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  • 1. Branth, S.
    et al.
    Hambraeus, L.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Essén-Gustavsson, B.
    Åkerfeldt, T.
    Olsson, R.
    Stridsberg, M.
    Ronquist, G.
    Metabolic stress-like condition can be induced by prolonged strenuous exercise in athletes2009In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 114, no 1, p. 12-25, article id PII 908457901Article in journal (Refereed)
    Abstract [en]

    Few studies have examined energy metabolism during prolonged, strenuous exercise. We wanted therefore to investigate energy metabolic consequences of a prolonged period of continuous strenuous work with very high energy expenditure. Twelve endurance-trained athletes (6 males and 6 females) were recruited. They performed a 7-h bike race on high work-load intensity. Physiological, biochemical, endocrinological, and anthropometric muscular compartment variables were monitored before, during, and after the race. The energy expenditure was high, being 5557 kcal. Work-load intensity (% of VO2 peak) was higher in females (77.7%) than in men (69.9%). Muscular glycogen utilization was pronounced, especially in type I fibres (>90%). Additionally, muscular triglyceride lipolysis was considerably accelerated. Plasma glucose levels were increased concomitantly with an unchanged serum insulin concentration which might reflect an insulin resistance state in addition to proteolytic glyconeogenesis. Increased reactive oxygen species (malondialdehyde (MDA)) were additional signs of metabolic stress. MDA levels correlated with glycogen utilization rate. A relative deficiency of energy substrate on a cellular level was indicated by increased intracellular water of the leg muscle concomitantly with increased extracellular levels of the osmoregulatory amino acid taurine. A kindred nature of a presumed insulin-resistant state with less intracellular availability of glucose for erythrocytes was also indicated by the findings of decreased MCV together with increased MCHC (haemoconcentration) after the race. This strenuous energy-demanding work created a metabolic stress-like condition including signs of insulin resistance and deteriorated intracellular glucose availability leading to compromised fuelling of ion pumps, culminating in a disturbed cellular osmoregulation indicated by taurine efflux and cellular swelling. © 2009 Informa UK Ltd All rights reserved.

  • 2.
    Eliason, Gabriella
    et al.
    Örebro University, School of Health and Medical Sciences.
    Abdel-Halim, S.
    Örebro University, School of Health and Medical Sciences.
    Arvidsson, B.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Physical performance and muscular characteristics in different stages of COPD2009In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 6, p. 865-870Article in journal (Refereed)
    Abstract [en]

    This study has examined exercise capacity and muscle morphology in patients with different severities of chronic obstructive pulmonary disease (COPD). Twenty-three patients and 12 healthy matched controls were recruited. Based on the severity of airflow obstruction, patients were divided into two subgroups. Exercise capacity was determined using a 6-min walk test. Muscle fiber composition, fiber area and number of satellite cells/muscle fiber were determined in muscle biopsies using immunohistochemistry. A progressive decline in exercise capacity was noted with ascending disease severity. Furthermore, a correlation between reduction in exercise capacity and changes in muscle fiber composition was observed in COPD. The group with severe and very severe COPD had a lower proportion of type I and a higher proportion of type IIa fibers compared with the other groups. In severe and very severe COPD, a reduction in fiber area of type IIa fibers was also seen. The number of satellite cells/muscle fiber did not differ between the groups. In conclusion, a decline in exercise capacity occurs already in mild and moderate COPD, indicating that the 6-min walk test is a reliable indicator of disease severity. Furthermore, changes in skeletal muscle morphology are associated with disease severity while muscle regenerative capacity is not altered.

  • 3.
    Eliason, Gabriella
    et al.
    Örebro University, School of Health and Medical Sciences.
    Abdel-Halim, Samy M.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
    Piehl-Aulin, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Rheumatology, Danderyds hospital, Stockholm, Sweden.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Alterations in the muscle-to-capillary interface in patients with different degrees of chronic obstructive pulmonary disease2010In: Respiratory research (Online), ISSN 1465-9921, E-ISSN 1465-993X, Vol. 11, article id 97Article in journal (Refereed)
    Abstract [en]

    Background: It is hypothesized that decreased capillarization of limb skeletal muscle is implicated in the decreased exercise tolerance in COPD patients. We have recently demonstrated decreased number of capillaries per muscle fibre (CAF) but no changes in CAF in relation to fibre area (CAFA), which is based on the diffusion distance between the capillary and muscle fibre. The aim of the current study is to investigate the muscle-to-capillary interface which is an important factor involved in oxygen supply to the muscle that has previously been suggested to be a more sensitive marker for changes in the capillary bed compared to CAF and CAFA.

    Methods: 23 COPD patients and 12 age-matched healthy subjects participated in the study. Muscle-to-capillary interface was assessed in muscle biopsies from the tibialis anterior muscle using the following parameters:

    1) The capillary-to-fibre ratio (C:Fi) which is defined as the sum of the fractional contributions of all capillary contacts around the fibre

    2) The ratio between C:Fi and the fibre perimeter (CFPE-index)

    3) The ratio between length of capillary and fibre perimeter (LC/PF) which is also referred to as the index of tortuosity.

    Exercise capacity was determined using the 6-min walking test.

    Results: A positive correlation was found between CFPE-index and ascending disease severity with CFPE-index for type I fibres being significantly lower in patients with moderate and severe COPD. Furthermore, a positive correlation was observed between exercise capacity and CFPE-index for both type I and type IIa fibres.

    Conclusion: It can be concluded that the muscle-to-capillary interface is disturbed in the tibialis anterior muscle in patients with COPD and that interface is strongly correlated to increased disease severity and to decreased exercise capacity in this patient group.

     

  • 4.
    Eliason, Gabriella
    et al.
    Örebro University, School of Health and Medical Sciences.
    Zakrisson, Ann-Britt
    Örebro University, School of Health and Medical Sciences.
    Piehl-Aulin, Karin
    Hurtig-Wennlöf, Anita
    Örebro University, School of Health and Medical Sciences.
    Physical activity patterns in patients in different stages of chronic obstructive pulmonary disease2011In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 8, no 5, p. 369-374Article in journal (Refereed)
    Abstract [en]

    It has previously been suggested that exercise capacity is decreased in COPD and that it is associated with degree of disease. The reduced exercise capacity may plausibly be due to low levels of physical activity in this patient group. The aim of the present study was to assess exercise capacity and physical activity in different stages of COPD and to examine the associations between exercise capacity, pulmonary function and degree of physical activity. A total of 44 COPD patients and 17 healthy subjects participated in the study. Exercise capacity was assessed using the 6-minute walking test and physical activity was assessed using an accelerometer worn all waking hours during 7 days. Mean exercise capacity was significantly lower in COPD patients compared with healthy subjects. Mean physical activity level and time spent at least moderately active were significantly lower in patients with moderate and severe COPD compared with healthy subjects while no differences in time spent sedentary were observed between the study groups. Pulmonary function, mean physical activity level and time spent at least moderately physically active were significantly associated with exercise capacity in the patients. We conclude that patients with moderate and severe COPD are less physically active compared with healthy subjects. Furthermore, mean physical activity level and physical activity of at least moderate intensity are positively associated with exercise capacity in COPD, while time spent sedentary is not, which stresses an important role of physical activity on exercise capacity in these patients.

  • 5.
    Folkesson, Mattias
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Mackey, Abigail L.
    Department of Orthopaedic Surgery M, Faculty of Health Sciences, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark; Centre for Healthy Ageing, University of Copenhagen, Copenhagen, Denmark.
    Langberg, Henning
    Department of Orthopaedic Surgery M, Faculty of Health Sciences, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark; Centre for Healthy Ageing, University of Copenhagen, Copenhagen, Denmark.
    Oskarsson, Eva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Piehl-Aulin, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.
    Henriksson, Jan
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The expression of heat shock protein in human skeletal muscle: effects of muscle fibre phenotype and training background2013In: Acta Physiologica, ISSN 1748-1708, E-ISSN 1748-1716, Vol. 209, no 1, p. 26-33Article in journal (Refereed)
    Abstract [en]

    Aim: Exercise-induced adaptations of skeletal muscle are related to training mode and can be muscle fibre type specific. This study aimed to investigate heat shock protein expression in type I and type II muscle fibres in resting skeletal muscle of subjects with different training backgrounds.

    Methods: Three groups of subjects were included: healthy active not engaged in any training programme (ACT, n = 12), resistance trained (RES, n = 6) and endurance trained (END, n = 8). Biopsies were obtained from vastus lateralis, and immunohistochemistry was performed using monoclonal antibodies against myosin heavy chain I and IIA, αB-crystallin, HSP27, HSP60 and HSP70.

    Results: In ACT and RES, but not in END, a fibre type–specific expression with higher staining intensity in type I than type II fibres was seen for αB-crystallin. The opposite (II > I) was found for HSP27 in subjects from ACT (6 of 12 subjects) and RES (3 of 6), whereas all subjects from END displayed uniform staining. HSP60 showed no fibre-specific expression. HSP70 displayed a fibre-specific expression pattern (I > II) in ACT (4 of 12), but not in END or RES.

    Conclusion: This study shows that the level of expression of the different HSPs in human skeletal muscle is influenced by muscle fibre phenotype. The fibre type–specific expression of HSP70 is influenced by resistance and endurance training, whereas those of αB-crystallin and HSP27 is influenced only by endurance training, suggesting the existence of a training-modality-specific action on the adaptive processes including heat shock proteins in human skeletal muscle.

  • 6.
    Jatta, Ken
    et al.
    Örebro University, School of Health and Medical Sciences.
    Eliason, Gabriella
    Örebro University, School of Health and Medical Sciences.
    Portela-Gomes, Guida M.
    Grimelius, Lars
    Caro, Oscar
    Nilholm, Lennart
    Sirsjö, Allan
    Örebro University, School of Health and Medical Sciences.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Abdel-Halim, Samy M.
    Örebro University, School of Health and Medical Sciences.
    Overexpression of von Hippel-Lindau protein in skeletal muscles of patients with chronic obstructive pulmonary disease2009In: Journal of Clinical Pathology, ISSN 0021-9746, E-ISSN 1472-4146, Vol. 62, no 1, p. 70-76Article in journal (Refereed)
    Abstract [en]

    Background/aim: A Significant number of patients with chronic obstructive pulmonary disease (COPD) exhibit skeletal muscle wasting and decreased capillary area formation which have been correlated to increased mortality. The current study aimed to determine the molecular mechanisms mediating decreased capillary formation in COPD.

    Methods: Twenty-four COPD patients and twelve matching controls were recruited. COPD patients were divided into mild, moderate and severe groups according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. Skeletal muscle biopsies were obtained from the tibialis anterior muscle. Fibre typing and capillary formation together with messenger RNA (mRNA) expression of hypoxia-inducible factors (HIF-1á and HIF-3á ), vascular endothelial growth factors (VEGF-A, -B and -C isoforms) and von Hippel Lindau (VHL) were determined. VHL expression and localization was further studied by immunohistochemistry.

    Results: Skeletal muscle capillary formation was significantly decreased with ascending disease severity. Compared to controls, a tendency to mRNA overexpression of HIF-1á, HIF-3á and VEGF isoforms was observed at mild and moderate COPD that decreased at the severe stage. By contrast, skeletal muscle biopsies from COPD patients exhibited significant overexpression of VHL both on the mRNA and protein levels by immunohistochemistry. VHL protein was further determined to be localized to satellite cells.

    Conclusions: Overexpression of VHL was identified in the skeletal muscle of patients with COPD. Increased VHL activity may exert a negative impact on transducing the hypoxic signal and may contribute to decreased capillarization in skeletal muscles of patients with COPD.

  • 7.
    Kadi, Fawzi
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ponsot, Elodie
    Örebro University, School of Health and Medical Sciences.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Mackey, Abigail
    Bispebjerg Hospital, University of Copenhagen, Denmark.
    Kjaer, Michael
    Bispebjerg Hospital, University of Copenhagen, Denmark.
    Oskarsson, Eva
    Örebro University, School of Health and Medical Sciences.
    Holm, Lars
    The effects of regular strength training on telomere length in human skeletal muscle2008In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 40, no 1, p. 82-87Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The length of DNA telomeres is an important parameter of the proliferative potential of tissues. A recent study has reported abnormally short telomeres in skeletal muscle of athletes with exercise-associated fatigue. This important report raises the question of whether long-term practice of sports might have deleterious effects on muscle telomeres. Therefore, we aimed to compare telomere length of a group of power lifters (PL; N = 7) who trained for 8 +/- 3 yr against that of a group of healthy, active subjects (C; N = 7) with no history of strength training. METHODS: Muscle biopsies were taken from the vastus lateralis, and the mean and minimum telomeric restriction fragments (TRF) (telomere length) were determined, using the Southern blot protocol previously used for the analysis of skeletal muscle. RESULTS: There was no abnormal shortening of telomeres in PL. On the contrary, the mean (P = 0.07) and the minimum (P = 0.09) TRF lengths in PL tended to be higher than in C. In PL, the minimum TRF length was inversely correlated to the individual records in squat (r = -0.86; P = 0.01) and deadlift (r = -0.88; P = 0.01). CONCLUSION: These results show for the first time that long-term training is not associated with an abnormal shortening of skeletal muscle telomere length. Although the minimum telomere length in PL remains within normal physiological ranges, a heavier load put on the muscles means a shorter minimum TRF length in skeletal muscle.

  • 8.
    Karlsson, Christina
    et al.
    Örebro University, School of Health and Medical Sciences.
    Bodin, Lennart
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Karlsson, Mats G.
    Örebro University, School of Health and Medical Sciences.
    Tissue microarray validation: a methodologic study with special reference to lung cancer2009In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 18, no 7, p. 2014-2021Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although tissue microarray (TMA) studies of histopathologic material have been frequently reported in studies of malignant diseases, the question of sample size (i.e., the diameter and the number of tissue cylinders investigated) has been rarely discussed. This study addresses the methodologic question of sample size in a variety of tumor types.

    MATERIAL AND METHODS: Material from 29 cases of lung carcinoma (small cell, squamous cell, and adenocarcinomas) was examined immunohistochemically for Ki-67 and p53 expression in virtually constructed cylinders of different diameters. The influence of tissue sample size (i.e., different numbers of virtual cylinders) was also investigated. Results from Ki-67 evaluation were analyzed as a continuous variable, whereas p53 expression was scored. p53 evaluations based on scoring in cylinders versus scoring of whole sections were also compared. Furthermore, 10 cases of endometrial and breast carcinomas were evaluated for estrogen receptor, Ki-67, and HER2 by scoring up to five cylinders.

    RESULTS AND CONCLUSIONS: Tissue cylinders of 0.6 and 1.0 mm diameters were compared and found equally informative about Ki-67 expression (intraclass correlation, 0.96). A statistical approach considering intraindividual and interindividual variation data is presented, indicating that in this specific setting three cylinders per case is an adequate sample size for TMA studies. Further sampling yields only a small gain in accuracy as determined by Ki-67 quantification and p53 scoring (kappa-coefficient, 0.9). For endometrial and breast tissues, TMA scoring of three cylinders yielded excellent agreement (kappa, >0.75) compared with whole-section scoring.

  • 9.
    Nilsson, Andreas
    et al.
    Örebro University, School of Health and Medical Sciences.
    Andersen, Lars Bo
    Ommundsen, Yngvar
    Froberg, Karsten
    Sardinha, Luis B.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Ekelund, Ulf
    Örebro University, School of Health and Medical Sciences.
    Correlates of objectively assessed physical activity and sedentary time in children: a cross-sectional study (The European Youth Heart Study)2009In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, article id 322Article in journal (Refereed)
    Abstract [en]

    Background

    Identifying leisure time activities performed before and after school that influence time in physical activity (PA) and/or time spent sedentary can provide useful information when designing interventions aimed to promote an active lifestyle in young people. The purpose of this study was to examine associations between mode of transportation to school, outdoor play after school, participation in exercise in clubs, and TV viewing with objectively assessed PA and sedentary behaviour in children.

    Methods

    A total of 1327 nine- and 15-year-old children from three European countries (Norway, Estonia, Portugal) participated as part of the European Youth Heart Study. PA was measured during two weekdays and two weekend days using the MTI accelerometer, and average percent of time in moderate-to-vigorous PA (MVPA) and time spent sedentary were derived. Potential correlates were assessed by self-report. Independent associations between self-reported correlates with percent time in MVPA and percent time sedentary were analysed by general linear models, adjusted by age, gender, country, measurement period, monitored days and parental socio-economic status.

    Results

    In 9-year-olds, playing outdoors after school was associated with higher percent time in MVPA (P < 0.01), while participation in sport clubs was associated with higher percent time in MVPA (P < 0.01) in 15-year-olds. No associations with percent time sedentary were observed in either age group.

    Conclusion

    Frequency of outdoor play after school is a significant correlate for daily time in MVPA in 9-year-olds, while this correlate is attenuated in favour of participation in sport and exercise in clubs in 15-year-olds. Targeting walking to school or reduced TV viewing time in order to increase time in daily MVPA in children is unlikely to be sufficient. Correlates related to time spent sedentary need further examination.

  • 10.
    Oskarsson, Eva
    et al.
    Örebro University, Department of Clinical Medicine.
    Gustafsson, Björn-Erik
    Örebro University, Department of Clinical Medicine.
    Pettersson, Kurt
    Handkirugiska kliniken, Örebro universitetssjukhus.
    Piehl Aulin, Karin
    Örebro University, Department of Clinical Medicine.
    Decreased intramuscular blood flow in patients with lateral epicondylitis2007In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 17, no 3, p. 211-215Article in journal (Refereed)
    Abstract [en]

    The purpose of this pilot study was to investigate intramuscular microcirculation in extensor carpi radialis brevis (ECRB) in patients with lateral epicondylitis.

    Ten patients with unilateral epicondylitis, mean duration of symptoms of 39 (12-96) months participated. The diagnosis was based on clinical examination and none was under treatment for the last 6 months. Isometric handgrip strength, 2-pinch grip strength and muscle strength during radial deviation and dorsal extension was determined. Functional perceived pain was evaluated by a modified BRS and perceived pain during contraction by VAS. Intramuscular and skin blood flow was recorded by a laser-Doppler flowmetry system technique (LDF) during stable temperature condition.

    Intramuscular blood flow was significantly lower in the affected side, 22.7 ± 9.8 PU as compared to 35.2 ± 11.9 PU in the control side (P = 0.01). There was no difference in skin blood flow or temperature between affected and control side. A positive correlation was found between duration of symptoms and the difference in intramuscular blood flow between affected and control arm (r = 0.65, P = 0.06).

    The present data indicate that decreased microcirculation and anaerobic metabolism in ECRB may contribute to the lateral epicondylitis symptoms.

  • 11.
    Oskarsson, Eva
    et al.
    Örebro University, Department of Clinical Medicine.
    Piehl Aulin, Karin
    Örebro University, Department of Clinical Medicine.
    Gustafsson, B-E
    Pettersson, K
    Orebro University Hospital.
    Improved intramuscular blood flow and normalized metabolism in lateral epicondylitis after botulinum toxin treatment2009In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 3, p. 323-328Article in journal (Refereed)
    Abstract [en]

    Lateral epicondylitis is a common cause of elbow pain, and decreased microcirculation in extensor carpi radialis brevis (ECRB) has recently been suggested to contribute to the symptoms. The purpose of this pilot study was to investigate the treatment response after injection of botulinum toxin type A. Ten patients with unilateral epicondylitis and decreased intramuscular blood flow in ECRB participated. Handgrip, 2-pinch grip and muscle strength during radial deviation and dorsal extension of the wrist were recorded. Perceived pain during contraction was evaluated with the Visual Analogue Scale (VAS) and function in daily activities was assessed using the Disability of Arm, Shoulder and Hand instrument (DASH) and the Canadian Occupational Performance Measure instrument (COPM). Intramuscular blood flow was recorded by laser Doppler flowmetry, and microdialysis was used to analyze muscle metabolism. The difference in intramuscular blood flow between the control and the affected side had decreased 3 and 12 months after treatment (P=0.03). Lactate concentration at the 12-month follow-up had decreased (P=0.02); perceived pain was reduced and function in daily activities had improved. Injection of botulinum toxin is an alternative treatment for epicondylitis. Symptom relief may be due to enhanced microcirculation causing an aerobic metabolism.

  • 12.
    Piehl-Aulin, Karin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Jones, I.
    Lindvall, Björn
    Magnuson, A.
    Abdel-Halim, S. M.
    Increased serum inflammatory markers in the absence of clinical and skeletal muscle inflammation in patients with chronic obstructive pulmonary disease2009In: Respiration, ISSN 0025-7931, E-ISSN 1423-0356, Vol. 78, no 2, p. 191-196Article in journal (Refereed)
    Abstract [en]

    Background: Muscle wasting and cachexia are common occurrences in patients with chronic obstructive pulmonary disease (COPD). Objectives: The current study aimed to investigate markers of inflammation in the circulation and skeletal muscle that might be associated with development of muscle wasting. Methods: Three groups of patients with mild, moderate and severe COPD and matched healthy controls were recruited. Serum levels of C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), IL-6, IL-8, TNF-α, cortisol, insulin-like growth factor 1 (IGF-1), leptin and ghrelin were analysed. Skeletal muscle inflammation was investigated microscopically using a panel of antibodies and standard staining for inflammatory cell infiltration. Results: All COPD patients were clinically stable, with no sign of inflammation and normal CRP values. Compared to controls, significantly increased hs-CRP levels were observed in all COPD patient groups. Significant rises in IL-6 levels were first observed in moderate COPD, while IL-8 levels were significantly elevated at the late severe stage. Circulating levels of TNF-α, cortisol, IGF-1, leptin and ghrelin were similar to control levels. No microscopic signs of skeletal muscle inflammation were observed. Conclusion: Our results identify hs-CRP as an early marker of inflammation that is significantly increased in the circulation even in mild COPD. Serum interleukin levels appear to be increased with disease progress. These changes were manifested in the absence of any clinical signs of disease exacerbation, evidence of skeletal muscle inflammation or hormonal changes. © 2009 S. Karger AG, Basel.

  • 13.
    Verney, Julien
    et al.
    Örebro University, School of Health and Medical Sciences.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Charifi, Nadia
    Örebro University, School of Health and Medical Sciences.
    Féasson, Léonard
    Saafi, Mohamed Ali
    Castells, Josiane
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Denis, Christian
    Effects of combined lower body endurance and upper body resistance training on the satellite cell pool in elderly subjects2008In: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 38, no 3, p. 1147-1154Article in journal (Refereed)
    Abstract [en]

    To distinguish the respective potential of endurance and resistance training to increase the satellite cell pool, we investigated the effects of 14 weeks of concurrent lower body endurance and upper body resistance training (3 sessions/week) on vastus lateralis (VLat) and deltoid (Del) muscles of 10 active elderly men. NCAM+ satellite cells and myonuclear number were assessed in VLat and Del. After 14 weeks of training the NCAM+ satellite cell pool increased similarly (+38%) in both muscles, mainly in type II muscle fibers (P < 0.05). There was no significant change in myonuclear number or myonuclear domain in either muscle. Combining resistance training in the upper limbs with endurance training in the lower limbs is an efficient strategy to enhance the satellite cell pool in upper and lower body muscles in elderly subjects. Our results provide a practical reference for the determination of optimal exercise protocols to improve muscle function and regeneration in the elderly.

  • 14.
    Verney, Julien
    et al.
    Örebro University, Department of Health Sciences.
    Kadi, Fawzi
    Örebro University, Department of Health Sciences.
    Saafi, Mohamed A.
    Piehl-Aulin, Karin
    Örebro University, Department of Health Sciences.
    Denis, Christian
    Combined lower body endurance and upper body resistance training improves performance and health parameters in healthy active elderly2006In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 97, no 3, p. 288-297Article in journal (Other academic)
    Abstract [en]

    We investigated the effects of combined lower body (LB) endurance and upper body (UB) resistance training on endurance, strength, blood lipid profile and body composition in active older men. Ten healthy still active men (73+/-4 years, V(O2) peak: 36 (31-41) ml min-1 kg-1) were tested before and after 14 weeks of combined training (3 times week-1). Training consisted of 3x12 min of high intensity interval training on a bicycle for endurance interspersed by 3x12 min of UB resistance exercises. V(O2) peak during leg cycling and arm cranking, isokinetic torque of knee extensor and shoulder abductor and the cross-sectional area (CSA) of several muscles from UB and LB were measured. Sagittal abdominal diameter (SAD) and abdominal fat area were measured on MRI scans. Total body composition was assessed by hydrostatic weighing (HW) and dual-energy X-ray absorptiometry (DEXA). Blood lipid profile was assessed before and after training. By the end of the training period, V(O2) peak (l min-1) increased significantly by 9 and 16% in leg cycling and arm cranking tests, respectively. Maximal isokinetic torque increased both for the knee extensor and shoulder abductor muscle groups. CSA increased significantly in deltoid muscle. Percentage of body fat decreased by 1.3% (P<0.05) and abdominal fat and SAD decreased by 12 and 6%, respectively (P<0.01). There was also a significant decrease in total cholesterol and low-density lipoprotein. Thus, combined LB endurance and UB resistance training can improve endurance, strength, body composition and blood lipid profile even in healthy active elderly.

  • 15.
    Wåhlin Larsson, Britta
    et al.
    Örebro University, School of Health and Medical Sciences. Dalarna University, Falun, Sweden.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ulfberg, Jan
    Avesta Hospital, Avesta, Sweden.
    Piehl Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Skeletal muscle morphology and aerobic capacity in patients with obstructive sleep apnoea syndrome2008In: Respiration, ISSN 0025-7931, E-ISSN 1423-0356, Vol. 76, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    Background: Despite the fact that patients with obstructive sleep apnoea syndrome (OSAS) often have symptoms at the level of skeletal muscle such as fatigue, the question of whether the structural, cellular and functional properties of limb skeletal muscles are affected has not been fully examined. Objective: The aim was to examine physiological and muscular parameters in patients with OSAS and to assess the relationship between these parameters and the clinical symptoms. Method: Eighteen patients with OSAS and 16 controls participated. Aerobic capacity was assessed using a submaximal test. Fibre type distribution and fibre area were analyzed on muscle biopsies taken from the tibialis anterior. The microvascularization was assessed using the following parameters: (1) the number of capillaries per fibre (CAF), (2) CAF per fibre area (CAFA), (3) capillary to fibre perimeter exchange (CFPE) index, which represents the interface between muscle fibre and capillaries, and (4) length of capillary/perimeter of the fibre (LC/PF) index or capillary tortuosity, which represents the percent of muscle fibre perimeter in contact with the wall of the microvessel. Results: The OSAS group had significantly lower predicted relative maximal oxygen uptake (p = 0.0047) which was inversely correlated to the apnoea/hypopnoea index (AHI; r = –0.6, p = 0.017). There was a significantly higher CFPE index for slow type I fibres (p = 0.007) and fast type II fibres (p = 0.0126) and a significantly higher LC/PF index for type I fibres (p = 0.0003) and type II fibres (p = 0.0285) in OSAS patients compared to controls. Conclusion: OSAS patients have a higher muscle microvascularization and a lower aerobic capacity than controls. Furthermore the aerobic capacity was inversely correlated to AHI.

  • 16.
    Wåhlin Larsson, Britta
    et al.
    Örebro University, Department of Clinical Medicine. Dalarna University, Falun, Sweden.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ulfberg, Jan
    Avesta Hospital, Avesta, Sweden.
    Piehl Aulin, Karin
    Örebro University, Department of Clinical Medicine.
    Skeletal muscle morphology in patients with restless legs syndrome2007In: European Neurology, ISSN 0014-3022, E-ISSN 1421-9913, Vol. 58, no 3, p. 133-137Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to assess the cellular and structural properties of skeletal muscle in restless legs syndrome (RLS).

    METHOD: Twenty patients and 16 controls were included. Aerobic performance was assessed using a submaximal test. On muscle biopsies taken from the tibialis anterior, fiber distribution and fiber area were analyzed together with parameters surveying the microvascularization, especially the tortuosity, which is expressed as a percent of muscle fiber perimeter in contact with the wall of the microvessel, length of capillary/perimeter of fiber (LC/PF) index.

    RESULTS: The RLS group had significantly lower predicted maximal oxygen uptake (p = 0.01) and significantly higher LC/PF index (p = 0.01) compared to the controls.

    CONCLUSION: The higher capillary tortuosity in RLS patients indicates the occurrence of significant remodeling in capillary geometry in RLS.

  • 17.
    Wåhlin-Larsson, Britta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ulfberg, Jan
    Sleep Disorder Center, Avesta .
    Lindvall, Björn
    Muscle Center, Departments of Neurology and Clinical Pathology, Örebro University Hospital.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Markers of local inflammation and oxidative enzymes in musculus tibialis anterior in Restless Legs Syndrome and Obstructive Sleep Apnoea SyndromeManuscript (Other academic)
  • 18.
    Wåhlin-Larsson, Britta
    et al.
    Örebro University, School of Health and Medical Sciences. Dalarna University, Falun, Sweden.
    Ulfberg, Jan
    Avesta Hospital, Avesta, Sweden.
    Piehl-Aulin, Karin
    Örebro University, School of Health and Medical Sciences.
    Kadi, Fawzi
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The expression of vascular endothelial growth factor in skeletal muscle of patients with sleep disorders2009In: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 40, no 4, p. 556-561Article in journal (Refereed)
    Abstract [en]

    An increased capillary network has been observed in the skeletal muscle in patients with Restless Legs Syndrome (RLS) and Obstructive sleep apnea syndrome (OSAS). These changes could be due to upregulation of growth factors responsible for angiogenesis.

    The aim of the study was to examine the occurrence and localization of VEGF and capillary proliferation in skeletal muscle of RLS (n=12), OSAS (n=12) and controls (n=11).

    Double-immunofluorescence staining for capillaries (CD31) and VEGF, and proliferating cells (Ki-67), was carried out on biopsies taken from the tibialis anterior. The percentage of capillaries expressing VEGF (CD31,VEGF+)  was significantly higher in OSAS and RLS compared to controls. The percentage of proliferating capillaries (CD31,Ki-67+)  was significantly higher in OSAS compared with controls.

    In conclusion our study shows the occurrence of proliferation of endothelial cells in skeletal muscle in RLS and OSAS, supporting an upregulation of VEGF located in capillaries probably due to local hypoxia.

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