Vogiatzis Ioannis, Stratakos Grigoris, Simoes Davina C M, Terzis Gerasimos, Georgiadou Olga, Roussos Charis, Zakynthinos Spyros
National and Kapodistrian University of Athens - Thorax Foundation, 3 Ploutarhou Str 106 75, Athens, Greece.
Thorax. 2007 Nov;62(11):950-6. doi: 10.1136/thx.2006.069310. Epub 2007 Jun 15.
Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation. This study investigated whether rehabilitative exercise training decreases the levels of systemic or local muscle inflammation or reverses the abnormalities associated with muscle deconditioning.
Fifteen patients with COPD (mean (SE) forced expiratory volume in 1 s 36 (4)% predicted) undertook high-intensity exercise training 3 days/week for 10 weeks. Before and after the training programme the concentration of tumour necrosis factor alpha (TNFalpha), interleukin-6 (IL-6) and C-reactive protein (CRP) in plasma was determined by ELISA, and vastus lateralis mRNA expression of TNFalpha, IL-6, total insulin-like growth factor-I (IGF-I) and its isoform mechanogrowth factor (MGF) and myogenic differentiation factor D (MyoD) were assessed by real-time PCR. Protein levels of TNFalpha, IGF-I and MyoD were measured by Western blotting.
Rehabilitation improved peak exercise work rate by 10 (2%) (p = 0.004) and mean fibre cross-sectional area from 4061 (254) microm(2) to 4581 (241) microm(2) (p = 0.001). Plasma inflammatory mediators and vastus lateralis expression of TNFalpha and IL-6 were not significantly modified by training. In contrast, there was a significant increase in mRNA expression of IGF-I (by 67 (22)%; p = 0.044), MGF (by 67 (15)%; p = 0.002) and MyoD (by 116 (30)%; p = 0.001). The increase observed at the mRNA level was also seen at the protein level for IGF-I (by 72 (36)%; p = 0.046) and MyoD (by 67 (21)%; p = 0.012).
Pulmonary rehabilitation can induce peripheral muscle adaptations and modifications in factors regulating skeletal muscle hypertrophy and regeneration without decreasing the levels of systemic or local muscle inflammation.
骨骼肌萎缩常见于慢性阻塞性肺疾病（COPD）患者，且与全身炎症的存在有关。本研究调查了康复运动训练是否能降低全身或局部肌肉炎症水平，或逆转与肌肉失健相关的异常情况。
15例COPD患者（1秒用力呼气量平均（标准误）为预计值的36（4）%），每周进行3天高强度运动训练，共10周。在训练计划前后，通过酶联免疫吸附测定法（ELISA）测定血浆中肿瘤坏死因子α（TNFα）、白细胞介素-6（IL-6）和C反应蛋白（CRP）的浓度，并通过实时聚合酶链反应（PCR）评估股外侧肌中TNFα、IL-6、总胰岛素样生长因子-I（IGF-I）及其异构体机械生长因子（MGF）和成肌分化因子D（MyoD）的mRNA表达。通过蛋白质印迹法测量TNFα、IGF-I和MyoD的蛋白质水平。
康复训练使峰值运动功率提高了10（2）%（p = 0.004），平均肌纤维横截面积从4061（254）μm²增加到4581（241）μm²（p = 0.001）。训练对血浆炎症介质以及股外侧肌中TNFα和IL-6的表达没有显著影响。相比之下，IGF-I的mRNA表达显著增加（增加67（22）%；p = 0.044），MGF增加（增加67（15）%；p = 0.002），MyoD增加（增加116（30）%；p = 0.001）。在mRNA水平观察到的增加在IGF-I（增加72（36）%；p = 0.046）和MyoD（增加67（21）%；p = 0.012）的蛋白质水平也可见。
肺康复可以诱导外周肌肉适应以及调节骨骼肌肥大和再生的因子发生改变，而不会降低全身或局部肌肉炎症水平。
