The effects of dietary nitrate supplementation on exercise tolerance in patients with fibrotic interstitial lung disease

Health Research BC is contributing matching funds to support the CANTRAIN-CTTP & Michael Smith Health Research BC Doctoral Studentship 2023 Award Program. Olivia Ferguson is a Ph.D. student at the University of British Columbia. Olivia will be conducting a clinical trial in patients with chronic lung conditions under the supervision of Dr. Jordan Guenette at the Cardiopulmonary Exercise Physiology Laboratory at St. Paul’s Hospital in Vancouver, BC.  

Interstitial lung disease (ILD) is a chronic progressive lung disease of either known or unknown cause, with a mean survival of only three years. ILD leads to progressive scarring of the lungs and debilitating reductions of exercise tolerance and functional abilities, which is strongly associated with reduced quality of life and mortality. Breathlessness and severely low oxygen levels in the blood are the hallmark features of ILD, which worsen with exercise. Unfortunately, very few effective and safe pharmacological therapies that target the lungs are available for ILD. Thus, preserving or enhancing muscle and heart function is essential to offset the progressive decline in lung health and for maintaining quality of life and independence. It is strongly advised that individuals with ILD undergo pulmonary rehabilitation, which is a structured exercise program; however, this may not be suitable for individuals who may not be able to handle strenuous exercise that can enhance muscle and heart function. Using nitrate in the form of concentrated beetroot juice, a safe and commercially available dietary supplement, may improve the delivery and efficiency of oxygen use at the site of exercising muscles. Orally ingesting dietary nitrate may improve the use of diminished oxygen availability rather than relying on external sources of supplemental oxygen, a common practice in ILD, which lacks real-world practicality. This novel therapeutic may allow individuals with ILD to reach exercise intensities sufficient for improving their overall exercise tolerance. If successful, it would enable them to sustain their functional abilities and engage in regular daily tasks, promoting independence and improved quality of life.