title: Effect of upper- and lower-limb exercise training on circulating soluble adhesion molecules, hs-CRP and stress proteins in patients with intermittent claudication.
abstract: OBJECTIVE
  To investigate the effects of exercise training on levels of circulating biomarkers associated with the progression of atherosclerosis and risk of cardiovascular events in patients with intermittent claudication.
  
  
  METHODS
  Circulating levels of soluble adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), high sensitivity C-reactive protein (hs-CRP) and stress proteins (Hsp60 and Hsp70) in patients randomised to a 24-week programme of arm- or leg-cranking exercise were compared with those in usual care controls.
  
  
  RESULTS
  Arm and leg exercise similarly improved lower-limb aerobic exercise capacity (20% vs 19%, respectively; P<0.001) and maximum walking distance (30% vs 35%, respectively; P<0.001). Improvements in training limb-specific peak oxygen consumption were attenuated for patients in the highest vs lowest quartile for circulating sVCAM-1 levels at baseline (3% vs 25% respectively, P<0.001). Although circulating hs-CRP levels tended to be lower in the arm-cranking group (-1.55 [95% CI: -1.06 to -2.26]mgl(-1)), exercise training had no effect on circulating levels of soluble adhesion molecules or stress proteins.
  
  
  CONCLUSIONS
  These findings suggest that high levels of circulating sVCAM-1 are associated with an attenuated exercise training response and that arm-cranking exercise may provide an effective stimulus for evoking systemic anti-inflammatory adaptations in patients with intermittent claudication.
authors.affiliation: Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield S10 2BP, UK. j.m.saxton@shu.ac.uk
authors.forename: J M
authors.initials: JM
authors.lastname: Saxton
authors.forename: I
authors.initials: I
authors.lastname: Zwierska
authors.forename: K
authors.initials: K
authors.lastname: Hopkinson
authors.forename: E
authors.initials: E
authors.lastname: Espigares
authors.forename: S
authors.initials: S
authors.lastname: Choksy
authors.forename: S
authors.initials: S
authors.lastname: Nawaz
authors.forename: R
authors.initials: R
authors.lastname: Walker
authors.forename: A G
authors.initials: AG
authors.lastname: Pockley
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015815:Cell Adhesion Molecules / Q000097:blood*; D018834:Chaperonin 60 / Q000097:blood; D018450:Disease Progression; D019040:E-Selectin / Q000097:blood; D005081:Exercise Therapy; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006360:Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007383:Intermittent Claudication / Q000097:blood* / Q000628:therapy*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D034941:Upper Extremity; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018834:Chaperonin 60; D019040:E-Selectin; D018840:HSP70 Heat-Shock Proteins; D006360:Heat-Shock Proteins; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein