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Effects of rehabilitative exercise on peripheral muscle TNFα, IL-6, IGF-I and MyoD expression in patients with COPD
  1. Ioannis Vogiatzis1,
  2. Grigoris Stratakos2,
  3. Davina C M Simoes2,
  4. Gerasimos Terzis1,
  5. Olga Georgiadou2,
  6. Charis Roussos2,
  7. Spyros Zakynthinos2
  1. 1
    National and Kapodistrian University of Athens, Department of Physical Education and Sport Science, Athens, Greece
  2. 2
    National and Kapodistrian University of Athens, Department of Critical Care Medicine and Pulmonary Services, Pulmonary Rehabilitation Centre, Evangelismos Hospital, G.P. Livanos and M. Simou Laboratories, Athens, Greece
  1. Dr Ioannis Vogiatzis, National and Kapodistrian University of Athens – Thorax Foundation, 3 Ploutarhou Str 106 75, Athens, Greece; gianvog{at}


Background: Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation. This study investigated whether rehabilitative exercise training decreases the levels of systemic or local muscle inflammation or reverses the abnormalities associated with muscle deconditioning.

Methods: Fifteen patients with COPD (mean (SE) forced expiratory volume in 1 s 36 (4)% predicted) undertook high-intensity exercise training 3 days/week for 10 weeks. Before and after the training programme the concentration of tumour necrosis factor α (TNFα), interleukin-6 (IL-6) and C-reactive protein (CRP) in plasma was determined by ELISA, and vastus lateralis mRNA expression of TNFα, IL-6, total insulin-like growth factor-I (IGF-I) and its isoform mechanogrowth factor (MGF) and myogenic differentiation factor D (MyoD) were assessed by real-time PCR. Protein levels of TNFα, IGF-I and MyoD were measured by Western blotting.

Results: Rehabilitation improved peak exercise work rate by 10 (2%) (p = 0.004) and mean fibre cross-sectional area from 4061 (254) μm2 to 4581 (241) μm2 (p = 0.001). Plasma inflammatory mediators and vastus lateralis expression of TNFα and IL-6 were not significantly modified by training. In contrast, there was a significant increase in mRNA expression of IGF-I (by 67 (22)%; p = 0.044), MGF (by 67 (15)%; p = 0.002) and MyoD (by 116 (30)%; p = 0.001). The increase observed at the mRNA level was also seen at the protein level for IGF-I (by 72 (36)%; p = 0.046) and MyoD (by 67 (21)%; p = 0.012).

Conclusions: Pulmonary rehabilitation can induce peripheral muscle adaptations and modifications in factors regulating skeletal muscle hypertrophy and regeneration without decreasing the levels of systemic or local muscle inflammation.

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  • This work was supported in part by the European Community CARED FP5 project (Contract No QLG5-CT-2002-0893), the Thorax Foundation and by Pfizer Inc (Contract No GA9000K5).

  • Competing interests: None.

  • Abbreviations:
    chronic obstructive pulmonary disease
    C-reactive protein
    forced expiratory volume in 1 s
    forced vital capacity
    glyceraldehyde-3-phosphate dehydrogenase
    insulin-like growth factor-I
    mechanogrowth factor
    myogenic differentiation factor D
    tumour necrosis factor α