The oxidative stress, inflammatory markers, and metabolomics response to exercise in patients with chronic obstructive pulmonary disease

There is limited information on oxidative, inflammatory, and metabolomic responses to exercise in individuals with chronic obstructive pulmonary disease (COPD). This study aimed to determine the oxidative, inflammatory, and metabolomic responses to incremental, constant, and interval work rate exercises in individuals with COPD and to compare pre-and post- exercise responses. Sixteen males with COPD (mean age = 50.94±6.42 years; predicted percentage of forced expiratory volume in one second [FEV1] = 63.37±19.90%) performed symptom-limited incremental cycle exercise testing. Based on the results of the exercise testing, constant and interval work rate exercises were performed. Oxidative (catalase [CAT], reduced glutathione [GSH], glutathione peroxidase [GPx], superoxide dismutase [SOD], total antioxidant status [TAS]), inflammatory (tumor necrosis factor [TNF]-α, soluble TNF receptor-1 [sTNFr1], soluble TNF receptor SuperFamily 1B [sTNFRSF1B], interleukin [IL]-1, IL-6, and C reactive protein [CRP]), and metabolomics responses to different exercises were analyzed from the plasma samples. The CAT, GSH, and TAS difference and fold change values for constant and interval work rate exercises were similar in individuals with COPD (p>0.05). The GPx change for constant work rate exercise were higher than those obtained with interval exercise (p=0.004). The SOD change for interval exercise were higher than those obtained with constant work rate exercise (p<0.017). There were no significant changes in TNF-α, sTNFr1, sTNFRSF1B, IL-1, IL-6, and CRP post-and pre-exercise differences and fold change values among incremental, constant, and interval work rate exercises. While isoleucine, L-carnitine and acylcarnitine decreased significantly with constant and intermittent workload exercises, a significant increase was found in ketone bodies (p<0.05). Acute constant and intermittent work rate exercises alter circulating GPx levels in individuals with COPD. Acute constant work and interval work rate exercises do not appear to worsen systemic inflammation in COPD. CE and IE decrease isoleucine, L-carnitine, and acylcarnitines while increasing ketone bodies demonstrating the shift in energy metabolism from carbohydrates to amino acid utilization and lipid metabolism. Interval exercise produces significant changes in much more metabolomics regarding carbohydrates, lipids, amino acids, nucleotides, and vitamins than constant work rate exercise. Considering the changes in oxidative and metabolomic responses to different exercise protocols while planning pulmonary rehabilitation programs will guide the implementation of personalized exercise approaches.