Oxidative and inflammatory effects of pulmonary rehabilitation in patients with bronchiectasis. A prospective, randomized study.

Abstract

INTRODUCTION:

Background: systemic inflammation and oxidative stress are important factors in the pathogenesis of bronchiectasis. Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is no data about its effect on the inflammatory and REDOX status of these patients. Aims: to investigate the effect of PR in non-cystic-fibrosis bronchiectasis (NCFB) patients, and to compare it with the effect of PR plus a hyperproteic oral nutritional supplement (PRS) enriched with beta-hydroxy-beta-methylbutyrate (HMB) on serum inflammatory and oxidative biomarkers. Materials and methods: this was an open randomized, controlled trial. Thirty individuals (65 years old or younger with a body mass index over 18.5, older than 65 years with a body mass index over 20) were recruited from September 2013 to September 2014, and randomly assigned to receive PR or PRS. Total neutrophils, and inflammatory and oxidative biomarker levels were measured at baseline, and then at 3 and 6 months. Results: in the PRS group neutrophil levels were decreased from baseline at 6 months. A significantly different fold change was found between the PR and PRS groups. In the PR group, IL-6 and adiponectin were increased by the end of the study while TNFα levels were decreased from baseline at 6 months. REDOX biomarkers remained stable throughout the study except for 8-isoprostane levels, which were increased from baseline at 6 months in both groups of patients. Conclusions: a PR program induced a pro-oxidative effect accompanied by changes in circulating inflammatory cytokine levels in NCFB patients. Our results would also suggest a possible beneficial effect of the HMB enriched supplement on neutrophil level regulation in these patients. The information provided in this study could be useful for choosing the right therapeutic approach in the management of bronchiectasis.

• Authors: Casilda Olveira, Eva García-Escobar, Esperanza Doña, Francisco J Palenque, Nuria Porras, Antonio Dorado, Ana María Godoy, Elezahara Rubio-Martín, Francisco-Javier Bermúdez-Silva, Silvana Y Romero-Zerbo, Gemma Rojo Martínez, Rocío Martín-Valero, José Abuín Fernández, Gabriel Olveira
• Journal: Nutricion hospitalaria (Nutr Hosp) Vol. 37 Issue 1 Pg. 6-13 (Feb 17 2020) ISSN: 1699-5198 [Electronic] Spain
• Vernacular Title: Efectos oxidativos e inflamatorios de la rehabilitación pulmonar en pacientes con bronquiectasia. Estudio prospectivo aleatorizado.
• PMID: 31960695 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• ADIPOQ protein, human
• Adiponectin
• Biomarkers
• Dietary Proteins
• IL6 protein, human
• Interleukin-6
• Tumor Necrosis Factor-alpha
• Valerates
• 8-epi-prostaglandin F2alpha
• beta-hydroxyisovaleric acid
• C-Reactive Protein
• Dinoprost

Topics

• Adiponectin (blood)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers
• Body Mass Index
• Bronchiectasis (blood, diet therapy, rehabilitation)
• C-Reactive Protein (analysis)
• Combined Modality Therapy
• Diet, Mediterranean
• Dietary Proteins (administration & dosage)
• Dietary Supplements (adverse effects)
• Dinoprost (analogs & derivatives, blood)
• Female
• Humans
• Inflammation (blood, complications)
• Interleukin-6 (blood)
• Leukocyte Count
• Male
• Middle Aged
• Neutrophils
• Nutritional Support
• Oxidation-Reduction
• Oxidative Stress
• Prospective Studies
• Respiratory Therapy (adverse effects, instrumentation, methods)
• Tumor Necrosis Factor-alpha (blood)
• Valerates (adverse effects, therapeutic use)
• Young Adult