Comprehensive effects of supplemented essential amino acids in patients with severe COPD and sarcopenia

Abstract

EAAs supplemented, but not patients assuming placebo, progressively improved all baseline variables overtime. In particular, at T12 of EAAs supplementation, body weight (BW) increased by 6 Kg (p = 0.002), FFM by 3.6 Kg (p = 0.05), plasma lactate decreased from 1.6 micromol/l to 1.3 micromol/l (p = 0.023), PaO2 increased by 4.6 mmHg (p = 0.01), physical activity increased by 80% (p = 0.01). Moreover, the score for cognitive dysfunction improved from 19.1 scores to 20.8 (p = 0.011), while the SRGQ score also improved from 723 to 69.6 even though this trend did not reach the statistical significance. CONCLUSIONS. A three-month EAAs supplementation may have comprehensive effects on nutritional status; muscle energy metabolism; blood oxygen tension, physical autonomy; cognitive function, and perception of health status in patients with severe COPD and secondary sarcopenia.

Essential amino acid supplementation in patients with severe COPD: a step towards home rehabilitation

“…From a clinical perspective, this study confirms data obtained in previous investigations carried out in patients with COPD [8,9] or with chronic heart failure [10] who were supplemented with the same amino acid formula, at the same dose used in the present study. EAAs should not be intended as a substitute for Rehab whenever possible.…”

“…Despite the high prevalence in COPD subjects [48,49], cognitive dysfunction is often underestimated in clinical practice, and an altered cognition may reflect the pulmonary dysfunction [48] and/or hyposaturation of oxygen [50,51]. The improvement of saturation of oxygen can contribute to reduce cognitive dysfunction [8], while EAAs may directly influence cognition as several amino acids are precursors of brain neurotransmitters [8].…”

“…This hypothesis relies on the following considerations: firstly, EAAs, by promoting protein synthesis [7], can increase body mass (mainly the muscle portion) which plays a crucial role for the exercise performance and the perception of well-being. Secondly, preliminary studies carried out by two independent groups [8,9] have shown that EAA supplementation increases physical activity, cognition and quality of life in cachectic/sarcopenic COPD subjects, while another study found that EAAs can improve the nutritional state; the muscle metabolism, and the exercise capacity in individuals with chronic heart failure [10]. Furthermore, several studies found that EAAs work as precursors in the synthesis of brain neurotransmitters [11] which are involved in mood, behavioural motor activity, and cognition [12].…”

Exercise training alone or with the addition of activity counseling improves physical activity levels in COPD: a systematic review and meta-analysis of randomized controlled trials

“…Included RCTs measured the effects of ET (n=10),15–24 activity counseling (n=15),25–40 health monitoring (n=1),41,42 pharmacological treatment (n=3),43–45 nutritional interventions (n=2),46–48 oxygen therapy (n=4),14,49–51 urban walking circuits (n=1)52 and integrated disease management (n=1)53 on PA levels in COPD. PA counseling was delivered either in a center-based setting (n=9),25–27,29,30,32–34,39 through phone calls (n=3)31,36,37 or by internet-mediated approaches (n=3) 35,38,40.…”

“…15,24 None of the studies included in the meta-analyses had blinded the assessors or the therapists from study groups. One study of essential amino acid (EAA) supplementation46,47 reported an increase in steps favoring the intervention arm at 3 months (577.6 steps, P =0.02); however, insufficient sample size details prevented ES calculations (Table S1). Important increases in daily steps were also reported in a crossover RCT in favor of the once-daily long-acting beta agonist, indacaterol 150 μg,45 compared to placebo at 3 weeks (0.32 [0.02–0.63]; Table S1).…”