Szczegielniak Jan, Bogacz Katarzyna, Luniewski Jacek, Majorczyk Edyta, Tukiendorf Andrzej, Czerwiński Marcin
Instytut Fizjoterapii, Wydział Wychowania Fizycznego i Fizjoterapii Politechniki Opolskiej.
Pneumonol Alergol Pol. 2011;79(3):184-8.
Interleukin-8 (IL-8, CXCL8), chemokine produced by macrophages and epithelium cells, plays a major role in activating neutrophils and eosinophils in the airways of patients with COPD and might act as a stimulator of inflammatory process. The aim of the research was to assess whether pulmonary physiotherapy influences the concentration of IL-8 in the induced sputum of patients with COPD.
The study included 44 patients (21 males, 23 females, average age 56.47 ± 9.52) with COPD treated in Physiotherapy Department of MSWiA Hospital in Glucholazy, with unchanged pharmacological treatment for the duration of the therapy. Before treatment, efficiency treadmill test by Bruce modified protocol and dyspnea assessment with the modified 20-point Borg scale was given to qualify each patient for physiotherapy. All patients participated in a 3-week multi-treatment pulmonary physiotherapy programme based on efficiency training on a cycloergometer. The physical workload was determined individually for each patient based on the assessment of individual exercise tolerance. Standard physiotherapy programme also included respiratory muscles' training with particular emphasis on training of abdominal muscles and diaphragm, inhalations with isotonic saline, drainage, chest clapping, relaxations and walking. IL-8 concentration in each patient's induced sputum was collected prior to complex physiotherapy, and after it has been completed. IL-8 concentration was determined with the use of the ELISA test.
It was found that the concentration of IL-8 was significantly lower in patients with COPD after a 3-week physiotherapy programme. It fell from 18.91 ± 25.2 to 9.69 ± 14.06 ng/ml (p = 0.0215). The most significant IL-8 concentration decrease was observed in patients with the highest initial level of IL-8.
The study shows that multi-treatment pulmonary physiotherapy causes decrease of IL-8 level in the induced sputum in patients with COPD, what can suggest decrease activity of neutrophils, which may be one of the factors leading to the improvement in patients' clinical condition.
白细胞介素-8（IL-8，CXCL8）是由巨噬细胞和上皮细胞产生的趋化因子，在慢性阻塞性肺疾病（COPD）患者气道中激活中性粒细胞和嗜酸性粒细胞方面起主要作用，可能作为炎症过程的刺激物。本研究的目的是评估肺部物理治疗是否会影响COPD患者诱导痰中IL-8的浓度。
本研究纳入了44例在格鲁乔莱齐的MSWiA医院理疗科接受治疗的COPD患者（21例男性，23例女性，平均年龄56.47±9.52岁），在治疗期间药物治疗不变。治疗前，采用改良的布鲁斯方案进行运动平板试验，并使用改良的20分博格量表进行呼吸困难评估，以使每位患者符合物理治疗条件。所有患者均参加了为期3周的基于功率计效率训练的多疗程肺部物理治疗方案。根据个体运动耐量评估为每位患者单独确定体力负荷。标准物理治疗方案还包括呼吸肌训练，特别强调腹肌和膈肌训练、等渗盐水吸入、引流、胸部叩击、放松和步行。在综合物理治疗前和完成后，收集每位患者诱导痰中的IL-8浓度。使用酶联免疫吸附测定（ELISA）试验测定IL-8浓度。
发现经过3周物理治疗方案后，COPD患者的IL-8浓度显著降低。从18.91±25.2降至9.69±14.06 ng/ml（p = 0.0215）。在初始IL-8水平最高的患者中观察到IL-8浓度下降最为显著。
该研究表明，多疗程肺部物理治疗可使COPD患者诱导痰中IL-8水平降低，这可能提示中性粒细胞活性降低，这可能是导致患者临床状况改善的因素之一。
