The following is a summary of “Dietary nitrate supplementation to enhance exercise capacity in patients with COPD: Evidence from a meta-analysis of randomized controlled trials and a network pharmacological analysis,” published in the February 2024 issue of Pulmonology by Wang, et al.

For a study, researchers sought to conduct an updated meta-analysis to evaluate the potential effects of nitrate in patients with chronic obstructive pulmonary disease (COPD), given the inconsistent results reported in previous clinical trials and meta-analyses. Additionally, they aimed to explore the potential mechanisms of nitrate action in COPD through network pharmacology analysis.

A comprehensive literature search was performed using PubMed, the Cochrane Library, Embase, and Web of Science databases to identify relevant trials assessing the efficacy and safety of nitrate in COPD patients. Data analysis was conducted using Revman 5.3 software, with mean difference (MD) or standardized mean difference (SMD) and 95% CI used as effect measures. Forest plots were utilized to display individual and pooled results. Network pharmacology analysis was conducted to investigate potential mechanisms of nitrate action in COPD.

The meta-analysis included eleven studies comprising 287 patients. Dietary nitrate supplementation increased plasma nitrate and nitrite concentrations, as well as fractional exhaled nitric oxide in COPD patients. Nitrate supplementation improved exercise capacity (SMD = 0.38, 95% CI = 0.04–0.72), endothelial function (MD = 9.41, 95% CI = 5.30–13.52), and relieved dyspnea in COPD patients. Network pharmacology analysis identified AKT1, IL1B, MAPK3, and CASP3 as key treatment targets.

Dietary nitrate supplementation shows promise as a potential treatment for COPD patients, particularly in improving exercise capacity. The identified mechanisms of action may involve AKT1, IL1B, MAPK3, and CASP3.

Reference: resmedjournal.com/article/S0954-6111(23)00386-4/abstract