Background: Decreased physical capacity and increased systemic inflammatory response are frequently\nobserved in patients with chronic obstructive pulmonary disease (COPD). The relationship\nbetween the inflammatory response and disease severity and the immunological response to\nexercise were addressed in COPD. Objective: The first objective was to identify systemic biomarkers\nand their relationship with COPD severity. The second objective was to examine the effect of\nboth acute exercise and pulmonary rehabilitation on these biomarkers. Methods: Forty subjects\nparticipated in the study. Thirty-two patients with moderate or severe COPD and 8 healthy nonsmokers\ncompleted the study. Spirometry was preformed. Physical capacity was determined by a\nprogressive symptom-limited cycle ergo meter (incremental) test. Blood samples were analyzed\nfor C-reactive protein (CRP), pro-inflammatory cytokines (IL-6, TNF-), pro-fibrotic cytokines\n(TGF-) and oxidative burst in circulating leukocytes before and after exercise, and before and after\npulmonary rehabilitation. Results: IL-6, CRP, WCC and TGF-were higher in COPD (p < 0.05)\nthan eight healthy controls. WCC, IL-6, TNF-, CRP and TGF- were negatively related to forced expiratory\nvolume in 1 s (FEV1) (r = 0.4054, 0.3221, 0.1528, 0.1846 and 0.1187, respectively). Acute\nexercise increased circulating leucocytes and oxidative stress in both groups (p = 0.000, 0.0049\nrespectively), while IL-6 was increased in COPD group ((p = 0.0115) and circulating TNF- in\nhealthy control (p = 0.0369). Pulmonary rehabilitation didn�t modify the levels of inflammatory\nmediators. Conclusions: Reduced lung function is associated with increased levels of systemic in-flammatory markers and acute exercise can further increase this inflammatory response. However\npulmonary rehabilitation is unlikely to exacerbate systemic inflammation in COPD.
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