Effect of combined exercise and N-acetylcysteine supplementation on inflammatory markers in patients with chronic obstructive pulmonary disease

Background and Aim: Chronic obstructive pulmonary disease (COPD) is a respiratory disease in which inflammation plays a significant role in its progression. Exercise and nutritional strategies are effective in improving inflammation; therefore, the aim of this study was to determine the effect of a combined exercise program and N-acetylcysteine supplementation on inflammatory markers in patients with COPD. Methods: In this semi-experimental study, 80 male patients with COPD were randomly divided into 4 groups (20 subjects each): combined exercise, combined exercise with supplementation, supplementation, and placebo. The exercises were performed for 12 weeks, 6 sessions per week, for 60 minutes. 1800 mg of N-acetylcysteine supplement was administered daily along with 3 main meals. The levels of interleukin-6, interleukin-8, and C-reactive protein were measured in the blood at pre- and post-test. Results: After 12 weeks of intervention, the mean values of interleukin-6, interleukin-8, and CRP decreased significantly by 12.9%, 20.3%, and 5%, respectively, in the exercise + supplement group (P=0.001). Interleukin-6 (P=0.001), interleukin-8 (P=0.001), and CRP (P=0.04) levels were significantly lower in the exercise + supplement group compared to the placebo group. Moreover, interleukin-6 (P=0.001) and interleukin-8 (P=0.001) levels were significantly lower in the exercise group compared to the placebo group. Conclusion: It seems that combined exercise and N-acetylcysteine supplementation have a positive effect on interleukin-6, interleukin-8, and CRP markers in patients with COPD.