scholarly journals EVALUATION OF CYTOKINE-MEDIATED MECHANISMS INVOLVED IN DEVELOPMENT OF RESPIRATORY MUSCLE DYSFUNCTION IN THE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2019 ◽  
Vol 21 (3) ◽  
pp. 487-494
Author(s):  
E. P. Kalinina ◽  
B. I. Geltser ◽  
I. G. Kurpatov ◽  
T. V. Gorborukova ◽  
T. A. Gvozdenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Moderate Increase ◽  
Clustering Methods ◽  
Obstructive Pulmonary Disease ◽  
Immune Parameters ◽  
Copd Patients

Respiratory muscle (RM) strength was studied in 85 men with exacerbations of chronic obstructive pulmonary disease (COPD). The strength indicators of expiratory (MEP) and inspiratory pressure (MIP, SNIP) in oral cavity were registered by means of the MicroRPM device (CareFusion, UK), as well as intranasal pressure levels by SNIP test. The measured MEP, MIP и SNIP values were compared to the proper indices. Serum concentrations of cytokines (IL-4, IL-6, IL-10, IL-17A, IL-21, TNFα, IFNγ and TGF-β) were determined. The results of the study were processed by means of canonical analysis and by clustering methods. Expiratory RM dysfunction was recorded in mild COPD, expiratory-inspiratory RM dysfunction was recorded in moderate COPD and the diaphragm dysfunction was recorded in severe COPD. Three groups of patients with different combinations of RM strength indicators and immune parameters were identified by means of cluster analysis. The cytokine profile in the first cluster was characterized by maximal concentrations of IL-17A, IL-21, TNFα and TGF-β, whereas RM strength indexes showed minimal values. In the second cluster, a decrease of RM strength indicators by 25-40% against control was associated with a sharp rise of IL-6, along with moderate increase of IL-21 and TGF-βconcentrations. In the third cluster, maximal levels of IL-6, IL-10 and IFNγwere registered, along with low levels of IL-17A, IL-21 and TGF-β concentrations, whereas MEP, MIP и SNIP values did not sufficiently differ from their levels in second cluster. The results of canonical and correlation analysis indicated to interconnections between either certain cytokines, or their pool with the RM strength indicators, dyspnea severity and functional state of COPD patients, thus suggesting involvement of cytokine-mediated mechanisms in pathogenesis of the respiratory muscle dysfunction.

scholarly journals Evaluation of the relationship between the parameters of peripheral skeletal and respiratory muscles in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 92 (3) ◽  
pp. 36-41
Author(s):  
A. K. Suleymanova ◽  
I. A. Baranova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Respiratory Muscles ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Limb Muscle ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Relationship

Chronic obstructive pulmonary disease (COPD) is a group of diseases with high levels of comorbidity. Pathological changes of peripheral skeletal and respiratory muscles in COPD patients, which are often underestimated, occupy a special place. Aim. To study the relationship between functional and quantitative parameters of the peripheral (limb muscle) and respiratory muscles in COPD patients. Materials and methods. 127 patients (98 men/29 women, mean age 67.68.2 years) were under observation without acute COPD. All COPD patients were classified according to GOLD (2019) into groups A, B, C, D. The algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) was used to diagnose sarcopenia. The muscle mass was measured using dual energy X-ray absorptiometry (DXA) and the appendicular lean mass index (ASM) was estimated. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured by body plethysmograph MasterScreen Body. Quantitative assessment of thoracic muscle cross-sectional areas were performed using the CT scan using Vidar Dicom Viewer software. Results. Sarcopenia was diagnosed in 43.3% of COPD patients. Respiratory muscle dysfunction was determined in 66.1% of patients with COPD, its probability increased in groups C and D in comparison with groups A and B [chance ratio 6.6 (95% confidence interval 2.915.0); p0.0001]. Correlations between the functional parameters of sarcopenia and respiratory muscle strength as well as between the mass of peripheral skeletal muscles and respiratory muscle area have been established according to the data of computerized tomography (р0.01). Sarcopenia as well as respiratory muscle dysfunction was observed more frequently in persons with severe and extremely severe airway obstruction and in patients with predominantly emphysematic COPD phenotype (p0.01). Conclusion. Sarcopenia is a frequent comorbidity in COPD and its development is connected with the severity of the course of the main disease. Correlation between parameters of peripheral (limb muscle) and respiratory muscles in patients with COPD has been determined.

Non-invasive Assessment of Respiratory Muscle Function and its Relationship to Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 34 (3) ◽  
pp. 240-246 ◽  
Author(s):  
J Chlumský ◽  
P Filipova ◽  
M Terl
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Muscle Function ◽  
Exercise Tolerance ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Respiratory Muscle Function ◽  
Copd Patients

Most patients with chronic obstructive pulmonary disease (COPD) have impaired respiratory muscle function. Maximal oesophageal pressure correlates closely with exercise tolerance and seems to predict the distance walked during the 6-min walk test. This study assessed the non-invasive parameters of respiratory muscle function in 41 patients with COPD to investigate their relationship to pulmonary function tests and exercise tolerance. The COPD patients, who demonstrated the full range of airway obstruction severity, had a mean forced expiratory volume in 1 s of 42.5% predicted (range, 20–79% predicted). Both the maximal inspiratory muscle strength and non-invasive tension-time index were significantly correlated with the degree of lung hyperinflation, as expressed by the ratio of residual volume to total lung capacity, and the distance walked in 6 min. We conclude that respiratory muscle function was influenced mainly by lung hyperinflation and that it had an important effect on exercise tolerance in COPD patients.

scholarly journals Epigenetic Mechanisms in Respiratory Muscle Dysfunction of Patients with Chronic Obstructive Pulmonary Disease

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e111514 ◽  
Author(s):  
Ester Puig-Vilanova ◽  
Rafael Aguiló ◽  
Alberto Rodríguez-Fuster ◽  
Juana Martínez-Llorens ◽  
Joaquim Gea ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Chronic Obstructive ◽  
Muscle Dysfunction ◽  
Epigenetic Mechanisms ◽  
Obstructive Pulmonary Disease

scholarly journals Functional State of Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 99 (6) ◽  
pp. 15-21
Author(s):  
I. G. Kurpаtov ◽  
B. I. Geltser ◽  
V. N. Kotelnikov ◽  
M. F. Kinyaykin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Muscle ◽  
Respiratory Muscles ◽  
Strength Characteristics ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Muscle Dysfunction ◽  
Obstructive Pulmonary Disease

The objective: to assess the strength of respiratory muscles (RM) in patients with chronic obstructive pulmonary disease (COPD) and determine the role of certain pathogenetic factors of COPD in the development of respiratory muscle dysfunction.Subjects and methods. In in-patient settings, the strength characteristics of respiratory muscles were studied in 85 men aged 39-78 years suffering fromCOPD exacerbation. MicroRPM (CareFusion, UK) was used to determine the levels of maximum inspiratory and expiratory pressures in the oral cavity, maximum rate of their rise during inspiration and expiration as well as the level of intranasal pressure before and after the test with salbutamol.Results. Significant variability in strength characteristics of respiratory muscles was observed depending on the stage of COPD, its phenotype, and the presence of hypoxemia or hypercapnia. In patients at early stage of COPD, only expiratory respiratory muscle dysfunction was documented; at moderate and severe stages, inspiratory and expiratory muscle dysfunction was observed, and at very severe stage – diaphragm dysfunction prevailed. The results of the salbutamol test demonstrated the maximum increase in the strength of respiratory in early and moderate COPD and the minimum increase in extremely severeCOPD indicating the role of the irreversible component of bronchial obstruction in the development of respiratory muscle dysfunction. The emphysematous phenotype of COPD was characterized by inspiratory respiratory muscle dysfunction, while the bronchitic phenotype was characterized by expiratory respiratory muscle dysfunction. In patients with hypoxemia and hypercapnia, the strength of inspiratory respiratory muscle was lower versus normoxemia.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

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.

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