Aerobic Training Improves Pulmonary and Systemic Inflammatory and Fibrotic Response in Asthmatics

Airway remodeling is a hallmark of asthma driven by non-resolved chronic inflammatory response, beyond exacerbated release of pro-fibrotic mediators. Aerobic exercise (AE) improves asthma management and airway inflammation, but its effects on pulmonary and systemic cellular and humoral immune response are unknown. Treadmill aerobic exercise (AE) (12 weeks, 3x/week, 40min/session, 60-80%MaxHR) was applied to 17 persistent moderate asthmatic patients (42.11±19.13). Body mass index (BMI), lung function, induced sputum, breath condensate, whole blood analysis and CD4+ cells proliferation, 6MWT, exhaled nitric oxide, was evaluated. AE improved VEF3 (L) (p<0.03) and PEF (L/min) (p<0.005) and PEF (%) (p<0.004), reduced the number of total leukocytes, eosinophils, neutrophils, lymphocytes and macrophages (p<0.01), as well as the levels of IL-1beta, IL-4, IL-5, IL-6, IL-8, IL-13, IL-17, IL-23 (p<0.01) in induced sputum. AE also reduced the levels of IL-1beta, IL-5, IL-6, IL-13, VEGF (p<0.01), while increased the levels of anti-inflammatory IL-1ra and IL-10 (p<0.01) and anti-fibrotic Relaxin 3 (p<0.01) in breath condensate. Systemically, AE reduced the number of eosinophils, neutrophils and lymphocytes (p<0.01), as well as the levels of IL-1beta, IL-5, IL-6, IL-13, VEGF (p<0.01), while increased anti-inflammatory IL-1ra, IL-10 (p<0.01) and anti-fibrotic Relaxin 3 (p<0.01) in plasma. AE improved 6MWT (p<0.01) and reduced exhaled nitric oxide (p<0.01) and CD4+ cells proliferation (p<0.01). AE improves airway and systemic inflammation reducing pro-inflammatory cytokines, while increased anti-inflammatory and anti-fibrotic mediators systemically and into the lungs.