Effects of a short-term rehabilitation program on airway inflammation in children with cystic fibrosis.
BACKGROUND
Respiratory therapy in cystic fibrosis (CF) consists of airway clearance, infection control, and reduction of airway inflammation. It is well recognized that physical activity as well as daily chest physiotherapy, enhance airway clearance. We investigated the effects of pulmonary rehabilitation, including physical activity and chest physiotherapy, on airway inflammation in children with CF.


METHODS
Eighteen children with stable CF (six females), aged 8.2-16.2 years, participating in a 3-week multidisciplinary inpatient rehabilitation program were recruited. Assessment at the beginning and the end of the program included clinical score, pulmonary function test, exhaled breath condensate (EBC) and sputum analysis. Sputum supernatant and EBC were analyzed for interleukin (IL)-1b, 6, 8, 10, 12, tumor necrosis factor-alpha (TNF-alpha) and LTB4.


RESULTS
Median (IQR) symptom scores decreased from 19 [23] to 16 [21], P = 0.005. Vital capacity and FVC increased significantly (P < 0.05). However no difference was found for the total sputum cells and sputum as well as EBC cytokines between the two visits. Significant correlations were found for sputum IL-1 (+), IL-6 (-), and IL-8 (+) to total sputum cell count and neutrophils and for IL-8 to TNF-alpha.


CONCLUSIONS
We have shown that a short-term inpatient rehabilitation for children with stable CF with intensive physical activity mainly improve subjective clinical symptoms and measures of lung function such as VC and FVC but does not influence airflow obstruction and airway inflammation as assessed by sputum and EBC analysis.
Moeller
Alexander
A
Swiss Paediatric Respiratory Research Group, Division of Respiratory Medicine, University Children's Hospital Zurich, Zurich, Switzerland. alexander.moeller@kispi.uzh.ch
Stämpfli
Simon F
SF
Rueckert
Beate
B
Rechsteiner
Thomas
T
Hamacher
Juerg
J
Wildhaber
Johannes H
JH
D000293:Adolescent; D000402:Airway Obstruction / Q000534:rehabilitation*; D002648:Child; D003550:Cystic Fibrosis / Q000235:genetics / Q000534:rehabilitation*; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D016207:Cytokines / Q000032:analysis / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000534:rehabilitation*; D008297:Male; D009043:Motor Activity; D009504:Neutrophils / Q000276:immunology; D026741:Physical Therapy Modalities; D012129:Respiratory Function Tests; D012138:Respiratory Therapy; D013183:Sputum / Q000276:immunology / Q000382:microbiology
D016207:Cytokines; D019005:Cystic Fibrosis Transmembrane Conductance Regulator