Pulmonary rehabilitation does not affect systemic inflammation in chronic obstructive pulmonary disease

Background: Chronic Obstructive Lung Disease (COPD) is characterised by persistent and progressive airflow obstruction with enhanced chronic inflammatory responses. This pulmonary inflammation might be localised or it can be an 9over-spill9 of a systemic process. Aims & Objectives : Through this study, the effects of a 12 week, high intensity Pulmonary Rehabilitation programme on markers of systemic inflammation were looked into. Such a programme resulted in improvements in 6 minute walking distance and health related quality of life. Methods: Forty-nine patients were enrolled. The following inflammatory makers were investigated at baseline, 4, 8 and at 12 weeks during rehabilitation - C Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), Neutrophil, Eosinophil counts and complete blood count (CBC). Serum Amyloid A (SAA) was measured at baseline, 8th and at the 12th week. Exhaled NO was measured at the start and end of the programme. Results: No statistically significant changes in the inflammatory markers occurred as a result of the exercise intervention. There was a marked peak in CRP, ESR and SAA by the 8th week. The levels declined to baseline values at the 12th week of Pulmonary Rehabilitation. Conclusions : The said programme resulted in improvements in 6 minute walking distance and Health Related Quality of Life. However, systemic inflammatory processes with exercise as a monitor of response to high intensity exercise in COPD is still debatable.