Tirakitsoontorn P, Nussbaum E, Moser C, Hill M, Cooper D M
Department of Pediatrics, University of California Irvine Medical Center, Irvine, California, USA.
Am J Respir Crit Care Med. 2001 Oct 15;164(8 Pt 1):1432-7. doi: 10.1164/ajrccm.164.8.2102045.
Exercise can stimulate catabolic inflammatory cytokines even in healthy children. For patients with cystic fibrosis (CF), this may be problematic because CF is characterized by increased inflammation and suppressed growth. We examined fitness and the response to brief exercise of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), insulinlike growth factor-I (IGF-I), and IGF binding protein-1 (IGFBP-1) in 14 subjects with CF (10.5 +/- 0.8 yr of age), 9 of whom were treated with ibuprofen, and 14 healthy control subjects (11.6 +/- 0.5 yr of age, NS). Subjects performed brief intermittent, constant work rate protocol (scaled to each individual's exercise capacity) with blood and urine sampling. Peak V O(2) was correlated with IGF-I (r = 0.68, p < 0.01) in control subjects but not in subjects with CF. In subjects with CF, baseline IL-6 was 79% greater (p < 0.05) and IGF-I was 47% lower than in control subjects (p < 0.05). Post hoc analysis revealed a progressive increase in the IL-6 response to exercise, with the lowest increase observed in control subjects (11.8 +/- 4.6 pg/L/kJ), higher increases in patients with CF treated with ibuprofen (23.4 +/- 7.7 pg/L/kJ), and highest in subjects with CF not receiving ibuprofen (29.2 +/- 7.5 pg/L/kJ). Qualitatively similar results were observed for TNF-alpha. Exercise also significantly increased IGFBP-1 in both control subjects and subjects with CF. Brief exercise can increase even chronically elevated inflammatory mediators in CF, and this response may be attenuated by ibuprofen.
即使在健康儿童中，运动也会刺激分解代谢性炎症细胞因子。对于囊性纤维化（CF）患者而言，这可能会成为问题，因为CF的特征是炎症增加和生长受抑制。我们研究了14名CF患者（年龄10.5±0.8岁）的健康状况以及白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、胰岛素样生长因子-I（IGF-I）和IGF结合蛋白-1（IGFBP-1）对短暂运动的反应，其中9名患者接受了布洛芬治疗，还研究了14名健康对照者（年龄11.6±0.5岁，无显著性差异）。受试者进行短暂的间歇性恒功率运动方案（根据每个人的运动能力进行调整），并采集血液和尿液样本。在对照者中，峰值摄氧量与IGF-I相关（r = 0.68，p < 0.01），但在CF患者中无此相关性。CF患者的基线IL-6比对照者高79%（p < 0.05），IGF-I比对照者低47%（p < 0.05）。事后分析显示，运动后IL-6反应呈逐步增加，对照者增加最少（11.8±4.6 pg/L/kJ），接受布洛芬治疗的CF患者增加较多（23.4±7.7 pg/L/kJ），未接受布洛芬治疗的CF患者增加最多（29.2±7.5 pg/L/kJ）。TNF-α的结果在性质上相似。运动也使对照者和CF患者的IGFBP-1显著增加。即使是短暂运动也会使CF患者体内长期升高的炎症介质增加，而布洛芬可能会减弱这种反应。
