Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial

• Published in: Thorax Vol. 70; no. 8; pp. 732 - 739
• Main Authors: França-Pinto, Andrezza, Mendes, Felipe A R, de Carvalho-Pinto, Regina Maria, Agondi, Rosana Câmara, Cukier, Alberto, Stelmach, Rafael, Saraiva-Romanholo, Beatriz M, Kalil, Jorge, Martins, Milton A, Giavina-Bianchi, Pedro, Carvalho, Celso R F
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.08.2015
• Subjects: Adult; Aerobics; Airway management; Anaerobic threshold; Asthma; Asthma - complications; Asthma - physiopathology; Asthma - therapy; Bronchial Hyperreactivity - etiology; Bronchial Hyperreactivity - prevention & control; Cytokines; Exercise; Exercise - physiology; Exercise Therapy - methods; Female; Fitness training programs; Follow-Up Studies; Histamine; Hospitals; Humans; Inflammation; Inflammation - etiology; Inflammation - prevention & control; Intervention; Male; Middle Aged; Nitric oxide; Physical fitness; Prospective Studies; Quality of Life; Questionnaires; Severity of Illness Index; Single-Blind Method; Surveys and Questionnaires; Tumor necrosis factor-TNF; Young Adult; United States > US; Pulmonary Rehabilitation; Exercise; Asthma
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thoraxjnl-2014-206070

BackgroundThe benefits of aerobic training for the main features of asthma, such as bronchial hyperresponsiveness (BHR) and inflammation, are poorly understood. We investigated the effects of aerobic training on BHR (primary outcome), serum inflammatory cytokines (secondary outcome), clinical control and asthma quality of life (Asthma Quality of Life Questionnaire (AQLQ)) (tertiary outcomes).MethodsFifty-eight patients were randomly assigned to either the control group (CG) or the aerobic training group (TG). Patients in the CG (educational programme+breathing exercises (sham)) and the TG (same as the CG+aerobic training) were followed for 3 months. BHR, serum cytokine, clinical control, AQLQ, induced sputum and fractional exhaled nitric oxide (FeNO) were evaluated before and after the intervention.ResultsAfter 12 weeks, 43 patients (21 CG/22 TG) completed the study and were analysed. The TG improved in BHR by 1 doubling dose (dd) (95% CI 0.3 to 1.7 dd), and they experienced reduced interleukin 6 (IL-6) and monocyte chemoattractant protein 1 (MCP-1) and improved AQLQ and asthma exacerbation (p<0.05). No effects were seen for IL-5, IL-8, IL-10, sputum cellularity, FeNO or Asthma Control Questionnaire 7 (ACQ-7; p>0.05). A within-group difference was found in the ACQ-6 for patients with non-well-controlled asthma and in sputum eosinophil and FeNO in patients in the TG who had worse airway inflammation.ConclusionsAerobic training reduced BHR and serum proinflammatory cytokines and improved quality of life and asthma exacerbation in patients with moderate or severe asthma. These results suggest that adding exercise as an adjunct therapy to pharmacological treatment could improve the main features of asthma.Trial registration numberNCT02033122.