Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

Beijers, Rosanne J.H.C.G.; Iersel, Lieke E J van; Schuurman, Lisanne; Hageman, Robert; Simons, Sami O.; Helvoort, Ardy van; Gosker, Harry R.; Schols, A.M.W.J.

doi:10.1136/bmjopen-2021-059252

Cited by 4 publications

(4 citation statements)

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“…This study shows that the intervention with the enriched diet may have positive effects on anxiety and cognition, and improved the BBB integrity, and seemed to improve the balance of the kynurenine pathway in the brain. A nutritional intervention with a comparable composition is being evaluated in COPD patients ( 45 ), and therefore, the current study is highly relevant for the clinic. Overall, the presented mouse model does represent some brain-related symptoms which are observed in COPD patients, which is relevant for future studies relating to nutritional or pharmaceutic therapy efficacy assessment for limiting the impact of brain comorbidities in COPD.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, omega-3 fatty acids have beneficial effects on processes in the brain, including the reduction of neuroinflammation, improvement of synapse function and support of blood-brain barrier integrity ( 42 , 43 ). Furthermore, the intake of fiber is low in COPD patients ( 37 , 44 , 45 ), which is related to the severity of decreased lung function ( 46 ). Prebiotics can ameliorate inflammatory processes via numerous pathways, in which short-chain fatty acids might play an important role ( 35 ).…”

Section: Introductionmentioning

confidence: 99%

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Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

et al. 2022

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One cluster of the extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) is related to the brain, which includes anxiety, depression and cognitive impairment. Brain-related comorbidities are related to worsening of symptoms and increased mortality in COPD patients. In this study, a murine model of COPD was used to examine the effects of emphysema and repetitive pulmonary inflammatory events on systemic inflammatory outcomes and brain function. In addition, the effect of a dietary intervention on brain-related parameters was assessed. Adult male C57Bl/6J mice were exposed to elastase or vehicle intratracheally (i.t.) once a week on three consecutive weeks. Two weeks after the final administration, mice were i.t. exposed to lipopolysaccharide (LPS) or vehicle for three times with a 10 day interval. A dietary intervention enriched with omega-3 PUFAs, prebiotic fibers, tryptophan and vitamin D was administered from the first LPS exposure onward. Behavior and cognitive function, the degree of emphysema and both pulmonary and systemic inflammation as well as blood-brain barrier (BBB) integrity and neuroinflammation in the brain were assessed. A lower score in the cognitive test was observed in elastase-exposed mice. Mice exposed to elastase plus LPS showed less locomotion in the behavior test. The enriched diet seemed to reduce anxiety-like behavior over time and cognitive impairments associated with the presented COPD model, without affecting locomotion. In addition, the enriched diet restored the disbalance in splenic T-helper 1 (Th1) and Th2 cells. There was a trend toward recovering elastase plus LPS-induced decreased expression of occludin in brain microvessels, a measure of BBB integrity, as well as improving expression levels of kynurenine pathway markers in the brain by the enriched diet. The findings of this study demonstrate brain-associated comorbidities – including cognitive and behavioral impairments – in this murine model for COPD. Although no changes in lung parameters were observed, exposure to the specific enriched diet in this model appeared to improve systemic immune disbalance, BBB integrity and derailed kynurenine pathway which may lead to reduction of anxiety-like behavior and improved cognition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

et al. 2022

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“…There is one ongoing study investigating the efficacy of 1-year targeted multi-nutrient supplementation on physical activity levels and health-related quality of life in patients with COPD. As an additional explorative aim, this study investigates the relative effect of targeted nutrient supplementation during the recovery phase after hospitalisation for a COPD exacerbation [ 74 ]. Therefore, more studies are needed to further investigate the window of opportunity for nutritional interventions during and after an exacerbation.…”

Section: Nutritional Supplementationmentioning

confidence: 99%

The role of diet and nutrition in the management of COPD

2023

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In 2014, the European Respiratory Society published a statement on nutritional assessment and therapy in COPD. Since then, increasing research has been performed on the role of diet and nutrition in the prevention and management of COPD. Here, we provide an overview of recent scientific advances and clinical implications. Evidence for a potential role of diet and nutrition as a risk factor in the development of COPD has been accumulating and is reflected in the dietary patterns of patients with COPD. Consuming a healthy diet should, therefore, be promoted in patients with COPD. Distinct COPD phenotypes have been identified incorporating nutritional status, ranging from cachexia and frailty to obesity. The importance of body composition assessment and the need for tailored nutritional screening instruments is further highlighted. Dietary interventions and targeted single or multi-nutrient supplementation can be beneficial when optimal timing is considered. The therapeutic window of opportunity for nutritional interventions during and recovering from an acute exacerbation and hospitalisation is underexplored.

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“…We also performed GO function and KEGG pathway enrichment analyses. Response to drug, response to nutrient levels, and response to extracellular stimulation may be the key biological processes in the ECXB formula treatment of COPD (Bidan et al, 2015;Beijers et al, 2022). Membrane raft and amide binding were the most significant cellular component and molecular functions, respectively.…”

Section: Figure 11mentioning

confidence: 99%

Herb-symptom analysis of Erchen decoction combined with Xiebai powder formula and its mechanism in the treatment of chronic obstructive pulmonary disease

Zhang

et al. 2023

Front. Pharmacol.

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Background: In recent years, the incidence and mortality rates of chronic obstructive pulmonary disease (COPD) have increased significantly. Erchen Decoction combined with Xiebai Powder (ECXB) formula is mainly used to treat lung diseases in traditional Chinese medicine (TCM). However, the active ingredients of ECXB formula, COPD treatment-related molecular targets, and the mechanisms are still unclear. To reveal its underlying action of mechanism, network pharmacology, molecular docking, and molecular dynamic (MD) simulation approaches were used to predict the active ingredients and potential targets of ECXB formula in treating COPD. As a result, Herb-Symptom analysis showed that the symptoms treated by both TCM and modern medicine of ECXB formula were similar to the symptoms of COPD. Network pharmacology identified 170 active ingredients with 137 targets, and 7,002 COPD targets was obtained. 120 targets were obtained by intersection mapping, among which the core targets include MAPK8, ESR1, TP53, MAPK3, JUN, RELA, MAPK1, and AKT1. Functional enrichment analysis suggested that ECXB formula might exert its treat COPD pharmacological effects in multiple biological processes, such as cell proliferation, apoptosis, inflammatory response, and synaptic connections, and ECXB formula treated COPD of the KEGG potential pathways might be associated with the TNF signaling pathway, cAMP signaling pathway, and VEGF signaling pathway. Molecular docking showed that ECXB formula treatment COPD core active ingredients can bind well to core targets. MD simulations showed that the RELA-beta-sitosterol complex and ESR1-stigmasterol complex exhibited higher conformational stability and lower interaction energy, further confirming the role of ECXB formula in the treatment of COPD through these core components and core targets. Our study analyzed the medication rule of ECXB formula in the treatment of COPD from a new perspective and found that the symptoms treated by both TCM and modern medicine of ECXB formula were similar to the symptoms of COPD. ECXB formula could treat COPD through multi-component, multi-target, and multi-pathway synergistic effects, providing a scientific basis for further study on the mechanism of ECXB formula treatment of COPD. It also provides new ideas for drug development.

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Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

Cited by 4 publications

References 122 publications

Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

The role of diet and nutrition in the management of COPD

Herb-symptom analysis of Erchen decoction combined with Xiebai powder formula and its mechanism in the treatment of chronic obstructive pulmonary disease

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