World Lung Day: an Italian study published in Thorax shows for the first time a benefit on fatigue in patients with severe chronic obstructive pulmonary disease (COPD) and chronic respiratory failure.
Arginine and vitamin C against tiredness in COPDthe dreaded chronic obstructive pulmonary disease. Just today, September 25, World Lung Dayan Italian study published in the international journal Thorax brings attention to one of the most underestimated symptoms of the disease: the fatigue. This is not normal tiredness after exertion. Fatigue causes a feeling of deep and persistent exhaustion. It can therefore limit even the simplest daily activities. The research evaluated the addition of L-arginine and liposomal vitamin C to standard pulmonary rehabilitation. The result indicates a greater reduction in tiredness compared to the placebo. «COPD is one of the main causes of respiratory disability in the world, with 3.5 million cases in Italy alone. In its most serious forms, the feeling of fatigue represents one of the most disabling extrapulmonary symptoms, like breathing difficulty”, he explains Mauro Maniscalcocoordinator of the study, professor of Respiratory Diseases at the Federico II in Naples and director of the pneumological rehabilitation operational unit at the IRCCS Maugeri in Telese Terme. “Identifying simple, safe and well-tolerated interventions, at minimal costs, capable of acting on this aspect could concretely improve the quality of life of a population of fragile patients.”
The Italian study: 28 days to reduce fatigue
THE’ICS Maugeri IRCCS of Telese coordinated the research. Ten Italian cardiopulmonary rehabilitation centers participated in the study. The researchers followed about 100 patients with COPD and chronic respiratory failurealready on long-term oxygen therapy. They all followed a 28-day pulmonary rehabilitation program. One group took over arginine and liposomal vitamin C. The other received a placebo. The researchers used a double-blind, randomized design. The result concerns above all the perception of tiredness. «Both groups benefited from rehabilitation, but those who took the supplement recorded an almost triple reduction in tiredness compared to the placebo group, with a drop in 27% versus 10% in the perception of tiredness”, he reports Giuseppe Fiorentinoamong the main authors of the study and director of the Diseases, Physiopathology and Respiratory Rehabilitation UOC of the Colli di Napoli Hospitals. Furthermore, in the treated group, approximately the 60% of patients has reached a state of exhaustion that is no longer clinically relevant. The result does not mean that arginine and vitamin C cure COPD. The study instead observed a specific benefit on fatiguea symptom that can affect autonomy and quality of life.
Why arginine and vitamin C
Why exactly these two elements? The answer starts from the biological mechanisms of Severe COPD. Oxidative stress, alterations in nitric oxide metabolism and vascular and muscular dysfunction can contribute to fatigue. «The scientific interest in this association arises from the biological mechanisms involved in COPD, in which alterations in nitric oxide metabolism, oxidative stress and vascular and muscular dysfunction can contribute to fatigue», explains Maniscalco. THE’arginine it is an amino acid involved in the production of nitric oxide. This molecule contributes to the regulation of vessel tone and blood flow. There liposomal vitamin Chowever, plays a role in processes linked to oxidative stress. The researchers consider these mechanisms a possible explanation for the results. However, further studies will be needed to clarify the relationship between the combination and the reduction of fatigue. The work thus introduces another perspective into the COPD rehabilitation. In fact, it is not enough to look at respiratory function. It is also necessary to consider the feeling of exhaustion that may persist after rehabilitation. «The improvement in the feeling of tiredness and quality of life represents a very important result», observes Fiorentino, «because it emerges in a complex population without side effects or the addition of further drugs». On the day dedicated to lung health, the message is therefore simple: in COPD treatment cannot stop at breathing. Because breathing better matters. But it’s also important to find the energy to go back to living your day.
