The potential contribution of the gut-muscle axis to the pathophysiology of sarcopenia and reduced physical capacity in COPD patients

Chronic obstructive pulmonary disease (COPD) is an inflammatory condition of the respiratory system which can also affect multiple organs. Most patients with COPD develop muscle weakness and atrophy, which contribute to functional compromise. In elderly patients with age-related muscle impairment, termed sarcopenia, the condition is further exacerbated with COPD. Causes of skeletal muscle loss in COPD are multifactorial and recent evidence suggests a potential contribution of intestinal dysbiosis and increased permeability to systemic inflammation. Increasing evidence suggests that gut permeability negatively affects skeletal muscle, partly due to the disruption of the neuromuscular junction.

In this scenario, Asima Karim and colleagues investigated the effects of the multistrain probiotic De Simone Formulation (DSF) on sarcopenia and functional capacity in COPD patients⁽¹⁾. During a randomized, double-blind, multicenter trial, researchers assessed the sarcopenia phenotype, the short physical performance battery (SPPB), plasma markers of intestinal permeability (zonulin and claudin-3), and neuromuscular junction degradation (CAF22), body composition, and handgrip strength (HGS) in 104 outpatients.

The primary finding was that DSF could improve muscle strength and functional capacity in COPD patients (one capsule of Vivomixx daily, 112 billion live bacteria, for 16 weeks). Results show that DSF supplementation reduced plasma zonulin, claudin-3, and CAF22, along with improved HGS, gait speed, and SPPB scores (p<0.05). Probiotics also reduced plasmatic c-reactive protein and 8-isoprostane, markers of systemic inflammation and oxidative stress (p<0.05).