High-intensity resistance training in newly diagnosed sarcoidosis- an exploratory study of effects on lung function, muscle strength, fatigue, dyspnea, health-related quality of life and lung immune cells

Kullberg, Susanna; Rivera, Natalia V.; Eriksson, Maria; Grünewald, Johan; Eklúnd, Anders

doi:10.1080/20018525.2020.1730137

Cited by 10 publications

(10 citation statements)

References 36 publications

(50 reference statements)

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“…In a cohort of 9 non-LS patients, as part of a study with controlled exercise [27], a second bronchoscopy was performed six months after the first one to follow patients longitudinally (Table II).…”

Section: Study Design and Patient Characteristicsmentioning

confidence: 99%

Monocytes in sarcoidosis are potent TNF producers and predict disease outcome

et al. 2021

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BackgroundPulmonary sarcoidosis is an inflammatory disease characterised by granuloma formation and heterogeneous clinical outcome. TNF is a proinflammatory cytokine contributing to granuloma formation and high levels of TNF have been shown to associate with progressive disease. Mononuclear phagocytes (MNPs) are potent producers of TNF and highly responsive to inflammation. In sarcoidosis, alveolar macrophages (AMs) have been well studied. However, MNPs also include monocytes/monocyte-derived cells and dendritic cells (DCs) that despite their central role in inflammation are poorly studied in sarcoidosis.ObjectiveTo determine the role of pulmonary monocyte-derived cells and DCs during sarcoidosis.MethodsWe performed in-depth phenotypic, functional and transcriptomic analysis of MNPs subsets from blood and bronchoalveolar lavage (BAL) fluid from 108 sarcoidosis patients and 30 healthy controls. We followed the clinical development of patients and assessed how the repertoire and function of MNP subsets at diagnosis correlated with 2-year disease outcome.ResultsMonocytes/monocyte-derived cells were increased in blood and BAL of sarcoidosis patients compared to healthy controls. Interestingly, high frequencies of blood intermediate monocytes at time of diagnosis associated with chronic disease development. RNAseq analysis showed highly inflammatory MNPs in BAL of sarcoidosis patients. Furthermore, frequencies of BAL monocytes/monocyte-derived cells producing TNF without exogenous stimulation at time of diagnosis increased in patients that were followed longitudinally. In contrast to AMs, the frequency of TNF producing BAL monocytes/monocyte-derived cells at time of diagnosis was highest in sarcoidosis patients that developed progressive disease.ConclusionOur data show that pulmonary monocytes/monocyte-derived cells are highly inflammatory and can be used as a predictor of disease outcome in sarcoidosis patients.

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Section: Study Design and Patient Characteristicsmentioning

confidence: 99%

Monocytes in sarcoidosis are potent TNF producers and predict disease outcome

et al. 2021

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“…Interestingly, our findings were supported by a recently published study by Kullberg and colleagues. 31 They reported a significant increase in muscle strength and less fatigue in patients with sarcoidosis following high-intensity RT. Even if their sample reported a baseline fatigue score of 30 points, which was below the cut-off for fatigue of 36 points for the fatigue severity scale (FSS), they concluded that high-intensity RT seemed to be safe and well tolerated.…”

Section: Discussionmentioning

confidence: 97%

The acute impact of resistance training on fatigue in patients with pulmonary sarcoidosis

et al. 2020

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Fatigue is the most prevalent symptom among patients with sarcoidosis, and skeletal muscle dysfunction is a common clinical feature, making resistance training (RT) a recommended treatment strategy. Despite lacking knowledge regarding whether high-intensity RT will aggravate fatigue, low to moderate-intensity is routinely used even if the evidence for this protocol to improve muscle strength is inconclusive. This study aimed to investigate whether one single session of high-intensity RT induces a higher increase in fatigue than one single session of moderate-intensity RT. In this randomized crossover study, 41 patients with pulmonary sarcoidosis (age: 53 ± 11 yr) were recruited. They randomly performed one single session of high-intensity RT, 4 sets × 5 repetitions maximum (5RM), and one single session of moderate-intensity RT, 2 sets × 25 RM. Fatigue was assessed with the Visual Analogue Scale (0–100 mm) immediately before (T0), immediately after (T1) and 24 hours after (T2) each exercise session. Fatigue development from T0 to T1 was significantly lower after 5RM (−3 ± 18 mm) than after 25RM (5 ± 15 mm), p = 0.004. No difference was seen from T0 to T2 between 5RM (0 ± 17 mm) and 25RM (6 ± 18 mm), p = 0.147. The high-intensity 5RM session did not induce a larger increase in fatigue than the moderate-intensity 25RM session. RT appears feasible and safe in patients with pulmonary sarcoidosis irrespective of the intensity. Thus, the long-term effects of high-intensity RT on fatigue should be explored in a RT programme of longer duration.

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“…This is in fact why high loads were used, as they increase neural adaptations compared with lower loads [ 49 ]. In this regard, a previous study applied high-load strength training to patients with sarcoidosis for 12 weeks [ 13 ]. Although the relatively short training duration of that study suggests that the strength gains noted were likely due to neural factors, the absence of muscle mass measurements and the persistence of adaptations five months after the training period makes it difficult to quantify the neural factor influence.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is still a lack of evidence as to which training program is best (type of exercise, intensity, frequency, or duration) for this patient population [ 10 ]. In general, physical exercise interventions in patients with sarcoidosis have combined aerobic and strength exercises (as well as breathing exercises) for a maximum duration of 13 weeks [ 11 , 12 , 13 , 14 , 15 ]. The typical aerobic component consists of moderate-intensity continuous training (MICT, e.g., 20–30 min of walking/cycling at ≤70% of maximal aerobic capacity).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Benefits of Tailored Exercise in Severe Sarcoidosis: A Case Report

Herrera-Olivares

García-Manso²,

Rodríguez-Gómez

et al. 2020

IJERPH

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Background: We studied the effects of a supervised, structured exercise program in a severe sarcoidosis patient. Methods: After being clinically stable for two years, a 52-year-old woman (stage IV, American Thoracic Society) who originally had irreversible lung fibrosis, pulmonary arterial hypertension (PAH), mild mitral insufficiency, and atrial dilatation, and was candidate for lung transplant, performed a combined high-intensity interval, high load resistance, and inspiratory muscle training for 4.5 years, and was tested (cardiopulmonary exercise testing and dual X-ray absorptiometry) every six months. Results: Cardiorespiratory fitness (CRF) and maximal pulmonary ventilation increased by 44% and 60%, respectively. Ventilatory efficiency also improved (decrease in the ventilatory equivalent for oxygen by 32% and 14% at the ventilatory threshold and respiratory compensation point, respectively). She improved New York Heart Association (NYHA) class (from III to II), and cardiac alterations as well as PAH reversed so that she was not in need of lung transplantation anymore. Likewise, she suffered no more episodes of hemoptysis. Bone health was overall maintained despite the post-menopausal status and the corticoid treatment. Conclusions: A long-term combined exercise intervention safely contributed—at least partly—to improve CRF and NYHA class in a patient with severe sarcoidosis, suggesting a potential coadjuvant effect to attenuate clinical manifestations.

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High-intensity resistance training in newly diagnosed sarcoidosis- an exploratory study of effects on lung function, muscle strength, fatigue, dyspnea, health-related quality of life and lung immune cells

Abstract: Eklund (2020) High-intensity resistance training in newly diagnosed sarcoidosis-an exploratory study of effects on lung function, muscle strength, fatigue, dyspnea, health-related quality of life and lung immune cells,

Cited by 10 publications

References 36 publications

Monocytes in sarcoidosis are potent TNF producers and predict disease outcome

Monocytes in sarcoidosis are potent TNF producers and predict disease outcome

The acute impact of resistance training on fatigue in patients with pulmonary sarcoidosis

Long-Term Benefits of Tailored Exercise in Severe Sarcoidosis: A Case Report

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