Pulmonary Rehabilitation Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037 Telese Terme, Italy.
Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy.
Cells. 2022 Jan 20;11(3):344. doi: 10.3390/cells11030344.
Chronic obstructive pulmonary disease (COPD) is characterized by different phenotypes and clinical presentations. Therefore, a single strategy of pulmonary rehabilitation (PR) does not always yield the expected clinical outcomes as some individuals respond excellently, others discreetly, or do not respond at all. Fifty consecutive COPD patients were enrolled. Of them, 35 starting a 5-week PR program were sampled at admission (T), after 2 (T) and 5 (T) weeks, while 15 controls not yet on PR were tested at T and T. Nuclear magnetic resonance (NMR) profiling of exhaled breath condensate (EBC) and multivariate statistical analysis were applied to investigate the relationship between biomarkers and clinical parameters. The model including the three classes correctly located T between T and T, but 38.71% of samples partially overlapped with T and 32.26% with T, suggesting that for some patients PR is already beneficial at T (32.26% overlapping with T), while for others (38.71% overlapping with T) more time is required. Rehabilitated patients presented several altered biomarkers. In particular, methanol from T to T decreased in parallel with dyspnea and fatigue, while the walk distance increased. Methanol could be ascribed to lung inflammation. We demonstrated that the metabolic COPD phenotype clearly evolves during PR, with a strict relationship between clinical and molecular parameters. Methanol, correlating with clinical parameters, represents a useful biomarker for monitoring personalized outcomes and establishing more targeted protocols.
慢性阻塞性肺疾病（COPD）的表型和临床表现各不相同。因此，单一的肺康复（PR）策略并不总能产生预期的临床效果，因为有些患者反应良好，有些则反应一般，还有些则根本没有反应。连续纳入了 50 名 COPD 患者。其中，35 名患者开始了为期 5 周的 PR 计划，在入院时（T）、第 2 周（T）和第 5 周（T）时进行采样，而 15 名未进行 PR 的对照者在 T 和 T 时进行测试。应用核磁共振（NMR）对呼出气冷凝液（EBC）进行分析，并进行多元统计分析，以研究生物标志物与临床参数之间的关系。包括三个类别的模型正确地标定了 T 在 T 和 T 之间，但 38.71%的样本与 T 部分重叠，32.26%与 T 重叠，这表明对于一些患者，PR 在 T 时已经有益（与 T 重叠 32.26%），而对于另一些患者（与 T 重叠 38.71%）则需要更多时间。接受康复治疗的患者表现出几种改变的生物标志物。特别是，从 T 到 T 时，甲醇的含量与呼吸困难和疲劳呈平行下降，而步行距离增加。甲醇可能归因于肺部炎症。我们证明，在 PR 过程中，COPD 的代谢表型明显演变，临床和分子参数之间存在严格的关系。与临床参数相关的甲醇代表了一种用于监测个性化结果和建立更具针对性方案的有用生物标志物。
