Matthew R Lammi1, Mohamed A Ghonim2, Jessica Johnson3, Johnny D'Aquin4, John B Zamjahn5, Andy Pellett5, Samuel C Okpechi6, Connie Romaine7, Kusma Pyakurel8, Hahn H Luu8, Judd E Shellito7, A Hamid Boulares8, Bennett P deBoisblanc9. 1. Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, United States; Comprehensive Pulmonary Hypertension Center-University Medical Center, United States. Electronic address: mlammi@lsuhsc.edu. 2. Louisiana State University Health Sciences Center, Stanley S. Scott Cancer Center, United States; The Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. 3. Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, United States; Xavier University of Louisiana School of Pharmacy, United States. 4. East Jefferson General Hospital, United States. 5. Louisiana State University Health Sciences Center, Cardiopulmonary Science, United States. 6. Louisiana State University Health Sciences Center, Stanley S. Scott Cancer Center, United States; Louisiana State University Health Sciences Center, Department of Biochemistry and Molecular Biology, United States. 7. Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, United States. 8. Louisiana State University Health Sciences Center, Stanley S. Scott Cancer Center, United States. 9. Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care and Allergy/Immunology, United States; Comprehensive Pulmonary Hypertension Center-University Medical Center, United States.
Abstract
BACKGROUND AND OBJECTIVE: We tested whether the prostacyclin analog inhaled iloprost modulates dead space, dynamic hyperinflation (DH), and systemic inflammation/oxidative stress during maximal exercise in subjects with chronic obstructive pulmonary disease (COPD) who were not selected based on pulmonary hypertension (PH). METHODS: Twenty-four COPD patients with moderate-severe obstruction (age 59 ± 7 years, FEV1 53 ± 13% predicted) participated in a randomized, double-blind, placebo-controlled crossover trial. Each subject received a single nebulized dose of 5.0 μg iloprost or placebo on non-consecutive days followed by maximal cardiopulmonary exercise tests. The primary outcome was DH quantified by end-expiratory lung volume/total lung capacity ratio (EELV/TLC) at metabolic isotime. RESULTS: Inhaled iloprost was well-tolerated and reduced submaximal alveolar dead-space fraction but did not significantly reduce DH (0.70 ± 0.09 vs 0.69 ± 0.07 following placebo and iloprost, respectively, p = 0.38). Maximal exercise time (9.1 ± 2.3 vs 9.3 ± 2.2 min, p = 0.31) and peak oxygen uptake (17.4 ± 6.3 vs 17.9 ± 6.9 mL/kg/min, p = 0.30) were not significantly different following placebo versus iloprost. CONCLUSIONS: A single dose of inhaled iloprost was safe and reduced alveolar dead space fraction; however, it was not efficacious in modulating DH or improving exercise capacity in COPD patients who were not selected for the presence of PH.
BACKGROUND AND OBJECTIVE: We tested whether the prostacyclin analog inhaled iloprost modulates dead space, dynamic hyperinflation (DH), and systemic inflammation/oxidative stress during maximal exercise in subjects with chronic obstructive pulmonary disease (COPD) who were not selected based on pulmonary hypertension (PH). METHODS: Twenty-four COPD patients with moderate-severe obstruction (age 59 ± 7 years, FEV1 53 ± 13% predicted) participated in a randomized, double-blind, placebo-controlled crossover trial. Each subject received a single nebulized dose of 5.0 μg iloprost or placebo on non-consecutive days followed by maximal cardiopulmonary exercise tests. The primary outcome was DH quantified by end-expiratory lung volume/total lung capacity ratio (EELV/TLC) at metabolic isotime. RESULTS: Inhaled iloprost was well-tolerated and reduced submaximal alveolar dead-space fraction but did not significantly reduce DH (0.70 ± 0.09 vs 0.69 ± 0.07 following placebo and iloprost, respectively, p = 0.38). Maximal exercise time (9.1 ± 2.3 vs 9.3 ± 2.2 min, p = 0.31) and peak oxygen uptake (17.4 ± 6.3 vs 17.9 ± 6.9 mL/kg/min, p = 0.30) were not significantly different following placebo versus iloprost. CONCLUSIONS: A single dose of inhaled iloprost was safe and reduced alveolar dead space fraction; however, it was not efficacious in modulating DH or improving exercise capacity in COPD patients who were not selected for the presence of PH.
Authors: M R Miller; J Hankinson; V Brusasco; F Burgos; R Casaburi; A Coates; R Crapo; P Enright; C P M van der Grinten; P Gustafsson; R Jensen; D C Johnson; N MacIntyre; R McKay; D Navajas; O F Pedersen; R Pellegrino; G Viegi; J Wanger Journal: Eur Respir J Date: 2005-08 Impact factor: 16.671
Authors: Matthew R Lammi; Mohamed A Ghonim; Kusma Pyakurel; Amarjit S Naura; Salome V Ibba; Christian J Davis; Samuel C Okpechi; Kyle I Happel; Bennett P deBoisblanc; Judd Shellito; A Hamid Boulares Journal: Am J Physiol Lung Cell Mol Physiol Date: 2016-02-05 Impact factor: 5.464
Authors: Norbert Weissmann; Borja Lobo; Alexandra Pichl; Nirmal Parajuli; Michael Seimetz; Raquel Puig-Pey; Elisabet Ferrer; Víctor I Peinado; David Domínguez-Fandos; Athanasios Fysikopoulos; Johannes-Peter Stasch; Hossein A Ghofrani; Núria Coll-Bonfill; Reiner Frey; Ralph T Schermuly; Jéssica García-Lucio; Isabel Blanco; Mariola Bednorz; Olga Tura-Ceide; Elsa Tadele; Ralf P Brandes; Jan Grimminger; Walter Klepetko; Peter Jaksch; Robert Rodriguez-Roisin; Werner Seeger; Friedrich Grimminger; Joan A Barberà Journal: Am J Respir Crit Care Med Date: 2014-06-01 Impact factor: 21.405