Acute inflammatory and anabolic systemic responses to peak and constant-work-rate exercise bout in hospitalized patients with COPD

Martijn A Spruit^1,2, Thierry Troosters^1,2, Rik Gosselink^1,2, Ahmad Kasran³, Marc Decramer^1,2

¹Respiratory Rehabilitation and Respiratory Division, University Hospital Gasthuisberg, Leuven, Belgium; ²Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; ³Laboratory of Experimental Immunology, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium

Study objectives: To explore the acute systemic inflammatory and anabolic effects of cycling in hospital admitted patients with chronic obstructive pulmonary disease (COPD) and in patients with clinically stable disease.

Design: Cross-sectional comparative study.

Setting: University Hospital Gasthuisberg, a tertiary care setting.

Patients: 16 patients with clinically stable COPD (no acute exacerbation in the past 12 weeks; median age: 73 years (IQR: 60 to 75); median forced expiratory volume in the first second (FEV₁): 45% predicted (IQR: 33 to 58)) and 14 patients who were admitted to a hospital due to an acute exacerbation of COPD (median age: 65 years (IQR: 59 to 74); median FEV₁ on day 8 of hospital stay: 41% predicted (IQR: 33 to 54)).

Interventions: None.

Measurements and results: Circulating levels of C reactive protein, interleukin 6, interleukin 8 and insulin-like growth factor I were determined before, at the end and 2 and 30 minutes after a symptom-limited peak cycling test and before, at the end and 2 and 30 minutes after a symptom-limited constant-work-rate cycling test at 70% of the peak load. Non-significant changes in the circulating markers of inflammation and anabolism were found during or up to 30 minutes after ceasing the peak or constant-work-rate cycling exercise tests. The systemic responses of the hospitalized patients with COPD did not differ from those with clinically stable disease.

Conclusions: High-intensity cycling exercises did not increase the circulating levels of inflammatory markers in patients with chronic obstructive pulmonary disease, irrespective of their clinical stability.

Keywords: C reactive protein, interleukin 6, interleukin 8, insulin-like growth factor 1