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13-12-2016 | Pulmonary hypertension | News | Article

Exercise modulates immune system in IPAH

medwireNews: A single bout of exercise causes immediate changes in circulating T lymphocyte levels and improvements in the altered cytokine profile of patients with idiopathic pulmonary arterial hypertension (IPAH), without aggravating the inflammatory state, researchers report.

The study data show that prior to single cardiopulmonary exercise testing, there was no significant difference in absolute levels of leukocytes, lymphocytes, neutrophils, and monocytes between 16 IPAH patients and 10 healthy controls.

But the IPAH patients, who were in World Health Organization functional class II (n=6) or III (n=10), had significantly higher levels of T helper (Th)2 lymphocytes, regulatory T lymphocytes, interleukin (IL)-6, and tumor necrosis factor-α and significantly lower levels of Th1/Th17 lymphocytes and IL-4 compared with the controls, who were matched for age, gender, and body mass index.

Directly after exercise testing, there was a significant elevation in absolute numbers of leukocytes and lymphocytes in both patients with IPAH and in controls that was sustained for at least 1 hour.

Further analysis showed that there were no relative significant differences between patients and controls in Th1, Th2, Th1/Th17, and regulatory T lymphocyte levels after exercise.

There was, however, a small but significant relative decrease in the level of Th17 lymphocytes in IPAH patients but not controls immediately after exercise that returned to pre-exercise levels after 1 hour.

The IPAH patients also had significant reductions in IL-1ß and IL-6 levels that were observed immediately after exercise and continued to fall for at least 1 hour.

Furthermore, IL-6 levels significantly correlated with oxygen consumption, with a greater fall in IL-6 correlating significantly with higher peak oxygen consumption.

“According to our data, exercise seemed to elicit a specific modulation of the circulating T lymphocyte subsets in patients with IPAH, a modulation of the chronic systemic inflammatory state,” say Lars Harbaum, from the University Medical Center Hamburg-Eppendorf in Germany, and co-researchers.

They add: “Exercise may shift the imbalance of the inflammatory status towards equilibrium or excess of the anti-inflammatory (or immune-regulatory) activity.”

Writing in BMC Pulmonary Medicine, Harbaum et al note that they only studied the “short-term, immediate effects of exercise on the systemic inflammatory state in a limited number of patients with IPAH.”

They add it “would be of great interest” to evaluate the long-term effects of controlled, supervised training on the systemic inflammatory state in patients with IPAH.

By Laura Cowen

medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2016

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