Low-Grade Systemic Inflammation and the Response to Exercise Training in Patients With Advanced COPD

Spruit, Martijn A.; Gosselink, Rik; Troosters, Thierry; Kasran, Ahmad; Vliet, Monique van; Decramer, Marc

doi:10.1378/chest.128.5.3183

Cited by 41 publications

(33 citation statements)

References 44 publications

(48 reference statements)

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“…In recent years, researchers have hypothesised that a ''lowgrade'' systemic inflammation may play an important role in the pathogenesis of systemic complications observed in chronic respiratory diseases such as COPD [248,252,268,[563][564][565][566][567][568]. In the Third National Health and Nutrition Examination Survey of the US population [564], a number of markers of systemic inflammation were shown to be associated with active smoking and reduced FEV1.…”

Section: Bloodmentioning

confidence: 99%

“…However, their level of involvement has since been questioned due to the crosssectional methodology used and the lack of information regarding the temporal aspects and biological plausibility of this observed association [569]. Previous studies [566,568,[570][571][572][573][574][575][576][577][578][579][580][581][582][583][584] have suggested roles for systemic CRP, fibrinogen, leukocytes, TNF-a, IL-6 and IL-8 in COPD and its exacerbations, but more longitudinal randomised controlled studies with larger sample sizes are needed to confirm their specificity and sensitivity as biomarkers in patients with reduced lung function [441].…”

Section: Bloodmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes for COPD pharmacological trials: from lung function to biomarkers

Cazzola¹,

MacNee²,

Martínez³

et al. 2008

European Respiratory Journal

744

566

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Section: Bloodmentioning

confidence: 99%

Section: Bloodmentioning

confidence: 99%

Outcomes for COPD pharmacological trials: from lung function to biomarkers

Cazzola¹,

MacNee²,

Martínez³

et al. 2008

European Respiratory Journal

744

566

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“…Nevertheless, the response to PR may vary considerably between patients with COPD [5,8,9,14,30,31]. Moreover, individual patients respond differential on various types of outcome measures [8,11].…”

Section: Differential Response To Prmentioning

confidence: 99%

“…Then again, the heterogeneity in pulmonary and extra-pulmonary features [32][33][34] is a clinical challenge to personalise PR programmes for patients with COPD. Consequently, not all patients with COPD are expected to benefit from PR [5,8,9,14,30,31]. These are clinically relevant observations, as patients, members from their social circle, healthcare professionals, policy makers and payers have a clear interest in the cost-effectiveness of interventions related to the integrated care of patients with COPD.…”

Section: Poor Response To Pulmonary Rehabilitationmentioning

confidence: 99%

“…So, the choice for exercise performance and/ or health status as key performance measures seems too simple, and the use of non-linear statistics seems inevitable. Moreover, multiple other outcomes (i.e., symptoms of dyspnoea, cycle endurance time, performance of problematic activities of daily life, and symptoms of anxiety and depression [2,12,14,15]) have been identified by healthcare professionals as essential to evaluate the efficacy of PR services [4]. So, a comprehensive evaluation of the efficacy of PR in individuals with COPD is complex, and requires a thorough initial and outcome assessment [1,16].…”

Section: Introductionmentioning

confidence: 99%

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Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

et al. 2015

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The aim of the present study was to profile a multidimensional response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD).Dyspnoea, exercise performance, health status, mood status and problematic activities of daily life were assessed before and after a 40-session pulmonary rehabilitation programme in 2068 patients with COPD (mean forced expiratory volume in 1 s of 49% predicted). Patients were ordered by their overall similarity concerning their multidimensional response profile, which comprises the overall response on MRC dyspnoea grade, 6MWD, cycle endurance time, Canadian Occupational Performance Measure performance and satisfaction scores, Hospital Anxiety and Depression Scale anxiety and depression, and St George's Respiratory Questionnaire total score, using a novel non-parametric regression technique.Patients were clustered into four groups with distinct multidimensional response profiles: n=378 (18.3%; "very good responder"), n=742 (35.9%; "good responder"), n=731 (35.4%; "moderate responder"), and n=217 (10.5%; "poor responder"). Patients in the "very good responder" cluster had higher symptoms of dyspnoea, number of hospitalisations <12 months, worse exercise performance, worse performance and satisfaction scores for problematic activities of daily life, more symptoms of anxiety and depression, worse health status, and a higher proportion of patients following an inpatient PR programme compared to the other three clusters.A multidimensional response outcome needs to be considered to study the efficacy of pulmonary rehabilitation services in patients with COPD, as responses to regular outcomes are differential within patients with COPD. @ERSpublications Efficacy of pulmonary rehabilitation in patients with COPD needs to be assessed using a multidimensional response http://ow.ly/RsfYK

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Factors Limiting Exercise Tolerance in Chronic Lung Diseases

Vogiatzis

Zakynthinos

2012

Comprehensive Physiology

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The major limitation to exercise performance in patients with chronic lung diseases is an issue of great importance since identifying the factors that prevent these patients from carrying out activities of daily living provides an important perspective for the choice of the appropriate therapeutic strategy. The factors that limit exercise capacity may be different in patients with different disease entities (i.e., chronic obstructive, restrictive or pulmonary vascular lung disease) or disease severity and ultimately depend on the degree of malfunction or miss coordination between the different physiological systems (i.e., respiratory, cardiovascular and peripheral muscles). This review focuses on patients with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and pulmonary vascular disease (PVD). ILD and PVD are included because there is sufficient experimental evidence for the factors that limit exercise capacity and because these disorders are representative of restrictive and pulmonary vascular disorders, respectively. A great deal of emphasis is given, however, to causes of exercise intolerance in COPD mainly because of the plethora of research findings that have been published in this area and also because exercise intolerance in COPD has been used as a model for understanding the interactions of different pathophysiologic mechanisms in exercise limitation. As exercise intolerance in COPD is recognized as being multifactorial, the impacts of the following factors on patients' exercise capacity are explored from an integrative physiological perspective: (i) imbalance between the ventilatory capacity and requirement; (ii) imbalance between energy demands and supplies to working respiratory and peripheral muscles; and (iii) peripheral muscle intrinsic dysfunction/weakness.

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Low-Grade Systemic Inflammation and the Response to Exercise Training in Patients With Advanced COPD

Cited by 41 publications

References 44 publications

Outcomes for COPD pharmacological trials: from lung function to biomarkers

Outcomes for COPD pharmacological trials: from lung function to biomarkers

Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

Factors Limiting Exercise Tolerance in Chronic Lung Diseases

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