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

<h4>Background/objectives</h4>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 mali...

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Main Authors: Bruno Memória Okubo, Anacélia Gomes de Matos, Howard Lopes Ribeiro Junior, Daniela de Paula Borges, Roberta Taiane Germano de Oliveira, Marilena Facundo de Castro, Manoel Ricardo Alves Martins, Romélia Pinheiro Gonçalves, Pedro Felipe Carvalhedo Bruin, Ronald Feitosa Pinheiro, Silvia Maria Meira Magalhães
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184079&type=printable
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author Bruno Memória Okubo
Anacélia Gomes de Matos
Howard Lopes Ribeiro Junior
Daniela de Paula Borges
Roberta Taiane Germano de Oliveira
Marilena Facundo de Castro
Manoel Ricardo Alves Martins
Romélia Pinheiro Gonçalves
Pedro Felipe Carvalhedo Bruin
Ronald Feitosa Pinheiro
Silvia Maria Meira Magalhães
author_facet Bruno Memória Okubo
Anacélia Gomes de Matos
Howard Lopes Ribeiro Junior
Daniela de Paula Borges
Roberta Taiane Germano de Oliveira
Marilena Facundo de Castro
Manoel Ricardo Alves Martins
Romélia Pinheiro Gonçalves
Pedro Felipe Carvalhedo Bruin
Ronald Feitosa Pinheiro
Silvia Maria Meira Magalhães
author_sort Bruno Memória Okubo
collection DOAJ
description <h4>Background/objectives</h4>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.<h4>Participants</h4>Individuals aged 60 and older with anemia secondary to MDS, non-clonal anemia and healthy elderly individuals.<h4>Measurements</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
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spelling doaj-art-69e77ed526a24084b52fe6547a5ce7b42025-08-20T02:03:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01129e018407910.1371/journal.pone.0184079Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?Bruno Memória OkuboAnacélia Gomes de MatosHoward Lopes Ribeiro JuniorDaniela de Paula BorgesRoberta Taiane Germano de OliveiraMarilena Facundo de CastroManoel Ricardo Alves MartinsRomélia Pinheiro GonçalvesPedro Felipe Carvalhedo BruinRonald Feitosa PinheiroSilvia Maria Meira Magalhães<h4>Background/objectives</h4>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.<h4>Participants</h4>Individuals aged 60 and older with anemia secondary to MDS, non-clonal anemia and healthy elderly individuals.<h4>Measurements</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184079&type=printable
spellingShingle Bruno Memória Okubo
Anacélia Gomes de Matos
Howard Lopes Ribeiro Junior
Daniela de Paula Borges
Roberta Taiane Germano de Oliveira
Marilena Facundo de Castro
Manoel Ricardo Alves Martins
Romélia Pinheiro Gonçalves
Pedro Felipe Carvalhedo Bruin
Ronald Feitosa Pinheiro
Silvia Maria Meira Magalhães
Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
PLoS ONE
title Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
title_full Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
title_fullStr Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
title_full_unstemmed Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
title_short Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?
title_sort myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity is disordered inflammatory signaling the culprit
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184079&type=printable
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