PMID- 37813825
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240307
IS  - 2372-952X (Print)
IS  - 2372-952X (Electronic)
IS  - 2372-952X (Linking)
VI  - 11
IP  - 1
DP  - 2024 Jan 25
TI  - Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Patients with 
      Underlying Alpha-1 Antitrypsin Deficiency: A Systematic Review and Practical 
      Recommendations.
PG  - 121-132
LID - 10.15326/jcopdf.2023.0434 [doi]
AB  - BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is an often-overlooked genetic 
      condition that makes individuals susceptible to early onset of chronic 
      obstructive pulmonary disease (COPD). The established benefits of exercise-based 
      pulmonary rehabilitation (PR) for usual COPD patients are unclear for those with 
      underlying AATD, especially given potentially differing muscle adaptations to 
      exercise. This review seeks to compare PR outcomes between AATD and usual COPD 
      patients and to consolidate current knowledge on exercise intervention outcomes 
      for the AATD population. METHODS: A thorough search of 4 databases (Ovid, 
      Medline, CINAHL, CENTRAL) was conducted based on 3 search concepts: (1) alpha-1 
      antitrypsin deficiency, (2) pulmonary rehabilitation OR exercise, and (3) muscle 
      morphology. A dual review process and quality assessment were independently 
      implemented throughout all stages of the review. RESULTS: Four studies 
      highlighted modest exercise capacity and quality of life in AATD patients 
      undergoing PR. However, one study reported unique muscle and mitochondrial 
      responses compared to usual COPD patients. Additionally, a moderate exercise 
      session did not alter pro-inflammatory cytokine levels in AATD patients, despite 
      higher levels of tumor necrosis factor-alpha levels in muscle biopsies compared to 
      usual COPD patients. CONCLUSIONS: The current literature base insufficiently 
      addresses the efficacy of PR on AATD, with indications that exercise adaptation 
      may deviate from that of usual COPD patients. Further research is needed to 
      optimize PR, particularly in identifying the most suitable exercise intensity, 
      and delivery setting, and addressing specific educational needs for individuals 
      with AATD.
CI  - JCOPDF (c) 2024.
FAU - Alwadani, Fawaz A
AU  - Alwadani FA
AD  - Institute for Applied Health Research, University of Birmingham, Birmingham, 
      United Kingdom.
AD  - Department of Physical Therapy, Jazan University, Jazan, Saudi Arabia.
FAU - Wheeler, Kyrie
AU  - Wheeler K
AD  - Heartlands Hospital, Birmingham, United Kingdom.
FAU - Pittaway, Harriet
AU  - Pittaway H
AD  - Institute of Inflammation and Ageing, University of Birmingham, Birmingham, 
      United Kingdom.
FAU - Turner, Alice M
AU  - Turner AM
AD  - Institute for Applied Health Research, University of Birmingham, Birmingham, 
      United Kingdom.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chronic Obstr Pulm Dis
JT  - Chronic obstructive pulmonary diseases (Miami, Fla.)
JID - 101635411
PMC - PMC10913928
OTO - NOTNLM
OT  - AATD
OT  - alpha-1 antitrypsin deficiency
OT  - chronic obstructive pulmonary disease
OT  - exercise therapy
OT  - pulmonary rehabilitation
COIS- All authors declare no conflict of interest.
EDAT- 2023/10/10 00:41
MHDA- 2023/10/10 00:42
PMCR- 2023/10/09
CRDT- 2023/10/09 22:53
PHST- 2023/10/10 00:42 [medline]
PHST- 2023/10/10 00:41 [pubmed]
PHST- 2023/10/09 22:53 [entrez]
PHST- 2023/10/09 00:00 [pmc-release]
AID - 10.15326/jcopdf.2023.0434 [doi]
PST - ppublish
SO  - Chronic Obstr Pulm Dis. 2024 Jan 25;11(1):121-132. doi: 
      10.15326/jcopdf.2023.0434.