Protocol for a systematic review of the associations between inflammatory markers and lung function, muscle force and exercise capacity in people with COPD

18 July 2023


Nadhirah Mohd Noor, Zawani Mustaffa, Alia Nizam, Mohd Arif Mohd Zim, Li Whye Cindy Ng, Fatim Tahirah Mirza

DOWNLOAD FULL PDF VIEW RESEARCH HERE
COPY CITATION
Copied!

Abstract

Introduction

The prevalence of chronic obstructive pulmonary disease (COPD) has been on the rise, with acute exacerbation of COPD associated with the highest burden and multiple pulmonary and systemic consequences. People with COPD have been found to have an abnormal response of systemic inflammation. To date, although limited, there are studies that suggest negative associations between inflammatory markers and important clinical outcomes such as exercise capacity and muscle force. This protocol aims to systematically review the evidence for (i) the associations between inflammatory markers and lung function, muscle force and exercise capacity and (ii) the influence of other factors (eg, hospitalisation, exercise programme) on the level of inflammatory markers in people with COPD.

Methods and analysis

Scopus, PubMed, Cochrane, Web of Science and ProQuest will be searched from database inception to February 2023 using PEO search strategy (Population: adults with COPD; Exposure: inflammatory markers; Outcomes: lung function, muscle force and exercise capacity). Four reviewers working in pairs will independently screen articles for eligibility and extract data that fulfilled the inclusion criteria. Depending on the design of the included studies, either Cochrane risk-of-bias version 2 or the Newcastle-Ottawa Scale tools will be used to rate the methodological quality of the included studies. Effect sizes reported in each individual study will be standardised to Cohen’s d and a random effects model will be used to calculate the pooled effect size for the association.

Ethics and dissemination

Ethical approval is unnecessary as this study will only use publicly available data. The findings will be disseminated through publication in peer-reviewed journals and conferences.

Reference

  1. Global Initiative for Chronic Obstructive Lung Disease. (2020). GOLD report 2020 (p. 141). https://doi.org/10.1155/2020/1031845
  2. Blanco, I., Diego, I., Bueno, P., Casas-Maldonado, F., Miravitlles, M., & Soriano, J. B. (2019). Geographic distribution of COPD prevalence in the world displayed by geographic information system maps. European Respiratory Journal, 54(5), Article 1900610. https://doi.org/10.1183/13993003.00610-2019
  3. Gutiérrez Villegas, C., Paz-Zulueta, M., Herrero-Montes, M., Parás-Bravo, P., & Madrazo-Perez, C. (2021). Cost analysis of chronic obstructive pulmonary disease (COPD): A systematic review. Health Economics Review, 11, Article 31. https://doi.org/10.1186/s13561-021-00329-9
  4. Praticò, D., Basili, S., Vieri, M., Cordova, C., Violi, F., & FitzGerald, G. A. (1998). Chronic obstructive pulmonary disease is associated with an increase in urinary levels of isoprostane F2α-III, an index of oxidant stress. American Journal of Respiratory and Critical Care Medicine, 158(6), 1709–1714. https://doi.org/10.1164/ajrccm.158.6.9803117
  5. Rahman, I., Morrison, D., Donaldson, K., & MacNee, W. (1996). Systemic oxidative stress in asthma, COPD, and smokers. American Journal of Respiratory and Critical Care Medicine, 154(4 Pt 1), 1055–1060. https://doi.org/10.1164/ajrccm.154.4.8887607
  6. Burnett, D., Chamba, A., Hill, S. L., & Stockley, R. A. (1987). Neutrophils from subjects with chronic obstructive lung disease show enhanced chemotaxis and extracellular proteolysis. The Lancet, 330(8567), 1043–1046. https://doi.org/10.1016/s0140-6736(87)91476-0
  7. Agustí, A. G. N., Noguera, A., Sauleda, J., Sala, E., Pons, J., & Busquets, X. (2003). Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal, 21(2), 347–360. https://doi.org/10.1183/09031936.03.00405703
  8. Sinden, N. J., & Stockley, R. A. (2010). Systemic inflammation and comorbidity in COPD: A result of ‘overspill’ of inflammatory mediators from the lungs. Thorax, 65(10), 930–936. https://doi.org/10.1136/thx.2009.130260
  9. Decramer, M., Rennard, S., Troosters, T., Mapel, D. W., Giardino, N., Vestbo, J., & Wedzicha, J. A. (2008). COPD as a lung disease with systemic consequences - clinical impact, mechanisms, and potential for early intervention. COPD: Journal of Chronic Obstructive Pulmonary Disease, 5(4), 235–256. https://doi.org/10.1080/15412550802237531
  10. Sevenoaks, M. J., & Stockley, R. A. (2006). Chronic obstructive pulmonary disease, inflammation and co-morbidity—a common inflammatory phenotype? Respiratory Research, 7, Article 70. https://doi.org/10.1186/1465-9921-7-70
  11. Agusti, À., & Soriano, J. B. (2008). COPD as a systemic disease. COPD: Journal of Chronic Obstructive Pulmonary Disease, 5(2), 133–138. https://doi.org/10.1080/15412550801941349
  12. Donaldson, G. C., Seemungal, T. A. R., Bhowmik, A., & Wedzicha, J. A. (2002). Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax, 57(10), 847–852. https://doi.org/10.1136/thorax.57.10.847
  13. Spruit, M. A., Gosselink, R., Troosters, T., Kasran, A., Gayan-Ramirez, G., de Paepe, W., & Decramer, M. (2003). Muscle force during an acute exacerbation in hospitalised patients with COPD and its relationship with Cxcl8 and IGF-I. Thorax, 58(9), 752–756. https://doi.org/10.1136/thorax.58.9.752
  14. Carr, S. J., Hill, K., Brooks, D., & Goldstein, R. S. (2009). Pulmonary rehabilitation after acute exacerbation of chronic obstructive pulmonary disease in patients who previously completed a pulmonary rehabilitation program. Journal of Cardiopulmonary Rehabilitation and Prevention, 29(5), 318–324. https://doi.org/10.1097/HCR.0b013e3181ac7bb8
  15. Tantucci, C., & Modina, D. (2012). Lung function decline in COPD. International Journal of Chronic Obstructive Pulmonary Disease, 7, 95–99. https://doi.org/10.2147/COPD.S27480
  16. Pitta, F., Troosters, T., Probst, V. S., Spruit, M. A., Decramer, M., & Gosselink, R. (2006). Physical activity and hospitalization for exacerbation of COPD. Chest, 129(3), 536–544. https://doi.org/10.1378/chest.129.3.536
  17. Carr, S. J., Goldstein, R. S., & Brooks, D. (2007). Acute exacerbations of COPD in subjects completing pulmonary rehabilitation. Chest, 132(1), 127–134. https://doi.org/10.1378/chest.07-0269
  18. Cote, C. G., Dordelly, L. J., & Celli, B. B. (2007). Impact of COPD exacerbations on patient-centered outcomes. Chest, 131(3), 696–704. https://doi.org/10.1378/chest.06-1610
  19. Ramon, M. A., Gimeno-Santos, E., Ferrer, J., Balcells, E., Rodríguez, E., de Batlle, J., ... & Garcia-Aymerich, J. (2014). Hospital admissions and exercise capacity decline in patients with COPD. European Respiratory Journal, 43(4), 1018–1027. https://doi.org/10.1183/09031936.00088313
  20. Alahmari, A. D., Kowlessar, B. S., Patel, A. R. C., Mackay, A. J., Allinson, J. P., Wedzicha, J. A., & Donaldson, G. C. (2016). Physical activity and exercise capacity in patients with moderate COPD exacerbations. European Respiratory Journal, 48(2), 340–349. https://doi.org/10.1183/13993003.01105-2015
  21. Pinto-Plata, V., Casanova, C., Müllerova, H., de Torres, J. P., Carrizo, S., Cell, B., & Celli, B. R. (2012). Inflammatory and repair serum biomarker pattern: Association to clinical outcomes in COPD. Respiratory Research, 13, 1–8. https://doi.org/10.1186/1465-9921-13-71
  22. Yende, S., Waterer, G. W., Tolley, E. A., Newman, A. B., Bauer, D. C., Erickson, S., ... & Kritchevsky, S. B. (2006). Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well functioning elderly subjects. Thorax, 61(1), 10–16. https://doi.org/10.1136/thx.2004.034181
  23. Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2019). Cochrane handbook for systematic reviews of interventions (2nd ed.). John Wiley & Sons. https://doi.org/10.1002/9781119536604
  24. Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., ... & PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 350, Article g7647. https://doi.org/10.1136/bmj.g7647
  25. Page, M. J., McKenzie, JE., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71
  26. Wells, G., Shea, B., O’Connell, D., Peterson, J., Welch, V., Losos, M., & Tugwell, P. (2011). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. The Ottawa Health Research Institute.
  27. Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557
  28. Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629
  29. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
  30. Ogilvie, D., Fayter, D., Petticrew, M., Sowden, A., Thomas, S., Whitehead, M., & Worthy, G. (2008). The harvest plot: A method for synthesising evidence about the differential effects of interventions. BMC Medical Research Methodology, 8, 1–7. https://doi.org/10.1186/1471-2288-8-8
  31. Akers, J. (2009). Systematic reviews: CRD’s guidance for undertaking reviews in health care (3rd ed., pp. 1–281). CRD, University of York.
  32. Schünemann, H. J., Oxman, A. D., Brozek, J., Glasziou, P., Jaeschke, R., Vist, G. E., ... & GRADE Working Group. (2008). Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ, 336(7653), 1106–1110. https://doi.org/10.1136/bmj.39500.677199.AE

Cite

Noor, N. M., Mustaffa, Z., Nizam, A., Mohd Zim, M. A., Ng, L. W. C., & Mirza, F. T. (2023). Protocol for a systematic review of the associations between inflammatory markers and lung function, muscle force and exercise capacity in people with COPD. BMJ open, 13(7), e068776. https://doi.org/10.1136/bmjopen-2022-068776

COPY CITATION Copied!
DOWNLOAD FULL PDF VIEW RESEARCH HERE