Effect of anti-inflammatory supplementation with whey peptide and exercise therapy in patients with COPD

SummaryBackgroundOne of the major pathophysiologies in advanced chronic obstructive pulmonary disease (COPD) has been attributed to systemic inflammation. Meta-analysis of the 2005 Cochrane Database concluded the effect of nutritional supplementation alone on stable COPD was insufficient to promote body weight gain or exercise capacity. The aim of this study was to investigate the effectiveness of nutritional supplementation therapy using a nutritional supplement containing whey peptide with low-intensity exercise therapy in stable elderly patients with COPD.MethodIn stable elderly COPD patients with %IBW and %FEV1 of less than 110 and 80%, respectively, anti-inflammatory nutritional supplementation therapy was added to low-intensity exercise therapy. Thirty-six COPD patients were divided into those with and those without the ingestion of an anti-inflammatory nutritional supplement containing whey peptide, which exhibited an anti-inflammatory effect. These two groups were designated as the nutritional support and the control groups, respectively. The body composition, skeletal muscle strength, exercise tolerance, health-related QOL (HRQOL), and inflammatory cytokines were evaluated before and three months after nutritional support combined with exercise therapy in both the nutritional support group and the control group.ResultsIn the nutritional support group, the body weight, %IBW, FM, energy intake, %AC, Alb, PImax, PEmax, 6MWD, WBI, emotional function, and CRQ total were significantly increased, and the levels of hsCRP, IL-6, IL-8, and TNF-α were reduced significantly, while no significant change was noted in any item of physiological evaluation or any biomarker in the control group.ConclusionConcomitant use of a anti-inflammatory nutritional supplement containing whey peptide, which exhibits an anti-inflammatory effect, with exercise therapy in stable elderly COPD patients with %IBW<110% and %FEV1<80% may not only increase body weight but may also inhibit systemic inflammation and thus improve exercise tolerance and HRQOL

Differences in content and organizational aspects of pulmonary rehabilitation programs

To study the overall content and organizational aspects of pulmonary rehabilitation programs from a global perspective to get an initial appraisal on the degree of heterogeneity worldwide.A twelve-question survey on content and organizational aspects was completed by representatives of pulmonary rehabilitation programs that previously participated in the European Respiratory Society (ERS) COPD Audit. Moreover, all ERS members affiliated with the ERS Scientific Groups 01.02 (Rehabilitation and Chronic Care) and/or 09.02 (Physiotherapy), all members of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), and all ATS Pulmonary Rehabilitation Assembly members were asked to complete the survey via multiple e-mailings.The survey has been completed by representatives of 430 centres from 40 countries. The findings demonstrate large differences among pulmonary rehabilitation programs across continents for all aspects that were surveyed, including the setting, the case-mix of individuals with a chronic respiratory disease, composition of the pulmonary rehabilitation team, completion rates, methods of referral, and types of reimbursement.The current findings stress the importance of future development of process and performance metrics to monitor pulmonary rehabilitation programs, to be able to start international benchmarking, and to provide recommendations for international standards based on evidence and best practice.status: publishe