Caracteristicas

PRACA ORYGINALNA ORIGINAL PAPER

Jan Szczegielniak, Katarzyna Bogacz, Jacek Łuniewski, Edyta Majorczyk, Andrzej Tukiendorf, Marcin Czerwiński
Institute of Physiotherapy, Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland Head: J. Szczegielniak, MD, PhD, Associate Professor

The effect of physiotherapy on interleukin-8 levels in patients withchronic obstructive pulmonary disease
A research statutory project NBS 40/08 conducted by Marcin Czerwiński as the principal investigator Topic: “Physical exercise and the expression of cytokines and chemokines in patients with chronic lung diseases”

Abstract
Introduction: Interleukin-8 (IL-8), a chemokine formed by macrophages and epithelial cells and a potent chemoattractant for neutrophils,plays the principal role in the activation of neutrophils and eosinophils in the airways of patients with chronic obstructive pulmonary disease (COPD) and may be used as a marker of inflammation. The inflammation in the course of COPD may be characterised by an increased neutrophil count in the sputum and elevated IL-8 levels. The aim of the study was to assess the effect of physiotherapy on IL-8levels in induced sputum in patients with COPD. Material and methods: The study included 44 patients (21 men and 23 women, mean age 56.47 ± 9.52) managed at the Ministry of Internal Affairs and Administration Specialist Hospital in Głuchołazy, Poland, and undergoing rehabilitation at the Therapeutic Rehabilitation Facility, with the diagnosis of COPD (FEV1/VC < 65%), receiving stable drug treatmentduring physiotherapy. Before physiotherapy all the patients underwent treadmill exercise testing according to the Bruce protocol and had their dyspnoea assessed on the 20-point Borg scale as part of qualification for physiotherapy. All the patients participated a multidirectional three-week respiratory physiotherapy programme based on aerobic training performed on a cycloergometer. The trainingloads were selected on an individual basis depending on exercise tolerance. The standard physiotherapy programme also included respiratory muscle exercises with a particular emphasis on the abdominal muscles and the diaphragm, saline inhalations, postural drainage and percussion, relaxation and walks. Results: IL-8 levels were significantly lower after completion of the three-week physiotherapy. IL-8levels in the sputum decreased from 18.91 ± 25.2 to 9.69 ± 14.06 ng/ml (p = 0.0215). The highest reduction of IL-8 levels was observed in patients with the highest baseline values. Conclusions: The decrease of IL-8 levels in induced sputum following comprehensive physiotherapy in patients with COPD suggests suppression of neutrophil activity, which may be one of the reasons for the improvedclinical condition of the patients. Key words: interleukin-8, chronic obstructive pulmonary disease, physiotherapy Pneumonol. Alergol. Pol. 2011; 79, 3: 184–188

Introduction
Chronic obstructive pulmonary disease (COPD) is a condition characterised by a limited flow of air in the respiratory tract. Ventilation abnormalities in COPD patients are caused by airway obstruction resulting form chronicinflammation

in the bronchial wall. Interleukin-8 (IL-8, CXCL8), a chemokine produced by macrophages and epithelial cells and a potent chemotactic factor for neutrophils, plays the fundamental role in the activation of neutrophils and eosinophils in the airways of patients with COPD and may be used as a marker of inflammation. Inflammation in the case

Corresponding author: Prof. JanSzczegielniak, MD, PhD, Ministry of Internal Affairs and Administration Specialist Hospital in Głuchołazy, Karłowicza St. 40, 48–340 Głuchołazy, Poland; tel.: +48 77 408 0165; fax: +48 77 439 3861; e-mail: dul@szpitalmsw-glucholazy.pl Received on 22 September 2010 Copyright © 2011 Via Medica ISSN 0867–7077

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Jan Szczegielniak et al., The effect of physiotherapy on...