Physical Exercise and Responses Measured by HIF-1 in COPD

Summary

Despite being considered a potentially preventable disease, COPD is classified as one of the respiratory problems with the highest prevalence and socioeconomic impact. According to the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD), people with COPD require actions that optimize quality of life by improving lung function and increasing tolerance to fatigue.

Research such as those carried out by Semenza, establish that metazoan organisms such as the human species present biomolecular mechanisms for O2 homeostasis, based on transcriptional changes that allow regulating or modifying the responses necessary for the maintenance of the cellular metabolic functions. Hypoxia Induced Factor 1 (HIF-1) is the primary molecular mechanism for the regulation of O2-regulated genes in nuclear cells; Therefore, they promote adaptive mechanisms to hypoxia, through the generation of protein synthesis that favor processes such as erythropoiesis, angiogenesis, changes in oxidative metabolism and modification of the pulmonary vascular response.

Research carried out in cells of people with COPD exposed to environmental hypoxia by low oxygen pressure (PO2), have shown changes in the nuclear concentrations of HIF-1, affecting the transcriptional mechanisms of specific genes for Erythropoietin (EPO), the Factor of Vascular Endothelial Growth (VEFG) and therefore limit the generation of essential proteins for systemic responses. These transcriptional mechanisms are conditioned by the structural changes of chromatin seconded by the inhibition in the performance of histone enzymes, which influences the synthesis of proteins involved in metabolic, hematological and / or ventilatory processes as a response. to hypoxia. However, the concentration and effect of HIF 1 on the synthesis of EPO and VEGF and its relationship with spirometric and hematological tests have not been studied in COPD people who live in medium altitudes and who are additionally exposed to additional hypoxic stimuli such as exercise physical.

Although it is known that in COPD there is a decrease in the diffusion of O2 through the blood-gas barrier generating hypoxia and that with low PO2 there are biomolecular adaptations to favor oxygenation, perfusion, and metabolism; At the moment, the responses of HIF-1 and its effect on the generation of proteins associated with erythropoiesis and angiogenesis (EPO, FEVG) in people with COPD with physical exercise-based treatments are unknown.

Conditions

• Pulmonary Disease, Chronic Obstructive

Interventions

OTHER

Physical exercise program

Step 1 • Diaphragmatic reeducation: • Aerobic capacity: Intensity: zone 2, 60% HRMax, 4-6 / 10 Borg Scale; Charge: 20 m. Step 2 • Aerobic capacity: Intensity: zone 2, 65% HRMax, 4-6 Borg Scale; Charge: 25 m. • Muscular strength: Method: Pyramidal; Intensity: 3-4 / 10 Omni-Res; Load: 20% 1RM; Series: 3; Reps: 1. • Flexibility and elasticity: Intensity: 31-60 Perflex Scale; Charge: 10 - 20 s. Step 3 • Aerobic capacity: Intensity: zone 3, 70% HRMax, 5-6 / 10 Borg scale, Load: 25 m. • Muscular strength: Method: Pyramidal; Intensity: 4-5 / 10 Omni-Res; Load: 30% 1RM; Series: 4; Reps: 10. • Flexibility and elasticity: Method: active stretching; Intensity: 31-60 Perflex Scale; Charge: 10 - 20 s. Step 4 •Aerobic capacity: Intensity: zone 3, 75% HRMax, 6-7 / 10 Borg scale, Load: 30 m. • Muscular strength: Intensity: 5-6 / 10 Omni-Res; Load: 40-50% 1RM; Series: 4 s; Reps: 13. • Flexibility and elasticity: Method: active stretching; Intensity: 31-60 Perflex Scale; Charge: 10 - 20 s.

OTHER

Health education in COPD

Week 1-2: Health education: COPD and respiratory care at home. Week 3-4: Importance of daily physical activity in COPD. Week 5-6: Early Signs of COPD Exacerbation and Action Plan Week 7-8: Use and care of respiratory devices at home.

Sponsors & Collaborators

• University of Barcelona

  collaborator OTHER

• Universidad Nacional de Colombia

  lead OTHER

Principal Investigators

• Wilder A Villamil-Parra, Therapist · Universidad Nacional de Colombia

Study Design

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-01-31

Primary Completion

2022-03-31

Completion

2022-06-30

Countries

• Colombia