Abstract

Peripheral muscle dysfunction is one of the most prominent systemic effects described in COPD patients and has important prognosis implications. The pathogenic mechanisms leading to muscle dysfunction/wasting are multifactorial and not fully understood. Apoptosis has been proposed as a contributor factor on this effect. Apoptosis was determined using two methodologies: immunoblotting to assess the protein levels of cleaved caspase-3 and the terminal deoxynucleotidyl transferase- mediated dUTP nick-end labeling (TUNEL) in paraffin-embedded sections from vastus lateralis specimens in COPD patients with low fat free mass index (FFMI) (COPD L ) (FEV 1 30±3.6 %pred, FFMI 15±0.2 Kg. m-2 ), ten patients with COPD and normal FFMI (COPD N ) (FEV 1 44±5.8 %pred, FFMI 19±0.5 Kg. m-2 ) and eight age and gender matched healthy controls (C) (FEV 1 95±3.9 %pred, FFMI 20±0.8 Kg. m-2 ). COPD L showed significantly higher levels of the cleaved caspase 3 in comparison to the COPD N and C (p<0.05). Figure 1: Protein levels of cleaved caspase 3 in vastus lateralis muscle of COPD patients with low fat free mass (COPD L ), COPD patients with normal fat free mass (COPD N ) and healthy controls (C). Results of the TUNEL assay show that the percentage of apoptotic nuclei was higher in COPD patients with low (55.7±25.48) and normal fat free mass (51.6±25.49) in comparison to C (37.5±37.51) (p=0.42). We conclude that apoptosis contributes to peripheral muscle wasting in this population of COPD patients.

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