Document Detail

MedLine Citation:
PMID:  23264538     Owner:  NLM     Status:  Publisher    
A profound remodeling of the diaphragm and vastus lateralis (VL) occurs in patients with moderate-to-severe COPD. In this mini-review, we discuss the following costal diaphragm remodeling features noted in patients with moderate-to-severe COPD: (a) increased proportion of slow-twitch fibers; (b) fast to slow isoform shift in sarcoendoplasmic reticulum ATPase (SERCA); (c) increased capacity of oxidative metabolism; (d) oxidative stress; and (e) myofiber atrophy. We then present the sole feature of diaphragm remodeling noted in mild-to-moderate COPD under the heading "myosin heavy chain and contractile remodeling noted in mild-to-moderate COPD." The importance of VL remodeling in COPD patients as a prognostic indicator as well as a major determinant of the ability to carry out activities of daily living is well-accepted. We present the remodeling of the VL noted in COPD patients under the following headings: (a) decrease in proportion of slow-twitch fibers; (b) decreased activity of oxidative pathways (c) oxidative and nitrosative stress; and (e) myofiber atrophy. For each of the remodeling features noted in both VL and costal diaphragm of COPD patients, we present mechanisms that are currently thought to mediate these changes as well as the pathophysiology of each remodeling feature. We hope that our mechanistic presentation stimulates pharmacological as well as rehabilitation medicine research that focuses on the ability of COPD patients to carry out increased activities of daily living.
Sanford Levine; Muhammad Hassaan Bashir; Thomas L Clanton; Scott K Powers; Sunil Singhal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-20
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  -     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1University of Pennsylvania.
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