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Altitude and chronic obstructive pulmonary disease

Manuela Funke, Thomas Geiser, Otto D Schoch
In 2015, the international guidelines for diagnosis and treatment of pulmonary hypertension (PH) were updated. Group 3 of the current classification includes PH associated with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), other pulmonary diseases with restrictive and obstructive pattern, sleep-disordered breathing, alveolar hypoventilation disorders, chronic exposure to high altitude, and developmental lung diseases [1]. PH associated with COPD and ILD is common but difficult to manage, as no long-term randomised controlled trial (RCT) has been conducted with specific pulmonary arterial hypertension (PAH) drugs in PH associated with COPD, and the one recent RCT in PH associated with ILD had to be stopped early due to a possible increased risk of death and side effects in the treatment group...
2016: Swiss Medical Weekly
Thomas Chaillou, Johanna T Lanner
Reduced oxygen (O2) levels (hypoxia) are present during embryogenesis and exposure to altitude and in pathologic conditions. During embryogenesis, myogenic progenitor cells reside in a hypoxic microenvironment, which may regulate their activity. Satellite cells are myogenic progenitor cells localized in a local environment, suggesting that the O2 level could affect their activity during muscle regeneration. In this review, we present the idea that O2 levels regulate myogenesis and muscle regeneration, we elucidate the molecular mechanisms underlying myogenesis and muscle regeneration in hypoxia and depict therapeutic strategies using changes in O2 levels to promote muscle regeneration...
September 6, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Jörn Rittweger, Tadej Debevec, Petra Frings-Meuthen, Patrick Lau, Uwe Mittag, Bergita Ganse, Philip G Ferstl, Elizabeth J Simpson, Ian A Macdonald, Ola Eiken, Igor B Mekjavic
Bone losses are common as a consequence of unloading and also in patients with chronic obstructive pulmonary disease (COPD). Although hypoxia has been implicated as an important factor to drive bone loss, its interaction with unloading remains unresolved. The objective therefore was to assess whether human bone loss caused by unloading could be aggravated by chronic hypoxia. In a cross-over designed study, 14 healthy young men underwent 21-day interventions of bed rest in normoxia (NBR), bed rest in hypoxia (HBR), and hypoxic ambulatory confinement (HAmb)...
October 2016: Bone
Vahid Mohsenin
PURPOSE: The aim of this review is to discuss hypoxia-induced pulmonary hypertension (PH) and the role of microRNAs (miRNAs). BACKGROUND: Acute global hypoxia causes pulmonary vasoconstriction and increased pulmonary arterial blood pressure. Chronic exposure to sustained or intermittent hypoxia as in high altitude residents, chronic obstructive lung disease and sleep-disordered breathing can lead to pulmonary hypertension (PH) and right ventricular dysfunction. The development of PH is a poor prognostic sign in these patients that affects both quality of life and mortality...
September 2016: Sleep & Breathing, Schlaf & Atmung
Rodrigo Iturriaga, Rodrigo Del Rio, Juan Idiaquez, Virend K Somers
The carotid body (CB) is the main peripheral chemoreceptor that senses the arterial PO2, PCO2 and pH. In response to hypoxemia, hypercapnia and acidosis, carotid chemosensory discharge elicits reflex respiratory, autonomic and cardiovascular adjustments. The classical construct considers the CB as the main peripheral oxygen sensor, triggering reflex physiological responses to acute hypoxemia and facilitating the ventilatory acclimation to chronic hypoxemia at high altitude. However, a growing body of experimental evidence supports the novel concept that an abnormally enhanced CB chemosensory input to the brainstem contributes to overactivation of the sympathetic nervous system, and consequent pathology...
2016: Biological Research
George M Balanos, Keith Pugh, Matthew C Frise, Keith L Dorrington
What is the central question of this study? Pulmonary arterial pressure is higher in older than younger humans and predicts mortality. It is also increased by acute hypoxia, which causes constriction of the pulmonary vasculature. We asked whether this pulmonary vascular response to hypoxia is greater in older humans. What is the main finding and its importance? Using Doppler echocardiography in 12 younger (∼ 20 years old) and nine older men (∼ 55 years old) exposed to 20 min of moderate isocapnic hypoxia, we demonstrated that older men showed a significantly greater rise in pulmonary arterial pressure during alveolar hypoxia than younger men...
October 2015: Experimental Physiology
En-Zhi Feng, Sheng-Yue Yang, Ning-Xia Huang, He Yin, Ying Zhang, Zhong-Xin Tian
OBJECTIVE: To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation. METHODS: Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i...
November 2014: Chinese Journal of Applied Physiology
Devan Jaganath, J Jaime Miranda, Robert H Gilman, Robert A Wise, Gregory B Diette, Catherine H Miele, Antonio Bernabe-Ortiz, William Checkley
BACKGROUND: It is unclear how geographic and social diversity affects the prevalence of chronic obstructive pulmonary disease (COPD). We sought to characterize the prevalence of COPD and identify risk factors across four settings in Peru with varying degrees of urbanization, altitude, and biomass fuel use. METHODS: We collected sociodemographics, clinical history, and post-bronchodilator spirometry in a randomly selected, age-, sex- and site-stratified, population-based sample of 2,957 adults aged ≥35 years (median age was 54...
2015: Respiratory Research
I Cano, J Roca, P D Wagner
KEY POINTS: We expanded a prior model of whole-body O2 transport and utilization based on diffusive O2 exchange in the lungs and tissues to additionally allow for both lung ventilation-perfusion and tissue metabolism-perfusion heterogeneities, in order to estimate V̇O2 and mitochondrial PO2 (PmO2) during maximal exercise. Simulations were performed using data from (a) healthy fit subjects exercising at sea level and at altitudes up to the equivalent of Mount Everest and (b) patients with mild and severe chronic obstructive pulmonary disease (COPD) exercising at sea level...
April 15, 2015: Journal of Physiology
Selma Denis Squassoni, Nadine Cristina Machado, Mônica Silveira Lapa, Priscila Kessar Cordoni, Luciene Costa Bortolassi, Juliana Nascimento de Oliveira, Cecilia Melo Rosa Tavares, Elie Fiss
OBJECTIVE: To evaluate the influence of the altitude on the 6-minute walking test in patients with moderate to severe pulmonary disease. METHODS: Twenty-nine patients performed the 6-minute walk test at a pulmonary rehabilitation clinic in Santo André (above sea level), in São Paulo State, and at the Enseada Beach, in Guarujá (at sea level), also in São Paulo State. Of these 29 patients, 8 did the test both on hard sand and on asphalt to analyze if there were differences in performance during the tests...
October 2014: Einstein
Wolfgang Domej, Karl Oettl, Wilfried Renner
Oxidative stress occurs when free radicals and other reactive species overwhelm the availability of antioxidants. Reactive oxygen species (ROS), reactive nitrogen species, and their counterpart antioxidant agents are essential for physiological signaling and host defense, as well as for the evolution and persistence of inflammation. When their normal steady state is disturbed, imbalances between oxidants and antioxidants may provoke pathological reactions causing a range of nonrespiratory and respiratory diseases, particularly chronic obstructive pulmonary disease (COPD)...
2014: International Journal of Chronic Obstructive Pulmonary Disease
Elie Fiss, Selma Squassoni, Monica Lapa, Nadine Machado, Priscila Cordoni, Luciene Bortolassi, Cecilia Tavares, Juliana Oliveira
Physiology/PFTs/Rehabilitation PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: Individuals with Chronic Obstructive Pulmonary Disease (COPD) may exhibit significant reduction in physical performance due to various factors such as dynamic hyperinflation and progressive deconditioning associated with inactivity. A study in the Dead Sea suggested that COPD patients showed improvement in dyspnea and the distance traveled at lower altitudes...
October 1, 2014: Chest
Michael H Smolensky, Francesco Portaluppi, Roberto Manfredini, Ramon C Hermida, Ruana Tiseo, Linda L Sackett-Lundeen, Erhard L Haus
Various medical conditions, disorders, and syndromes exhibit predictable-in-time diurnal and 24 h patterning in the signs, symptoms, and grave nonfatal and fatal events, e.g., respiratory ones of viral and allergic rhinorrhea, reversible (asthma) and non-reversible (bronchitis and emphysema) chronic obstructive pulmonary disease, cystic fibrosis, high altitude pulmonary edema, and decompression sickness; cardiac ones of atrial premature beats and tachycardia, paroxysmal atrial fibrillation, 3rd degree atrial-ventricular block, paroxysmal supraventricular tachycardia, ventricular premature beats, ventricular tachyarrhythmia, symptomatic and non-symptomatic angina pectoris, Prinzmetal vasospastic variant angina, acute (non-fatal and fatal) incidents of myocardial infarction, sudden cardiac arrest, in-bed sudden death syndrome of type-1 diabetes, acute cardiogenic pulmonary edema, and heart failure; vascular and circulatory system ones of hypertension, acute orthostatic postprandial, micturition, and defecation hypotension/syncope, intermittent claudication, venous insufficiency, standing occupation leg edema, arterial and venous branch occlusion of the eye, menopausal hot flash, sickle cell syndrome, abdominal, aortic, and thoracic dissections, pulmonary thromboembolism, and deep venous thrombosis, and cerebrovascular transient ischemic attack and hemorrhagic and ischemic stroke...
June 2015: Sleep Medicine Reviews
Tolga Sinan Güvenç, Seref Kul, Coşkun Doğan, Binnaz Zeynep Yıldırım, Yavuz Karabağ, Rengin Cetin, Yüksel Kaya, Pelin Karadağ, Aleks Değirmencioğlu, Bahattin Balcı
Degree of increase in pulmonary artery pressure (PAP) and adaptive responses in right ventricular morphology and mechanics play an important role in the prognosis of chronic obstructive pulmonary disease (COPD) patients. Three dimensional echocardiography and deformation imaging are recent advancements in echocardiography that allow more through assessment of right ventricle. We aimed to investigate right ventricular geometry and mechanics in a stable COPD population living at moderately high altitude. A total of 26 stable COPD patients with variable disease severity were included to this study...
October 2014: International Journal of Cardiovascular Imaging
Ta-Chien Chan, Po-Huang Chiang, Ming-Daw Su, Hsuan-Wen Wang, Michael Shi-yung Liu
Chronic obstructive pulmonary disease (COPD) causes a high disease burden among the elderly worldwide. In Taiwan, the long-term temporal trend of COPD mortality is declining, but the geographical disparity of the disease is not yet known. Nationwide COPD age-adjusted mortality at the township level during 1999-2007 is used for elucidating the geographical distribution of the disease. With an ordinary least squares (OLS) model and geographically weighted regression (GWR), the ecologic risk factors such as smoking rate, area deprivation index, tuberculosis exposure, percentage of aborigines, density of health care facilities, air pollution and altitude are all considered in both models to evaluate their effects on mortality...
2014: PloS One
Michael Lichtenauer, Matthias Zimmermann, Stefanie Nickl, Alexander Lauten, Bjoern Goebel, Rudin Pistulli, Atilla Yilmaz, Hans-Reiner Figulla, Hendrik Jan Ankersmit, Christian Jung
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a worldwide burden. We have previously shown that elevated levels of heat shock protein-27 (HSP27), -70 (HSP70), and caspase-cleaved cytokeratin 18 (ccCK-18) were found in serum of COPD patients correlating with disease severity. We hypothesized that transient hypoxia triggers the release of HSPs and ccCK-18. METHODS: Fourteen healthy volunteers were subjected to transient normobaric hypoxia in an air-conditioned hypoxia chamber simulating an oxygen concentration at an altitude of up to 5500 meters...
2014: Clinical Laboratory
Simon N Young
Recent research indicates that suicide rates are elevated in those living at higher altitudes in both the United States and South Korea. A possible mechanism that was proposed is metabolic stress associated with hypoxia. This commentary discusses these results, and also the association between elevated suicide rates and other conditions associated with hypoxia (smoking, chronic obstructive pulmonary disease and asthma). Tryptophan hydroxylase may not normally be saturated with oxygen, so mild hypoxia would decrease serotonin synthesis...
November 2013: Journal of Psychiatry & Neuroscience: JPN
Enzhi Feng, Ronghua Wan, Shengyue Yang, Ziqiang Yan, Shaolin Wang, Wei He, Ying Zhang, He Yin, Zongru Chen, Ruinian Liu
The aim of this study was to assess the expression levels of induced sputum interleukin (IL)-8 and IL-10 levels in patients with acute exacerbated chronic obstructive pulmonary disease (AECOPD) complicated with chronic cor pulmonale (CCP) at high altitude, and to evaluate the intervention effects of an inhaled corticosteroid (ICS) and a β2-adrenoceptor agonist in this disease. A total of 186 patients with AECOPD complicated with CCP were randomly divided into three groups, with 62 cases in each. With regard to the two treatment groups, group A was treated with salmeterol/fluticasone (50 μg/250 μg, respectively) by airway inhalation twice daily, while group B received budesonide (1 mg) as a spray inhalation, twice daily...
September 2013: Experimental and Therapeutic Medicine
Dario Maldonado, Mauricio González-García, Margarita Barrero, Claudia Jaramillo, Alejandro Casas
BACKGROUND: At Bogota's altitude (2640 m), the lower barometric pressure (560 mmHg) causes severe hypoxemia in COPD patients, limiting their exercise capacity. The aim was to compare the effects of breathing oxygen on exercise tolerance. METHODS: In a blind, crossover clinical study, 29 COPD patients (FEV1 42.9 ± 11.9%) breathed room air (RA) or oxygen (FIO2 28% and 35%) during three treadmill exercise tests at 70% of their maximal capacity in a randomized order...
August 2014: COPD
Simon N Young
Recent research indicates that suicide rates are elevated in those living at higher altitudes in both the United States and South Korea. A possible mechanism that was proposed is metabolic stress associated with hypoxia. This commentary discusses these results, and also the association between elevated suicide rates and other conditions associated with hypoxia (smoking, chronic obstructive pulmonary disease and asthma). Tryptophan hydroxylase may not normally be saturated with oxygen, so mild hypoxia would decrease serotonin synthesis...
August 13, 2013: Journal of Psychiatry & Neuroscience: JPN
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