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Cited by 38Chronic Obstructive Pulmonary Disease (COPD) ResearchExercise and Physiological ResponsesMuscle Physiology and Disorders

Additional Effects of Nutritional Antioxidant Supplementation on Peripheral Muscle during Pulmonary Rehabilitation in COPD Patients: A Randomized Controlled Trial

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Gouzi, Fares, Maury, Jonathan, Héraud, Nelly, Molinari, Nicolas, Bertet, Héléna, Ayoub, Bronia, Blaquière, Marine, Bughin, François +9 more·2019·Oxidative Medicine and Cellular Longevity
DOI 10.1155/2019/5496346PMC PMC6501222
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Abstract

Background. Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease (COPD) is not fully reversed by exercise training. Antioxidants are critical for muscle homeostasis and adaptation to training. However, COPD patients experience antioxidant deficits that worsen after training and might impact their muscle response to training. Nutritional antioxidant supplementation in combination with pulmonary rehabilitation (PR) would further improve muscle function, oxidative stress, and PR outcomes in COPD patients. Methods. Sixty-four COPD patients admitted to inpatient PR were randomized to receive 28 days of oral antioxidant supplementation targeting the previously observed deficits (PR antioxidant group; α-tocopherol: 30 mg/day, ascorbate: 180 mg/day, zinc gluconate: 15 mg/day, selenomethionine: 50 μ g/day) or placebo (PR placebo group). PR consisted of 24 sessions of moderate-intensity exercise training. Changes in muscle endurance (primary outcome), oxidative stress, and PR outcomes were assessed. Results. Eighty-one percent of the patients (FEV1=58.9±20.0%pred) showed at least one nutritional antioxidant deficit. Training improved muscle endurance in the PR placebo group (+37.4±45.1%, p<0.001), without additional increase in the PR antioxidant group (-6.6±11.3%; p=0.56). Nevertheless, supplementation increased the α-tocopherol/γ-tocopherol ratio and selenium (+58±20%, p<0.001, and +16±5%, p<0.01, respectively), muscle strength (+11±3%, p<0.001), and serum total proteins (+7±2%, p<0.001), and it tended to increase the type I fiber proportion (+32±17%, p=0.07). The prevalence of muscle weakness decreased in the PR antioxidant group only, from 30.0 to 10.7% (p<0.05). Conclusions. While the primary outcome was not significantly improved, COPD patients demonstrate significant improvements of secondary outcomes (muscle strength and other training-refractory outcomes), suggesting a potential “add-on” effect of the nutritional antioxidant supplementation (vitamins C and E, zinc, and selenium) during PR. This trial is registered with NCT01942889.

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Authors
Gouzi, F., Maury, J., Héraud, N., Molinari, N., Bertet, H., Ayoub, B., Blaquière, M., Bughin, F., De Rigal, P., Poulain, M., Pincemail, J., Cristol, J.-P., Laoudj-Chenivesse, D., Mercier, J., Préfaut, C., Pomiès, P., & Hayot, M.
Affiliations
  • PhyMedExp, Montpellier University, INSERM U1046, CNRS UMR 9214, Montpellier University Hospital, France
  • Centre National de la Recherche Scientifique (FR)
  • Pulmonary Rehabilitation Centers Les Cliniques du Souffle®, 5 Santé/Fontalvie Corporation, 66350 Toulouges, France
  • University of Liège (BE)
  • PhyMedExp, Montpellier University, INSERM U1046, CNRS UMR 9214, France
  • Montpellier University, France
ORCID
Venue
Oxidative Medicine and Cellular Longevity
Publisher
Wiley
Published
2019-04-17
Volume
2019
Pages
1-13
ISSN
  • 1942-0994 (ISSN-L)
  • 1942-0900
DOI
10.1155/2019/5496346
PMC
PMC6501222
OpenAlex
W2937030029
Cited by
38
References
5
Citations by year
2026: 2 · 2025: 8 · 2024: 8 · 2023: 8 · 2022: 2 · 2021: 4 · 2020: 6
FWCI
2.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Oxidative Medicine and Cellular Longevity (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Montpellier University Hospital
  • French Ministry of Public Health
  • Association Nationale de la Recherche et de la Technologie
  • 5 Santé/Fontalvie Corporation
  • Agir à Dom/Homair
  • Bastide Medical
  • SOS Oxygene
  • APARD
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Keywords
chronic obstructive pulmonary disease, pulmonary rehabilitation, peripheral muscle, oxidative stress, muscular endurance, muscle strength, muscle weakness, alpha-tocopherol, vitamin C, zinc, selenium, muscle fiber type, exercise training, muscle adaptation, serum proteins, vitamin E deficiency, selenium deficiency, zinc deficiency, scurvy, sarcopenia
MeSH terms
Adult, Aged, Female, Humans, Lung, Male, Middle Aged, Muscle, Skeletal, Dietary Supplements, Pulmonary Disease, Chronic Obstructive

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