Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?

Autor: Okubo BM; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil., Matos AG; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil., Ribeiro Junior HL; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil., Borges DP; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil., Oliveira RTG; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil., de Castro MF; Department of Clinical and Toxicological Analysis, Federal University of Ceará, Ceará, Brazil., Martins MRA; Department of Clinical Medicine, Federal University of Ceará, Ceará, Brazil., Gonçalves RP; Department of Clinical and Toxicological Analysis, Federal University of Ceará, Ceará, Brazil., Bruin PFC; Department of Clinical Medicine, Federal University of Ceará, Ceará, Brazil., Pinheiro RF; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil.; Department of Clinical Medicine, Federal University of Ceará, Ceará, Brazil., Magalhães SMM; Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Brazil.; Post-Graduate Program in Medical Science, Federal University of Ceará, Ceará, Brazil.; Department of Clinical Medicine, Federal University of Ceará, Ceará, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2017 Sep 06; Vol. 12 (9), pp. e0184079. Date of Electronic Publication: 2017 Sep 06 (Print Publication: 2017).
DOI: 10.1371/journal.pone.0184079
Abstrakt: Background/objectives: The ageing process is associated with gradual decline in respiratory system performance. Anemia is highly prevalent among older adults and usually associated with adverse outcomes. Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic malignancies with increasing incidence with age and characterized by anemia and other cytopenias. The main objectives of this study were to evaluate respiratory muscle strength and lung function in elderly patients with anemia, compare data between myelodysplastic syndromes and non-clonal anemias and evaluate the influence of serum IL-8 level and NF-kB activity on deteriorate pulmonary function in this specific population.
Participants: Individuals aged 60 and older with anemia secondary to MDS, non-clonal anemia and healthy elderly individuals.
Measurements: Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/ FVC ratio were measured by spirometry. Respiratory muscle strength was evaluated by maximal static respiratory pressures measurement. IL-8 analysis was performed by ELISA and activity of NF-kB by chemiluminescent assay.
Results: Mean Hb concentration was comparable between patients with anemia. Significant differences were detected between all patients with anemia and controls for maximum-effort inspiratory mouth pressure (PImax) and also for maximum-effort expiratory mouth pressure (PEmax). The MDS group recorded a significantly lower PImax and PEmax percent predicted when compared to non-clonal anemia group. For FVC and FEV1, a significant difference was found in anemic patients, with even significantly lower values for FVC and FEV1 in MDS group. No significant differences were detected for PImax and PEmax and spirometry parameters when anemic patients were stratified according to the degree of anemia. A significant negative impact in FVC (% pred), PImax (% pred) and PEmax (% pred) was observed in patients with MDS and higher levels of IL-8 or increased activity of NF-kB.
Conclusion: A negative impact of anemia, independent of its degree, was demonstrated in respiratory muscle strength and lung function particularly in MDS. The well known elevated proinflammatory cytokines in MDS patients were proposed to play a role as was demonstrated by detrimental effect of higher IL-8 and NF-kB in pulmonary function tests in this population.
Databáze: MEDLINE
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