Abstract

BackgroundThis study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, CC16, SP-D, and CC16/SP-D ratio) and lung function (FEV1, FVC, and FEV1/FVC ratio) in male smokers.MethodsAfter applying inclusion criteria, a total of 40 healthy male smokers were recruited in this study. The participants were randomly divided into four groups as follows: Aerobic Exercise + vitamin D Supplementation (AE + VitD, n = 10), Aerobic Exercise (AE, n = 10), vitamin D Supplementation (VitD, n = 10), and Control (C, n = 10). The participants in the AE + VitD and AE groups performed aerobic exercise training (running) up to 50% of the maximum heart rate, three times a week for four weeks. Participants in AE + VitD and VitD groups received 6000 IU/w vitamin D3 for four weeks. The participants in control group did not receive any intervention. Serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, Clara cell protein (CC16), surfactant protein (SP)-D, CC16/SP-D ratio, and lung function (FEV1, FVC, and FEV1/FVC ratio) were measured before and after four weeks of intervention.ResultsSerum levels of TNF-α, IL-6, and CC16 decreased significantly in AE + VitD, VitD, and AE groups after four weeks (P < 0.05). Serum SP-D level decreased significantly only in the AE + VitD group (P = 0.011). In addition, FEV1 and FVC increased significantly (P < 0.05) in AE + VitD and AE groups after four weeks of intervention. However, the interventions did not have a significant effect on CC16/SP-D ratio and FEV1/FVC ratio (P > 0.05). Furthermore, serum levels of 1,25-dihydroxyvitamin D increased significantly in AE + VitD and VitD groups (P < 0.05) after four weeks of intervention. However, except for TNF-α, between-group comparisons showed no significant differences in levels of IL-6, CC16, SP-D, CC16/SP-D ratio, FEV1, FVC, FEV1/FVC, and 1,25-dihydroxyvitamin D (P > 0.05).ConclusionsThe results of present study were that aerobic exercise combined with vitamin D supplementation can reduce serum inflammatory factors and anti-inflammatory proteins and improve lung function after four weeks of intervention. Further trials with larger sample size and longer duration are suggested to confirm these results.Trial registration Retrospectively registered. IRCT20180513039637N4. Registration date: 2020/10/20. URL: https://www.irct.ir/search/result?query=IRCT20180513039637N4

Highlights

  • This study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, Clara cell protein (CC16), surfactant protein D (SP-D), and CC16/SP-D ratio) and lung function ­(FEV1, Forced vital capacity (FVC), and ­Forced expiratory volume in one second (FEV1)/FVC ratio) in male smokers

  • Based on the results of one-way ANOVA test, there was no significant difference in anthropometric characteristics, VO2

  • No difference was observed for IL-6 between groups (P = 0.079) whereas a difference in Tumor Necrosis factor-α (TNF-α) was present between Aerobic exercise (AE) + Vitamin D supplementation (VitD) and other groups (P = 0.001)

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Summary

Introduction

This study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, CC16, SP-D, and CC16/SP-D ratio) and lung function ­(FEV1, FVC, and ­FEV1/FVC ratio) in male smokers. Longterm cigarette smoking causes various diseases by affecting the organs of the body [3], but the most well-known effect of toxic substances of cigarettes is on the pulmonary system, which is subject to pulmonary epithelial and cell-membrane damage and altered mucosal permeability [4, 5]. Long-term cigarette smoking causes the release of inflammatory cells (e.g., macrophages, neutrophils, and lymphocytes) and inflammatory mediators (e.g., TNF-α and IL-6) from epithelial and smooth muscle cells These inflammatory factors initiate the inflammatory process [5, 9, 10]. The serum CC16/ SP-D ratio is a valid and sensitive marker for the diagnosis of lung epithelial cell injury [12]

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