Am. J. Respir. Crit. Care Med., Volume 164, Number 8, October 2001, 1432-1437

Fitness, Acute Exercise, and Anabolic and Catabolic Mediators in Cystic Fibrosis

PORNCHAI TIRAKITSOONTORN, ELIEZER NUSSBAUM, CHUANPIT MOSER, MARYANN HILL, and DAN M. COOPER

Department of Pediatrics, University of California Irvine Medical Center, Irvine; and Division of Pediatric Pulmonology, Miller Children's Hospital at Long Beach Memorial Medical Center, Long Beach, California

Exercise can stimulate catabolic inflammatory cytokines even in healthy children. For patients with cystic fibrosis (CF), this may be problematic because CF is characterized by increased inflammation and suppressed growth. We examined fitness and the response to brief exercise of interleukin-6 (IL-6), tumor necrosis factor- (TNF-), insulinlike growth factor-I (IGF-I), and IGF binding protein-1 (IGFBP-1) in 14 subjects with CF (10.5 ± 0.8 yr of age), 9 of whom were treated with ibuprofen, and 14 healthy control subjects (11.6 ± 0.5 yr of age, NS). Subjects performed brief intermittent, constant work rate protocol (scaled to each individual's exercise capacity) with blood and urine sampling. Peak O₂ was correlated with IGF-I (r = 0.68, p < 0.01) in control subjects but not in subjects with CF. In subjects with CF, baseline IL-6 was 79% greater (p < 0.05) and IGF-I was 47% lower than in control subjects (p < 0.05). Post hoc analysis revealed a progressive increase in the IL-6 response to exercise, with the lowest increase observed in control subjects (11.8 ± 4.6 pg/L/kJ), higher increases in patients with CF treated with ibuprofen (23.4 ± 7.7 pg/L/kJ), and highest in subjects with CF not receiving ibuprofen (29.2 ± 7.5 pg/L/kJ). Qualitatively similar results were observed for TNF-. Exercise also significantly increased IGFBP-1 in both control subjects and subjects with CF. Brief exercise can increase even chronically elevated inflammatory mediators in CF, and this response may be attenuated by ibuprofen.

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