Elevated serum Activin A in chronic obstructive pulmonary disease with skeletal muscle wasting

Abstract

OBJECTIVE: Muscle wasting contributes to the reduced quality of life and increased mortality in chronic obstructive pulmonary disease (COPD). Muscle atrophy in mice with cachexia was caused by Activin A binding to ActRIIB. The role of circulating Activin A leading to muscle atrophy in COPD remains elusive. METHODS: In the present study, we evaluated the relationship between serum levels of Activin A and skeletal muscle wasting in COPD patients. The expression levels of serum Activin A were measured in 78 stable COPD patients and in 60 healthy controls via ELISA, which was also used to determine the expression of circulating TNF-α levels. Total skeletal muscle mass (SMM) was calculated according to a validated formula by age and anthropometric measurements. The fat-free mass index (FFMI) was determined as the fat-free mass (FFM) corrected for body surface area. RESULTS: Compared to the healthy controls, COPD patients had upregulated Activin A expression. The elevated levels of Activin A were correlated with TNF-α expression, while total SMM and FFMI were significantly decreased in COPD patients. Furthermore, serum Activin A expression in COPD patients was negatively associated with both FFMI and BMI. CONCLUSION: The above results showed an association between increased circulating Activin A in COPD patients and the presence of muscle atrophy. Given our previous knowledge, we speculate that Activin A contributes to skeletal muscle wasting in COPD.

Progranulin And Activin A Concentrations Are Elevated In Serum From Patients With Acute Exacerbations of Idiopathic Pulmonary Fibrosis

“…Activin A can stimulate broblast differentiation into myo broblasts inducing the proliferation of lung broblasts, airway smooth muscle cells, and bronchial epithelial cells [18] . Levels were raised in airways severe asthma [19] and in the serum of patients with COPD compared to healthy controls [20] . Activin A and activin B are expressed at increased levels in alveolar epithelial cells and in ammatory cells in patients with idiopathic pulmonary brosis [6] , and the activin A antagonist follicle suppressor can also reduce bleomycin-induced pulmonary brosis [17] .…”

Diagnosis of Parapneumonia Pleural Effusion With Serum and Pleural Effusion Activin A

“…Functionally, activin A as a remarkable biological actor in asthma, chronic obstructive lung disease (COPD) and lung cancer were supported in recent studies [11,12]. In our previous study, we found that levels of serum Activin A were increased in COPD patients with skeletal muscle wasting [13]. Furthermore, we recently identi ed that higher expression of serum Activin A was associated with poor prognosis of Community-Acquired Pneumonia (CAP) (not yet published).…”

“…The clinical investigation found that a higher concentration of Activin A in bronchoalveolar uid (BALF) could predict poorer mortality in ARDS patients [28]. Our previous study found that compared with healthy individuals, patients with chronic obstructive pulmonary disease have elevated levels of serum Activin A correlated with TNF-α expression [13]. Furthermore, we recently revealed that increased levels of Activin A in serum not in uenced by etiology play a more a more effective predictor of hospital mortality in CAP patients (not yet published).…”

Pro-cachectic factors link experimental and human chronic kidney disease to skeletal muscle wasting programs

“…Increased circulating pro-cachectic factors (e.g., activin A) have been observed in patients with cancer (22,61), in patients with chronic obstructive pulmonary disease (23), and now in patients with CKD. Furthermore, our findings also suggest that blood levels of activin A increased with the progression of renal impairment.…”