Pilot study : can inspiratory muscle training relieve symptoms ff dyspnoea and improve quality of life for advanced cancer patients ?: 1872 Board #24 June 2, 3: 30 PM - 5: 00 PM.

Dyspnoea is a common symptom of advanced cancer patients, and impacts upon physical, social and psychological wellbeing. Currently opioids are recommended for those suffering with chronic dyspnoea, despite an association with longer term health issues. Inspiratory muscle training (IMT) promotes chronic adaptations within the inspiratory musculature and has consistently been shown to reduce dyspnoea and improve lung mechanics, functional exercise capacity and quality of life in a variety of clinical populations, however this has yet to be tested in patients with cancer.N/

The Effects of PCSO-524®, a Patented Marine Oil Lipid derived from the New Zealand Green Lipped Mussel (Perna canaliculus), on Pulmonary and Respiratory Muscle Function in Non-asthmatic Elite Runners

International Journal of Exercise Science 11(3): 669-680, 2018. Habitual endurance training may be associated with mild airway inflammation and subsequent deterioration in lung function. PCSO-524™ (Lyprinol®/Omega-XL®), a supplement extracted from the New Zealand green-lipped mussel (Perna canaliculus), has been shown to moderate airway inflammation in asthmatic subjects. The purpose of this study was to determine whether supplementation with PCSO-524™ improves pulmonary and respiratory muscle function in non-asthmatic elite runners. Sixteen male, non-asthmatic elite runners were randomly assigned to either a treatment (PCSO-524™; 1 capsule contains 50 mg n-3 polyunsaturated fatty acids and 100 mg olive oil, n=8) or placebo (1 capsule contains 150 mg olive oil; n=8) group. During the supplementation period, subjects ingested 8 capsules of either treatment or placebo per day for 12 weeks. Resting pulmonary and respiratory muscle function testing were assessed at baseline and every two weeks throughout the 12 week supplementation period. No significant between- or within-subjects main effects were observed in forced vital capacity, forced expiratory volume in 1-second, forced expiratory flow from 25-75% of lung volume (FEF25-75), peak expiratory flow, maximal voluntary ventilation, maximal inspiratory mouth pressure, and closing volume (p\u3e0.05). A significant within-subjects main effect was observed in maximal expiratory mouth pressure (PEmax) (p=0.024) and lung diffusion capacity (DLCO) (pPEmax and DLCO (p\u3e0.05). A significant treatment by time interaction was observed in FEF25-75 (p=0.026) and DLCO (p=0.024), but no other significant interactions were observed (all p\u3e0.05). Supplementation with PCSO-524™ (Lyprinol®/Omega-XL®) does not improve pulmonary or respiratory muscle function in non-asthmatic elite runners

Eicosapentaenoic acid is more effective than docosahexaenoic acid in inhibiting proinflammatory mediator production and transcription from LPS-induced human asthmatic alveolar macrophage cells

Background & aims: The purpose of the study was to determine which of the active constituents of fish oil, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is most effective in suppressing proinflammatory mediator generation and cytokine expression from LPS-stimulated human asthmatic alveolar macrophages (AMΦ). Methods: The AMΦ were obtained from twenty-one asthmatic adults using fiberoptic bronchoscopy. Cells were pretreated with DMEM, pure EPA, an EPA-rich media (45% EPA/10% DHA), pure DHA, a DHArich media (10% EPA/50% DHA) or Lipovenos® (n-6 PUFA), and then exposed to Dulbecco’s Modified Eagle’s Medium (DMEM) (-) or LPS (+). Supernatants were analyzed for leukotriene (LT)B4, prostaglandin (PG)D2, tumor necrosis factor (TNF)-α and interleukin (IL)-1β production. Detection of TNF-α and IL-1β mRNA expression levels was quantified by reverse transcriptase polymerase chain reaction. Results: 120 μM pure EPA and EPA-rich media significantly (p < 0.05) suppressed TNF-a and IL-1b mRNA expression and the production of LTB4, PGD2 and TNF-a and IL-1b in LPS-stimulated primary AMφ cells obtained from asthmatic patients to a much greater extent than 120 mM pure DHA and DHA-rich media respectively. Conclusions: This study has shown for the first time that EPA is a more potent inhibitor than DHA of inflammatory responses in human asthmatic AMΦ cells

Pulmonary adaptations to swim and inspiratory muscle training

Because the anomalous respiratory characteristics of competitive swimmers have been suggested to be due to inspiratory muscle work, the respiratory muscle and pulmonary function of 30 competitively trained swimmers was assessed at the beginning and end of an intensive 12-week swim training (ST) program. Swimmers (n = 10) combined ST with either inspiratory muscle training (IMT) set at 80% sustained maximal inspiratory pressure (SMIP) with progressively increased work–rest ratios until task failure for 3-days per week (ST + IMT) or ST with sham-IMT (ST + SHAM-IMT, n = 10), or acted as controls (ST only, ST, n = 10). Measures of respiratory and pulmonary function were assessed at the beginning and end of the 12 week study period. There were no significant differences (P > 0.05) in respiratory and pulmonary function between groups (ST + IMT, ST + SHAM-IMT and ST) at baseline and at the end of the 12 week study period. However, within all groups significant increases (P < 0.05) were observed in a number of respiratory and pulmonary function variables at the end of the 12 week study, such as maximal inspiratory and expiratory pressure, inspiratory power output, forced vital capacity, forced expiratory and inspiratory volume in 1-s, total lung capacity and diffusion capacity of the lung. This study has demonstrated that there are no appreciable differences in terms of respiratory changes between elite swimmers undergoing a competitive ST program and those undergoing respiratory muscle training using the flow-resistive IMT device employed in the present study; as yet, the causal mechanisms involved are undefined

Omega-3 Fatty Acids and Airway Hyperresponsiveness in Asthma

ABSTRACT Despite the progress that has been made in the treatment of asthma, the prevalence and burden of this disease has continued to increase. Exercise is a powerful trigger of asthma symptoms and reversible airflow obstruction and may result in the avoidance of physical activity by patients with asthma, resulting in detrimental consequences to their health. Approximately 90% of patients with asthma are hyperresponsive to exercise and experience exercise-induced bronchoconstriction (EIB). While pharmacologic treatment of asthma is usually highly effective, medications often have significant side-effects or exhibit tachyphylaxis. Alternative therapies for treatment (complementary medicine) that reduce the dose requirements of pharmacologic interventions would be beneficial, and could potentially reduce the public health burden of this disease. There is accumulating evidence that dietary modification has potential to influence the severity of asthma and reduce the prevalence and incidence of this condition. A possible contributing factor to the increased incidence of asthma in Western societies may be the consumption of a proinflammatory diet. In the typical Western diet, 20-to 25-fold more -6 polyunsaturated fatty acids (PUFA) than -3 PUFA are consumed, which causes the release of proinflammatory arachidonic acid metabolites (leukotrienes and prostanoids). This review analyzes the existing literature on -3 PUFA supplementation as a potential modifier of airway hyperresponsiveness in asthma and includes studies concerning the efficacy of -3 PUFA supplementation in EIB. While clinical data evaluating the effect of -3 PUFA supplementation in asthma has been equivocal, it has recently been shown that pharmaceuticalgrade fish oil (-3 PUFA) supplementation reduces airway hyperresponsiveness after exercise, medication use, and proinflammatory mediator generation in nonatopic elite athletes with EIB. These findings are provocative and suggest that dietary -3 PUFA supplementation may be a viable treatment modality and/or adjunct therapy in airway hyperresponsiveness. Further studies are needed to confirm these results and understand their mechanism of action. 106

Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma

SummaryBackgroundPrevious research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects.ObjectiveDetermine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction (EIB).MethodsEight asthmatic subjects with documented EIB participated in a randomized, placebo controlled double-blind crossover trial. Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation (1500mg/day) or placebo, followed by a 1-week washout period, before crossing over to the alternative diet. Pre- and post-exercise pulmonary function, asthma symptom scores, fraction of exhaled nitric oxide (FENO), and urinary leukotriene (LT) C4–E4 and 9α, 11β-prostagladin (PG)F2] were assessed at the beginning of the trial (usual diet) and at the end of each treatment period.Results: The ascorbic acid diet significantly reduced (p<0.05) the maximum fall in post-exercise FEV1 (−6.4±2.4%) compared to usual (−14.3±1.6%) and placebo diet (−12.9±2.4%). Asthma symptoms scores significantly improved (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet. Post-exercise FENO, LTC4–E4 and 9α, 11β-PGF2 concentration was significantly lower (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet.ConclusionAscorbic acid supplementation provides a protective effect against exercise-induced airway narrowing in asthmatic subjects

Randomized Controlled Trial of Fish Oil and Montelukast and Their Combination on Airway Inflammation and Hyperpnea-Induced Bronchoconstriction

Both fish oil and montelukast have been shown to reduce the severity of exercise-induced bronchoconstriction (EIB). The purpose of this study was to compare the effects of fish oil and montelukast, alone and in combination, on airway inflammation and bronchoconstriction induced by eucapnic voluntary hyperpnea (EVH) in asthmatics. In this model of EIB, twenty asthmatic subjects with documented hyperpnea-induced bronchoconstriction (HIB) entered a randomized double-blind trial. All subjects entered on their usual diet (pre-treatment, n = 20) and then were randomly assigned to receive either one active 10 mg montelukast tablet and 10 placebo fish oil capsules (n = 10) or one placebo montelukast tablet and 10 active fish oil capsules totaling 3.2 g EPA and 2.0 g DHA (n = 10) taken daily for 3-wk. Thereafter, all subjects (combination treatment; n = 20) underwent another 3-wk treatment period consisting of a 10 mg active montelukast tablet or 10 active fish oil capsules taken daily. While HIB was significantly inhibited (p0.017) between treatment groups; percent fall in forced expiratory volume in 1-sec was −18.4±2.1%, −9.3±2.8%, −11.6±2.8% and −10.8±1.7% on usual diet (pre-treatment), fish oil, montelukast and combination treatment respectively. All three treatments were associated with a significant reduction (p0.017) in these biomarkers between treatments. While fish oil and montelukast are both effective in attenuating airway inflammation and HIB, combining fish oil with montelukast did not confer a greater protective effect than either intervention alone. Fish oil supplementation should be considered as an alternative treatment for EIB

Eicosapentaenoic acid is more effective than docosahexaenoic acid in inhibiting proinflammatory mediator production and transcription from LPS-induced human asthmatic alveolar macrophage cells

This paper was published in the journal, Clinical Nutrition [© Elsevier Ltd and European Society for Clinical Nutrition and Metabolism] and the definitive version is available at: http://dx.doi.org/10.1016/j.clnu.2008.10.012Background & aims: The purpose of the study was to determine which of the active constituents of fish oil, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is most effective in suppressing proinflammatory mediator generation and cytokine expression from LPS-stimulated human asthmatic alveolar macrophages (AMΦ). Methods: The AMΦ were obtained from twenty-one asthmatic adults using fiberoptic bronchoscopy. Cells were pretreated with DMEM, pure EPA, an EPA-rich media (45% EPA/10% DHA), pure DHA, a DHArich media (10% EPA/50% DHA) or Lipovenos® (n-6 PUFA), and then exposed to Dulbecco’s Modified Eagle’s Medium (DMEM) (-) or LPS (+). Supernatants were analyzed for leukotriene (LT)B4, prostaglandin (PG)D2, tumor necrosis factor (TNF)-α and interleukin (IL)-1β production. Detection of TNF-α and IL-1β mRNA expression levels was quantified by reverse transcriptase polymerase chain reaction. Results: 120 μM pure EPA and EPA-rich media significantly (p < 0.05) suppressed TNF-a and IL-1b mRNA expression and the production of LTB4, PGD2 and TNF-a and IL-1b in LPS-stimulated primary AMφ cells obtained from asthmatic patients to a much greater extent than 120 mM pure DHA and DHA-rich media respectively. Conclusions: This study has shown for the first time that EPA is a more potent inhibitor than DHA of inflammatory responses in human asthmatic AMΦ cells

Neuro-ophthalmologic and blood biomarker responses in ADHD following subconcussive head impacts: a case–control trial

IntroductionThis clinical trial aimed to determine the influence of attention-deficit/hyperactivity disorder (ADHD) on neuro-ophthalmologic function and brain-derived blood biomarkers following acute subconcussive head impacts.MethodsThe present trial consisted of age- and sex-matched samples with a ratio of 1:1 between two groups with a total sample size of 60 adults (age ± SD; 20.0 ± 1.8 years). Soccer players diagnosed with and medicated daily for ADHD were assigned into an ADHD group (n = 30). Soccer players without ADHD were assigned into a non-ADHD group (n = 30). Participants performed 10 soccer headers with a soccer ball projected at a velocity of 25mph. King-Devick test (KDT), near point of convergence (NPC), and serum levels of NF-L, tau, GFAP, and UCH-L1 were assessed at baseline (pre-heading) and at 2 h and 24 h post-heading.ResultsThere were no statistically significant group-by-time interactions in outcome measures. However, at baseline, the ADHD group exhibited lower neuro-ophthalmologic functions compared to the non-ADHD group (NPC: p = 0.019; KDT: p = 0.018), and persisted at 2 h-post (NPC: p = 0.007; KDT: p = 0.014) and 24 h-post heading (NPC: p = 0.001). NPC significantly worsened over time in both groups compared to baseline [ADHD: 2 h-post, 1.23 cm, 95%CI:(0.77, 1.69), p &lt; 0.001; 24 h-post, 1.68 cm, 95%CI:(1.22, 2.13), p = 0.001; Non-ADHD: 2 h-post, 0.96 cm, 95%CI:(0.50, 1.42), p &lt; 0.001; 24 h-post, 1.09 cm, 95%CI:(0.63, 1.55), p &lt; 0.001]. Conversely, improvements in KDT time compared to baseline occurred at 2 h-post in the non-ADHD group [−1.32 s, 95%CI:(−2.55, −0.09), p = 0.04] and at 24 h-post in both groups [ADHD: −4.66 s, 95%CI:(−5.89, −3.43), p &lt; 0.001; Non-ADHD: −3.46 s, 95%CI:(−4.69, −2.23), p &lt; 0.001)]. There were no group-by-time interactions for GFAP as both groups exhibited increased levels at 2 h-post [ADHD: 7.75 pg./mL, 95%CI:(1.41, 14.10), p = 0.019; Non-ADHD: 7.91 pg./mL, 95%CI:(1.71, 14.14), p = 0.015)] that returned to baseline at 24 h-post. NF-L levels increased at 2 h-post heading in the ADHD group [0.45 pg./mL, 95%CI:(0.05, 0.86), p = 0.032], but no significant NF-L changes were observed in the non-ADHD group over time.DiscussionTen soccer headers elevated GFAP levels and NPC impairment in both groups. However, persisting group difference in NPC, blunted KDT performance, and increased NF-L levels in the ADHD group suggest that ADHD may reduce neuro-ophthalmologic function and heighten axonal response to soccer headers.Clinical trial registrationClinicalTrials.gov, identifier ID: (NCT04880304)

Dietary restriction improves pulmonary function in exercice-induced asthma

Une étude sur les effets d'une alimentation plus ou moins riche en chlorure de sodium sur les fonctions respiratoires des sujets souffrant d'asthme. 16 personnes dont 8 souffrant d'asthme ont reçu pendant deux semaines un régime alimentaire normal, hypersodé ou hyposodé. Leur capacité respiratoire a été mesurée après des exercices physiques, avant et après les deux semaines de régime