Measurement of the acute inflammatory response to walking exercise in COPD: effects of pulmonary rehabilitation

Abstract

Objective

This pilot study concerns the evaluation of the acute cytokine response to exercise and changes in this throughout a 7 week pulmonary rehabilitation programme.

Methods

17 (10 male, 7 female) stable COPD patients, mean (SD) age 69 (8) yrs, mean FEV₁, 51.3 (17.3) % predicted entered into 7 weeks of rehabilitation. The acute cytokine response (ACR) was measured from serum cytokine levels; Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) taken pre, post and 1 hour post-maximal incremental shuttle walking test (ISWT). The ACR to maximal exercise was determined before rehabilitation (T0) and post rehabilitation (T7). The ACR (pre/post test) to iso-distance exercise (based on initial ISWT distance) was determined throughout the rehabilitation period at 2 (T2), 4 (T4) weeks and at the end (T7).

Results

12 patients completed the study. Maximal ISWT distance significantly increased after rehabilitation. There was no significant change in baseline cytokine level throughout; or in pre/post-exercise cytokine levels prior to, during or following rehabilitation.

Conclusions

There was no significant inflammatory response associated with maximal exercise before or after training. Cytokine responses to a fixed bout of exercise did not alter markedly throughout. Clinical PR is unlikely to exacerbate systemic inflammation in COPD.

Keywords:

• chronic obstructive pulmonary disease
• cytokines
• exercise

Acknowledgements

We gratefully acknowledge the financial support of St. George’s NHS Therapies Research Fund in the development of this work.