scholarly journals Lipoprotein-associated phospholipase A2 predicts exercise tolerance in COPD patients

2021 ◽  
Author(s):  
Mingming Deng ◽  
Yan Yin ◽  
Qin Zhang ◽  
Xiaoming Zhou ◽  
Ting Yang ◽  
...  
Keyword(s):  
Exercise Tolerance ◽  
Professional Training ◽  
Characteristic Curve ◽  
Differentially Expressed Gene ◽  
Clinical Feature ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Potential Biomarker ◽  
Minute Walk

Abstract Background & aimsImpaired exercise tolerance is a clinical feature of chronic obstructive pulmonary disease (COPD) associated with disease progression and increased mortality. The 6-minute walk test (6MWT) is a reliable and widely used measure of exercise capacity. However, it is not commonly used in primary medical institutions because it requires a suitable venue and professional training. Developing a simple tool to assess exercise tolerance is important. Molecular biomarkers show potential for evaluating the clinical outcomes (mortality, exacerbation) of COPD patients. The aim of this study was to identify simple and effective biomarkers to predict poor exercise tolerance in COPD patients.MethodsTen genes were selected by weighted correlation network analysis and differentially expressed gene analysis. Validation in an independent dataset led to the identification of PLA2G7, which was verified as a potential biomarker in COPD by bioinformatics analysis. The concentration of lipoprotein-associated phospholipase A2 (Lp-PLA2), which is encoded by the PLA2G7 gene, was assessed by enzyme-linked immunosorbent assay in a prospective validation cohort. The predictive capacity of Lp-PLA2 for 6-minute walk distance (6MWD) < 350 m was assessed using the area under the receiver operating characteristic curve (AUC). Traditional clinical features and Lp-PLA2 levels were incorporated into a nomogram to build a predictive model for poor exercise tolerance.ResultsThe final cohort included 92 stable COPD patients and 16 healthy smokers. Lp-PLA2 was upregulated in COPD patients and increased along with GOLD stage. Lp-PLA2 level was significant correlated with FEV1/FVC, BMI, FFMI, CAT score, mMRC score, and 6MWD in COPD patients. The predictive efficacy of Lp-PLA2 level (AUC: 0.796) and the derived nomogram model (AUC: 0.884) for exercise tolerance was superior to that of the sit-to-stand test and traditional clinical features.ConclusionLp-PLA2 is a promising biomarker for COPD patients and is suitable for assessing exercise tolerance in clinical practice.

scholarly journals Identification of Inflammation-Related Biomarker Lp-PLA2 for Patients With COPD by Comprehensive Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Mingming Deng ◽  
Yan Yin ◽  
Qin Zhang ◽  
Xiaoming Zhou ◽  
Gang Hou
Keyword(s):  
Exercise Tolerance ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Go Enrichment ◽  
Potential Biomarker ◽  
Immune Pathway

PurposeChronic obstructive pulmonary disease (COPD) is a complex and persistent lung disease and lack of biomarkers. The aim of this study is to screen and verify effective biomarkers for medical practice.MethodsDifferential expressed genes analysis and weighted co-expression network analysis were used to explore potential biomarker. Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene set enrichment analysis (GSEA) analysis were used to explore potential mechanism. CIBERSORTx website was used to evaluate tissue-infiltrating immune cells. Enzyme-linked immunosorbent assay (ELISA) was used to assess the concentrations of the Lp-PLA2 in serum.ResultsTen genes were selected via combined DEGs and WGCNA. Furthermore, PLA2G7 was choose based on validation from independent datasets. Immune infiltrate and enrichment analysis suggest PLA2G7 may regulate immune pathway via macrophages. Next, Lp-PLA2(coded by PLA2G7 gene) level was upregulated in COPD patients, increased along with The Global Average of COPD (GOLD) stage. In additional, Lp-PLA2 level was significant correlate with FEV1/FVC, BMI, FFMI, CAT score, mMRC score and 6MWD of COPD patients. Finally, the predictive efficiency of Lp-PLA2 level (AUC:0.796) and derived nomogram model (AUC:0.884) in exercise tolerance was notably superior to that of the sit-to-stand test and traditional clinical features.ConclusionLp-PLA2 is a promising biomarker for COPD patients and is suitable for assessing exercise tolerance in clinical practice.

scholarly journals Ultrasound assessment of the rectus femoris in patients with chronic obstructive pulmonary disease predicts poor exercise tolerance: an exploratory study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Deng ◽  
Chaonan Liang ◽  
Yan Yin ◽  
Jun Shu ◽  
Xiaoming Zhou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Skeletal Muscle ◽  
Pulmonary Disease ◽  
Exercise Tolerance ◽  
Professional Training ◽  
Rectus Femoris ◽  
Clinical Feature ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Validation Set

Abstract Background Reduced exercise tolerance is an important clinical feature of chronic obstructive pulmonary disease (COPD) and is associated with poor prognosis. The 6-min walk test (6MWT) is widely used to assess exercise capacity; however, it is not commonly administered in primary medical institutions because it requires a suitable site and professional training. Ultrasound has great potential for evaluating skeletal muscle dimensions in COPD. However, whether skeletal muscle ultrasound can predict impaired exercise tolerance is unclear. Methods The study included 154 stable patients with COPD, who were randomly divided into a development set and a validation set. The thickness (RFthick) and cross-sectional area (RFcsa) of the rectus femoris were measured using ultrasound. Standardized RFthick (STD- RFthick) and Standardized RFcsa (STD-RFcsa) were obtained via standardization of RFthick and RFcsa by patients' height. Results Strong correlations were observed between the 6MWD and RFthick (r = 0.84, p < 0.001) and between the 6MWD and RFcsa (r = 0.81, p < 0.001). In the development set, the optimal cut-off values for men and women for predicting poor exercise tolerance were < 3.098 cm/m and < 3.319 cm/m for STD-RFthick and < 4.052 cm2/m and < 4.366 cm2/m for STD-RFcsa, respectively. In the validation set, the area under the curve (AUC) values for the prediction of a 6MWD < 350 by STD-RFthick and STD-RFcsa were 0.881 and 0.903, respectively. Finally, the predictive efficacy of STD-RFthick (AUC: 0.922), STD-RFcsa (AUC: 0.904), and the derived nomogram model (AUC: 0.98) for exercise tolerance was superior to that of the sit-to-stand test and traditional clinical features. Conclusions Rectus femoris ultrasound has potential clinical application to predict impaired exercise tolerance in patients with COPD.

scholarly journals Methylation of SERPINA1 gene promoter may predict chronic obstructive pulmonary disease in patients affected by acute coronary syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
John Charles Rotondo ◽  
Giorgio Aquila ◽  
Lucia Oton-Gonzalez ◽  
Rita Selvatici ◽  
Paola Rizzo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Coronary Syndrome ◽  
Pulmonary Disease ◽  
Blood Cells ◽  
Gene Promoter ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Copd Patients ◽  
Potential Biomarker

Abstract Background Diagnostic biomarkers for detecting chronic obstructive pulmonary disease (COPD) in acute coronary syndrome (ACS) patients are not available. SERPINA1, coding for the most potent circulating anti-inflammatory protein in the lung, has been found to be differentially methylated in blood cells from COPD patients. This study aimed to investigate the methylation profile of SERPINA1 in blood cells from ACS patients, with (COPD+) or without COPD (COPD−). Methods Blood samples were from 115 ACS patients, including 30 COPD+ and 85 COPD− according to lung function phenotype, obtained with spirometry. DNA treated with sodium bisulfite was PCR-amplified at SERPINA1 promoter region. Methylation analysis was carried out by sequencing the PCR products. Lymphocytes count in ACS patients was recorded at hospital admission and discharge. Results SERPINA1 was hypermethylated in 24/30 (80%) COPD+ and 48/85 (56.5%) COPD− (p < 0.05). Interestingly, at hospital discharge, lymphocytes count was higher in COPD− patients carrying SERPINA1 hypermethylated (1.98 × 103 ± 0.6 cell/µl) than in COPD− carrying SERPINA1 hypomethylated (1.7 × 103 ± 0.48 cell/µl) (p < 0.05). Conclusions SERPINA1 is hypermethylated in blood cells from COPD+ patients. COPD− carrying SERPINA1 hypermethylated and high lymphocytes count may be at risk of COPD development. Therefore, SERPINA1 hypermethylation may represent a potential biomarker for predicting COPD development in ACS patients.

scholarly journals Nutrition in chronic obstructive pulmonary disease: A review

2015 ◽  
Vol 3 (4) ◽  
pp. 151-154 ◽  
Author(s):  
Gautam Rawal ◽  
Sankalp Yadav
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exercise Tolerance ◽  
Muscle Wasting ◽  
Nutritional Supplement ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Supplement Therapy

AbstractCachexia and muscle wasting is a frequent but partly reversible complication in patients with chronic obstructive pulmonary disease (COPD), and affects the disease progression and prognosis. Weight loss in COPD is a consequence of increased energy requirements unbalanced by dietary intake. Nutritional supplement therapy has been shown to be effective for maintaining and improving the muscle strength and exercise tolerance in poorly nourished COPD patients, thereby decreasing morbidity and mortality. This mini review discusses the role of nutritional supplement therapy in the treatment of COPD.

scholarly journals Exercise tolerance and dyspnea in patients with chronic obstructive pulmonary disease

2010 ◽  
Vol 67 (1) ◽  
pp. 36-41
Author(s):  
Ivan Cekerevac ◽  
Zorica Lazic ◽  
Ljiljana Novkovic ◽  
Marina Petrovic ◽  
Vojislav Cupurdija ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Exercise Tolerance ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Tolerance Level ◽  
Lung Hyperinflation ◽  
Copd Patients

Background/Aim. Peripheral muscle weakness and nutritional disorders, firstly loss of body weight, are common findings in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the impact of pulmonary function parameters, nutritional status and state of peripheral skeletal muscles on exercise tolerance and development of dyspnea in COPD patients. Methods. Thirty COPD patients in stable state of disease were analyzed. Standard pulmonary function tests, including spirometry, body pletysmography, and measurements of diffusion capacity were performed. The 6-minute walking distance test (6MWD) was done in order to assess exercise tolerance. Level of dyspnea was measured with Borg scale. In all patients midthigh muscle cross-sectional area (MTCSA) was measured by computerized tomography scan. Nutritional status of patients was estimated according to body mass index (BMI). Results. Statistically significant correlations were found between parameters of pulmonary function and exercise tolerance. Level of airflow limitation and lung hyperinflation had significant impact on development of dyspnea at rest and especially after exercise. Significant positive correlation was found between MTCSA and exercise tolerance. Patients with more severe airflow limitation, lung hyperinflation and reduced diffusion capacity had significantly lower MTCSA. Conclusion. Exercise tolerance in COPD patients depends on severity of bronchoobstruction, lung hyperinflation and MTCSA. Severity of bronchoobstruction and lung hyperinflation have significant impact on dyspnea level.

scholarly journals Impact of HACOR Score on Noninvasive Ventilation Failure in Non-COPD Patients with Acute-on-Chronic Respiratory Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Min Ding ◽  
Xiaoli Han ◽  
Linfu Bai ◽  
Shicong Huang ◽  
Jun Duan
Keyword(s):  
Respiratory Failure ◽  
Sensitivity And Specificity ◽  
Noninvasive Ventilation ◽  
Rating Scale ◽  
Characteristic Curve ◽  
Respiratory Acidosis ◽  
Chronic Respiratory Failure ◽  
Chronic Obstructive ◽  
Hospital Data ◽  
Copd Patients

Background. A rating scale that takes into account heart rate, acidosis, consciousness, oxygenation, and respiratory rate (the HACOR score) has been used to predict noninvasive ventilation (NIV) failure in patients with chronic obstructive pulmonary disease (COPD). However, the HACOR score has not been used to predict NIV failure in non-COPD patients with acute-on-chronic respiratory failure. Methods. This study was performed in the respiratory intensive care unit of a teaching hospital. Data had been collected prospectively between June 2011 and January 2019. We enrolled non-COPD patients who received NIV due to acute-on-chronic respiratory failure, pH < 7.35, and PaCO2 >45 mmHg. NIV failure was defined as requiring intubation or dying during NIV. The HACOR score was determined at initiation and after 1-2, 12, and 24 h of NIV. Scores can range from 0 to 27, with higher scores indicating a higher risk of NIV failure. Results. A total of 148 patients were enrolled in the study, 52 with sleep apnea-hypopnea syndrome, 34 with chronic thoracic sequelae, 31 with bronchiectasis, 14 with chest wall deformity, 5 with obesity-hypoventilation syndrome, and 12 with other conditions. Of the patients, 19 (13%) experienced NIV failure. From initiation to 24 h of NIV, the HACOR scores of patients who experienced NIV failure were much higher than those of patients who received successful NIV. The area under the receiver operating characteristic curve was 0.69, 0.91, 0.91, and 0.94 when the HACOR score was tested at initiation and after 1-2, 12, and 24 h of NIV, respectively. To obtain the best sensitivity and specificity, the cutoff value at initiation was 7 with a sensitivity of 68% and a specificity of 61%. After 1-2 h of NIV, it was 5 with a sensitivity of 90% and a specificity of 85%. After 12 h of NIV, it was 4 with a sensitivity of 82% and a specificity of 91%. After 24 h of NIV, it was 2 with a sensitivity of 100% and a specificity of 76%. Conclusions. The HACOR score has high sensitivity and specificity for predicting NIV failure among non-COPD patients who receive NIV due to acute-on-chronic respiratory failure with respiratory acidosis.

scholarly journals Correlation of spirometry and six minute walk test in patients with chronic obstructive pulmonary disease from Sundargarh, Odisha, India

2019 ◽  
Vol 8 (1) ◽  
pp. 205
Author(s):  
Yara Dinakar ◽  
Pradeep Panchadi Kiran ◽  
Akshaya K. Mohanty ◽  
Praveen Kishore Sahu ◽  
Anita Mohanty
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Significant Positive Correlation ◽  
Significant Negative Correlation ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Obstructive Pulmonary Disease ◽  
Positive Correlation ◽  
Six Minute Walk Test ◽  
Copd Patients ◽  
Minute Walk

Background: Six‑Minute Walk Test (6MWT) is a simple, objective, reproducible test which correlated well with different spirometric indices, and thus able to predict severity of Chronic Obstructive Pulmonary Disease (COPD) and can replace spirometry in resource poor set‑up. Here, author evaluated the correlation of 6 minute walk distance (6MWD) with spirometric indices in COPD patients and the potential of 6MWT as an alternative to the assessment of severity of COPD.Methods: This cross-sectional observational study included a total of 80 COPD patients, diagnosed by GOLD criteria (Post bronchodilator FEV1/ FVC ratio <0.7). Modified Medical Research Council (mMRC) grading was used (age, weight, height, body mass index- BMI and breathlessness) and all the patients underwent spirometric measurement of FEV1, FVC and FEV1/ FVC ratio and tests were repeated after bronchodilation using 200-400 μg of salbutamol. 6MWT was performed following American Thoracic Society (ATS) protocol of 6MWT and distance was measured in meters.Results: Author found significant negative correlation of 6MWT with age (r=-0.384, p=0.00) and mMRC grading of dyspnea (r=-0.559, p=0.00) and significant positive correlation with height (r=0.267, p=0.019) and weight (r=0.293, p=0.008). Significant positive correlation of 6MWD was noted with post bronchodilator FEV1(r=0.608, p=0.00), FEV1% (r=0.429, p=0.00), FVC (r=0.514 p=0.00), FVC% (r=0.313 p=0.005), FEV1/FVC % (r=0.336, p=0.001). Positive correlation was also observed between 6MWT and BMI but statistically insignificant (r=0.177, p=0.116). There was significant negative correlation between 6MWT and GOLD staging (r=-0.536, p=0.00).Conclusions: This finding concludes that 6MWT can be used for the assessment of severity of disease in COPD patients in places where spirometry is not available.

scholarly journals CXCL-8 in Preoperative Colorectal Cancer Patients: Significance for Diagnosis and Cancer Progression

2020 ◽  
Vol 21 (6) ◽  
pp. 2040 ◽  
Author(s):  
Sara Pączek ◽  
Marta Łukaszewicz-Zając ◽  
Mariusz Gryko ◽  
Piotr Mroczko ◽  
Agnieszka Kulczyńska-Przybik ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Marker ◽  
Cancer Progression ◽  
Characteristic Curve ◽  
Distant Metastases ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Predictive Values ◽  
Potential Biomarker ◽  
Tumor Stages

Introduction. Since colorectal cancer (CRC) is the second most commonly diagnosed malignancy in Europe and third worldwide, novel biomarkers for diagnosing the disease are critically needed. Objectives. According to our knowledge, the present study is the first to evaluate the clinical usefulness of serum CXCL-8 (C-X-C motif chemokine 8) in the diagnosis and progression of CRC compared to classical tumor marker CEA (carcinoembryonic antigen) and marker of inflammation CRP (C-reactive protein). Patients and Methods. The study included 59 CRC patients and 46 healthy volunteers. Serum levels of selected proteins were measured using ELISA (enzyme-linked immunosorbent assay), CMIA (chemiluminescent microparticle immunoassay), and immunoturbidimetric methods. Results. Serum concentrations of CXCL-8, similarly to those of the classical tumor marker CEA and inflammatory state marker CRP, were significantly higher in CRC patients than in healthy controls. There were statistically significant differences in CXCL-8 concentrations between tumor stages, as established by the Kruskal–Wallis test and confirmed by the post hoc Dwass–Steele–Critchlow–Fligner test. CXCL-8 levels were also significantly elevated in CRC patients with distant metastases compared to patients in the subgroup without metastases. Diagnostic sensitivity, predictive values for negative results (NPV), and AUC (area under the Receiver Operating Characteristic Curve—ROC curve) of CXCL-8 were higher than those of CEA, while diagnostic specificity and predictive values for positive results (PPV) of CXCL-8 were higher than those of CRP. Conclusions. Our findings indicate greater utility of CXCL-8 in comparison to the classical tumor marker CEA in the diagnosis of CRC. Moreover, serum CXCL-8 might be a potential biomarker of colorectal cancer progression.

scholarly journals Intermittent Use of Portable NIV Increases Exercise Tolerance in COPD: A Randomised, Cross-Over Trial

2019 ◽  
Vol 8 (1) ◽  
pp. 94 ◽  
Author(s):  
Ioannis Vogiatzis ◽  
Nikolaos Chynkiamis ◽  
Matthew Armstrong ◽  
Nicholas Lane ◽  
Tom Hartley ◽  
...  
Keyword(s):  
Exercise Tolerance ◽  
Moderate Intensity ◽  
Chronic Obstructive ◽  
Dynamic Hyperinflation ◽  
Invasive Ventilation ◽  
Inspiratory Capacity ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Copd Patients ◽  
Non Invasive Ventilation

During exercise, non-invasive ventilation (NIV) prolongs endurance in chronic obstructive pulmonary disease (COPD), but routine use is impractical. The VitaBreath device provides portable NIV (pNIV); however, it can only be used during recovery. We assessed the effect of pNIV compared to pursed lip breathing (PLB) on exercise tolerance. Twenty-four COPD patients were randomised to a high-intensity (HI: 2-min at 80% peak work rate (WRpeak) alternated with 2-min recovery; n = 13), or a moderate-intensity (MOD: 6-min at 60% WRpeak alternated with 2-min recovery; n = 11) protocol, and within these groups two tests were performed using pNIV and PLB during recovery in balanced order. Upon completion, patients were provided with pNIV; use over 12 weeks was assessed. Compared to PLB, pNIV increased exercise tolerance (HI: by 5.2 ± 6.0 min; MOD: by 5.8 ± 6.7 min) (p < 0.05). With pNIV, mean inspiratory capacity increased and breathlessness decreased by clinically meaningful margins during recovery compared to the end of exercise (HI: by 140 ± 110 mL and 1.2 ± 1.7; MOD: by 170 ± 80 mL and 1.0 ± 0.7). At 12 weeks, patients reported that pNIV reduced anxiety (median: 7.5/10 versus 4/10, p = 0.001) and recovery time from breathlessness (17/24 patients; p = 0.002); 23/24 used the device at least weekly. pNIV increased exercise tolerance by reducing dynamic hyperinflation and breathlessness in COPD patients.

scholarly journals Exercise Performance as a Predictor for Balance Impairment in COPD Patients

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 171 ◽  
Author(s):  
Chalerm Liwsrisakun ◽  
Chaicharn Pothirat ◽  
Warawut Chaiwong ◽  
Chaiwat Bumroongkit ◽  
Athavudh Deesomchok ◽  
...  
Keyword(s):  
Exercise Performance ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
P Value ◽  
Chiang Mai ◽  
Timed Up And Go ◽  
Balance Impairment ◽  
Adjusted Risk ◽  
Copd Patients ◽  
Minute Walk

Background and objective: Six-minute walk test (6-MWT) is a widely used test for assessing exercise performance in chronic obstructive pulmonary (COPD). However, the association between reduced walking distance and balance impairment in COPD has not been directly investigated. Therefore, the aim of this study was to identify exercise performance as a predictor for balance impairment in COPD. Materials and Methods: The cross-sectional study was conducted at a single visit involving stable COPD patients in Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand from November 2015 to October 2017. The 6-MWT was measured for in all subjects. The prognostic confounding factors were also collected for all subjects. Balance test was measured using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. A cut-off score of BBS < 46 and/or the TUG ≥ 13.5 s was classified as balance impairment. Multivariable logistic regressions were performed to identify the six-minute walk distance (6-MWD) as a predictor for balance impairment in COPD. Results: Of the 176 COPD subjects assessed for eligibility, 118 COPD patients were enrolled including 86 males (72.9%) with a mean age of 73.5 ± 8.1 years. Thirty-three (28.0%) cases were classified with a balance impairment. The 6-MWD < 300 m was the predictor of balance impairment in COPD with an adjusted risk ratio of 10.10 (95%CI; 2.87, 35.61, p-value < 0.001). Conclusions: The 6-MWT is not only useful for evaluation of exercise performance, but also for prediction of balance impairment in patients with COPD. Our study suggests that the 6-MWD < 300 m is an important risk factor for balance impairment in COPD.

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