Acute effects of exercise on the inflammatory state in patients with idiopathic pulmonary arterial hypertension.
Exercise training positively influences exercise tolerance and functional capacity of patients with idiopathic pulmonary arterial hypertension (IPAH). However, the underlying mechanisms are unclear. We hypothesized that exercise modulates the activated inflammatory state found in IPAH patients.



Single cardiopulmonary exercise testing was performed in 16 IPAH patients and 10 healthy subjects. Phenotypic characterization of peripheral blood mononuclear cells and circulating cytokines were assessed before, directly after and 1 h after exercise.



Before exercise testing, IPAH patients showed elevated Th2 lymphocytes, regulatory T lymphocytes, IL-6, and TNF-alpha, whilst Th1/Th17 lymphocytes and IL-4 were reduced. In IPAH patients but not in healthy subject, exercise caused an immediate relative decrease of Th17 lymphocytes and a sustained reduction of IL-1-beta and IL-6. The higher the decrease of IL-6 the higher was the peak oxygen consumption of IPAH patients.



Exercise seems to be safe from an immune and inflammatory point of view in IPAH patients. Our results demonstrate that exercise does not aggravate the inflammatory state and seems to elicit an immune-modulating effect in IPAH patients.
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. l.harbaum@uke.de.|Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. l.harbaum@uke.de.
Lars
L
Harbaum
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Emilia
E
Renk
Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA.|Department of Stem Cell Transplantation, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Sara
S
Yousef
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Antonia
A
Glatzel
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Nicole
N
Lüneburg
Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.|Cardiovascular Institute and Department of Pediatrics, Wall Center for Pulmonary Vascular Diseases, Stanford University School of Medicine, Stanford, USA.
Jan K
JK
Hennigs
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Tim
T
Oqueka
Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Hans J
HJ
Baumann
Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.|Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA.
Djordje
D
Atanackovic
Center for Pulmonary Hypertension, Thoraxclinic, University Hospital Heidelberg, Heidelberg, Germany.
Ekkehard
E
Grünig
Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Rainer H
RH
Böger
Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Carsten
C
Bokemeyer
Center for Pulmonary Arterial Hypertension, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Section Pneumology, Department of Medicine II, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Hans
H
Klose
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D017079:Exercise Tolerance / Q000502:physiology; D065627:Familial Primary Pulmonary Hypertension / Q000276:immunology / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D053583:Interleukin-1beta / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D058504:Th17 Cells / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D000070857:Walk Test
C508585:IL1B protein, human; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha
Cytokine; Exercise; Immunology; Inflammation; Pulmonary arterial hypertension; Training