scholarly journals Effects of fluticasone propionate inhalation on levels of arachidonic acid metabolites in patients with chronic obstructive pulmonary disease

2001 ◽  
Vol 10 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Gert T. Verhoeven ◽  
Ingrid M. Garrelds ◽  
Henk C. Hoogsteden ◽  
Freek J. Zijlstra

Background: In smoking COPD patients the bronchoalveolar lavage (BAL) fluid contains high numbers of inflammatory cells. These cells might produce arachidonic acid (AA) metabolites, which contribute to inflammation and an increased bronchomotor tone.Aims: To investigate levels of AA metabolites in BAL fluid, before and after inhaled glucocorticoid therapy: fluticasone propionate (FP) 1mg per day, or placebo.Methods: A double-blind placebo controlled trial lasting six months. COPD patients were selected by clinical criteria and the presence of bronchial hyperresponsiveness (BHR). Lung function was recorded and in BAL fluid we counted cell numbers and measured LTB4, LTC4/D4/E4, PGE2, 6kPGF1α , PGF2α and TxB2. A control group consisted of asymptomatic smokers(n=6).Results: Paired data were obtained from 9 FP treated and 11 placebo patients. BAL cells were almost exclusively alveolar macrophages. In patients and controls both cellularity and levels of AA metabolites were equal. Cell numbers did not change after treatment. Statistically significant decreases after FP therapy were noticed for PGE2(30%), 6kPGF1α (41%) and PGF2α (54%).Conclusions: In COPD, the capability of inflammatory cells to produce certain AA metabolites was decreased after inhaled FP treatment. This result is discussed in its relation to clinical effects, the influence of smoking, and the results of an earlier, similar study in asthma patients.

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Aileen W. K. Chan ◽  
Albert Lee ◽  
Diana T. F. Lee ◽  
Janet W. H. Sit ◽  
S. Y. Chair

Objectives. To evaluate the sustaining effects of Tai Chi Qigong (TCQ) in improving the psychosocial health in chronic obstructive pulmonary disease (COPD) patients in the sixth month.Background. COPD affects both physical and emotional aspects of life. Measures to minimize patients' suffering need to be implemented.Methods. 206 COPD patients were randomly assigned into three groups: TCQ group, exercise group, and control group. The TCQ group completed a three-month TCQ program, the exercise group practiced breathing and walking exercise, and the control group received usual care.Results. Significant group-by-time interactions in quality of life (QOL) using St. George's respiratory questionnaire (P= 0.002) and the perceived social support from friends using multidimensional scale of perceived social support (P= 0.04) were noted. Improvements were observed in the TCQ group only.Conclusions. TCQ has sustaining effects in improving psychosocial health; it is also a useful and appropriate exercise for COPD patients.


2014 ◽  
Vol 45 (2) ◽  
pp. 347-354 ◽  
Author(s):  
Laura Mendoza ◽  
Paula Horta ◽  
José Espinoza ◽  
Miguel Aguilera ◽  
Nicolás Balmaceda ◽  
...  

Physical inactivity is a cardinal feature of chronic obstructive pulmonary disease (COPD), and is associated with increased morbidity and mortality. Pedometers, which have been used in healthy populations, might also increase physical activity in patients with COPD.COPD patients taking part in a 3-month individualised programme to promote an increase in their daily physical activity were randomised to either a standard programme of physical activity encouragement alone, or a pedometer-based programme. Assessments were performed by investigators blinded to treatment allocation. Change in average 1-week daily step count, 6-min walking distance (6MWD), modified Medical Research Council scale, St George’s respiratory questionnaire (SGRQ) and COPD assessment test (CAT) were compared between groups.102 patients were recruited, of whom 97 completed the programme (pedometer group: n=50; control group: n=47); 60.8% were male with a mean±sd age of 68.7±8.5 years, and forced expiratory volume in 1 s (FEV1) 66.1±19.4% and FEV1/forced vital capacity 55.2±9.5%. Both groups had comparable characteristics at baseline. The pedometer group had significantly greater improvements in: physical activity 3080±3254 steps·day−1versus 138.3±1950 steps·day−1 (p<0.001); SGRQ −8.8±12.2 versus −3.8±10.9 (p=0.01); CAT score −3.5±5.5 versus −0.6±6.6 (p=0.001); and 6MWD 12.4±34.6 versus −0.7±24.4 m (p=0.02) than patients receiving activity encouragement only.A simple physical activity enhancement programme using pedometers can effectively improve physical activity level and quality of life in COPD patients.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


2018 ◽  
Vol 17 (2) ◽  
pp. 24-28
Author(s):  
O. M. Polikutina ◽  
Y. S. Slepynina ◽  
E. D. Bazdyrev ◽  
V. N. Karetnikova ◽  
O. L. Barbarach

Aim. To evaluate the structural and functional changes in the lungs of ST elevation myocardial infarction (STEMI) patients with absence or presence of chronic obstructive lung disease (COPD), and the relation with myocardial dysfunction and systemic inflammation.Material and methods. Totally, 189 STEMI patients included: group 1 — STEMI with COPD of moderate and mild grade, 2 — STEMI with no lung pathology. Groups were comparable by clinical and anamnestic parameters. Assessment of lung function and blood collection were done at 10­12 day of STEMI. For comparison of the parameters representing structural and functional changes in the lungs and comparison of C­reactive protein (CRP), N­terminal pro­brain natriuretic peptide (NT­proBNP) concentration, a control group was formed with no pulmonary pathology, comparable by age and sex with the STEMI patients.Results. In COPD patients, higher values revealed of the parameters representing the part of residual volumes in pulmonary structure. Higher residual volume (RV) was found also in STEMI and no COPD comparing to controls, however the relation RV/TLC (total lung capacity) was not higher than normal range. In both groups there were lower values of diffusion lung capacity (DLCO) comparing to controls. The lowest DLCO found in COPD patients. Concentration of NT­proBNP (H=41,6; p<0,001) and CRP (H=38,6; p<0,001) in COPD was significantly higher in STEMI with no COPD patients than in controls. The negative correlations found for NT­proBNP and CRP with forced expiratory volume 1 sec, FEV/FVC1, DLCO, and positive — with the values of thoracic volume, RV/TLC.Conclusion. In STEMI patients the increase revealed of residual lung volumes. Mostly the level of residual volumes is high in STEMI and COPD patients. There are associations of NT­proBNP and CRP with structural and functional parameters of the lungs regardless of COPD.


Author(s):  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Jesus G. Ponce-Gonzalez ◽  
Alberto Marin-Galindo ◽  
...  

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = −435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, −8.5 L/min, BF10 = 25), respiratory rate (RR, −3.3 breaths/min, BF10 = 2), heart rate (HR, −13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, −183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, −3.8 L/min, BF10 = 1.1) and compared to CG in VE (−8.3 L/min, BF10 = 3.6), VCO2 (−215.9 L/min, BF10 = 3.0), EqCO2 (−3.7 L/min, BF10 = 1.1) and HR (−12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (−4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.


2021 ◽  
Vol 74 (10) ◽  
pp. 2605-2609
Author(s):  
Tetyana M. Ternushchak ◽  
Marianna I. Tovt-Korshynska

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.


Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2019 ◽  
Vol 39 (2) ◽  
pp. 103-112
Author(s):  
Maratus Sholihah ◽  
Suradi Suradi ◽  
Jatu Aphridasari

Introduction: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Cigarette smoke and noxious agent result in oxidative stress and activate release of inflammatory mediators such as Interleukin-8 (IL-8). Quercetin is a flavonoid compound containing anti-inflammatory effects which can be used as an adjuvant therapy in stable COPD. Objective: To analyze the effect of quercetin on serum IL-8 levels, % VEP1, and CAT score of stable COPD patients. Methods: Experimental clinical trial with pre-test and pasca-test design was performed in 30 patients with stable COPD in Dr. Moewardi Surakarta between December 2017 and January 2018. The samples taken by using purposive sampling were divided into two groups treatment groups received standard therapy and quercetin 500mg/day for 28 days and control groups only received standard therapy. The decrease in inflammation was measured by serum IL-8 examination, improvement of obstruction measured by %FEV1 and clinical improvement measured by CAT score. Results: IL-8 serum level was significantly lower in treatment group than of in control group (p=0,001). The percentage of FEV1 was insignificant different between the two group (p=0,236). However CAT score was significantly lower in treatment group compared to that of in control group (p=0,001) Conclusions: Quercetin can decrease IL-8 serum level and decrease CAT score when given in combination with standard therapy for COPD patients. (J Respir Indo 2019; 39(2))


2018 ◽  
Vol 38 (3) ◽  
pp. 164-172
Author(s):  
Khilyatul Baroroh ◽  
Suradi Suradi ◽  
Ade Rima

Background: Amplification of inflammation in acute exacerbation of chronic obstructive pulmonary disease (COPD) increases inflammatory mediators and oxidative stress in the airways, pulmonary and systemic circulation that are characterized by increased plasma level of IL-6 and MDA, resulting in worsening of clinical symptoms. Xanthones in mangosteen pericarp have anti-inflammatory and antioxidant effects, potentially as an adjuntive therapy in acute exacerbations of COPD. Methods: The aim of this study was to determine the effect of mangosteen pericarp extract to clinical improvements, plasma level of IL-6 and MDA of acute exacerbation COPD patients. A clinical trial of experimental with pretest and posttest was conducted on 34 acute exacerbation of COPD patients in Dr. Moewardi Hospital Surakarta and Dr. Ario Wirawan Lung Hospital Salatiga from April until May 2016. The sample was taken by consecutive sampling. Subjects were divided by randomized double blind technique into the treatment group (n=17) received mangosteen pericarp extract 2x1100mg/day and control group (n = 17) received placebo. Clinical improvements were measured in CAT score and length of stay. CAT score, plasma level of IL-6 and MDA were measured on admission and at discharge. Length of stay based on the number of days of care in hospitals. Results: There was significant difference (p=0,011) towards decreased of IL-6 plasma level between treatment group (-2,17 ± 3,46 pg/ mL) and control group (+1,67 ± 6,81 pg/mL). There were no significant difference towards decreased of length of stay (p=0,34) between treatment group (4,12 ± 1,54 days) and control group (5,24 ± 2,49 days), towards decreased of CAT score (p=0,252) between treatment group (-19,18 ± 3,96) and control group (-18,24 ± 2,75), and towards decreased of MDA plasma level (p=0,986) between treatment group (+0,03 ± 0,36μmol/L) and control group (+0,35 ± 1,58). Conclusions: The addition of mangosteen pericarp extract 2x1100mg/day during hospitalization was significantly lowered plasma levels of IL-6, but were not significant in lowering the CAT score, shortening the length of stay, and reducing the increase in plasma level of MDA.


2008 ◽  
pp. 39-44
Author(s):  
G. E. Mironova ◽  
E. P. Vasiliev ◽  
B. T. Velichkovsky

The aim of this study was to investigate human antioxidant defense at various COPD stages and to substantiate administration of vitamins C and E as a part of complex treatment of COPD at the Far North. We followed-up 92 COPD patients aged 20 to 50 yrs (of them, 42 males). The control group consisted of 58 healthy persons of 20 to 45 yrs of age. A total blood antioxidant activity (TAA) was detected using G.I.Klebanov's method. Superoxide dismutase (SOD) and catalase levels in erythrocyte membrane were assessed with chemiluminescent methods. Lipid peroxide (LPO) activity was measured by malone dialdehyde (MDA) plasma concentration. We also investigated hepatic and renal functions, protein, lipoid, and carbohydrate metabolism. Patients with exacerbation of stage II COPD had increased LPO activity (2.97 ± 0.12 nmol/ml compared to 1.86 ± 0.09 nmol/ml in stable phase and 1.36 ± 0.06 nmol/ml in controls) with TAA increased by 40 %. The stage III COPD patients demonstrated more significant growth of LPO activity (2.04 ± 0.08 nmol/ml in stable phase and 3.44 ± 0.15 nmol/ml in exacerbation; p < 0.05) accompanied by less prominent increase in TAA. Early stages of COPD were characterized by increased levels of antioxidant enzymes (2.44 ± 0.06 μg/g of Hb for SOD and 8.30 ± 0.15 –g/g of Hb for catalase compared to 1.56 ± 0.02 and 7.36 ± 0.10 μg/g Hb in controls). At the later COPD stages, the SOD level was less high and catalase concentration even decreased. COPD patients had increased concentrations of oxyproline (1.76 ± 0.48 g/ml to 2.80 ± 0.50 μg/ml; р<0.05 for both when compared to the controls) and α1-antitripsin (for stage II COPD, 284 ± 47 μg/ml in stable phase and 240 ± 20 μg/ml in exacerbation, for stage III COPD, 245 ± 18 μg/ml and 223 ± 15 μg/ml, respectively). Administration of vitamins C and E 25 mg/kg and 5 mg/kg of body weight, respectively, as a part of a complex therapy of the disease exacerbation resulted in shortening of exacerbation, improvement in clinical status and lung function, TAA activation, and lowering of LPO activity. Therefore, COPD is accompanied by significant activation of oxidantive processes, which depend on the stage and phase of the disease. The results allow including antioxidant vitamins in programs of treatment of COPD to be recommended.


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