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

Jane Canavan¹, Rachel Garrod¹, Johanna Marshall¹, David Jackson¹, Paula Ansley², Andy Jewell³

¹School of Physiotherapy, Faculty of Health and Social Care Sciences, St. George’s, University of London, London, United Kingdom; ²Department of Sport and Exercise Science, Institute of Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, United Kingdom; ³Radiography, Faculty of Health and Social Sciences, St. George’s, University of London, London, United Kingdom

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