Lung and Allergy Research Centre, Diamantina Institute, The University of Queensland, Brisbane, Queensland, Australia.
Priority Research Centre for Healthy Lungs, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
Ann Am Thorac Soc. 2022 Nov;19(11):1848-1855. doi: 10.1513/AnnalsATS.202109-1053OC.
Exercise is associated with improvements in asthma; however, the mechanisms responsible are not clear. Exercise induces changes in systemic inflammation, and it is possible that these inflammatory effects extend to the airways of people with asthma. Studies in healthy adults suggest inflammatory responses are dependent on exercise intensity: Although acute moderate exercise is antiinflammatory, acute vigorous exercise appears to be neutral or proinflammatory. The effect of exercise intensity on inflammation has not been investigated in people with asthma. To compare acute changes in airway and systemic inflammation after a bout of moderate or vigorous exercise in physically inactive adults with asthma and to establish whether these effects differ according to asthma phenotype. Participants were randomized to either ) control (no intervention), ) 45 minutes of moderate exercise, or ) 30 minutes of vigorous exercise. Induced sputum and blood samples were collected at baseline and 4 hours after intervention. Fifty-six participants (75% female; mean age, 33.4 [9.9] yr) completed the trial. Moderate exercise induced a significant reduction in sputum eosinophil count (-173 [-337 to -10]; = 0.032) and sputum percentage eosinophils (-2.2 [-4.9 to 0.5]; = 0.049) relative to control. Vigorous exercise had no effect on airway inflammation. The antiinflammatory effects of moderate exercise were greatest in participants with eosinophilic asthma, with larger reductions in sputum eosinophils and larger increases in plasma interleukin (IL)-1ra than seen in participants with noneosinophilic asthma. Vigorous exercise induced a systemic proinflammatory response in participants with eosinophilic asthma, indicated by an increase in serum IL-5 and IL-1β; however, this had no effect on airway inflammation. Exercise intensity modifies the acute inflammatory response to exercise in adults with asthma. Although a bout of moderate exercise is associated with a reduction in eosinophilic airway inflammation, vigorous exercise has no effect on airway inflammation. Interestingly, the effects of moderate exercise vary by asthma phenotype, with greater antiinflammatory effects in participants with eosinophilic asthma. Future studies should examine the impact of exercise training at different intensities on inflammation and clinical asthma outcomes. Clinical trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12615000294550).
运动与哮喘的改善有关；然而，负责的机制尚不清楚。运动引起全身炎症的变化，并且这些炎症效应可能扩展到哮喘患者的气道。在健康成年人中的研究表明，炎症反应取决于运动强度：虽然急性适度运动具有抗炎作用，但急性剧烈运动似乎呈中性或促炎。运动强度对炎症的影响尚未在哮喘患者中进行研究。目的：比较中度或剧烈运动后，运动能力差的哮喘成人气道和全身炎症的急性变化，并确定这些影响是否根据哮喘表型而不同。方法：参与者随机分为）对照组（无干预）、）45 分钟的中度运动或）30 分钟的剧烈运动。在干预前和干预后 4 小时采集诱导痰和血液样本。结果：56 名参与者（75%为女性；平均年龄，33.4[9.9]岁）完成了试验。与对照组相比，中度运动显著降低了痰嗜酸性粒细胞计数（-173[-337 至-10]；=0.032）和痰嗜酸性粒细胞百分比（-2.2[-4.9 至 0.5]；=0.049）。剧烈运动对气道炎症没有影响。中度运动的抗炎作用在嗜酸性粒细胞性哮喘患者中最大，与非嗜酸性粒细胞性哮喘患者相比，痰嗜酸性粒细胞减少和血浆白细胞介素（IL）-1ra 增加更大。剧烈运动引起嗜酸性粒细胞性哮喘患者全身促炎反应，表现为血清 IL-5 和 IL-1β增加；然而，这对气道炎症没有影响。结论：运动强度改变了哮喘成人对运动的急性炎症反应。虽然一次适度运动与减少嗜酸性气道炎症有关，但剧烈运动对气道炎症没有影响。有趣的是，中度运动的效果因哮喘表型而异，在嗜酸性粒细胞性哮喘患者中具有更大的抗炎作用。未来的研究应研究不同强度的运动训练对炎症和临床哮喘结局的影响。这项临床试验已在澳大利亚和新西兰临床试验注册中心（ACTRN 12615000294550）注册。
