Crul T, Spruit M A, Gayan-Ramirez G, Quarck R, Gosselink R, Troosters T, Pitta F, Decramer M
Respiratory Muscle Research Unit, Laboratory of Pneumology, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
Eur J Clin Invest. 2007 Nov;37(11):897-904. doi: 10.1111/j.1365-2362.2007.01867.x. Epub 2007 Sep 20.
Disuse and/or local inflammation in the muscle cannot be excluded as potential influences for the decreased muscle force in patients hospitalised due to an acute chronic obstructive pulmonary disease (COPD) exacerbation. This study aims to compare expression levels of markers of disuse (insulin-like growth factor-1 (IGF-I), MyoD and myogenin) and inflammation [interleukin-6 (IL-6), IL-8 and tumour necrosis factor-alpha (TNF-alpha)] in the muscle of hospitalised and stable COPD patients and healthy elderly.
Muscle biopsies (m. vastus lateralis) were taken in 14 hospitalised COPD patients (aged 68 +/- 8), 11 clinically stable COPD patients (aged 68 +/- 9) and seven healthy subjects (aged 70 +/- 7) to analyse local mRNA expression levels of IL-6, IL-8, TNF-alpha, IGF-I and protein expression levels of IGF-I, MyoD and myogenin. Relationships of these expression levels with lung and skeletal muscle function were investigated.
IGF-I mRNA and MyoD protein levels were significantly lower in hospitalised patients compared to healthy subjects. MyoD protein levels were positively related to quadriceps force. Muscle IL-6 and IL-8 expression in hospitalised patients was similar compared to stable patients and healthy subjects and was not related to expression levels of muscle markers of disuse or quadriceps force. Muscle TNF-alpha and myogenin were not detected.
Decreased expression levels of muscle IGF-I and MyoD in hospitalised patients suggest a potential influence of disuse in the increased muscle weakness during an acute COPD exacerbation. This study did not find any evidence supporting local inflammation via IL-6, IL-8 and/or TNF-alpha in the vastus lateralis muscle of COPD patients.
因急性慢性阻塞性肺疾病(COPD)加重而住院的患者,其肌肉力量下降的潜在影响因素不能排除废用和/或局部炎症。本研究旨在比较住院的COPD患者、稳定期COPD患者和健康老年人肌肉中废用标志物(胰岛素样生长因子-1(IGF-I)、肌分化抗原(MyoD)和肌细胞生成素)及炎症标志物(白细胞介素-6(IL-6)、IL-8和肿瘤坏死因子-α(TNF-α))的表达水平。
对14例住院的COPD患者(年龄68±8岁)、11例临床稳定的COPD患者(年龄68±9岁)和7例健康受试者(年龄70±7岁)进行外侧股四头肌肌肉活检,以分析IL-6、IL-8、TNF-α、IGF-I的局部mRNA表达水平以及IGF-I、MyoD和肌细胞生成素的蛋白表达水平。研究这些表达水平与肺和骨骼肌功能的关系。
与健康受试者相比,住院患者的IGF-I mRNA和MyoD蛋白水平显著降低。MyoD蛋白水平与股四头肌力量呈正相关。住院患者的肌肉IL-6和IL-8表达与稳定期患者及健康受试者相似,且与废用肌肉标志物的表达水平或股四头肌力量无关。未检测到肌肉TNF-α和肌细胞生成素。
住院患者肌肉IGF-I和MyoD表达水平降低表明,在急性COPD加重期,废用可能对肌肉无力增加有潜在影响。本研究未发现任何证据支持COPD患者外侧股四头肌中通过IL-6、IL-8和/或TNF-α发生局部炎症。