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Juliana Souza Uzeloto,1 Alessandra Choqueta de Toledo-Arruda,2 Bruna Spolador de Alencar Silva,1 Marjorie de Assis Golim,3 Aline Márcia Marques Braz,3 Fabiano Francisco de Lima,1 Isis Grigoletto,1 Ercy Mara Cipulo Ramos1 1São Paulo State University (UNESP), Faculty of Science and Technology, Department of Physiotherapy, Postgraduate Program in Physiotherapy, Presidente Prudente, São Paulo, Brazil; 2Department of Physiotherapy, Federal University of Rio de Janeiro, Rio De Janeiro, Brazil; 3São Paulo State University (UNESP), Botucatu Medical School, Postgraduate Program in Research & Development: Medical Biotechnology, Blood Center, Flow Cytometry Laboratory, Botucatu, São Paulo, BrazilCorrespondence: Juliana Souza Uzeloto Email juliana_uzeloto@hotmail.comAims: To evaluate the expressions of intracellular cytokines in CD4+ T lymphocytes and to investigate the correlation between biomarker expressions and clinical and functional characteristics of stable COPD patients.Patients and Methods: Peripheral blood was collected from 36 COPD patients, and the expression of cytokines (IL-8, IL-13, IL-17, IL-6, IL-2, IL-10, and TNF-α) in T lymphocytes CD4 + was investigated. In addition, lung function, dyspnea symptoms, quality of life, vital signs, body composition, level of physical activity, peripheral muscle strength, and functional capacity were assessed.Results: Individuals with greater bronchial obstruction present a higher proportion of CD4 + IL-2 + lymphocytes compared to individuals with less severe bronchial obstruction. We found a positive correlation between the expression of the cytokines IL-13, IL-17, IL-6, IL-2, IL-10, and TNF-α in CD4+ T lymphocytes. In addition, we found a positive correlation between CD4+ IL-10+ T lymphocytes and lower limb muscle strength and a negative correlation between CD4+ IL-8+ T lymphocytes and peripheral oxygen saturation and steps per day.Conclusion: Systemic CD4+IL-2+, IL-8+, and IL-10+ T lymphocytes presented a correlation with clinical characteristics and functional status in stable COPD.Keywords: chronic obstructive pulmonary disease, inflammation, phenotype, flow cytometry

Marceli Rocha Leite,1 Ercy Mara Cipulo Ramos,1 Carlos Augusto Kalva-Filho,2 Ana Paula Coelho Figueira Freire,1 Bruna Spolador de Alencar Silva,1 Juliana Nicolino,1 Alessandra Choqueta de Toledo-Arruda,3 Marcelo Papoti,4 Luiz Carlos Marques Vanderlei,1 Dionei Ramos1 1Department of Physiotherapy, São Paulo State University, Presidente Prudente, 2Program in Rehabilitation and Functional Performance, São Paulo University, Ribeirão Preto, 3Department of Medicine, São Paulo University, 4School of Physical Education and Sport of Ribeirão Preto, São Paulo University, Ribeirão Preto, São Paulo, Brazil Introduction: Patients with chronic obstructive pulmonary disease (COPD) exhibit aerobic function, autonomic nervous system, and mucociliary clearance alterations. These parameters can be attenuated by aerobic training, which can be applied with continuous or interval efforts. However, the possible effects of aerobic training, using progressively both continuous and interval sessions (ie, linear periodization), require further investigation.Aim: To analyze the effects of 12-week aerobic training using continuous and interval sessions on autonomic modulation, mucociliary clearance, and aerobic function in patients with COPD.Methods: Sixteen patients with COPD were divided into an aerobic (continuous and interval) training group (AT) (n=10) and a control group (CG) (n=6). An incremental test (initial speed of 2.0 km·h-1, constant slope of 3%, and increments of 0.5 km·h-1 every 2 minutes) was performed. The training group underwent training for 4 weeks at 60% of the peak velocity reached in the incremental test (vVO2peak) (50 minutes of continuous effort), followed by 4 weeks of sessions at 75% of vVO2peak (30 minutes of continuous effort), and 4 weeks of interval training (5×3-minute effort at vVO2peak, separated by 1 minute of passive recovery). Intensities were adjusted through an incremental test performed at the end of each period.Results: The AT presented an increase in the high frequency index (ms2) (P=0.04), peak oxygen uptake (VO2peak) (P=0.01), vVO2peak (P=0.04), and anaerobic threshold (P=0.02). No significant changes were observed in the CG (P>0.21) group. Neither of the groups presented changes in mucociliary clearance after 12 weeks (AT: P=0.94 and CG: P=0.69).Conclusion: Twelve weeks of aerobic training (continuous and interval sessions) positively influenced the autonomic modulation and aerobic parameters in patients with COPD. However, mucociliary clearance was not affected by aerobic training. Keywords: COPD, exercise, aerobic treatment, mucociliary clearance

Dionei Ramos,1 Giovana Navarro Bertolini,1 Marceli Rocha Leite,1 Luiz Carlos Soares Carvalho Junior,1 Paula Roberta da Silva Pestana,1 Vanessa Ribeiro dos Santos,2 Ana Claudia de Souza Fortaleza,2 Fernanda Maria Machado Rodrigues,1 Ercy Mara Cipulo Ramos1 1Department of Physiotherapy, São Paulo State University, Presidente Prudente, Brazil; 2Department of Motricity Sciences, São Paulo State University, Rio Claro, Brazil Introduction: Sarcopenia is characterized by a progressive and generalized decrease of strength and muscle mass. Muscle mass loss is prevalent in patients with chronic obstructive pulmonary disease (COPD) as a result of both the disease and aging. Some methods have been proposed to assess body composition (and therefore identify muscle mass loss) in this population. Despite the high accuracy of some methods, they require sophisticated and costly equipment.Aim: The purpose of this study was to infer the occurrence of muscle mass loss measured by a sophisticated method (dual energy X-ray absorptiometry [DEXA]) using a more simple and affordable equipment (dynamometer).Methods: Fifty-seven stable subjects with COPD were evaluated for anthropometric characteristics, lung function, functional exercise capacity, body composition, and peripheral muscle strength. A binary logistic regression model verified whether knee-extension strength (measured by dynamometry) could infer muscle mass loss (from DEXA).Results: Patients with decreased knee-extension strength were 5.93 times more likely to have muscle mass loss, regardless of sex, disease stage, and functional exercise capacity (P=0.045).Conclusion: Knee-extension dynamometry was able to infer muscle mass loss in patients with COPD. Keywords: COPD, sarcopenia, peripheral muscle strength