4.7 Article

Dichloroacetate enhances performance and reduces blood lactate during maximal cycle exercise in chronic obstructive pulmonary disease

期刊

出版社

AMER THORACIC SOC
DOI: 10.1164/rccm.200707-1032OC

关键词

exercise limitation; chronic obstructive pulmonary disease; energy metabolism; dichloroacetate; skeletal muscle dysfunction

向作者/读者索取更多资源

Rationale: Impaired skeletal muscle function contributes to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). This is characterized by reduced mitochondrial adenosine triphosphate generation, and greater reliance on nonmitochondrial energy production. Dichloroacetate (DCA) infusion activates muscle pyruvate dehydrogenase complex (PDC) at rest, reducing inertia in mitochondrial energy delivery at the onset of exercise and diminishing anaerobic energy production. Objectives: This study aimed to determine whether DCA infusion enhanced mitochondrial energy delivery during symptom-limited maximal exercise, thereby reducing exercise-induced lactate and ammonia accumulation and, consequently, improving exercise performance in patients with COPD. Methods: A randomized, double-blind crossover design was used. Eighteen subjects with COPD performed maximal cycle exercise after an intravenous infusion of DCA (50 mg/kg body mass) or saline (control). Exercise work output was determined, and blood lactate and ammonia concentrations were measured at rest, 1 and 2 minutes of exercise, peak exercise, and 2 minutes postexercise. Measurements and Main Results: DCA infusion reduced peak blood lactate concentration by 20% (mean [SE]; difference, 0.48 [0.11] mmol/L, P < 0.001) and peak blood ammonia concentration by 15% (mean [SE]; difference, 14.2 [2.9] mu mol/L, P < 0.001] compared with control. After DCA, peak exercise workload improved significantly by a mean (SE) of 8 (1) W (P < 0.001) and peak oxygen consumption by 1.2 (0.5) ml/kg/minute (P = 0.03) compared with control. Conclusions: We have shown that a pharmacologic intervention known to activate muscle PDC can reduce blood lactate and ammonia accumulation during exercise and improve maximal exercise performance in subjects with COPD. Skeletal muscle PDC activation may be a target for pharmacologic intervention in the management of exercise intolerance in COPD.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

Article Endocrinology & Metabolism

Antecubital Vein Cannula Position Impacts Assessment of Forearm Glucose Uptake During an Oral Glucose Challenge in Healthy Volunteers

Cecile Betry, Aline Nixon, Paul L. Greenhaff, Elizabeth J. Simpson

Summary: The study found that the position of the antecubital vein cannula significantly impacts the calculation of postprandial forearm glucose uptake. These findings have important implications for longitudinal intervention studies requiring continuous determination of forearm glucose uptake.

EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES (2022)

Article Respiratory System

Whole-body and muscle responses to aerobic exercise training and withdrawal in ageing and COPD

Lorna E. Latimer, Dumitru Constantin-Teodosiu, Bhavesh Popat, Despina Constantin, Linzy Houchen-Wolloff, Charlotte E. Bolton, Michael C. Steiner, Paul L. Greenhaff

Summary: The study found that aging and COPD do not impair intrinsic mitochondrial function in untrained state, but AET has robust effects on whole-body and muscle mitochondrial responses in HY, significant effects in HO, and deficiencies in COPD. All groups showed strong muscle mRNA responses.

EUROPEAN RESPIRATORY JOURNAL (2022)

Article Medicine, General & Internal

Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19 The RECOVERY-RS Randomized Clinical Trial

Gavin D. Perkins, Chen Ji, Bronwen A. Connolly, Keith Couper, Ranjit Lall, J. Kenneth Baillie, Judy M. Bradley, Paul Dark, Chirag Dave, Anthony De Soyza, Anna Dennis, Anne Devrell, Sara Fairbairn, Hakim Ghani, Ellen A. Gorman, Christopher A. Green, Nicholas Hart, Siew Wan Hee, Zoe Kimbley, Shyam Madathil, Nicola McGowan, Benjamin Messer, Jay Naisbitt, Chloe Norman, Dhruv Parekh, Emma M. Parkin, Jaimin Patel, Scott E. Regan, Clare Ross, Anthony J. Rostron, Mohammad Saim, Anita K. Simonds, Emma Skilton, Nigel Stallard, Michael Steiner, Rama Vancheeswaran, Joyce Yeung, Daniel F. McAuley

Summary: Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

Article Medicine, General & Internal

Culturally adapted pulmonary rehabilitation for adults living with post-tuberculosis lung disease in Kyrgyzstan: protocol for a randomised controlled trial with blinded outcome measures

Azamat Akylbekov, Mark W. Orme, Amy Jones, Maamed Mademilov, Aibermet Muratbekova, Shoira Aidaralieva, Gulzada Mirzalieva, Alena Oleinik, Kamila Magdieva, Aijan Taalaibekova, Aidai Rysbek Kyzy, Zainab K. Yusuf, Jones Rupert, Andy Barton, Ruhme B. Miah, Adrian Manise, Jesse A. Matheson, Dominic Malcolm, Robert C. Free, Michael C. Steiner, Talant Sooronbaev, Sally J. Singh

Summary: Pulmonary rehabilitation (PR) is recommended for managing COPD and other chronic respiratory diseases, but is often not available for people with TB or PTBLD in low and middle-income countries. This study aims to adapt a culturally appropriate PR programme in Kyrgyzstan for people with PTBLD and to test its effectiveness in improving exercise capacity through a fully powered RCT.

BMJ OPEN (2022)

Article Respiratory System

Developing Appropriate Pulmonary Rehabilitation Services in Sri Lanka: Assessment of People Living with COPD and Healthcare Providers in Urban and Semi Urban Areas in Sri Lanka

A. Chamilya H. Perera, Akila R. Jayamaha, Amy Jones, Zainab K. Yusuf, K. D. C. Upendra Wijayasiri, Thamara Amarasekara, Anthony Seneviratne, Ruhme Miah, Andy Barton, Michael C. Steiner, Savithri W. Wimalasekara, Mark W. Orme, Sally J. Singh

Summary: Adults living with COPD in Sri Lanka are interested in participating in a culturally appropriate Pulmonary Rehabilitation (PR) programme, preferably in a supervised, group-based setting in hospitals. However, there is a lack of awareness about PR among both patients and healthcare providers (HCPs), and HCPs feel unprepared to refer patients to PR programmes. It is crucial to provide training for HCPs and develop effective referral strategies to support the uptake and delivery of PR for adults living with COPD in Sri Lanka.

INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (2022)

Editorial Material Respiratory System

Perioperative rehabilitation in thoracic surgery: get up and go!

Edward Caruana, Michael C. Steiner

THORAX (2023)

Article Primary Health Care

Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways

Gillian E. Doe, Marie T. Williams, Stacey Chantrell, Michael C. Steiner, Natalie Armstrong, Ann Hutchinson, Rachael A. Evans

Summary: This study explored the experiences of patients with chronic breathlessness who were awaiting a diagnosis and primary care clinicians. The findings identified potential reasons for delays in diagnosis and suggested interventions to improve symptom recognition, diagnostic approaches, and clinician communication to achieve earlier diagnosis and management for better patient outcomes.

BRITISH JOURNAL OF GENERAL PRACTICE (2023)

Article Cardiac & Cardiovascular Systems

COPD: Providing the right treatment for the right patient at the right time

Alvar Agusti, Nicolino Ambrosino, Felicity Blackstock, Jean Bourbeau, Richard Casaburi, Bartolome Celli, Rebecca Crouch, Roberto Dal Negro, Michael Dreher, Christine Garvey, Daniel Gerardi, Roger Goldstein, Nicola Hanania, Anne E. Holland, Antarpreet Kaur, Suzanne Lareau, Peter K. Lindenauer, David Mannino, Barry Make, Francois Maltais, Jeffrey D. Marciniuk, Paula Meek, Mike Morgan, Jean-Louis Pepin, Jane Z. Reardon, Carolyn Rochester, Sally Singh, Martijn A. Spruit, Michael C. Steiner, Thierry Troosters, Michele Vitacca, Enico Clini, Jose Jardim, Linda Nici, Jonathan Raskin, Richard ZuWallack

Summary: Chronic Obstructive Pulmonary Disease (COPD) is a common and preventable disease with significant morbidity and mortality. Understanding the complexity of COPD is a major challenge, as it is now recognized as a multi-component disease with various clinical phenotypes and associated co-morbidities. Optimizing treatment strategies and delivery of care in COPD has shown impressive benefits in patient outcomes and healthcare utilization.

RESPIRATORY MEDICINE (2023)

Article Primary Health Care

Comparing research recruitment strategies to prospectively identify patients presenting with breathlessness in primary care

Gillian Doe, Simon Wathall, Jill Clanchy, Sarah Edwards, Helen Evans, Michael C. Steiner, Rachael A. Evans

Summary: This study compared two recruitment strategies and found that using an electronic template triggered during a consultation significantly increased recruitment of patients with breathlessness for prospective research.

NPJ PRIMARY CARE RESPIRATORY MEDICINE (2022)

Article Respiratory System

Body mass index across adulthood and the development of airflow obstruction and emphysema

Ruth E. Trethewey, Nicole L. Spartano, Ramachandran S. Vasan, Martin G. Larson, George T. O'Connor, Dale W. Esliger, Emily S. Petherick, Michael C. Steiner

Summary: The study finds that low body mass index (BMI) is associated with COPD, and also identifies associations between the development of emphysema and airflow obstruction with BMI and lung density.

CHRONIC RESPIRATORY DISEASE (2022)

Article Respiratory System

Exercise rehabilitation in COPD and heart failure: comparison of two national audits

Amy V. Jones, Rachael A. Evans, Alexander S. Harrison, Lauren B. Sherar, Michael C. Steiner, Patrick Doherty, Sally J. Singh

Summary: This study investigated the participation and completion of rehabilitation programs by patients with coexisting COPD and CHF, and compared the outcomes. The results showed that patients with COPD and CHF had lower participation in cardiac rehabilitation, but higher participation in pulmonary rehabilitation. Patients with COPD had better performance in the incremental shuttle walk test following rehabilitation compared to patients with COPD+CHF. The improvements in the 6-min walk test, quality of life, and mood state were similar between the two groups, regardless of diagnosis.

ERJ OPEN RESEARCH (2022)

Article Respiratory System

Mortality associated with metabolic syndrome in people with COPD managed in primary care

Urvee Karsanji, Rachael A. Evans, Jennifer K. Quint, Kamlesh Khunti, Claire A. Lawson, Emily Petherick, Neil J. Greening, Sally J. Singh, Matthew Richardson, Michael C. Steiner

Summary: The prevalence of MetS in COPD patients is 10.1%, and it is associated with higher 5-year mortality risk. However, the impact is minimal when adjusted for COPD disease severity and other comorbidities. Individual components of MetS have differential impacts on mortality.

ERJ OPEN RESEARCH (2022)

Article Health Care Sciences & Services

Usability of Wearable Multiparameter Technology to Continuously Monitor Free-Living Vital Signs in People Living With Chronic Obstructive Pulmonary Disease: Prospective Observational Study

Grace Hawthorne, Neil Greening, Dale Esliger, Samuel Briggs-Price, Matthew Richardson, Emma Chaplin, Lisa Clinch, Michael C. Steiner, Sally J. Singh, Mark W. Orme

Summary: This study investigated the usability and acceptability of continuous vital signs monitoring using wearable multiparameter technology in people with chronic obstructive pulmonary disease (COPD). The results showed that the technology was well accepted by participants and was able to accurately measure vital signs, although the data quality was influenced by body composition.

JMIR HUMAN FACTORS (2022)

Article Respiratory System

A proof of concept for continuous, non-invasive, free-living vital signs monitoring to predict readmission following an acute exacerbation of COPD: a prospective cohort study

Grace Hawthorne, Matthew Richardson, Neil J. Greening, Dale Esliger, Samuel Briggs-Price, Emma J. Chaplin, Lisa Clinch, Michael C. Steiner, Sally J. Singh, Mark W. Orme

Summary: This study found that increased heart rate and reduced physical activity may be associated with exacerbations of chronic obstructive pulmonary disease. Respiratory rate and heart rate are potential indicators for predicting worsening symptoms in the future.

RESPIRATORY RESEARCH (2022)

Article Respiratory System

CRD Editor's corner archive: October-December

Michael C. Steiner

CHRONIC RESPIRATORY DISEASE (2022)

暂无数据