title: Measurement of the acute inflammatory response to walking exercise in COPD: effects of pulmonary rehabilitation.
abstract: 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-alpha (TNF-alpha) 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 (TO) 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.
authors.affiliation: School of Physiotherapy, Faculty of Health and Social Care Sciences, St. George's, University of London, London, United Kingdom. p0500319@sgul.ac.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Canavan
authors.forename: Rachel
authors.initials: R
authors.lastname: Garrod
authors.forename: Johanna
authors.initials: J
authors.lastname: Marshall
authors.forename: David
authors.initials: D
authors.lastname: Jackson
authors.forename: Paula
authors.initials: P
authors.lastname: Ansley
authors.forename: Andy
authors.initials: A
authors.lastname: Jewell
mesh_terms: D000368:Aged; D016207:Cytokines / Q000032:analysis / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000276:immunology* / Q000534:rehabilitation; D006113:United Kingdom; D016138:Walking
chemical_list: D016207:Cytokines