Lung Function Decline Dramatically Slowed with a Flavonoid

 

Lung Function Decline Dramatically Slowed with a Flavonoid

Lung Function Decline Dramatically Slowed with a Flavonoid

Previous research has shown that the plant-produced chemicals known as flavonoids have beneficial antioxidant and anti-inflammatory properties. Anthocyanins, the type of flavonoid investigated in the current study, have been detected in lung tissue shortly after being ingested, and in animals models of chronic obstructive pulmonary disease (COPD). The plant chemicals appear to reduce mucus and inflammatory secretions.

Dietary Intake of Anthocyanin Flavonoids and Ten Year Lung Function Decline in Adults from the European Community Respiratory Health Survey (ECRHS) V. Garcia Larsen, R. Villegas, E.R. Omenaas, C. Svanes, J. Garcia-Aymerich, P.G.J. Burney, D. Jarvis, and ECRHS Diet Working Group B23. ENVIRONMENTAL EPIDEMIOLOGICAL INVESTIGATIONS IN ASTHMA. May 1, 2018, A2797-A2797

Anthocyanin, Flavonoids, COPD, FEV1, FVC, lung, Lung Age, Lung Decline, Lung Function, Remedy, Food

Dietary antioxidants may help repair the Lungs

Dietary antioxidants may help repair the Lungs

Over a 10 year period researchers observed that regular intake of tomatoes may help slow the natural decline in lung function among all adults as well as other findings.

Dietary antioxidants and ten-year lung function decline in adults from the ECRHS survey. European Respiratory Journal, December 2017 DOI: 10.1183/13993003.02286-2016

Doctors Group Sues FDA over ( Daxas, Daliresp) , Roflumilast for COPD

Highlights:

-Physicians for Integrity in Medical Research says in its federal complaint against Food and Drug Administration Commissioner Margaret Hamburg

– best-case scenario showed that roflumilast reduced the number of exacerbations by one episode a year for every five patients treated

– the regulator ignored the “statistically significant increase in incidents of prostate and lung cancer in patients taking roflumilast.”

———- Possible safe Option Vinpocetine

-Published today in the Proceedings of the National Academy of Sciences vinpocetine has great potential for the treatment of COPD and other inflammatory diseases.”

-has no evidence of toxicity or noticeable side effects in human patients Continue reading “Doctors Group Sues FDA over ( Daxas, Daliresp) , Roflumilast for COPD”

Doctors Group Sues FDA, Saying Drug Does More Harm Than Good

roflumilast, a drug used to treat chronic obstructive pulmonary disease

English: Logo of the .
English: Logo of the . (Photo credit: Wikipedia)
 

By ELIZABETH WARMERDAM

 

LOS ANGELES (CN) – A physicians group sued the U.S. FDA, seeking revocation of FDA approval of roflumilast, a drug used to treat chronic obstructive pulmonary disease. Continue reading “Doctors Group Sues FDA, Saying Drug Does More Harm Than Good”

Vitamin C could ease muscle fatigue in chronic obstructive pulmonary disease patients

Contact: Donna Krupa dkrupa@the-aps.org American Physiological Society

Bethesda, Md. (Nov. 7, 2013)—Chronic obstructive pulmonary disease—a health problem in which the lungs lose their inherent springiness, making it progressively harder to breathe—can have a dramatic effect on the ability to exercise and even perform simple activities of daily life because of the disease’s fallout effects on skeletal muscles. Several factors have been implicated in these muscle problems. These include loss of fitness from inactivity, problems with the part of cells that convert fuel to energy caused by the COPD itself, and oxidative stress, a phenomenon in which cells and tissues become damaged by unstable molecules called free radicals that harm other molecules in domino-like chain reactions. Some research suggests that easing oxidative stress could improve skeletal muscle function.

To test this idea, researchers led by Matthew J. Rossman of the George E. Whalen VA Medical Center and the University of Utah gave COPD patients intravenous (IV) infusions of vitamin C, a powerful antioxidant that can combat oxidative stress, or saline as a placebo before the patients performed knee extension exercises and underwent neuromuscular function tests. Their findings show that IV infusions of vitamin C can improve skeletal muscle fatigue in COPD patients, further implicating the role of oxidative stress in the skeletal muscle problems that accompany this disease.

The article is entitled “Ascorbate Infusion Increases Skeletal Muscle Fatigue Resistance in Patients with Chronic Obstructive Pulmonary Disease“. It appears in the online edition of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, published by the American Physiological Society.

Methodology

The researchers worked with 10 COPD patients. Each patient performed a set of knee extension exercises, receiving either an IV infusion of saline or an IV infusion of vitamin C before the set, but both the study volunteers and the researchers monitoring the exercises didn’t know which infusion the volunteers received. Two to three days later, the volunteers performed a second set of knee exercises after receiving the other type of infusion. Before and after they performed these exercises, the study subjects had blood drawn to test for antioxidant levels. Immediately after the exercises, the researchers measured a variety of other factors, including the volunteers’ breathing and heart rate, blood pressure, feelings of exertion of breathlessness, and blood flow.

Results

The researchers found that during exercises, patients had significantly less muscle fatigue after receiving vitamin C and breathed better and slower. After vitamin C infusions, the volunteers also had significantly higher blood antioxidant activity than when they received only saline. Additionally, vitamin C infusions lowered their resting blood pressure and blood flow.

Importance of the Findings

These findings suggest that IV infusions of antioxidants, such as vitamin C, can curb the skeletal muscle fatigue that plagues COPD patients. They also provide further evidence that oxidative stress plays a critical role in the skeletal muscle dysfunction that many COPD patients experience. They suggest that antioxidants could eventually be used as a treatment for these problems.

“Targeting oxidative stress with some form of antioxidant therapy in a clinical setting may represent an important therapeutic avenue for patients with COPD,” they write.

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Study Team

In addition to Matthew J. Rossman, the study team also includes Ryan S. Garten, J. Jonathan Groot, Van Reese, Jia Zhao, Markus Amann, and Russell S. Richardson, all of the George E. Whalen VA Medical Center and the University of Utah.

Physiology is the study of how molecules, cells, tissues, and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first US society in the biomedical sciences field. The Society represents more than 11,000 members and publishes 14 peer-reviewed journals with a worldwide readership.

NOTE TO EDITORS: To schedule an interview with a member of the research team, please contact Donna Krupa at dkrupa@the-aps.org, @Phyziochick, or 301.634.7209. The article is available online at http://bit.ly/1bZiW5W.

Frequently prescribed drug used in concerning ways with harmful side effects: i.e. Death – benzodiazepines

Contact: Kate Taylor TaylorKa@smh.ca 647-393-7527 St. Michael’s Hospital

TORONTO, Feb. 6, 2013—A popular class of drugs commonly used to treat sleep and mood symptoms continues to be frequently prescribed despite being known to have potentially life-threatening side effects.

Previous studies have linked benzodiazepines – a medication class that may be used in chronic obstructive pulmonary disease (COPD) to treat symptoms of insomnia, depression, anxiety and shortness of breath – with adverse outcomes, but until now there has been little information on how frequently it’s prescribed or who is using it.

COPD, also known as emphysema or chronic bronchitis, is most commonly caused by smoking in North America and is estimated to affect 5 to10 per cent of the Canadian population. American Thoracic Society-European Respiratory Society guidelines recommend that benzodiazepines be avoided in these  patients because of potential respiratory-related side-effects.

Dr. Nicholas Vozoris is the lead author of a study published this week in Drugs and Aging looking at the scope of benzodiazepine use in the older adult COPD population to determine just how many people are using the drug.

“I see a large number of COPD patients taking this medication class to help relieve disease-related symptoms like insomnia, depression and anxiety,” said Dr. Vozoris, a respirologist at St. Michael’s Hospital. “But considering the potential respiratory side-effects, and the well-documented neurocognitive side effects like memory loss, decreased alertness, falls and increased risk of motor vehicle accidents, the high frequency of benzodiazepine use in COPD is very concerning.”

Dr. Vozoris and colleagues looked at more than 100,000 adults 66 years and older with COPD in Ontario between 2004 and 2009 to see how many new benzodiazepines were dispensed and the severity of each patients’ COPD while on the drug.

The results found that new benzodiazepine dispensing was common and occurred in more than a third of the adults. Use of the drugs was 40 per cent more common amongst those with more severe COPD. This group also had the highest number of repeat prescriptions and early refills and benzodiazepines were also commonly dispensed to patients while they were having flare-ups of the disease.

“These findings are new and they are concerning because they tell us that the patients most at risk to be affected by the adverse effects of this drug are the same ones that are using it with the most frequency,” Dr. Vozoris said. “This medication could be causing harm in this already respiratory-vulnerable population.”

Although benzodiazepines can be effective for helping patients sleep, this medication class has been previously found to affect breathing ability and oxygen levels at night.

“Patients need to hear this and health care providers need to give thought into who they are prescribing this medication class to,” Dr. Vozoris said. “We’re talking about a very vulnerable sub-group and we may be inappropriately prescribing this medication class to those patients.”

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The study was funded by the Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

For more information, or to speak to Dr. Vozoris please contact:

Kate Taylor  Communications Adviser St. Michael’s Hospital  Phone: 416-864-6060 x. 6537 TaylorKa@smh.ca Inspired Care. Inspiring Science www.stmichaelshospital.com

The respirology clinics at St. Michael’s Hospital and inpatient beds, now located in some of the older wings, will be moving into the new patient care tower on the corner of Queen and Victoria Street in downtown Toronto in 2018.

Long-term use of vitamin E may decrease COPD risk

2010 study posted for filing

Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society

ATS 2010, NEW ORLEANS— Long-term, regular use of vitamin E in women 45 years of age and older may help decrease the risk of chronic obstructive pulmonary disease (COPD) by about 10 percent in both smokers and non-smokers, according to a study conducted by researchers at Cornell University and Brigham and Women’s Hospital.

“As lung disease develops, damage occurs to sensitive tissues through several proposed processes, including inflammation and damage from free radicals,” said Anne Hermetet Agler, doctoral candidate with Cornell University’s Division of Nutritional Sciences. “Vitamin E may protect the lung against such damage.”

The results of the study will be presented at the ATS 2010 International Conference in New Orleans.

“The findings from our study suggest that increasing vitamin E prevents COPD,” said Ms. Agler. “Previous research found that higher intake of vitamin E was associated with a lower risk of COPD, but the studies were not designed to answer the question of whether increasing vitamin E intake would prevent COPD. Using a large, randomized controlled trial to answer this question provided stronger evidence than previous studies.”

Ms. Agler and colleagues reviewed data compiled by the Women’s Health Study, a multi-year, long-term effort ending in 2004 that focused on the effects of aspirin and vitamin E in the prevention of cardiovascular disease and cancer in nearly 40,000 women aged 45 years and older. Study participants were randomized to receive either 600 mg of vitamin E or a placebo every other day during the course of the research.

Although fewer women taking vitamin E developed COPD, Ms. Agler noted the supplements appeared to have no effect on asthma, and women taking vitamin E supplements were diagnosed with asthma at about the same rate as women taking placebo pills. Importantly, Ms. Agler noted the decreased risk of COPD in women who were given vitamin E was the same for smokers as for non-smokers.

Ms. Agler said further research will explore the way vitamin E affects the lung tissue and function, and will assess the effects of vitamin E supplements on lung diseases in men.

“If results of this study are borne out by further research, clinicians may recommend that women take vitamin E supplements to prevent COPD,” Ms. Agler noted. “Remember that vitamin E supplements are known to have detrimental effects in some people; for example vitamin E supplementation increased risk of congestive heart failure in cardiovascular disease patients. Broader recommendations would need to balance both benefits and risks. ”

 

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“Randomized Vitamin E Supplementation and Risk of Chronic Lung Disease (CLD) in the Women’s Health Study” (Session C103, Tuesday, May 18, 1:30- 4:00 p.m., CC-Room 353-355 (Third Level), Morial Convention Center; Abstract 3727)

Common bronchodilator linked to increased deaths

2008 Post for filing

Contact: Marla Paul Marla-Paul@northwestern.edu 312-503-8928 Northwestern University

CHICAGO — A common bronchodilator drug which has been used for more than a decade by patients with chronic obstructive pulmonary disease (COPD) has been linked to a one-third higher risk of cardiovascular-related deaths.

The drug, ipratropium, is sold under the brand names Atrovent and Combivent, the latter a combination product that contains ipratropium.

A new study from Northwestern University’s Feinberg School of Medicine found that veterans with recently diagnosed COPD using ipratropium were 34 percent more likely to die of a heart attack or of arrhythmia than COPD patients using only albuterol (another bronchodilator) or patients not using any treatment.

The study is published in the Sept. 15 issue of the Annals of Internal Medicine.

“This medication may be having some systemic cardiovascular effect that is increasing the risk of death in COPD patients,” said Todd Lee, lead author and research assistant professor in the Institute for HealthCare Studies at the Feinberg School.

COPD is an umbrella term for respiratory diseases that include chronic bronchitis and emphysema. The primary cause is smoking. An estimated 12 million people in the U.S.  have COPD. The disease is the fourth leading cause of death in the U.S. and is expected to grow to the third leading cause by 2020 due largely to an aging population with a higher historical rate of smoking.

Todd noted his study is observational and indicates the need for researchers to take a closer look at this medication, which has been considered safe for many years. The study looked at the cause of death of 145,000 veterans with newly diagnosed COPD from 1999 to 2003.

“The safety of drugs for COPD patients has flown under the radar,” Lee said. “We decided to look into the safety of respiratory medications for COPD patients because of some concerns that had been raised in asthma drugs. We were curious as to whether there were safety problems with these medications in patients with COPD.”

Todd said patients and providers should be aware of the potential risk. “When they make treatment decisions they need to weigh these potential risks against other medications that are available for COPD,” he noted

Sulforaphane, which occurs naturally in broccoli restores certain functions in COPD

2008 Post for filing

Contact: Keely Savoie ksavoie@thoracic.org 212-315-8620 American Thoracic Society

COPD?  Eat your veggies

You know it’s good for you in other ways, but could eating your broccoli also help patients with chronic lung disease? It just might.

According to recent research from Johns Hopkins Medical School, a decrease in lung concentrations of NRF2-dependent antioxidants, key components of the lung’s defense system against inflammatory injury, is linked to the severity of chronic obstructive pulmonary disease (COPD) in smokers. Broccoli is known to contain a compound that prevents the degradation of.

The findings were published in the second issue for September of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

COPD is the fourth-leading cause of death in the U.S. and affects more than 16 million Americans.

In this study, researchers examined tissue samples from the lungs of smokers with and without COPD to determine if there were differences in measured levels of NRF2 expression and the level of its biochemical regulators, including KEAP1, which inhibits NRF2, and DJ-1, which stabilizes it. Dr. Biswal had previously shown that disruption in NRF2 expression in mice exposed to cigarette smoke caused early onset of severe emphysema.

When compared to non-COPD lungs, the lungs of patients with COPD showed markedly decreased levels of NRF2-dependent antioxidants, increased oxidative stress markers, a significant decrease in NRF2 protein with no change in NRF2 mRNA levels (indicating that it was expressed, but subsequently degraded), and similar KEAP1 levels, but a marked decrease in the level of DJ-1.

“NRF2-dependent antioxidants and DJ-1 expression was negatively associated with severity of COPD,” wrote principle investigator, Shyam Biswal, Ph.D., an associate professor in the Bloomberg School’s Department of Environmental Health Sciences and Division of Pulmonary and Critical Care at the Johns Hopkins School of Medicine. “Therapy directed toward enhancing NRF2-regulated antioxidants may be a novel strategy for attenuating the effects of oxidative stress in the pathogenesis of COPD.”

While clinical trials to date of antioxidants have been disappointing in improving the clinical course of patients with COPD, this study points to a possibility of benefit from restoring NRF2 levels in damaged lungs by reducing the action of KEAP1, which is an inhibitor of NRF2. “[I]ncreasing NRF2 may also restore important detoxifying enzymes to counteract other effects of tobacco smoke,” wrote Peter Barnes, D.M., of the National Heart and Lung Institute in London, in the accompanying editorial. “This has been achieved in vitro and in vivo by isothiocynate compounds, such as sulforaphane, which occurs naturally in broccoli and [wasabi].”

Sulforapane has been shown to be able to restore antioxidant gene expression in human epithelial tissue in which DJ-1 has been reduced. Isothicyanate compounds such as that found in broccoli inhibit KEAP1, and thus prevent it from degrading NRF2, according to Dr. Barnes.

“Future studies should target NRF2 as a novel strategy to increase antioxidant protection in the lungs and test its ability to decrease exacerbations and improve lung function in patients with COPD,” concluded Dr. Biswal.

John Heffner, MD, past president of the ATS, commented that “mounting evidence over several decades underscores the importance of oxidant-mediated damage for the development of COPD in addition to other lung diseases. This study adds greater precision to our understanding of the specific antioxidants that may protect the lung against emphysema to allow clinical trials based on valid pathophysiologic principles.”

Researchers Discover Why Steroid Treatment for COPD Is Ineffective

 

Findings Offer Potential New Drug Target for COPD Therapy

Chronic obstructive pulmonary disease (COPD) leads to persistent inflammation of the airways and is typically managed with corticosteroids, a class of anti-inflammatory medication. However, corticosteroids do not improve survival nor alter the progression of COPD and may reduce lung symptoms as little as 20 percent. A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health, found why corticosteroids do not work well for COPD patients and how additional treatment with sulforaphane—an ingredient of broccoli and other vegetables—can improve the effectiveness of corticosteroids. The study was published online October 17, 2011, in advance of print in the Journal of Clinical Investigation.

COPD is a major public health problem for both the developed and the developing world, and is most often caused by cigarette smoking or exposure to pollutants from combustion. Characterized by chronic bronchitis and emphysema, COPD is the third leading cause of death in the U.S. and affects 24 million Americans and 210 million people worldwide.

Histone deacetylase 2 (HDAC2) is critical component in a chain of reactions that enable corticosteroids to reduce inflammation. However, HDAC2 is substantially reduced in the lung tissue of individuals with COPD. In the study, Johns Hopkins researchers found that S-nitrosylation causes HDAC2 dysfunction and leads to corticosteroid insensitivity in the alveolar macrophages of the lungs of individuals with COPD. S-nitrosylation of HDAC2 occurs from exposure to cigarette smoke, a primary cause of COPD.

“This study provides the mechanism of exaggerated inflammation observed in COPD patients during exacerbations, which has been a barrier to developing effective therapy,” said Rajesh Thimmulappa, PhD, co-author of the study and an assistant scientist in the Bloomberg School’s Department of Environmental Health Sciences.

Furthermore, the research team found that treatment with sulforaphane restored HDAC2 activity and corticosteroid sensitivity. Previous studies by the research team showed sulforaphane activates the Nrf2 pathway (nuclear factor erythroid 2–related factor 2) and it is being tested in clinical trial for patients with COPD.

“Restoring corticosteroid sensitivity in patients with COPD by targeting the Nrf2 pathway holds promise for effectively treating exacerbations,” said Shyam Biswal, PhD, senior author of the study and professor in the Bloomberg School’s Department of Environmental Health Sciences and Division of Pulmonary and Critical Care Medicine at the Johns Hopkins School of Medicine.