Heart & lung : the journal of critical care · 2025
Asthma-chronic obstructive pulmonary disease overlap is associated with a higher degree of neuromuscular junction degradation than either disease alone.
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Qaisar Rizwan, Khan Imran Ullah, Ahmad Firdos, Karim Asima
Аннотация
BACKGROUND: Patients with asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO) exhibit an advanced form of age-related decline of skeletal muscle and physical performance, termed sarcopenia. However, the relative contribution of neuromuscular junction (NMJ) degradation to sarcopenia in these patients remains partly elusive.
METHODS: We recruited older men, including controls (n=68) and patients with asthma (n=61), COPD (n=74), and ACO (n=53), to measure handgrip strength (HGS), skeletal muscle mass index (SMI), gait speed (GS), and a short physical performance battery (SPPB). We also measured plasma C-terminal agrin-fragment-22 (CAF22; a marker of NMJ degradation) and neurofilament light-chain (NfL; a marker of neurodegeneration) in the study population.
RESULTS: Patients with asthma, COPD, and ACO had lower HGS, SMI, GS, and SPPB scores and higher CAF22 levels than controls (all p<0.05). Among individual diseases, ACO was associated with the lowest HGS and SPPB scores and highest CAF22 levels (all p<0.05). We also observed significant correlations of CAF22 with HGS, GS, and SPPB in patients with asthma, COPD, and ACO (all p<0.05). Lastly, CAF22 exhibited significant efficacy in diagnosing sarcopenia in all three diseases, with the highest AUC reported in ACO patients (all p<0.05).
CONCLUSION: Altogether, we report a higher degree of sarcopenia and physical compromise with elevation of NMJ degradation biomarkers in patients with ACO than those with either disease alone. Our findings suggest NMJ as a therapeutic target to restore muscle health and functional capacity in patients with chronic airway diseases.
METHODS: We recruited older men, including controls (n=68) and patients with asthma (n=61), COPD (n=74), and ACO (n=53), to measure handgrip strength (HGS), skeletal muscle mass index (SMI), gait speed (GS), and a short physical performance battery (SPPB). We also measured plasma C-terminal agrin-fragment-22 (CAF22; a marker of NMJ degradation) and neurofilament light-chain (NfL; a marker of neurodegeneration) in the study population.
RESULTS: Patients with asthma, COPD, and ACO had lower HGS, SMI, GS, and SPPB scores and higher CAF22 levels than controls (all p<0.05). Among individual diseases, ACO was associated with the lowest HGS and SPPB scores and highest CAF22 levels (all p<0.05). We also observed significant correlations of CAF22 with HGS, GS, and SPPB in patients with asthma, COPD, and ACO (all p<0.05). Lastly, CAF22 exhibited significant efficacy in diagnosing sarcopenia in all three diseases, with the highest AUC reported in ACO patients (all p<0.05).
CONCLUSION: Altogether, we report a higher degree of sarcopenia and physical compromise with elevation of NMJ degradation biomarkers in patients with ACO than those with either disease alone. Our findings suggest NMJ as a therapeutic target to restore muscle health and functional capacity in patients with chronic airway diseases.