of General Practice, University of Montpellier, Montpellier, France.,CEPS Platform, Universities of Montpellier, Montpellier, France.,Research Unit EA4556 Epsylon, University of Montpellier Paul Valery, University of Montpellier, Montpellier, France.,Avicenne Multiprofessional Health Center, Cabestany, France.,Institut du Cancer Montpellier, Montpellier, France
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Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JLE, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing. J Frailty Aging 2017; 5:233-241. [PMID: 27883170 DOI: 10.14283/jfa.2016.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Souweine JS, Kuster N, Chenine L, Rodriguez A, Patrier L, Morena M, badia E, Leray H, Mourad G, Hayot M, Le Quintrec M, Gouzi F, Cristol JP. SP679PHYSICAL ACTIVITY AND MALNUTRITION INFLAMMATION COMPLEX SYNDROME CONSPIRE TO MUSCLE WEAKNESS AND ATROPHY IN HAEMODIALYSiS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx155.sp679] [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: 11/12/2022] Open
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Souweine JS, Boudet A, Chenine L, Leray H, Rodriguez A, Mourad G, Mercier J, Cristol JP, Hayot M, Gouzi F. Standardized Method to Measure Muscle Force at the Bedside in Hemodialysis Patients. J Ren Nutr 2017; 27:194-200. [PMID: 28320574 DOI: 10.1053/j.jrn.2017.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/26/2016] [Accepted: 01/06/2017] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES In hemodialysis, diminution of muscle strength constitutes a major prognostic factor of mortality. Currently, measurement of quadriceps isometric maximal voluntary force (MVF) represents the reference method to investigate muscle strength. However, reduction of MVF is rarely detected in these patients due to the absence of portative bedside tools in clinical practice. The purposes of this study were therefore to assess the agreement of a belt-stabilized handheld dynamometer (HHD) with the dynamometer chair (reference method) and to determine intratester and intertester reliability of the quadriceps MVF measurements using belt-stabilized HHD in healthy subjects and in hemodialysis patients. DESIGN Repeated-measures cross-sectional study. SETTING Clinical and academic hospital. PARTICIPANTS Fifty-three healthy adult subjects (23 males, 36.5 + 12.5 y.o.) and 21 hemodialysis patients (14 males, 72.4 + 13.3 y.o., dialysis vintage 30 + 75.1 months). INTERVENTION Not applicable. MAIN OUTCOME MEASURE MVF measurements were assessed with belt-stabilized HHD and dynamometer chair, by two independent investigators. The agreement between the two devices would be quantified using the Bland-Altman 95% limits of agreement (LOA) method and the Spearman correlation. RESULTS For healthy subjects and hemodialysis patients, Spearman coefficients between belt-stabilized HHD and dynamometer chair were 0.63 and 0.75, respectively (P < .05). In hemodialysis group, reliability was excellent for both the intratester and intertester reliability R2 = 0.85 (P < .01) and R2 = 0.90 (P < .01), respectively. In all individuals, the mean difference between the dynamometer chair and the belt-stabilized HHD was -13.07 ± 21.77 N.m. (P < .001). The LOA for the upper and the lower was 29.59 and -55.73 N.m., respectively. CONCLUSION In healthy subjects and in hemodialysis patients, the belt-stabilized HHD dynamometer appears as a valid and reliable method to measure in clinical practice isometric MVF of quadriceps in hemodialysis patients. Therefore, the belt-stabilized HHD appears as a suitable and a relevant diagnostic tool for the identification of muscle dysfunction in hemodialysis patients.
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Affiliation(s)
- Jean-Sébastien Souweine
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France; Department of Nephrology, University Hospital of Montpellier, University of Montpellier, Montpellier, France; PhyMedExp, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France.
| | - Agathe Boudet
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Leila Chenine
- Department of Nephrology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Helene Leray
- Department of Nephrology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | | | - Georges Mourad
- Department of Nephrology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Jacques Mercier
- PhyMedExp, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France; Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Jean-Paul Cristol
- Department of Biochemistry, University Hospital of Montpellier, University of Montpellier, Montpellier, France; PhyMedExp, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France; Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
| | - Fares Gouzi
- PhyMedExp, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France; Department of Physiology, University Hospital of Montpellier, University of Montpellier, Montpellier, France
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Mane J, Boissin C, Bughin F, Ayoub B, Suc A, Caule S, Mazars A, Lopez N, Bacon L, Matecki S, Mercier J, Bourdin A, Hayot M, Gouzi F. Mise en évidence d’un défaut de recrutement du lit capillaire pulmonaire par méthode de double transfert NO/CO chez le patient atteint d’hypertension artérielle pulmonaire. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.322] [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: 11/17/2022]
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Gouzi F, Maury J, Bughin F, Blaquière M, Ayoub B, Mercier J, Perez-Martin A, Pomiès P, Hayot M. Impaired training-induced adaptation of blood pressure in COPD patients: implication of the muscle capillary bed. Int J Chron Obstruct Pulmon Dis 2016; 11:2349-2357. [PMID: 27703345 PMCID: PMC5038574 DOI: 10.2147/copd.s113657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Indexed: 12/17/2022] Open
Abstract
Background and aims Targeting the early mechanisms in exercise-induced arterial hypertension (which precedes resting arterial hypertension in its natural history) may improve cardiovascular morbidity and mortality in COPD patients. Capillary rarefaction, an early event in COPD before vascular remodeling, is a potential mechanism of exercise-induced and resting arterial hypertension. Impaired training-induced capillarization was observed earlier in COPD patients; thus, this study compares the changes in blood pressure (BP) during exercise in COPD patients and matches control subjects (CSs) after a similar exercise training program, in relationship with muscle capillarization. Methods Resting and maximal exercise diastolic pressure (DP) and systolic pressure (SP) were recorded during a standardized cardiopulmonary exercise test, and a quadriceps muscle biopsy was performed before and after training. Results A total of 35 CSs and 49 COPD patients (forced expiratory volume in 1 second =54%±22% predicted) completed a 6-week rehabilitation program and improved their symptom-limited maximal oxygen uptake (VO2SL: 25.8±6.1 mL/kg per minute vs 27.9 mL/kg per minute and 17.0±4.7 mL/kg per minute vs 18.3 mL/kg per minute; both P<0.001). The improvement in muscle capillary-to-fiber (C/F) ratio was significantly greater in CSs vs COPD patients (+11%±9% vs +23%±21%; P<0.05). Although maximal exercise BP was reduced in CSs (DP: 89±10 mmHg vs 85±9 mmHg; P<0.001/SP: 204±25 mmHg vs 196±27 mmHg; P<0.05), it did not change in COPD patients (DP: 94±14 mmHg vs 97±16 mmHg; P=0.46/SP: 202±27 mmHg vs 208±24 mmHg; P=0.13). The change in muscle C/F ratio was negatively correlated with maximal exercise SP in CSs and COPD patients (r=−0.41; P=0.02). Conclusion COPD patients showed impaired training-induced BP adaptation related to a change in muscle capillarization, suggesting the possibility of blunted angiogenesis.
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Affiliation(s)
- Fares Gouzi
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
| | - Jonathan Maury
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Pulmonary Rehabilitation Center "La Solane", 5 Santé Group, Osséja
| | - François Bughin
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
| | - Marine Blaquière
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
| | - Bronia Ayoub
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
| | - Jacques Mercier
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
| | - Antonia Perez-Martin
- Dysfunction of Vascular Interfaces Laboratory, EA 2992, University of Montpellier; Department of Vascular Medicine and Investigations, Nîmes University Hospital, Nîmes, France
| | - Pascal Pomiès
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier
| | - Maurice Hayot
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier; Department of Clinical Physiology, Montpellier University Hospital, Montpellier
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Souweine J, Kuster N, Chenine L, Rodriguez A, Gouzi F, Hayot M, Mercier J, Mourad G, Cristol J. Dysfonctions musculaires en hémodialyse chronique : quels en sont les déterminants ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.323] [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: 11/16/2022]
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Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí AA, Criner GJ, MacNee W, Make BJ, Rennard SI, Stockley RA, Vogelmeier C, Anzueto A, Au DH, Barnes PJ, Burgel PR, Calverley PM, Casanova C, Clini EM, Cooper CB, Coxson HO, Dusser DJ, Fabbri LM, Fahy B, Ferguson GT, Fisher A, Fletcher MJ, Hayot M, Hurst JR, Jones PW, Mahler DA, Maltais F, Mannino DM, Martinez FJ, Miravitlles M, Meek PM, Papi A, Rabe KF, Roche N, Sciurba FC, Sethi S, Siafakas N, Sin DD, Soriano JB, Stoller JK, Tashkin DP, Troosters T, Verleden GM, Verschakelen J, Vestbo J, Walsh JW, Washko GR, Wise RA, Wouters EFM, ZuWallack RL. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD. Eur Respir Rev 2016; 24:159-72. [PMID: 26028628 PMCID: PMC9487818 DOI: 10.1183/16000617.00000315] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes. ATS/ERS statement highlighting research areas that will have the greatest impact on patient-centred outcomes in COPDhttp://ow.ly/LXW2J
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Bousquet J, Bourret R, Camuzat T, Augé P, Domy P, Bringer J, Best N, Jonquet O, de la Coussaye JE, Noguès M, Robine JM, Avignon A, Blain H, Combe B, Dray G, Dufour V, Fouletier M, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laune D, Laurent C, Mares P, Marion C, Pastor E, Pélissier JY, Radier-Pontal F, Reynes J, Royère E, Ychou M, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet PA, Alomène B, Amouyal M, Arnavielhe S, Asteriou T, Attalin V, Aubas P, Azevedo C, Badin M, Bakhti, Baptista G, Bardy B, Battesti MP, Bénézet O, Bernard PL, Berr C, Berthe J, Bobia X, Bockaert J, Boegner C, Boichot S, Bonnin HY, Boulet P, Bouly S, Boubakri C, Bourdin A, Bourrain JL, Bourrel G, Bouix V, Breuker C, Bruguière V, Burille J, Cade S, Caimmi D, Calmels MV, Camu W, Canovas G, Carre V, Cavalli G, Cayla G, Chiron R, Claret PG, Coignard P, Coroian F, Costa DJ, Costa P, Cottalorda, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cristol JP, Cros V, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dhivert-Donnadieu H, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fesler P, Fraisse P, Froger J, Gabrion P, Galano E, Gellerat-Rogier M, Gellis A, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hantkié H, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Kouyoudjian P, Labauge P, Landreau L, Lapierre M, Leblond C, Léglise MS, Lemaitre JM, Le Moing V, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert JM, Makinson A, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Morquin D, Mottet D, Nérin P, Nicolas P, Ninot G, Nouvel F, Ortiz JP, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Picot MC, Pin JP, Pinto N, Porte E, Portejoie F, Pujol JL, Quantin X, Quéré I, Raffort N, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Rolland C, Roubille F, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Soua B, Stephan Y, Strubel D, Sultan A, Taddei-Ologeanu, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Touchon J, Tribout V, Uziel A, Van de Perre P, Vasquez X, Verdier JM, Vergne-Richard C, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Villiet M, Viollet E, Wojtusciszyn A, Aoustin M, Bourquin C, Mercier J. Introduction. Presse Med 2015; 44 Suppl 1:S1-5. [DOI: 10.1016/j.lpm.2015.07.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí A, Criner GJ, MacNee W, Make BJ, Rennard SI, Stockley RA, Vogelmeier C, Anzueto A, Au DH, Barnes PJ, Burgel PR, Calverley PM, Casanova C, Clini EM, Cooper CB, Coxson HO, Dusser DJ, Fabbri LM, Fahy B, Ferguson GT, Fisher A, Fletcher MJ, Hayot M, Hurst JR, Jones PW, Mahler DA, Maltais F, Mannino DM, Martinez FJ, Miravitlles M, Meek PM, Papi A, Rabe KF, Roche N, Sciurba FC, Sethi S, Siafakas N, Sin DD, Soriano JB, Stoller JK, Tashkin DP, Troosters T, Verleden GM, Verschakelen J, Vestbo J, Walsh JW, Washko GR, Wise RA, Wouters EFM, ZuWallack RL. An Official American Thoracic Society/European Respiratory Society Statement: Research questions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015; 191:e4-e27. [PMID: 25830527 DOI: 10.1164/rccm.201501-0044st] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this Official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. METHODS Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarized, and then salient knowledge gaps were identified. RESULTS Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. CONCLUSIONS Great strides have been made in the diagnosis, assessment, and management of COPD as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS Research Statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centered outcomes.
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Sebbane M, El Kamel M, Millot A, Jung B, Lefebvre S, Rubenovitch J, Mercier G, Eledjam JJ, Jaber S, Hayot M. Effect of Weight Loss on Postural Changes in Pulmonary Function in Obese Subjects: A Longitudinal Study. Respir Care 2015; 60:992-9. [PMID: 25852166 DOI: 10.4187/respcare.03668] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Postural changes are known to affect normal lung volumes. A reduction in sitting to supine functional residual capacity (FRC) is well-described in non-obese subjects adopting a supine position. However, postural changes in lung volumes in the obese require further exploration. We aimed to longitudinally address the effects of weight loss on postural changes in lung volumes and pulmonary function in obese subjects. We tested the hypothesis that supine reduction in FRC would be absent in morbid obesity and recovered upon weight loss. METHODS This was a prospective, observational, longitudinal study. Consecutive morbidly obese adults (N = 12, age: 44 ± 14 y, body mass index: 45 ± 5 kg/m(2)) enrolled in a bariatric surgery program were included. Standard pulmonary function tests and blood gas analysis were performed both before and 1 y after surgery. Pulmonary function was assessed in both the sitting and supine position using spirometry and multi-breath helium dilution. Parameters recorded before and after weight loss were compared. The main outcome measure was FRC. RESULTS Ten subjects were retested 1 y after surgery (body mass index: 31 ± 5 kg/m(2)). FRC was not affected by change in posture before surgery. Supine reduction in FRC was observed after weight loss (ΔFRC: -0.6 ± 0.4 L, sitting vs supine, P = .002). Pulmonary gas exchange improved (alveolar-to-arterial oxygen partial pressure difference: -8 ± 11 mm Hg, P = .035). CONCLUSIONS Although postural change in FRC is absent when the morbidly obese adopt a supine position, supine reduction in FRC can be recovered following gastroplasty-induced weight loss, despite residual mild to moderate obesity. This also shows that mild to moderate obesity may affect supine FRC more than morbid obesity. (ClinicalTrials.gov registration NCT02207192.).
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Affiliation(s)
| | - Moez El Kamel
- Département d'Anesthésie-Réanimation B, Hôpital St Eloi
| | - Alice Millot
- Département d'Anesthésie-Réanimation B, Hôpital St Eloi
| | - Boris Jung
- Département d'Anesthésie-Réanimation B, Hôpital St Eloi PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CHRU de Montpellier, Montpellier, France
| | | | | | | | | | - Samir Jaber
- Département d'Anesthésie-Réanimation B, Hôpital St Eloi PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CHRU de Montpellier, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CHRU de Montpellier, Montpellier, France
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Passerieux E, Hayot M, Jaussent A, Carnac G, Gouzi F, Pillard F, Picot MC, Böcker K, Hugon G, Pincemail J, Defraigne JO, Verrips T, Mercier J, Laoudj-Chenivesse D. Effects of vitamin C, vitamin E, zinc gluconate, and selenomethionine supplementation on muscle function and oxidative stress biomarkers in patients with facioscapulohumeral dystrophy: a double-blind randomized controlled clinical trial. Free Radic Biol Med 2015; 81:158-69. [PMID: 25246239 DOI: 10.1016/j.freeradbiomed.2014.09.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 12/29/2022]
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant disease characterized by progressive weakness and atrophy of specific skeletal muscles. As growing evidence suggests that oxidative stress may contribute to FSHD pathology, antioxidants that might modulate or delay oxidative insults could help in maintaining FSHD muscle function. Our primary objective was to test whether oral administration of vitamin C, vitamin E, zinc gluconate, and selenomethionine could improve the physical performance of patients with FSHD. Adult patients with FSHD (n=53) were enrolled at Montpellier University Hospital (France) in a randomized, double-blind, placebo-controlled pilot clinical trial. Patients were randomly assigned to receive 500 mg vitamin C, 400mg vitamin E, 25mg zinc gluconate and 200 μg selenomethionine (n=26), or matching placebo (n=27) once a day for 17 weeks. Primary outcomes were changes in the two-minute walking test (2-MWT), maximal voluntary contraction, and endurance limit time of the dominant and nondominant quadriceps (MVCQD, MVCQND, TlimQD, and TlimQND, respectively) after 17 weeks of treatment. Secondary outcomes were changes in the antioxidant status and oxidative stress markers. Although 2-MWT, MVCQ, and TlimQ were all significantly improved in the supplemented group at the end of the treatment compared to baseline, only MVCQ and TlimQ variations were significantly different between groups (MVCQD: P=0.011; MVCQND: P=0.004; TlimQD: P=0.028; TlimQND: P=0.011). Similarly, the vitamin C (P<0.001), vitamin E as α-tocopherol (P<0.001), vitamin C/vitamin E ratio (P=0.017), vitamin E γ/α ratio (P=0.022) and lipid peroxides (P<0.001) variations were significantly different between groups. In conclusion, vitamin E, vitamin C, zinc, and selenium supplementation has no significant effect on the 2-MWT, but improves MVCQ and TlimQ of both quadriceps by enhancing the antioxidant defenses and reducing oxidative stress. This trial was registered at clinicaltrials.gov (number: NCT01596803).
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Affiliation(s)
- Emilie Passerieux
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France
| | - Maurice Hayot
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France and Department of Clinical Physiology, University Hospital, Montpellier, France
| | - Audrey Jaussent
- Department of Biostatistics and Epidemiology, University Hospital of Montpellier, Montpellier, France
| | - Gilles Carnac
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France
| | - Fares Gouzi
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France and Department of Clinical Physiology, University Hospital, Montpellier, France
| | - Fabien Pillard
- Department of Respiratory Exploration and Department of Sports Medicine, Larrey University Hospital, Toulouse CEDEX, France
| | - Marie-Christine Picot
- Department of Biostatistics and Epidemiology, University Hospital, Montpellier, France and CIC 1001-INSERM
| | - Koen Böcker
- Alan Turing Institute Almere, The Netherlands
| | - Gerald Hugon
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France
| | - Joel Pincemail
- Department of cardiovascular Surgery and Department of CREDEC, University Hospital of Liege, Belgium
| | - Jean O Defraigne
- Department of cardiovascular Surgery and Department of CREDEC, University Hospital of Liege, Belgium
| | - Theo Verrips
- Utrecht University, Department of Biology, The Netherlands
| | - Jacques Mercier
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France and Department of Clinical Physiology, University Hospital, Montpellier, France
| | - Dalila Laoudj-Chenivesse
- University of Montpellier 1 and 2, INSERM Unit 1046, Montpellier, France and Department of Clinical Physiology, University Hospital, Montpellier, France.
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Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí A, Criner GJ, MacNee W, Make BJ, Rennard SI, Stockley RA, Vogelmeier C, Anzueto A, Au DH, Barnes PJ, Burgel PR, Calverley PM, Casanova C, Clini EM, Cooper CB, Coxson HO, Dusser DJ, Fabbri LM, Fahy B, Ferguson GT, Fisher A, Fletcher MJ, Hayot M, Hurst JR, Jones PW, Mahler DA, Maltais F, Mannino DM, Martinez FJ, Miravitlles M, Meek PM, Papi A, Rabe KF, Roche N, Sciurba FC, Sethi S, Siafakas N, Sin DD, Soriano JB, Stoller JK, Tashkin DP, Troosters T, Verleden GM, Verschakelen J, Vestbo J, Walsh JW, Washko GR, Wise RA, Wouters EF, ZuWallack RL. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD. Eur Respir J 2015; 45:879-905. [DOI: 10.1183/09031936.00009015] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management.Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified.Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulatedviadiscussion and consensus.Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes.
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Bommart S, Marin G, Bourdin A, Revel MP, Klein F, Hayot M, Vachier I, Chanez P, Picot MC, Mercier J, Molinari N, Vernhet-Kovacsik H. Computed tomography quantification of airway remodelling in normal ageing subjects: a cross-sectional study. Eur Respir J 2014; 45:1167-70. [DOI: 10.1183/09031936.00215314] [Citation(s) in RCA: 13] [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] [Indexed: 11/05/2022]
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Bousquet J, Bourquin C, Augé P, Domy P, Bringer J, Aoustin M, Camuzat T, Bourret R, Best N, Jonquet O, de la Coussaye J, Robine J, Avignon A, Blain H, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laurent C, Noguès M, Pélissier J, Radier-Pontal F, Royère E, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet P, Alomène B, Amouyal M, Arnavieilhe S, Attalin V, Aubas P, Badin M, Baptista G, Bardy B, Battesti M, Bénézet O, Bernard P, Berr C, Berthe J, Bockaert J, Boubakri C, Bourdin A, Bourrain J, Bourrel G, Bouix V, Burille J, Cade S, Caimmi D, Calmels M, Camu W, Cavalli G, Cayla G, Chiron R, Combe B, Costa D, Costa P, Courrouy-Michel M, Courtet P, Cristol J, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy J, Delignières D, Demoly P, Dhivert-Donnadieu H, Dray G, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Fesler P, Gellerat-Rogier M, Gouzi F, Gressard F, Hoa D, Jacquemin S, Gris J, Guillot B, Handweiler V, Hayot M, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Lapierre M, Laune D, Léglise M, Le Quellec A, Leclerc F, Lehmann S, Lognos B, Lussert J, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Mercier G, Messner P, Meunier C, Mondain M, Morel J, Morquin D, Nérin P, Ninot G, Nouvel F, Ortiz J, Pandraud G, Pasdelou M, Pasquié J, Pastor E, Perrey S, Pers Y, Picot M, Pin J, Pinto N, Portejoie F, Pujol J, Quantin X, Quéré I, Raffort N, Ramdani S, Reynes J, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Rolland C, Roubille F, Roux E, Salvat A, Savy J, Stephan Y, Strubel D, Sultan A, Tallon G, Tassery H, Torre K, Uziel A, Van de Perre P, Vasquez X, Verdier J, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Viollet E, Ankri J, Berrut G, Crooks G, Joël M, Michel J, Samolinski B, Strandberg T, Vellas B, Mercier J. MACVIA-LR, Reference site of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) in Languedoc Roussillon. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.07.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Watz H, Pitta F, Rochester CL, Garcia-Aymerich J, ZuWallack R, Troosters T, Vaes AW, Puhan MA, Jehn M, Polkey MI, Vogiatzis I, Clini EM, Toth M, Gimeno-Santos E, Waschki B, Esteban C, Hayot M, Casaburi R, Porszasz J, McAuley E, Singh SJ, Langer D, Wouters EFM, Magnussen H, Spruit MA. An official European Respiratory Society statement on physical activity in COPD. Eur Respir J 2014; 44:1521-37. [PMID: 25359358 DOI: 10.1183/09031936.00046814] [Citation(s) in RCA: 325] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This European Respiratory Society (ERS) statement provides a comprehensive overview on physical activity in patients with chronic obstructive pulmonary disease (COPD). A multidisciplinary Task Force of experts representing the ERS Scientific Group 01.02 "Rehabilitation and Chronic Care" determined the overall scope of this statement through consensus. Focused literature reviews were conducted in key topic areas and the final content of this Statement was agreed upon by all members. The current knowledge regarding physical activity in COPD is presented, including the definition of physical activity, the consequences of physical inactivity on lung function decline and COPD incidence, physical activity assessment, prevalence of physical inactivity in COPD, clinical correlates of physical activity, effects of physical inactivity on hospitalisations and mortality, and treatment strategies to improve physical activity in patients with COPD. This Task Force identified multiple major areas of research that need to be addressed further in the coming years. These include, but are not limited to, the disease-modifying potential of increased physical activity, and to further understand how improvements in exercise capacity, dyspnoea and self-efficacy following interventions may translate into increased physical activity. The Task Force recommends that this ERS statement should be reviewed periodically (e.g. every 5-8 years).
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Affiliation(s)
| | - Fabio Pitta
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Carolyn L Rochester
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Judith Garcia-Aymerich
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard ZuWallack
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Thierry Troosters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Anouk W Vaes
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Milo A Puhan
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Melissa Jehn
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael I Polkey
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Ioannis Vogiatzis
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Enrico M Clini
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael Toth
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Elena Gimeno-Santos
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Benjamin Waschki
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Cristobal Esteban
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Maurice Hayot
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard Casaburi
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Janos Porszasz
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Edward McAuley
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Sally J Singh
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Daniel Langer
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Emiel F M Wouters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Helgo Magnussen
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
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Pomiès P, Rodriguez J, Blaquière M, Sedraoui S, Gouzi F, Carnac G, Laoudj-Chenivesse D, Mercier J, Préfaut C, Hayot M. Reduced myotube diameter, atrophic signalling and elevated oxidative stress in cultured satellite cells from COPD patients. J Cell Mol Med 2014; 19:175-86. [PMID: 25339614 PMCID: PMC4288361 DOI: 10.1111/jcmm.12390] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 09/27/2013] [Accepted: 07/07/2014] [Indexed: 12/02/2022] Open
Abstract
The mechanisms leading to skeletal limb muscle dysfunction in chronic obstructive pulmonary disease (COPD) have not been fully elucidated. Exhausted muscle regenerative capacity of satellite cells has been evocated, but the capacity of satellite cells to proliferate and differentiate properly remains unknown. Our objectives were to compare the characteristics of satellite cells derived from COPD patients and healthy individuals, in terms of proliferative and differentiation capacities, morphological phenotype and atrophy/hypertrophy signalling, and oxidative stress status. Therefore, we purified and cultivated satellite cells from progressively frozen vastus lateralis biopsies of eight COPD patients and eight healthy individuals. We examined proliferation parameters, differentiation capacities, myotube diameter, expression of atrophy/hypertrophy markers, oxidative stress damages, antioxidant enzyme expression and cell susceptibility to H2O2 in cultured myoblasts and/or myotubes. Proliferation characteristics and commitment to terminal differentiation were similar in COPD patients and healthy individuals, despite impaired fusion capacities of COPD myotubes. Myotube diameter was smaller in COPD patients (P = 0.015), and was associated with a higher expression of myostatin (myoblasts: P = 0.083; myotubes: P = 0.050) and atrogin-1 (myoblasts: P = 0.050), and a decreased phospho-AKT/AKT ratio (myoblasts: P = 0.022). Protein carbonylation (myoblasts: P = 0.028; myotubes: P = 0.002) and lipid peroxidation (myotubes: P = 0.065) were higher in COPD cells, and COPD myoblasts were significantly more susceptible to oxidative stress. Thus, cultured satellite cells from COPD patients display characteristics of morphology, atrophic signalling and oxidative stress similar to those described in in vivo COPD skeletal limb muscles. We have therefore demonstrated that muscle alteration in COPD can be studied by classical in vitro cellular models.
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Affiliation(s)
- Pascal Pomiès
- INSERM U-1046, University Montpellier I, University Montpellier II, Montpellier, France
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