Fatigue and plasma cytokine concentrations at rest and during exercise in patients with sarcoidosis
Fatigue and plasma cytokine concentrations at rest and during exercise in patients with sarcoidosis
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DOI：
10.1111/j.1752-699x.2010.00214.x
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发表时间：
2011-07-01
影响因子：
1.7
通讯作者：
Sharma, Om Prakash
中科院分区：
文献类型：
--
作者：
Baydur, Ahmet;Alavy, Bahram;Sharma, Om Prakash
背景：结节病患者表现出运动不耐受相关的疲劳和静止时循环促炎细胞因子水平升高。运动可能导致健康成人血浆细胞因子水平（PCLs）升高，但这种关系尚未在结节病患者中研究。目的：探讨结节病患者疲劳与静息时PCLs及心肺运动试验（CPET）的关系。方法：我们对22例结节病患者（13例接受免疫调节药物治疗）和22例对照组进行肺功能、CPET数据、多维疲劳量表、血浆肿瘤坏死因子- α (tnf - α)和白细胞介素-1 β (IL-1 β)浓度的评估。结果：患者表现出更大的疲劳，心肺功能下降，更高的医学研究委员会（MRC）评分和更高的血浆tnf - α浓度在任何时候都比对照组。血浆IL-1 β水平在队列之间没有差异。患者在运动后立即表现出28%的tnf - α水平升高（统计学上无显著性）。血浆il - β浓度在各组间没有变化。与未治疗的患者相比，接受治疗的患者表现出更高的MRC和身体疲劳评分，更低的呼吸储备，但心肺功能或pcl没有差异。在接受治疗的患者中，运动前血浆IL-1 β与身体疲劳、动力降低和总疲劳相关；tnf - α水平仅与一般疲劳评分相关。结论：经治疗的结节病患者表现出体力疲劳、动力下降和总疲劳与运动前血浆IL-1 β浓度的关系。急性运动不会增加pcl。治疗患者的MRC评分降低和身体疲劳是否与治疗有关或与潜在的炎症过程有关尚难以确定。
Background: Patients with sarcoidosis exhibit exercise intolerance-related fatigue and increased levels of circulating proinflammatory cytokines at rest. Exercise may result in increased plasma cytokine levels (PCLs) in healthy adults, but such a relationship has not been studied in sarcoidosis patients.Objectives: To assess relationship of fatigue in sarcoidosis with PCLs at rest and with cardiopulmonary exercise testing (CPET).Methods: We assessed lung function, CPET data, multidimensional fatigue inventory, plasma tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) concentrations before, immediately after, and 4-6 h following CPET in 22 sarcoidosis patients (13 receiving immunomodulatory drugs) and 22 controls.Results: Patients exhibited greater fatigue, reduced cardiorespiratory function, higher Medical Research Council (MRC) scores and higher plasma TNF-alpha concentrations than controls at all times. Plasma IL-1 beta levels did not differ between cohorts. Patients exhibited a 28% increase (statistically not significant) in TNF-alpha level immediately post exercise. Plasma IL-beta concentrations did not change among cohorts. Treated patients exhibited higher MRC and physical fatigue scores and lower breathing reserve, but no differences in cardiorespiratory function or PCLs compared to untreated patients. In treated patients, pre-exercise plasma IL-1 beta correlated with physical fatigue, reduced motivation and total fatigue; TNF-alpha levels only correlated with general fatigue score.Conclusion: Treated sarcoidosis patients exhibit a relation between physical fatigue, reduced motivation and total fatigue and pre-exercise plasma IL-1 beta concentrations. Acute exercise does not increase PCLs. Whether the reduced MRC score and physical fatigue in treated patients is related to the therapy or to the underlying inflammatory process is difficult to determine.