The Effect of Physiotherapy on Interleukin-8 Levels in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Interleukin-8 (IL-8, CXCL8), chemokine produced by macrophages and epithelium cells, plays a major role in activating neutrophils and eosinophils in the airways of patients with COPD and might act as a stimulator of inflammatory process. The aim of the research was to assess whether pulmonary physiotherapy influences the concentration of IL-8 in the induced sputum of patients with COPD. The study included 44 patients (21 males, 23 females, average age 56.47 ± 9.52) with COPD treated in Physiotherapy Department of MSWiA Hospital in Glucholazy, with unchanged pharmacological treatment for the duration of the therapy. Before treatment, efficiency treadmill test by Bruce modified protocol and dyspnea assessment with the modified 20-point Borg scale was given to qualify each patient for physiotherapy. All patients participated in a 3-week multi-treatment pulmonary physiotherapy programme based on efficiency training on a cycloergometer. The physical workload was determined individually for each patient based on the assessment of individual exercise tolerance. Standard physiotherapy programme also included respiratory muscles' training with particular emphasis on training of abdominal muscles and diaphragm, inhalations with isotonic saline, drainage, chest clapping, relaxations and walking. IL-8 concentration in each patient's induced sputum was collected prior to complex physiotherapy, and after it has been completed. IL-8 concentration was determined with the use of the ELISA test. It was found that the concentration of IL-8 was significantly lower in patients with COPD after a 3-week physiotherapy programme. It fell from 18.91 ± 25.2 to 9.69 ± 14.06 ng/ml (p = 0.0215). The most significant IL-8 concentration decrease was observed in patients with the highest initial level of IL-8. The study shows that multi-treatment pulmonary physiotherapy causes decrease of IL-8 level in the induced sputum in patients with COPD, what can suggest decrease activity of neutrophils, which may be one of the factors leading to the improvement in patients' clinical condition.