Acute Exercise Testing of COPD Patients: The Effect on Systemic Inflammatory Proteins

Jane      Canavan; Ben      Linton-Willoughby; Rachel      Garrod

Abstract

Strenuous exercise can cause significant changes in the concentration of several pro- and anti-inflammatory cytokines in healthy people, with wide ranging effects, but research evidence addressing this is limited in COPD. A systematic review was therefore undertaken to clarify whether acute exercise affects circulating inflammatory proteins in stable COPD. Computerised searches were conducted of The Cochrane Database of Systematic Reviews, EMBASE, CINAHL, OVID MEDLINE and NLM gateway to identify relevant articles up to July 2010. Ten published studies using various exercise modes to ascertain the impact of acute exercise tests on systemic inflammation in COPD were retained for the review. Six studies reported significant increases in inflammatory markers, of varying magnitude; four out of five maximal cycling studies reported increased IL-6/TNF-α. There was considerable variance in pre-test conditions/patient characterization, exercise protocols, and assay techniques. The findings indicate that exercise intensity and duration, body composition, individual immunity, hypoxaemia and blood sampling method possibly explain most variations between studies.

Keywords: COPD, cytokines, exercise, fat free mass, interleukins, breathlessness, apoptosis, systemic inflammation, Forced Expiratory Volume, TNF