Severity of COPD and its relationship with IL-10.

BACKGROUND: The present study was designed to compare inflammatory and metabolic responses according to severity of airflow among patients with COPD and to verify the relationship between pulmonary function, body composition, metabolic and inflammatory profile. METHODS: Fifty-one patients with mild to very severe COPD were recruited and divided according lung function in Mild-moderate (GOLD 1-2) n= 21; Severe (GOLD 3) n=25 and Very severe (GOLD 4) n=5. Patients were submitted to assessments of lung function (spirometry), functional exercise capacity (6-min walk test), body composition (Octopolar bioelectrical impedance), metabolic profile (glucose, triglycerides, total cholesterol, HDL-cholesterol and albumin (colorimetric assay)) and inflammatory profile (cytokines: IL-6, IL-10, TNF-α and IL-15 (ELISA)). RESULTS: We found that patients in GOLD 3 group had lower levels of IL-10, triglycerides, visceral fat area, and higher IL-6 and IL-6/IL-10 ratio when compared to GOLD 1-2 patients. Additionally, GOLD 1-2 group presented negative correlation between TNF-α and HDL cholesterol (p= .01) and positive correlation between IL-15 and FEV1/FVC (p=.01), while GOLD 3 group showed positive correlation between IL-6 and IL-10 (p< .01), IL-6 and total cholesterol (p<.01) and negative correlation between IL-10 and HDL-cholesterol (p=.01). CONCLUSION: Our findings suggest that patients with severe COPD can exhibit compromised "inflammatory status", characterized by higher IL6, IL-6/IL-10 ratio and lower IL-10 concentration. Furthermore, IL-10 seems to be an interesting cytokine to be investigated in this kind of patients.

Resistance Training using Low Cost Elastic Tubing is Equally Effective to Conventional Weight Machines in Middle-Aged to Older Healthy Adults: A Quasi-Randomized Controlled Clinical Trial.

The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p < 0.05 for both), functional exercise capacity (ETG Δ4 ± 4% and CTG Δ6±8%; p < 0.05 for both). Improvement on "pain" domain of HRQOL could only be observed in the CTG (Δ21 ± 26% p = 0.037). CG showed no statistical improvement in any of the variables investigated. Resistance training using elastic tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults.

Resistance Training With Elastic Tubing Improves Muscle Strength, Exercise Capacity, and Post-Exercise Creatine Kinase Clearance in Subjects With COPD.

BACKGROUND: Among the types of physical exercise, resistance exercises have been gaining significant attention in the COPD population. The aim of this study was to compare effects of conventional resistance training and of training by using elastic tubes on muscle strength, exercise capacity, and creatine kinase clearance in subjects with COPD. METHODS: Twenty-eight subjects with COPD were randomized into the following: resistance training with the elastic tubing group and resistance training with the weight-machine training group (conventional resistance group), performed 3 times a week for 12 weeks. The subjects were submitted to spirometry, functional exercise capacity (the 6-min walk test), muscle strength (dynamometry), and the repetition maximum test. Differences between the initial and final evaluations (Δ) and the (final - initial evaluations)/initial evaluations ×100 (Δ%) of each group were expressed as mean [95% CI]. RESULTS: Nineteen subjects (FEV1 % predicted, 52 ± 18; years, 65 ± 8) completed the training program. Similar improvements were observed in both modalities on muscle strength (knee extension, Δ%18 [6 to 29]; knee flexion, Δ%35 [17 to 54]; elbow flexion, Δ%28 [9 to 48]; shoulder abduction, Δ%41 [25 to 58] and shoulder flexion, Δ%31 [11 to 51] in the weight-machine training group (conventional resistance group); knee extension, Δ%15 [8 to 21]; knee flexion, Δ%28 [15 to 41]; elbow flexion, Δ%36 [22 to 51]; and shoulder abduction, Δ%43 [32 to 55] and shoulder flexion, Δ%43 [25 to 61] in the elastic tubing group, P < .05 for intra-group analysis and P > .05 for between groups analysis), 6-min walk test (baseline 493 ± 67m vs 12 weeks 526 ± 78 in the weight-machine training group (P = .10); baseline 493 ± 71 vs 12 weeks 524 ± 68 in the elastic tubing group (P < .01), P = .88 between groups). The elastic tubing group had lower accumulated creatine kinase levels between 24 and 72 h ((Δ%-24 [-31 to 16] than subjects in the weight-machine training group Δ%3 [-21 to 28], P = .042 between the groups. CONCLUSIONS: Training with elastic resistance provided similar changes in muscle strength and exercise capacity to conventional resistance group in the subjects with COPD. The elastic tubing group had faster creatine kinase clearance after a training session than the weight-machine training group (conventional resistance group). The ease of its application associated with similar training benefits to conventional training supported its application in clinical routine.

Função pulmonar e depuração mucociliar nasal de cortadores de cana-de-açúcar brasileiros expostos à queima de biomassa / Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Resumo Objetivos: avaliar a função pulmonar e a depuração mucociliar nasal de cortadores de cana-de-açúcar. Métodos: foram avaliados dezesseis cortadores de cana-de-açúcar em dois períodos: durante o plantio da cana-de-açúcar, em abril/2011, e no final da safra, no período de queima e colheita manual da cana-de-açúcar, outubro/2011. A função pulmonar e a depuração mucociliar foram avaliadas por meio da espirometria e do teste de tempo de trânsito da sacarina (TTS), respectivamente. Resultados: a função pulmonar apresentou diminuição no %FEF25-75 [99,31 (23,79) até 86,36 (27,41); p = 0,001]; %VEF1 [92,19 (13,24) até 90,44 (12,76); p = 0,022] e VEF1/CVF [88,62 (5.68) até 84,90 (6.47); p = 0,004] no período da colheita em comparação ao de plantio. Também houve uma diminuição significativa no resultado do teste do TTS na colheita [3 (1) min] em comparação ao plantio [8 (3) min] (p < 0,001). Conclusão: os cortadores de cana-de-açúcar apresentaram diminuição do %FEF25-75, %VEF1, do índice VEF1/CVF, e aumento da velocidade do transporte mucociliar nasal no final do período de colheita.

Abstract Objective: to evaluate the effects of sugarcane burning on lung function and mucociliary clearance in sugarcane workers. Methods: sixteen sugarcane workers were evaluated in two sequential periods: during the non-harvest season, in April/2011, and during the sugarcane burning harvest season, in October/2011. Mean values (standard deviation) of lung function and mucociliary clearance were evaluated through spirometry and the saccharin transit time (STT) test, respectively. Results: lung function decreased %FEF25-75 [99.31 (23.79) to 86.36 (27.41); p = 0.001]; %FEV1 [92.19 (13.24) to 90.44 (12.76); p = 0.022]; and FEV1/FVC [88.62 (5.68) to 84.90 (6.47); p = 0.004] during the harvest season compared with the non-harvest season. A significant decrease was found in saccharin transit time during the harvest [3 (1) min] season compared with the non-harvest season [8 (3) min] (p < 0.001). Conclusion: sugarcane workers present a decrease in %FEF25-75, %FEV1, FEV1/FVC ratio, and increase in nasal mucociliary transport velocity at the end of the harvest season.