Fernando De Benedetto1, Roberta Pastorelli2, Manuela Ferrario3, Francesca de Blasio4, Stefano Marinari1, Laura Brunelli2, Emiel F M Wouters5, Francesca Polverino6, Bartolome R Celli7. 1. Department of Pneumology, SS Annunziata Hospital, Chieti, Italy. 2. Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. 3. Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy. 4. Department of Medical Sciences, University of Turin, Italy. Electronic address: francesca.deblasio@unito.it. 5. Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands. 6. University of Arizona, Tucson, AZ, United States. 7. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Abstract
BACKGROUND: Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPD patients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPD patients on long-term O2 therapy. METHODS:One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS:Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION: These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
RCT Entities:
BACKGROUND: Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPDpatients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPDpatients on long-term O2 therapy. METHODS: One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS: Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION: These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
Authors: Wassim W Labaki; Tian Gu; Susan Murray; Jeffrey L Curtis; Larisa Yeomans; Russell P Bowler; R Graham Barr; Alejandro P Comellas; Nadia N Hansel; Christopher B Cooper; Igor Barjaktarevic; Richard E Kanner; Robert Paine; Merry-Lynn N McDonald; Jerry A Krishnan; Stephen P Peters; Prescott G Woodruff; Wanda K O'Neal; Wenqi Diao; Bei He; Fernando J Martinez; Theodore J Standiford; Kathleen A Stringer; MeiLan K Han Journal: Sci Rep Date: 2019-08-06 Impact factor: 4.379
Authors: Francisco Miguel Gutierrez-Mariscal; Antonio Pablo Arenas-de Larriva; Laura Limia-Perez; Juan Luis Romero-Cabrera; Elena Maria Yubero-Serrano; Jose López-Miranda Journal: Int J Mol Sci Date: 2020-10-23 Impact factor: 5.923