Abstract
Background: Decreased physical capacity and increased systemic inflammatory response are frequently observed in patients with chronic obstructive pulmonary disease (COPD). The relationship between the inflammatory response and disease severity and the immunological response to exercise were addressed in COPD. Objective: The first objective was to identify systemic biomarkers and their relationship with COPD severity. The second objective was to examine the effect of both acute exercise and pulmonary rehabilitation on these biomarkers. Methods: Forty subjects participated in the study. Thirty-two patients with moderate or severe COPD and 8 healthy non-smokers completed the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom-limited cycle ergo meter (incremental) test. Blood samples were analyzed for C-reactive protein (CRP), pro-inflammatory cytokines (IL-6, TNF-α), pro-fibrotic cytokines (TGF-β) and oxidative burst in circulating leukocytes before and after exercise, and before and after pulmonary rehabilitation. Results: IL-6, CRP, WCC and TGF-β were higher in COPD (p α, CRP and TGF-β were negatively related to forced expiratory volume in 1 s (FEV1) (r = 0.4054, 0.3221, 0.1528, 0.1846 and 0.1187, respectively). Acute exercise increased circulating leucocytes and oxidative stress in both groups (p = 0.000, 0.0049 respectively), while IL-6 was increased in COPD group ((p = 0.0115) and circulating TNF-α in healthy control (p = 0.0369). Pulmonary rehabilitation didn’t modify the levels of inflammatory mediators. Conclusions: Reduced lung function is associated with increased levels of systemic inflammatory markers and acute exercise can further increase this inflammatory response. However pulmonary rehabilitation is unlikely to exacerbate systemic inflammation in COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is a complex condition characterised by chronic cough and sputum reflecting airway inflammation and more importantly progressive airflow limitation with variable alveolar destruction
C-reactive protein (CRP), an acute-phase protein synthesized predominantly by hepatocytes in response to tissue damage or inflammation has been reported as a predictor of lung function decline and mortality in COPD [7] [8]
COPD group showed moderate to severe airflow obstruction and reduced exercise capacity
Summary
Chronic obstructive pulmonary disease (COPD) is a complex condition characterised by chronic cough and sputum reflecting airway inflammation and more importantly progressive airflow limitation with variable alveolar destruction. The extent and severity of inflammation may be estimated by measurement of oxidative stress and concentrations of inflammatory mediators and acute-phase proteins [2]-[6]. Transforming Growth Factor-beta (TGF-β) and oxidative stress are biomarkers that may play a role in the pathogenesis of COPD. Decreased physical capacity and increased systemic inflammatory response are frequently observed in patients with chronic obstructive pulmonary disease (COPD). Blood samples were analyzed for C-reactive protein (CRP), pro-inflammatory cytokines (IL-6, TNF-α), pro-fibrotic cytokines (TGF-β) and oxidative burst in circulating leukocytes before and after exercise, and before and after pulmonary rehabilitation. Acute exercise increased circulating leucocytes and oxidative stress in both groups (p = 0.000, 0.0049 respectively), while IL-6 was increased in COPD group ((p = 0.0115) and circulating TNF-α in healthy control (p = 0.0369). Conclusions: Reduced lung function is associated with increased levels of systemic in-
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