Rodríguez-Chiaradía Diego A, Khilzi Karys, Blanco Isabel, Rodó-Pin Anna, Martin-Ontiyuelo Clara, Herranz Blasco Anna, Garcia-Lucio Jessica, Molina Lluis, Marco Ester, Barreiro Esther, Piccari Lucilla, Peinado Victor I, Garcia Agustín R, Tura-Ceide Olga, Barberà Joan Albert
Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain.
Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), 28029 Madrid, Spain.
Biomedicines. 2023 Jun 25;11(7):1822. doi: 10.3390/biomedicines11071822.
In stable patients with pulmonary arterial hypertension (PAH), pulmonary rehabilitation (PR) is an effective, safe and cost-effective non-pharmacological treatment. However, the effects of PR on vascular function have been poorly explored. This study aimed to compare the amounts of circulating progenitor cells (PCs) and endothelial microvesicles (EMVs) in patients with PAH before and after 8 weeks of endurance exercise training as markers of vascular competence.
A prospective study of 10 consecutive patients with PAH that successfully finished a PR program (8 weeks) was carried out before and after this intervention. Levels of circulating PCs defined as CD34+CD45low progenitor cells and levels of EMVs (CD31+ CD42b-) were measured by flow cytometry. The ratio of PCs to EMVs was taken as a measure of the balance between endothelial damage and repair capacity.
All patients showed training-induced increases in endurance time (mean change 287 s). After PR, the number of PCs (CD34+CD45low/total lymphocytes) was increased ( < 0.05). In contrast, after training, the level of EMVs (CD31+ CD42b-/total EMVs) was reduced. The ratio of PCs to EMVs was significantly higher after training ( < 0.05).
Our study shows, for the first time, that endurance exercise training in patients with stable PAH has a positive effect, promoting potential mechanisms of damage/repair in favor of repair. This effect could contribute to a positive hemodynamic and clinical response.
在患有肺动脉高压（PAH）的稳定患者中，肺康复（PR）是一种有效、安全且具有成本效益的非药物治疗方法。然而，PR对血管功能的影响尚未得到充分研究。本研究旨在比较PAH患者在进行8周耐力运动训练前后循环祖细胞（PCs）和内皮微泡（EMVs）的数量，以此作为血管功能的标志物。
对10例连续成功完成PR计划（8周）的PAH患者进行前瞻性研究，在干预前后分别进行检测。通过流式细胞术测量定义为CD34 + CD45low祖细胞的循环PCs水平和EMVs（CD31 + CD42b-）水平。PCs与EMVs的比率作为内皮损伤与修复能力平衡的指标。
所有患者均表现出训练诱导的耐力时间增加（平均变化287秒）。PR后，PCs数量（CD34 + CD45low/总淋巴细胞）增加（<0.05）。相反，训练后，EMVs水平（CD31 + CD42b-/总EMVs）降低。训练后PCs与EMVs的比率显著升高（<0.05）。
我们的研究首次表明，稳定PAH患者进行耐力运动训练具有积极作用，促进了有利于修复的损伤/修复潜在机制。这种作用可能有助于产生积极的血流动力学和临床反应。
