Effects of aerobic training on airway inflammation in asthmatic patients.
OBJECTIVE
there is evidence suggesting that physical activity has anti-inflammatory effects in many chronic diseases; however, the role of exercise in airway inflammation in asthma is poorly understood. We aimed to evaluate the effects of an aerobic training program on eosinophil inflammation (primary aim) and nitric oxide (secondary aim) in patients with moderate or severe persistent asthma.


METHODS
sixty-eight patients randomly assigned to either control (CG) or aerobic training (TG) groups were studied during the period between medical consultations. Patients in the CG (educational program + breathing exercises; N = 34) and TG (educational program + breathing exercises + aerobic training; N = 34) were examined twice a week during a 3-month period. Before and after the intervention, patients underwent induced sputum, fractional exhaled nitric oxide (FeNO), pulmonary function, and cardiopulmonary exercise testing. Asthma symptom-free days were quantified monthly, and asthma exacerbation was monitored during 3 months of intervention.


RESULTS
at 3 months, decreases in the total and eosinophil cell counts in induced sputum (P = 0.004) and in the levels of FeNO (P = 0.009) were observed after intervention only in the TG. The number of asthma symptom-free days and VO(2max) also significantly improved (P < 0.001), and lower asthma exacerbation occurred in the TG (P < 0.01). In addition, the TG presented a strong positive relationship between baseline FeNO and eosinophil counts as well as their improvement after training (r = 0.77 and r = 0.9, respectively).


CONCLUSIONS
aerobic training reduces sputum eosinophil and FeNO in patients with moderate or severe asthma, and these benefits were more significant in subjects with higher levels of inflammation. These results suggest that aerobic training might be useful as an adjuvant therapy in asthmatic patients under optimized medical treatment.
Mendes
Felipe Augusto Rodrigues
FA
Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, BRAZIL.
Almeida
Francine Maria
FM
Cukier
Alberto
A
Stelmach
Rafael
R
Jacob-Filho
Wilson
W
Martins
Milton A
MA
Carvalho
Celso Ricardo Fernandes
CR
D000328:Adult; D001249:Asthma / Q000503:physiopathology* / Q000628:therapy*; D003935:Diagnostic Techniques, Cardiovascular; D004804:Eosinophils / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology; D012129:Respiratory Function Tests / Q000379:methods; D012137:Respiratory System / Q000503:physiopathology; D013183:Sputum / Q000502:physiology; D055815:Young Adult
D009569:Nitric Oxide