Individualised exercise training enhances antioxidant buffering capacity in idiopathic pulmonary fibrosis
Individualised exercise training enhances antioxidant buffering capacity in idiopathic pulmonary fibrosis
Exercise training is recommended for patients with idiopathic pulmonary fibrosis (IPF); however, the mechanism(s) underlying its physiological benefits remain unclear. We investigated the effects of an individualised aerobic interval training programme on exercise capacity and redox status in IPF patients. IPF patients were recruited prospectively to an 8-week, twice-weekly cardiopulmonary exercise test (CPET)-derived structured responsive exercise training programme (SRETP). Systemic redox status was assessed pre- and post-CPET at baseline and following SRETP completion. An age- and sex-matched non-IPF control cohort was recruited for baseline comparison only. At baseline, IPF patients (n = 15) had evidence of increased oxidative stress compared with the controls as judged by; the plasma reduced/oxidised glutathione ratio (median, control 1856 vs. IPF 736 p = 0.046). Eleven IPF patients completed the SRETP (median adherence 88%). Following SRETP completion, there was a significant improvement in exercise capacity assessed via the constant work-rate endurance time (+82%, p = 0.003). This was accompanied by an improvement in post-exercise redox status (in favour of antioxidants) assessed via serum total free thiols (median increase, +0.26 μmol/g protein p = 0.005) and total glutathione concentration (+0.73 μM p = 0.03), as well as a decrease in post-exercise lipid peroxidation products (-1.20 μM p = 0.02). Following SRETP completion, post-exercise circulating nitrite concentrations were significantly lower compared with baseline (-0.39 μM p = 0.04), suggestive of exercise-induced nitrite utilisation. The SRETP increased both endurance time and systemic antioxidant capacity in IPF patients. The observed reduction in nitrite concentrations provides a mechanistic rationale to investigate nitrite/nitrate supplementation in IPF patients.
exercise training, idiopathic pulmonary fibrosis, oxidative stress, redox balance
Wallis, Tim J.M.
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Minnion, Magdalena
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Freeman, Anna
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Bates, Andrew
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Otto, James M.
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Wootton, Stephen A.
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Fletcher, Sophie V.
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Grocott, Michael P.W.
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Feelisch, Martin
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Jones, Mark G.
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Jack, Sandy
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20 August 2023
Wallis, Tim J.M.
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Minnion, Magdalena
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Freeman, Anna
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Bates, Andrew
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Otto, James M.
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Wootton, Stephen A.
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Fletcher, Sophie V.
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Grocott, Michael P.W.
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Feelisch, Martin
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Jones, Mark G.
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Jack, Sandy
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Wallis, Tim J.M., Minnion, Magdalena, Freeman, Anna, Bates, Andrew, Otto, James M., Wootton, Stephen A., Fletcher, Sophie V., Grocott, Michael P.W., Feelisch, Martin, Jones, Mark G. and Jack, Sandy
(2023)
Individualised exercise training enhances antioxidant buffering capacity in idiopathic pulmonary fibrosis.
Antioxidants, 12 (8), [1645].
(doi:10.3390/antiox12081645).
Abstract
Exercise training is recommended for patients with idiopathic pulmonary fibrosis (IPF); however, the mechanism(s) underlying its physiological benefits remain unclear. We investigated the effects of an individualised aerobic interval training programme on exercise capacity and redox status in IPF patients. IPF patients were recruited prospectively to an 8-week, twice-weekly cardiopulmonary exercise test (CPET)-derived structured responsive exercise training programme (SRETP). Systemic redox status was assessed pre- and post-CPET at baseline and following SRETP completion. An age- and sex-matched non-IPF control cohort was recruited for baseline comparison only. At baseline, IPF patients (n = 15) had evidence of increased oxidative stress compared with the controls as judged by; the plasma reduced/oxidised glutathione ratio (median, control 1856 vs. IPF 736 p = 0.046). Eleven IPF patients completed the SRETP (median adherence 88%). Following SRETP completion, there was a significant improvement in exercise capacity assessed via the constant work-rate endurance time (+82%, p = 0.003). This was accompanied by an improvement in post-exercise redox status (in favour of antioxidants) assessed via serum total free thiols (median increase, +0.26 μmol/g protein p = 0.005) and total glutathione concentration (+0.73 μM p = 0.03), as well as a decrease in post-exercise lipid peroxidation products (-1.20 μM p = 0.02). Following SRETP completion, post-exercise circulating nitrite concentrations were significantly lower compared with baseline (-0.39 μM p = 0.04), suggestive of exercise-induced nitrite utilisation. The SRETP increased both endurance time and systemic antioxidant capacity in IPF patients. The observed reduction in nitrite concentrations provides a mechanistic rationale to investigate nitrite/nitrate supplementation in IPF patients.
Text
antioxidants-12-01645
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More information
Accepted/In Press date: 16 August 2023
Published date: 20 August 2023
Additional Information:
Funding Information:
This research was funded by a research fellowship from the NIHR Southampton Biomedical Research Centre (recipient T.W.) (NIHR-INF-0032) and a research grant from the Asthma, Allergy, and Inflammation Charity (AAIR) (funding award number N/A).
Funding Information:
The authors thank the NIHR Southampton Respiratory and Critical Care Biomedical Research Centre and the NIHR and Wellcome Trust Southampton Clinical Research Facility for support and access to equipment. They thank Helen Moyses, NIHR Southampton Respiratory and Critical Care Biomedical Research Centre medical statistician, for her input in designing the statistical analysis plan. They also thank the participants for their contribution to the study.
Publisher Copyright:
© 2023 by the authors.
Keywords:
exercise training, idiopathic pulmonary fibrosis, oxidative stress, redox balance
Identifiers
Local EPrints ID: 482341
URI: http://eprints.soton.ac.uk/id/eprint/482341
ISSN: 2076-3921
PURE UUID: 3a95a177-b239-450f-9c92-5acbd9473754
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Date deposited: 27 Sep 2023 16:32
Last modified: 30 Nov 2024 03:17
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Contributors
Author:
Tim J.M. Wallis
Author:
Magdalena Minnion
Author:
Anna Freeman
Author:
Andrew Bates
Author:
James M. Otto
Author:
Sophie V. Fletcher
Author:
Sandy Jack
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