理学療法と理学リハビリテーションのジャーナル

Do COPD and Healthy Subjects have Similar Acute Inflammatory Response Induced by Sub-maximum Effort Test?

Abstract

Krislainy De Sousa Corrêa, Adeliane Castro Da Costa, Ana Paula Perillo Ferreira Carvalho, José Laerte Rodrigues Da Silva Júnior, Maria Rosedália De Moraes, Ana Paula Junqueira-Kipnis and Marcelo Fouad Rabahi

Introduction: COPD (chronic obstructive pulmonary disease) presents a low degree of systemic inflammation responsible for the disease’s extra pulmonary consequences. Its inflammatory profile can be altered by acute exercise. However, acute effects of a sub maximum test, capable of reproducing activities of daily living (ADL) in sedentary COPD individuals, are not well-known

Objective: To evaluate if the six-minute walk test (6MWT) is capable of altering interleukin-6 (IL-6) blood levels, tumoral necrosis factor alfa (TNF-α) and hypersensitive C reactive protein (hs-CRP) in relation to the basal level of COPD individuals.

Methods: 21 individuals with moderate and severe COPD and 8 healthy individuals, with no history of smoking, sedentary, matched by age were assessed regarding plasma levels of IL-6, TNF-α and hs-CRP before and right after a 6MWT. They also did spirometry and body composition analysis.

Results: 6MWT did not provoke significant alteration in IL-6 levels in COPD individuals (pre=4.53 ± 9.0 pg/ml vs. post=7.14 ± 11.31 pg/ml, p=0.11), whereas in healthy individuals this increase was significant (pre=1.56 ± 6.45 pg/ml vs. post=4.37 ± 8.0 pg/ml, p<0.01). COPD individuals present higher hs-CRP blood levels when compared to healthy subjects both in rest (8.15 ± 9.68 pg/ml vs. 2.60 ± 1.88 pg/ml, p=0.02), and after exercise (8.18 ± 9.08 pg/ml vs. 2.62 ± 1.85 pg/ml, p=0.02. TNF-α did not present difference between groups during rest (COPD=2.13 ± 1.03 pg/ml vs. healthy=2.00 ± 0.59 pg/ml, p>0.05) as well as after 6MWT (COPD=2.48 ± 1.92 pg/ml vs. healthy=1.89 ± 0.69 pg/ml, p>0.05), and their intragroup focus was not affected by the effort (p>0.05).

Conclusions: In COPD patients, 6MWT does not induce acute inflammatory response of IL-6 at the same proportion of that of healthy subjects. Hs-CRP’s and TNFα’s response to 6MWT was similar between groups. COPD patients presented higher concentrations of hs-CRP than healthy individuals.