Abstract:Zuo L, Nogueira L, Hogan MC. Effect of pulmonary TNF-␣ overexpression on mouse isolated skeletal muscle function. Am J Physiol Regul Integr Comp Physiol 301: R1025-R1031, 2011. First published June 22, 2011 doi:10.1152/ajpregu.00126.2011.-TNF-␣ is a proinflammatory cytokine that is involved in numerous pathological processes including chronic obstructive pulmonary disease (COPD). In the present study, we used a transgenic mouse model that overexpresses TNF-␣ in the lung (Tg ϩ ) to test the hypothesis that ch… Show more
“…An interesting hypothesis on molecular level is increased reactive oxygen species formation and oxidative stress (Zuo et al, 2012). This could lead to increased TNF α levels, which reduce skeletal muscle force and resistance to fatigue (Zuo, Nogueira & Hogan, 2011). As a systemic inflammatory disorder, COPD is associated with respiratory muscle dysfunction (Wouters, 2002) which could be further worsened by this mechanism and contribute to the mortality.…”
IntroductionOne-year mortality in COPD patients is reported to be between 4% and 43%, depending on the group examined.AimTo examine the one-year mortality in COPD patients after severe exacerbation and the correlation between mortality and patients’ characteristics and comorbidities.MethodsA total of 152 COPD patients hospitalized for severe exacerbation were assessed for vitamin D status, diabetes mellitus (DM), arterial hypertension (AH), and metabolic syndrome (MS). Data were gathered about smoking status and number of exacerbations in previous year. CAT and mMRC questionnaires were completed by all patients. Pre- and post-bronchodilatory spirometry was performed. One-year mortality was established from national death register.ResultsOne-year mortality is 7.2%. DM, MS, and VD are not predictors for one-year mortality. However there is a trend for increased mortality in patients with AH (9.5% vs. 2.1%, p = 0.107). There is increased mortality in patients with mMRC > 2 (11.1 vs. 0%, p = 0.013). The presence of severe exacerbation in the previous year is a risk factor for mortality (12.5% vs. 1.4%, p = 0.009). There is a trend for increased mortality in the group with FEV1 < 50% (11.5 vs. 4.4%, p = 0.094). Cox regression shows 3.7% increase in mortality rate for 1% decrease in FEV1, 5.2% for 1% decrease in PEF, 7.8% for one year age increase and 8.1% for 1 CAT point increase (all p < 0.05).ConclusionsThis study finds relatively low one-year mortality in COPD patients after surviving severe exacerbation. Grade C and FEV1 > 80% may be factors for good prognosis. Risk factors for increased mortality are age, FEV1 value, severe exacerbation in previous year and reduced quality of life.
“…An interesting hypothesis on molecular level is increased reactive oxygen species formation and oxidative stress (Zuo et al, 2012). This could lead to increased TNF α levels, which reduce skeletal muscle force and resistance to fatigue (Zuo, Nogueira & Hogan, 2011). As a systemic inflammatory disorder, COPD is associated with respiratory muscle dysfunction (Wouters, 2002) which could be further worsened by this mechanism and contribute to the mortality.…”
IntroductionOne-year mortality in COPD patients is reported to be between 4% and 43%, depending on the group examined.AimTo examine the one-year mortality in COPD patients after severe exacerbation and the correlation between mortality and patients’ characteristics and comorbidities.MethodsA total of 152 COPD patients hospitalized for severe exacerbation were assessed for vitamin D status, diabetes mellitus (DM), arterial hypertension (AH), and metabolic syndrome (MS). Data were gathered about smoking status and number of exacerbations in previous year. CAT and mMRC questionnaires were completed by all patients. Pre- and post-bronchodilatory spirometry was performed. One-year mortality was established from national death register.ResultsOne-year mortality is 7.2%. DM, MS, and VD are not predictors for one-year mortality. However there is a trend for increased mortality in patients with AH (9.5% vs. 2.1%, p = 0.107). There is increased mortality in patients with mMRC > 2 (11.1 vs. 0%, p = 0.013). The presence of severe exacerbation in the previous year is a risk factor for mortality (12.5% vs. 1.4%, p = 0.009). There is a trend for increased mortality in the group with FEV1 < 50% (11.5 vs. 4.4%, p = 0.094). Cox regression shows 3.7% increase in mortality rate for 1% decrease in FEV1, 5.2% for 1% decrease in PEF, 7.8% for one year age increase and 8.1% for 1 CAT point increase (all p < 0.05).ConclusionsThis study finds relatively low one-year mortality in COPD patients after surviving severe exacerbation. Grade C and FEV1 > 80% may be factors for good prognosis. Risk factors for increased mortality are age, FEV1 value, severe exacerbation in previous year and reduced quality of life.
“…So the question is whether circulating or lung-derived TNF-/ would have an impact on muscle function. In a transgenic mouse model overexpressing TNF-/ in the lung, TNF-/ impaired peripheral skeletal muscle function due to excessive formation of superoxide in contracting skeletal muscle [36,37]. However, a study of 426 COPD patients over a 3-year period found that TNF-/ levels were associated with muscle loss only in patients who were cachectic at entry into the study; the authors concluded that inflammation is a consequence rather than a cause of initial loss of fat-free mass [38].…”
“…It appears that this cytokine may be a key factor in reducing contractile function of the heart, diaphragm, and limb muscles (28,45,59). Specifically, pulmonary TNF-␣ overexpression has been shown to induce peripheral skeletal muscle dysfunction (60) and impair muscle regeneration (27). However, the mechanism by which this occurs has not been fully elucidated.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, we have investigated the potential link between TNF-␣ and ROS formation in skeletal muscle. We used a pulmonary TNF-␣ overexpression (Tg ϩ ) mouse to model COPD conditions, as previously described (16,60), and to delineate the role of ROS in a contracting peripheral skeletal muscle (soleus) affected by TNF-␣ overexpression in the lung.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, it is important to evaluate skeletal muscle ROS generation in a model of pulmonary TNF-␣ overexpression. In the current study, we used an in vitro soleus muscle model from transgenic (Tg ϩ , pulmonary TNF-␣ overexpression) mice, which mimics many of the pathophysiological conditions of COPD (16,60). We tested the hypothesis that pulmonary TNF-␣ overexpression would increase ROS release from skeletal muscle and decrease fatigue resistance.…”
Chronic obstructive pulmonary disease (COPD) often results in increased levels of tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, which circulates in the blood. However, it is not clear whether pulmonary TNF-α overexpression (a COPD mimic) induces excessive reactive oxygen species (ROS) formation in skeletal muscle and thereby may contribute to the muscle impairment often seen in COPD. We hypothesized that ROS generation in contracting skeletal muscle is elevated when there is TNF-α overproduction in the lung and that this can induce muscle dysfunction. Cytochrome c (cyt c) in the perfusate was used to assay superoxide (O2·−) release from isolated contracting soleus muscles from transgenic mice of pulmonary TNF-α overexpression (Tg+) and wild-type (WT) mice. Our results showed that Tg+ muscle released significantly higher levels of O2·− than WT during a period of intense contractile activity (in nmol/mg wt; 17.5 ± 2.3 vs. 4.4 ± 1.3, respectively; n = 5; P < 0.05). In addition, the soleus muscle demonstrated a significantly reduced fatigue resistance in Tg+ mice compared with WT mice. Perfusion of the contracting soleus muscle with superoxide dismutase, which specifically scavenges O2·− in the perfusate, resulted in significantly less cyt c reduction, thereby indicating that the type of ROS released from the Tg+ muscles is O2·−. Our results demonstrate that pulmonary TNF-α overexpression leads to a greater O2·− release from contracting soleus muscle in Tg+ compared with WT and that the excessive formation of O2·− in the contracting muscle of Tg+ mice leads to earlier fatigue.
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