enteric bacteria in cirrhosis are not defined, although portal Bacterial translocation (BT) has been involved in the hypertension has been involved. There are certain situations pathogenesis of spontaneous bacterial peritonitis (SBP) associated with a high rate of BT, such as disruption of the in experimental cirrhosis. Because malnutrition is a equilibrium of indigenous flora, immunological defects, and common feature in cirrhosis, the aim of this study was malnutrition, [8][9][10] which frequently appear in cirrhosis. to evaluate the effect of nutrition on BT and SBP. WeThe aim of this study was to evaluate the influence of malinduced cirrhosis in 44 Sprague-Dawley rats by adminisnutrition on the prevalence of BT and the development of tration of oral CCl 4 , and, afterward, 26 animals were SBP in a model of experimental cirrhosis. Recently, an experimaintained with dietary restriction. Cultures of mesenmental model of cirrhotic rats by oral administration of CCl 4 teric lymph nodes (MLN), peripheral and portal blood, has been published, in which the SBP prevalence is very high liver, and spleen were performed. SBP occurred in 48%and quite similar to that in humans. 11 This makes this model of the rats with ascites, this being more frequent in the very suitable for studying the involved mechanisms and the malnourished animals (80%) than in control rats (29%).promoting factors. BT appeared in all the rats with SBP (100%) but only in 57% without it. In the malnourished animals, the BT rate MATERIALS AND METHODS was 95%, while it was 30% in the control group. These results suggest that malnutrition increases the BT rate Experimental Model. This study was conducted according to the experimental model of cirrhotic rats described by Runyon et al. 11 and the risk of developing SBP in experimental cirrhoOne hundred one male Sprague-Dawley rats were caged in consis, and that BT is frequent in cirrhosis and may play teric lymph nodes (MLN) 1 ; subsequently, these bacteria are using a 50% dilution with olive oil by esophagic cannulation with a capable of spreading to other extraintestinal sites. This prospecial needle without anesthesia. CCl 4 was given weekly with a cess has been associated with the development of sepsis starting dose of 40 mL, increasing subsequent doses depending on caused by gram-negative bacteria. 2 In animal models, numer-the change in body weight. ous factors have been identified that may promote the transMalnutrition was induced in a group of rats by reducing the adminlocation of enteric bacteria, including trauma, thermal injury, istration of standard rodent chow, administering 0.7 g protein per mesenteric ischemia, hemorrhagic shock, intestinal bacterial day. Rats fed ad libitum were the control group. Nutritional evaluaovergrowth, and endotoxinemia. [1][2][3] Although there are few tion was based on physical (weight) and biochemical (serum albumin and proteins) parameters and nitrogenous balance.clinical studies in humans, BT has been postulated as an Methodology. Throughout the study, the ...

Background: In chronic obstructive pulmonary disease (COPD), low muscle mass has been associated with several clinical outcomes such as low exercise capacity, hospital admission, and mortality. The Sarcopenia Index (SI) is a novel way to estimate muscle mass based on the ratio of serum creatinine (produced exclusively by muscle)/cystatin C (produced by all nucleated body cells). Objectives: This study aims to assess the SI in stable COPD outpatients, as compared with a healthy control group, to quantify its relationship with several important clinical features in COPD, and to study its potential usefulness to predict COPD exacerbations and hospital admissions. Methods: The SI was calculated in 18 healthy control subjects and 65 stable COPD outpatients were included in the study. Patients were prospectively followed for 1 year after being enrolled in the study. Results: COPD patients had a lower SI than controls, that is lower muscle mass. Furthermore, patients with a modified Medical Research Council dyspnea score ≥2, patients with a COPD Assessment Test score ≥10, and patients with a high risk of exacerbation had lower levels of SI compared with patients without these characteristics. SI correlated with FEV1 (r = 0.491, p < 0.001), the 6-min walking test (r = 0.560, p = 0.001), and the Fat-Free Mass Index (r = 0.431, p = 0.017). Univariate and multivariate Cox proportional risk analysis showed that a low SI is an independent predictor of hospital admission in COPD outpatients followed for 1 year (HR 5.16, p = 0.025). Conclusions: The ratio serum creatinine/serum cystatin C correlates with several COPD characteristics, and it can be used to predict COPD hospitalization.

BackgroundMOTS-c and Romo1 are mitochondrial peptides that are modulated by oxidative stress. No previous studies have explored circulating levels of MOTS-c in patients with chronic obstructive pulmonary disease (COPD).MethodsWe enrolled 142 patients with stable COPD and 47 smokers with normal lung function in an observational cross-sectional study. We assessed serum levels of both MOTS-c and Romo1 and associated these findings with clinical characteristics of COPD.ResultsCompared with smokers with normal lung function, patients with COPD had lower levels of MOTS-c (p = 0.02) and higher levels of Romo1 (p = 0.01). A multivariate logistic regression analysis revealed that above-median MOTS-c levels were positively associated with Romo1 levels (OR 1.075, 95% CI 1.005–1.150, p = 0.036), but no association was found with other COPD characteristics. Below-median levels of circulating MOTS-c were associated with oxygen desaturation (OR 3.25 95% CI 1.456–8.522, p = 0.005) and walking &lt;350 meters (OR 3.246 95% CI 1.229–8.577, p = 0.018) in six-minute walk test. Above-median levels of Romo1 were positively associated with current smoking (OR 2.756, 95% CI 1.133–6.704, p = 0.025) and negatively associated with baseline oxygen saturation (OR 0.776 95% CI 0.641–0.939, p = 0.009).ConclusionsReduced levels of circulating MOTS-c and increased levels of Romo1 were detected in patients diagnosed with COPD. Low levels of MOTS-c were associated with oxygen desaturation and poorer exercise capacity using 6 min walk test. Romo1 was associated with current smoking and baseline oxygen saturation.Trial registrationwww.clinicaltrials.gov; No.: NCT04449419; URL: www.clinicaltrials.gov. Date of registration: June 26, 2020.

Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Except for GDF15, studies on this subject are lacking. A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months. Baseline serum HN (p = 0.037) and GDF-15 (p = 0.013) levels were higher in the COPD group. High HN levels were independently associated with a high risk of exacerbation (HRE) (OR 2.798, 95% CI 1.266–6.187, p = 0.011), malnutrition (OR 6.645, 95% CI 1.859–23.749, p = 0.004), and 6MWD (OR 0.995, 95% CI 0.991–0.999, p = 0.008), and future moderate (HR 1.826, 95% CI 1.181–2.822, p = 0.007) and severe exacerbations (HR 3.445, 95% CI 1.357–8.740, p = 0.009). High GDF15 levels were associated with HRE (OR 3.028, 95% CI 1.134–8.083, p = 0.027), 6MWD (OR 0.995, 95% CI 0.990–0.999, p = 0.017) and predicted desaturation in 6MWT (OR 3.999, 95% CI 1.487–10.757, p = 0.006). High FGF21 levels were associated with HRE (OR 2.144, 95% CI 1.000–4.600, p = 0.05), and predicted future severe exacerbation (HR 4.217, 95% CI 1.459–12.193, p = 0.008). The mitokine levels were higher in patients with COPD than smokers without COPD, and were associated with important clinical outcomes such as exercise capacity and COPD exacerbation. Among the mitokines, HN showed the strongest association with COPD and may serve as a future risk biomarker in this disease.Trial registation NCT04449419.

Background: Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Except for GDF15, studies on this subject are lacking.Methods: A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months.Results: Baseline serum HN (p=0.037) and GDF-15 (p= 0.013) levels were higher in the COPD group. High HN levels were independently associated with a high risk of exacerbation (HRE) (p=0.011), malnutrition (p=0.004) and 6MWD (p=0.008), and future moderate (p=0.007) and severe exacerbations (p=0.009). High GDF15 levels were associated with HRE (p=0.027), 6MWD (p=0.017) and predicted desaturation in 6MWT (p=0.006). High FGF21 levels were associated with HRE (p=0.05), and predicted future severe exacerbation (p=0.008). Conclusions: The mitokine levels were higher in patients with COPD than smokers without COPD, and were associated with important clinical outcomes such as exercise capacity and COPD exacerbation. Among the mitokines, HN showed the strongest relationship with COPD and may serve as a future risk biomarker in this disease. Trial registry: ClinicalTrials.gov; No.: NCT04449419; URL: www.clinicaltrials.gov. Date of registration: June 26, 2020.

Background: Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Methods: A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months.Results: Baseline serum HN (p=0.037) and GDF15 (p= 0.013) levels were higher in the COPD group. High HN levels were associated with a high risk of exacerbation (HRE) (p=0.011), malnutrition (p=0.004) 6MWD (p=0.008), and future moderate (p=0.007) and severe exacerbations (p=0.009). High GDF15 levels were associated with HRE (p=0.027), 6MWD (p=0.017) and desaturation in 6MWT (p=0.006). High FGF21 levels were predicted future severe exacerbation (p=0.008).Conclusions: The mitokine levels were higher in patients with COPD than controls, and were associated with important clinical outcomes. Among the mitokines, HN showed the strongest relationship with COPD and may serve as a future risk biomarker in this disease.Trial registry: ClinicalTrials.gov; No.: NCT04449419; URL: www.clinicaltrials.gov. Date of registration: June 26, 2020.

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