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Immune cell response to strenuous resistive breathing: comparison with whole body exercise and the effects of antioxidants

Authors Asimakos A, Toumpanakis D, Karatza MH, Vasileiou S, Katsaounou P, Mastora Z, Vassilakopoulos T

Received 19 October 2017

Accepted for publication 16 December 2017

Published 7 February 2018 Volume 2018:13 Pages 529—545


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Andreas Asimakos,1,2,* Dimitrios Toumpanakis,1,2,* Maria-Helena Karatza,3 Spyridoula Vasileiou,3 Paraskevi Katsaounou,1,2 Zafeiria Mastora,1,2 Theodoros Vassilakopoulos1,2,4

1GP Livanos and M Simou Laboratories, Thorax Foundation, 2Critical Care Department and Pulmonary Unit, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 3Flow Cytometry Unit, Hematology Clinic Evangelismos Hospital, 43rd Department of Critical Care Medicine, Evgenideion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

*These authors contributed equally to this work

Background/hypothesis: Whole body exercise (WBE) changes lymphocyte subset percentages in peripheral blood. Resistive breathing, a hallmark of diseases of airway obstruction, is a form of exercise for the inspiratory muscles. Strenuous muscle contractions induce oxidative stress that may mediate immune alterations following exercise. We hypothesized that inspiratory resistive breathing (IRB) alters peripheral blood lymphocyte subsets and that oxidative stress mediates lymphocyte subpopulation alterations following both WBE and IRB.
Patients and methods: Six healthy nonathletes performed two WBE and two IRB sessions for 45 minutes at 70% of VO2 maximum and 70% of maximum inspiratory pressure (Pimax), respectively, before and after the administration of antioxidants (vitamins E, A, and C for 75 days, allopurinol for 30 days, and N-acetylcysteine for 3 days). Blood was drawn at baseline, at the end of each session, and 2 hours into recovery. Lymphocyte subsets were determined by flow cytometry.
Results: Before antioxidant supplementation at both WBE end and IRB end, the natural killer cell percentage increased, the T helper cell (CD3+ CD4+) percentage was reduced, and the CD4/CD8 ratio was depressed, a response which was abolished by antioxidants only after IRB. Furthermore, at IRB end, antioxidants promoted CD8+ CD38+ and blunted cytotoxic T-cell percentage increase. CD8+ CD45RA+ cell percentage changes were blunted after antioxidant supplementation in both WBE and IRB.
Conclusion: We conclude that IRB produces (as WBE) changes in peripheral blood lymphocyte subsets and that oxidative stress is a major stimulus predominantly for IRB-induced lymphocyte subset alterations.

Keywords: resistive breathing, exercise, antioxidants, lymphocyte

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