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Original Research: COPD |

Systemic and Pulmonary Oxidative Stress After Single-Leg Exercise in COPD

Evi M. Mercken, MSc; Harry R. Gosker, PhD; Erica P. Rutten, PhD; Emiel F. Wouters, MD, PhD, FCCP; Aalt Bast, PhD; Geja J. Hageman, PhD; Annemie M. Schols, PhD
Author and Funding Information

Affiliations: From the Departments of Respiratory Medicine (Ms. Mercken, and Drs. Gosker, Wouters, and Schols), Pharmacology and Toxicology (Dr. Bast), and Health Risk Analysis and Toxicology (Dr. Hageman), Maastricht University, Maastricht, the Netherlands; and the Centre for Integrated Rehabilitation Organ Failure (Drs. Rutten and Wouters), Horn, the Netherlands.

Correspondence to: Evi M. Mercken, MSc, Department of Respiratory Medicine, Maastricht University, PO Box 5800, 6202 AZ Maastricht, the Netherlands; e-mail: e.mercken@pul.unimaas.nl


Funding/Support: This research was supported by Numico Research (Ms. Mercken) and by an award from the Netherlands Asthma Foundation 3.2.05.038 (Dr. Gosker).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(5):1291-1300. doi:10.1378/chest.08-2767
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Background:  Our aim for this study was to disentangle the contribution of muscular vs pulmonary oxidative stress during endurance exercise in patients with COPD.

Methods:  Fifteen COPD patients and 10 healthy age-matched control subjects performed a continuously submaximal single-leg ergometer test (40% of peak workload) for 20 min or until they stopped (muscle endurance [Tlim]). Venous blood, urine samples, and exhaled breath condensate were sampled before, immediately after, and 2 h after exercise.

Results:  Tlim was lower in COPD patients than in control subjects (p < 0.01). No exercise-induced systemic inflammation (ie, no raised levels of interleukin-6 or tumor necrosis factor-α) was found in the groups. Urinary malondialdehyde and uric acid levels (p < 0.05) were increased in COPD patients, whereas erythrocyte oxidized glutathione/reduced glutathione levels tended to be increased in COPD patients compared with control subjects after exercise (p = 0.08). Despite the relatively low cardioventilatory response to this localized muscle exercise, hydrogen peroxide levels in breath condensate significantly increased in COPD patients (p < 0.01). Nuclear factor κB DNA-binding activity of p50 in peripheral blood monocytes was elevated after exercise in both COPD patients (p < 0.01) and control subjects (p < 0.05), whereas p65 protein levels were not altered.

Conclusion:  COPD patients showed increased pulmonary and systemic oxidative stress after localized leg muscle exercise compared with healthy control subjects, without evidence of increased levels of systemic inflammation.

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