This study will examine the inflammatory response to exercise encompassed as part of a standard pulmonary rehabilitation programme in patients with chronic obstructive pulmonary disease (COPD). Patients will be split into two groups, frequent exacerbators or infrequent exacerbators, dependent upon exacerbation history to compare responses to pulmonary rehabilitation amongst phenotypes.
Pulmonary rehabilitation has been proven to benefit COPD patients in terms of quality of life and functional capabilities. The effects of pulmonary rehabilitation (exercise) on immune function are unclear despite clear benefits of exercise on immune function in healthy individuals being identified. Moderate-intensity and frequency of exercise has been shown to decrease the risk of upper respiratory tract infections in healthy individuals in comparison to sedentary individuals. Respiratory infections, also known as exacerbations, in COPD are the main cause of hospitalisation and mortality. Therefore, if exercise can modulate immune function in COPD, it can be encouraged further in COPD to reduce hospitalisation risk. However, it is important to compare the effects of exercise amongst different phenotypes as frequent exacerbators are known to have elevated inflammatory markers, and may consequently respond to exercise differently to infrequent exacerbators, paving a rationale for a different approach to this subset of patients.
Study Type
OBSERVATIONAL
Enrollment
85
Frequent exacerbators and infrequent exacerbators will have blood and sputum samples obtained around pulmonary rehabilitation. No other intervention will be administered. Healthy controls will have resting blood samples taken.
Lindum Medical Practice
Lincoln, Lincolnshire, United Kingdom
Nettleham Medical Practice
Lincoln, Lincolnshire, United Kingdom
Welton Surgery
Lincoln, Lincolnshire, United Kingdom
Birchwood Medical Practice
Lincoln, Lincolnshire, United Kingdom
Concentration of inflammatory markers in plasma and sputum (C-reactive protein, Fibrinogen, Interleukin(IL)-6, IL-8
Time frame: July 2016 - August 2018
Changes in the expression of anti-inflammatory genes
Time frame: July 2016 - August 2018
Total and differential blood leukocyte count
Time frame: July 2016 - August 2018
Pre-activation and activation of blood neutrophils using flow cytometry
Time frame: July 2016 - August 2018
Pro-coagulant and pro-inflammatory microparticle signatures in plasma
Time frame: July 2016 - August 2018
Severe, moderate and mild exacerbations (number of /days to defined events, severity, recovery)
Time frame: July 2016 - August 2018
Respiratory Symptoms™ (RS-Total score; RS-Breathlessness; RS-Cough and Sputum, and RS-Chest Symptoms)
Time frame: July 2016 - August 2018
Routine clinical outcome measures following pulmonary rehabilitation (completion rates and clinically important differences - ISWT, ESWT, 6MWD, CRQ)
Time frame: July 2016 - August 2018
Differences in basal levels of inflammation between frequent and infrequent exacerbators in comparison to healthy controls
Time frame: July 2016 - August 2018
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Sudbrooke Drive Community Centre
Lincoln, United Kingdom
Bracebridge Community Centre
Lincoln, United Kingdom