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1. Quadriceps Endurance Increases Following Cycling Exercise With Non-Invasive Ventilation In Moderate-To-Severe COPD Patients. A Non-Randomized Controlled Study

Author

Labeix P, Berger M, Court Fortune I, Feasson L, Verges S, and Costes F

Subjects
limb muscle, endurance, non invasive ventilation, exercise, copd, Diseases of the respiratory system, RC705-779
Abstract

Pierre Labeix,1,2 Mathieu Berger,3 Isabelle Court Fortune,4 Léonard Feasson,2,5 Samuel Verges,6 Frédéric Costes7,8 1Centre VISAS, Service de Physiologie Clinique et de l’Exercice, CHU St Etienne, France; 2Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint-Etienne F-42023, France; 3Univ Lyon, UJM Saint-Etienne, laboratoire SNA-EPIS, EA4607, Saint-Etienne, France; 4Service de Pneumologie et d’Oncologie Thoracique, CHU St Etienne, France; 5Unité de Myologie, CHU St Etienne, France; 6Université Grenoble Alpes, Inserm, Laboratoire HP2, Grenoble, France; 7Université Clermont Auvergne, INRA, UNH Clermont Ferrand, France; 8Service de Médecine du Sport et des Explorations Fonctionnelles, CHU Clermont Ferrand, FranceCorrespondence: Frédéric CostesService de Médecine du Sport et des Explorations Fonctionnelles CHU Gabriel Montpied, 58 rue Montalembert, F63002 Clermont Ferrand cedex 1, FranceTel +33473751665Email fcostes@chu-clermontferrand.frPurpose: Application of non-invasive ventilation (NIV) during exercise improves exercise tolerance in severe COPD patients; however, the underlying mechanism is only partially unraveled. As part of its known effect to unload the respiratory muscles, we looked for the influence of NIV on post-exercise quadriceps muscle endurance.Patients and methods: We included 25 severe COPD patients entering an outpatient pulmonary rehabilitation program. They performed, on successive days, three quadriceps endurance tests at 70% of the maximal strength (1RM) to task failure (TlimQ); 1) control condition; 2) following constant load cycling exercise to exhaustion without Inspiratory Pressure Support (TlimQ IPS-); 3) following the same cycling exercise with IPS (TlmQ IPS+).Results: Dyspnea Borg score was significantly reduced at the end of the constant load cycling exercise with IPS+ compared to IPS- (3.5±2.6 to 4.3±2.3, p

Published
2019

8. Prevalence of sarcopenia and malnutrition during acute exacerbation of COPD and after 6 months recovery

Author

Perrot, L., Greil, A., Boirie, Y., Farigon, N., Mulliez, A., Costes, F., and Caillaud, D.

Subjects
Malnutrition -- Statistics -- Prognosis -- Demographic aspects, Lung diseases, Obstructive -- Care and treatment -- Prognosis, Sarcopenia -- Statistics -- Prognosis -- Demographic aspects, Food/cooking/nutrition, Health
Abstract

Background/Objectives Sarcopenia defined by the association of skeletal muscle mass depletion and a decreased physical performance is underdiagnosed in chronic obstructive pulmonary disease (COPD) patients. The objective was to assess prevalence of sarcopenia and malnutrition in hospitalized COPD patients during an acute exacerbation, after 6 months follow-up and the 1-year survival. Subjects/Methods Hospitalized COPD patients were recruited for the assessment of body composition, handgrip strength, respiratory function, and maximal inspiratory and expiratory pressures (MIP and MEP), during hospitalization and 6 months later. Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older Adults, malnutrition was defined according to French criteria 2007. Survival data were collected 12 months after hospitalization. Results We analyzed data from 54 patients, aged 68 [plus or minus] 9 years and BMI 26.9 [plus or minus] 7.8 kg/m.sup.2, with an average FEV1 of 1.13 [plus or minus] 0.49 l (45 [plus or minus] 16% predicted value). Sarcopenia and malnutrition prevalence were, respectively, 48% and 52% during hospitalization, 30% and 30% after 6 months. MIP and MEP were lower in sarcopenic patients (p = 0.01 and 0.009, respectively). In multivariate analysis, skeletal muscle mass index and MIP were positively correlated at 6 months' follow-up (r = 0.40, p = 0.04). The 1-year survival rate was lower in sarcopenic patients (65 vs 86%, p = 0.03), particularly when malnutrition was associated (p = 0.02). Conclusions Sarcopenia in COPD patients is highly prevalent during and after recovery of an acute exacerbation, exposing to lower survival. A multimodal management is required to treat sarcopenia and improve prognosis., Author(s): L. Perrot [sup.1] [sup.6] , A. Greil [sup.1] , Y. Boirie [sup.2] [sup.3] , N. Farigon [sup.2] , A. Mulliez [sup.4] , F. Costes [sup.3] [sup.5] , D. Caillaud [...]

Published
2020
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22. Haemodynamic compensations for exercise tissue oxygenation in early stages of COPD: an integrated cardiorespiratory assessment study

Author

Darcy Marciniuk, Jean Bourbeau, Bruno Pereira, Laura Filaire, Hélène Perrault, Ruddy Richard, François Maltais, Julianne Touron, Aurélien Mulliez, Wan Tan, Dennis Jensen, and Costes Frederic

Subjects
Medicine, Diseases of the respiratory system, RC705-779
Abstract

Background Cardiovascular comorbidities are increasingly being recognised in early stages of chronic obstructive pulmonary disease (COPD) yet complete cardiorespiratory functional assessments of individuals with mild COPD or presenting with COPD risk factors are lacking. This paper reports on the effectiveness of the cardiocirculatory-limb muscles oxygen delivery and utilisation axis in smokers exhibiting no, or mild to moderate degrees of airflow obstruction using standardised cardiopulmonary exercise testing (CPET).Methods Post-bronchodilator spirometry was used to classify participants as ‘ever smokers without’ (n=88), with ‘mild’ (n=63) or ‘mild-moderate’ COPD (n=56). All underwent CPET with continuous concurrent monitoring of oxygen uptake (V’O2) and of bioimpedance cardiac output (Qc) enabling computation of arteriovenous differences (a-vO2). Mean values of Qc and a-vO2 were mapped across set ranges of V’O2 and Qc isolines to allow for meaningful group comparisons, at same metabolic and circulatory requirements.Results Peak exercise capacity was significantly reduced in the ‘mild-moderate COPD’ as compared with the two other groups who showed similar pulmonary function and exercise capacity. Self-reported cardiovascular and skeletal muscle comorbidities were not different between groups, yet disease impact and exercise intolerance scores were three times higher in the ‘mild-moderate COPD’ compared with the other groups. Mapping of exercise Qc and a-vO2 also showed a leftward shift of values in this group, indicative of a deficit in peripheral O2 extraction even for submaximal exercise demands. Concurrent with lung hyperinflation, a distinctive blunting of exercise stroke volume expansion was also observed in this group.Conclusion Contrary to the traditional view that cardiovascular complications were the hallmark of advanced disease, this study of early COPD spectrum showed a reduced exercise O2 delivery and utilisation in individuals meeting spirometry criteria for stage II COPD. These findings reinforce the preventive clinical management approach to preserve peripheral muscle circulatory and oxidative capacities.

Published
2024
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24. Guide for follow-up of patients with SARS-CoV-2 pneumonia. Management proposals developed by the French-language Respiratory Medicine Society

Author

Andréjak, Claire, Blanc, F.-X., Costes, F., Crestani, B., Debieuvre, D., Perez, T., Philippe, B., Plantier, L., Schlemmer, F., Sesé, L., Stach, B., Uzunhan, Y., Zanetti, C., Zysman, M., Raherison, C., Maitre, B., Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Unité de Nutrition Humaine (UNH), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de Pneumologie et Centre de Compétence des Maladies Pulmonaires Rares [AP-HP Hôpital Bichat, Paris], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Service d'explorations fonctionnelles respiratoires [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier René Dubos [Pontoise], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Henri Mondor, Hopital Avicennes, Université Paris 13 (UP13), Cabinet Medicale St Michel, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cabinet médical, CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), and ROSSI, Sabine

Subjects
body regions, Plethysmography, CT scan, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Follow-up, fungi, skin and connective tissue diseases, Fibrosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, respiratory tract diseases, COVID
Abstract

International audience; The French-language Respiratory Medicine Society (SPLF) proposes a guide for the follow-up of patients who have presented with SARS-CoV-2 pneumonia. The proposals are based on known data from previous epidemics, on acute lesions observed in SARS-CoV-2 patients and on expert opinion. This guide proposes a follow-up based on three categories of patients: (1) patients managed outside hospital for possible or proven SARS-CoV-2 infection, referred by their physician for persistent dyspnoea; (2) patients hospitalized for SARS-CoV-2 pneumonia in a medical unit; (3) patients hospitalized for SARS-CoV-2 pneumonia in an intensive care unit. The subsequent follow-up will have to be adapted to the initial assessment. This guide emphasises the possibility of others causes of dyspnoea (cardiac, thromboembolic, hyperventilation syndrome...). These proposals may evolve over time as more knowledge becomes available.

Published
2020

25. Lung function testing under COVID-19: A position paper

Author

Plantier, L, Costes, F, ROSSI, Sabine, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Nutrition Humaine (UNH), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
MESH: Respiration, MESH: Pandemics, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Humans, MESH: Coronavirus Infections, MESH: Personal Protective Equipment, MESH: Cross Infection, MESH: Respiratory Function Tests, MESH: Asymptomatic Diseases, MESH: Physical Exertion, MESH: Aerosols, MESH: Infection Control, MESH: Procedures and Techniques Utilization, MESH: Pneumonia, Viral, MESH: Air Microbiology, MESH: Infectious Disease Transmission, Patient-to-Professional, MESH: Betacoronavirus, MESH: Hygiene, MESH: Rest, MESH: Lung, MESH: Exercise Test, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience

Published
2020

40. Impaired exercise training-induced muscle fiber hypertrophy and Akt/mTOR pathway activation in hypoxemic patients with COPD

Author

Costes, F., Costes, F., Gosker, H.R., Feasson, L., Desgeorges, M., Kelders, M.C., Castells, J., Schols, A.M., Freyssenet, D.G., Costes, F., Costes, F., Gosker, H.R., Feasson, L., Desgeorges, M., Kelders, M.C., Castells, J., Schols, A.M., and Freyssenet, D.G.

Abstract

Exercise training (ExTr) is largely used to improve functional capacity of chronic obstructive pulmonary disease (COPD) patients. However, ExTr partially restores muscle function in COPD patients, suggesting that confounding factors may limit the efficiency of ExTr. In the present study, we hypothesized that skeletal muscle adaptations triggered by ExTr could be compromised in hypoxemic COPD patients. Vastus lateralis muscle biopsies were obtained from normoxemic (n = 15; resting arterial PO2 = 68.5 +/- 1.5 mm Hg) and hypoxemic (n = 8; resting arterial PO2 = 57.0 +/- 1.0 mm Hg) COPD patients before and after a 2 month-ExTr program. ExTr induced a significant increase in exercise capacity both in normoxemic and hypoxemic COPD patients. However, ExTr increased citrate synthase and lactate dehydrogenase enzyme activities only in skeletal muscle of normoxemic patients. Similarly, muscle fiber cross-sectional area and capillary-to-fiber ratio were only increased in normoxemic patients. Expression of atrogenes (MuRF1, MAFbx/Atrogin-1) and autophagy-related genes (Beclin, LC3, Bnip, Gabarapl) remained unchanged in both groups. The phosphorylation level of Akt (Ser473), GSK-3beta (Ser9) and p70S6k (Thr389), which was non-significantly increased in normoxemic patients in response to ExTr, was significantly decreased in hypoxemic patients. We further showed on C2C12 myotubes that hypoxia completely prevented IGF-1-induced phosphorylation of Akt, GSK-3beta and p70S6K. Together, our observations suggest a role for hypoxemia in the adaptive response of skeletal muscle of COPD patients to ExTr.

Published
2015

43. A randomized study of endobronchial valves for advanced emphysema

Author

Sciurba, Fc, Ernst, A, Herth, Fj, Strange, C, Criner, Gj, Marquette, Ch, Kovitz, Kl, Chiacchierini, Rp, Goldin, J, Mclennan, G, Sciurba, F, Landreneau, R, Crespo, M, Lane, L, Slivka, W, Fuhrman, C, Ferson, P, Witt, C, End, A, Schneider, F, Klepetko, W, Stanzel, F, Weber, N, Haeussinger, K, Gasparini, S, De Luca, S, Golden, E, Smith, M, Williams, G, Feller Kopman, D, Garland, R, Ashiku, S, Decamp, M, Ferguson, G, Thompson, Tm, McKenna R., Jr, Geaga, C, Kusuanco, D, Pison, Ch, Wuyam, B, Ferretti, G, Vivodtzev, I, Righini, C, Lebargy, F, Deslee, G, Dury, S, Schmidt, B, Gonzalez Bermejo, J, Trosini Desert, V, Similowski, T, Beigelman, C, Becquemin, Mh, Simoff, M, Almario, R, Mal, H, Marceau, A, Fournier, M, Brugière, O, Dauriat, G, Marquette, C, Leroy, S, Perez, T, Bautin, N, Massard, G, Kessler, R, Charloux, A, Jeung, My, Jory, A, Muir, Jf, Viacroze, C, Benhamou, D, Cuvelier, A, Molano, L, Degano, B, Hermant, C, Pontier, S, Rami, J, Chabbert, V, Vergnon, Jm, Veyret, C, Costes, F, De Matos, L, Febvre, M, Chouaid, C, Lebeau, B, Pinet, C, Dutau, H, Thomas, P, Badier, M, Gaubert, Jy, Xaubet, A, Torres, A, Agustí, C, Barberà, J, Agustí, A, Togores, B, Renom, F, Sauleda, J, Ramos, R, Nathan, S, Ahmad, S, Collazo, L, Battle, E, Hecker, E, Volmerig, J, Jahn, T, Ficker, J, Wagner, M, Fink, T, Egan, J, Coyle, J, Edell, E, Midthun, D, Utz, J, Andrist, B, Meiras, K, Silvestri, G, Williams Cummings, E, Freilich, E, Amin, D, Masson, J, Orlando, D, Morgan, L, Bowler, R, Wheeler, C, Mitchell, K, Maxfield, R, Ginsburg, M, Jellen, P, Brogan, F, Valipour, A, Kohansal, R, Burghuber, C, Elton, D, Sy, A, Mcfarland, E, Haase, N, Stout, M, Tillis, W, Whitten, P, Crabb, J, Hartwig, K, Scott, A, Levine, B, Ross, J, Baratz, D, Fu, L, Cordasco, E, Adamo, J, Botte, J, Voelker, K, Horiuchi, T, Hurwitz, K, Ferreira, G, Morgan, K, Jantz, M, Deem, A, Fox, A, Campbell, S, Vincent, T, Shen, W, Hazelrigg, S, Boley, T, Boomer, Wm, Goulet, J, Mullins, C, Cicena, J, O'Neill, P, Criner, G, Travaline, J, Chatila, W, Jones, G, Herth, F, Eberhardt, R, Leeds, W, Fair, G, Ludlow, L, Nicklin, S, Davis, C, Kovitz, K, Ditta, S, Chan, A, Allen, R, Albertson, T, Morrissey, B, Juarez, M, Germonpre, P, Janssens, A, De Backer, W, Noppen, M, De Mey, J, Meysman, M, Ferguson, J, Ross, A, Sprenger, K, Keating, J, Zgoda, M, Berger, R, Mcclung, J, Cortes, R, Krasna, M, Britt, J, Gamliel, Z, Moskowitz, I, Gay, S, Konkle, J, Goodnight White, S, Soubra, S, Smithwick, P, Velamuri, K, Cooper, C, Badduke, B, Hsiao, E, Wise, R, Celli, B, Ciccone, Annamaria, Keenan, R, Gilman, D, Brown, M, McNitte Gray, M, da Costa, I, Ho, J, Kaplan, R, Ganiats, T, Groessl, E, Harvey, J, Mulligan, B., Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
MESH: Exercise Tolerance, Exacerbation, MESH: Pulmonary Disease, Chronic Obstructive, law.invention, MESH: Proportional Hazards Models, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, law, Forced Expiratory Volume, Medicine, 030212 general & internal medicine, Antibiotic prophylaxis, Pneumonectomy, MESH: Aged, COPD, Exercise Tolerance, MESH: Middle Aged, Respiratory disease, Prostheses and Implants, General Medicine, Middle Aged, Bronchodilator Agents, 3. Good health, Pulmonary Emphysema, MESH: Pulmonary Emphysema, Respiratory Physiological Phenomena, Adult, medicine.medical_specialty, Randomization, MESH: Prostheses and Implants, MESH: Forced Expiratory Volume, 03 medical and health sciences, Internal medicine, Bronchoscopy, MESH: Antibiotic Prophylaxis, Humans, MESH: Bronchoscopy, Aged, Proportional Hazards Models, MESH: Humans, business.industry, Proportional hazards model, MESH: Pneumonectomy, Endobronchial valve, MESH: Adult, Antibiotic Prophylaxis, medicine.disease, Surgery, MESH: Respiratory Physiological Phenomena, 030228 respiratory system, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Bronchodilator Agents, business
Abstract

International audience; BACKGROUND: Endobronchial valves that allow air to escape from a pulmonary lobe but not enter it can induce a reduction in lobar volume that may thereby improve lung function and exercise tolerance in patients with pulmonary hyperinflation related to advanced emphysema. METHODS: We compared the safety and efficacy of endobronchial-valve therapy in patients with heterogeneous emphysema versus standard medical care. Efficacy end points were percent changes in the forced expiratory volume in 1 second (FEV1) and the 6-minute walk test on intention-to-treat analysis. We assessed safety on the basis of the rate of a composite of six major complications. RESULTS: Of 321 enrolled patients, 220 were randomly assigned to receive endobronchial valves (EBV group) and 101 to receive standard medical care (control group). At 6 months, there was an increase of 4.3% in the FEV1 in the EBV group (an increase of 1.0 percentage point in the percent of the predicted value), as compared with a decrease of 2.5% in the control group (a decrease of 0.9 percentage point in the percent of the predicted value). Thus, there was a mean between-group difference of 6.8% in the FEV1 (P=0.005). Roughly similar between-group differences were observed for the 6-minute walk test. At 12 months, the rate of the complications composite was 10.3% in the EBV group versus 4.6% in the control group (P=0.17). At 90 days, in the EBV group, as compared with the control group, there were increased rates of exacerbation of chronic obstructive pulmonary disease (COPD) requiring hospitalization (7.9% vs. 1.1%, P=0.03) and hemoptysis (6.1% vs. 0%, P=0.01). The rate of pneumonia in the target lobe in the EBV group was 4.2% at 12 months. Greater radiographic evidence of emphysema heterogeneity and fissure completeness was associated with an enhanced response to treatment. CONCLUSIONS: Endobronchial-valve treatment for advanced heterogeneous emphysema induced modest improvements in lung function, exercise tolerance, and symptoms at the cost of more frequent exacerbations of COPD, pneumonia, and hemoptysis after implantation. (Funded by Pulmonx; ClinicalTrials.gov number, NCT00129584.)

Published
2010

44. Finite element thermomechanical simulation of steel continuous casting

Author

Forestier, R., Costes, F., Jaouen, O., Michel Bellet, Ascometal Creas, Ascométal, Transvalor, Transvalor S. A., Centre de Mise en Forme des Matériaux (CEMEF), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), and Steve L. Cockcroft, Daan M. Maijer Editors

Subjects
hot tearing, air gap, stress-strain, continuous casting, thermal-mechanical modelling, [SPI.MAT]Engineering Sciences [physics]/Materials
Abstract

International audience; In continuous casting (CC), thermomechanical simulation is essential to analyze important issues: gap formation; stress and deformation of the solidified shell; bulging of product between supporting rolls in the case of steel CC; size of final product, butt-curl defect in direct chill casting of aluminium. The numerical simulation package THERCAST has been developed with the objective of supplying an accurate analysis of those phenomena, permitting to define relevant process actuators. In this paper, some characteristic features especially developed for steel continuous casting are presented and illustrated by examples of industrial application.

Published
2009

48. 3D thermomechanical simulation of the secondary cooling zone of steel continuous casting

Author

Costes, F., Heinrich, A., Michel Bellet, Centre de Mise en Forme des Matériaux (CEMEF), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), D.M. Stefanescu, J.A. Warren, and M.R. Jolly & M.J.M. Krane editors

Subjects
steel, Computer simulation, Thermomechanical treatment, Cooling, Continuous casting, Secondary cooling zones, [SPI.MAT]Engineering Sciences [physics]/Materials
Abstract

International audience; This paper addresses the simulation of steel continuous casting (CC) using two non steady-state approaches: a slice method and a global method. Both methods can take into account the curvature of the CC machine. We describe the implementation of the two methods. We present the resolution of the thermo mechanical problem of the process. The two methods are compared in the case of CC of thick products.

Published
2003

49. Hypoxia and muscle maintenance regulation: implications for chronic respiratory disease

Author

de Theije, C., de Theije, C., Costes, F., Langen, R.C., Pison, C., Gosker, H.R., de Theije, C., de Theije, C., Costes, F., Langen, R.C., Pison, C., and Gosker, H.R.

Abstract

PURPOSE OF REVIEW: Muscle wasting and impaired muscle oxidative metabolism are common extrapulmonary features of chronic respiratory failure (CRF) that significantly increase disease burden. This review aims to address the question whether hypoxia, an obvious consequence of this disease, actually plays a causal role in these muscle impairments. RECENT FINDINGS: In experimental models, a causal role for hypoxia in muscle atrophy and metabolic impairments has clearly been shown. Although the hypoxia-inducible factors and nuclear factor kappa B are putative mediators of these hypoxia-induced alterations, their true involvement remains to be proven. Molecular signatures of disrupted regulation of muscle mass and oxidative metabolism observed in these experimental models also have been shown in muscles of patients suffering from CRF, suggestive of but not conclusive for a causal role of hypoxia. Therapies, including but not restricted to those aimed at alleviating hypoxia, have been shown to partially but not completely restore muscle mass and oxidative capacity in CRF patients, which may imply an additive effect of nutritional modulation of substrate metabolism. SUMMARY: Although hypoxia clearly affects skeletal muscle maintenance, it remains to be confirmed whether and by which underlying molecular mechanisms hypoxia is causally involved in CRF-related muscle atrophy and impaired oxidative capacity.

Published
2011

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