Abstract
This study aimed to determine the use of lipid profiling to assess the effects of moderate intensity exercise training (ET) on patients with sarcoidosis. Fourteen patients with sarcoidosis (mean age, 46.0 ± 9.6 years) were examined before and after 3-week of ET programme in hospital settings. Symptoms (fatigue: FAS, dyspnoea: MRC), lung function tests and physical function tests (6 MWT, muscle force) were measured before and after ET. Proton nuclear magnetic resonance (NMR) spectroscopy combined with orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to determine lipid profile before and after ET. Twenty-five NMR signals from lipid compounds were selected for further analysis as well as serum lipid and inflammatory markers. Three weeks of ET results in improvement of symptoms (FAS: 27.5 vs. 21.0; p < 0.001, MRC: 0.86 vs. 0.14; p = 0.002) and physical function (6MWT: 508.43 vs. 547.29; p = 0.039). OPLS-DA analysis of the lipid profiles of patients with sarcoidosis revealed differences among the samples before and after ET, including decreases in fatty acids (p < 0.017), triglycerides (p < 0.022) and total cholesterol (p < 0.020). Other changes included shifts in fatty acids oxidation products and triacylglycerol esters. A short-time, in-hospital exercise training benefits patients with sarcoidosis by enhancing their physical function. Additionally, positive effect on lipid profile was observed also in this study. It is suggested that lipid profiling could become a new prognostic method to assess effects of pulmonary rehabilitation in patients with sarcoidosis.
Highlights
maximal expiratory pressure (MEP) Maximal expiratory pressure maximal inspiratory pressure (MIP) Maximal inspiratory pressure MRC Medical Research Council NMR Nuclear magnetic resonance orthogonal partial least squares-DA (OPLS-DA) Orthogonal partial least squares-discriminant analysis PE Phosphatidylethanolamine PC Posphatidylocholine PL Plasmalogen PUFA Polyunsaturated fatty acids RH Right hand SM Sphingomyelin TCH Total cholesterol TG Triglycerides TLCO Transfer factor for carbon monoxide TNF Tumor necrosis factor
Previous studies focusing on the lipid profile status in pulmonary sarcoidosis demonstrated that the pathogenesis of sarcoidosis has been associated with alterations in the lipid profile including the reduction in highdensity lipoprotein cholesterol levels, lower apolipoprotein A1 levels and higher oxidative s tress[8,12]
Exercise intolerance, which is defined as an inability or decreased ability to perform physical exercise is influenced in pulmonary sarcoidosis by multiple factors, including sarcoidosis-related skeletal muscle abnormalities, decreased pulmonary function, small fibre neuropathy, and increased risk of a therosclerosis[13,14,15]
Summary
MEP Maximal expiratory pressure MIP Maximal inspiratory pressure MRC Medical Research Council NMR Nuclear magnetic resonance OPLS-DA Orthogonal partial least squares-discriminant analysis PE Phosphatidylethanolamine PC Posphatidylocholine PL Plasmalogen PUFA Polyunsaturated fatty acids RH Right hand SM Sphingomyelin TCH Total cholesterol TG Triglycerides TLCO Transfer factor for carbon monoxide TNF Tumor necrosis factor. The disease is characterized by a hyperimmune response in which excessive secretion of inflammatory mediators and uncontrolled oxidative stress have a detrimental effect on the mitochondria function and amino acid metabolism in myocytes and on lipid p rofiles[4,5,6]. These alterations in myocytes lead to myopathy and contribute to the development of fatigue, a common complain among sarcoidosis p atients[4]. Exercise training may have other positive effects, including changes in lipid metabolism, increased antioxidant protection and reduced inflammation[3,6,19]
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