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Activation of regenerative pathways by exercise intervention in subjects with chronic obstructive pulmonary disease : A study protocol

Larsson, Caroline LU ; Elowsson, Linda LU ; Tufvesson, Ellen LU ; Cederberg, Anna LU orcid ; Öhrneman, Hugo LU ; Falcones, Bryan LU orcid ; Karlsson, Lisa LU ; Akbarshahi, Hamid LU ; Ankerst, Jaro LU orcid and Bjermer, Leif LU , et al. (2025) In Respiratory Research 27.
Abstract
Introduction

Although Chronic Obstructive Pulmonary Disease (COPD) is generally considered a progressive condition with limited reversibility, recent data suggests potential for lung function improvement with exercise. Mechanistic insights into exercise-induced benefits remain limited, but in vitro models offer promise for understanding cellular and molecular changes. This study aims to elucidate the mechanisms behind lung tissue regeneration in COPD through adapted exercise training as well as validating advanced lung function tests, such as Impulse Oscillometry (IOS) and Airspace Dimension Assessment (AiDA) for improved detection of early physiological /structural changes and predicting clinical... (More)
Introduction

Although Chronic Obstructive Pulmonary Disease (COPD) is generally considered a progressive condition with limited reversibility, recent data suggests potential for lung function improvement with exercise. Mechanistic insights into exercise-induced benefits remain limited, but in vitro models offer promise for understanding cellular and molecular changes. This study aims to elucidate the mechanisms behind lung tissue regeneration in COPD through adapted exercise training as well as validating advanced lung function tests, such as Impulse Oscillometry (IOS) and Airspace Dimension Assessment (AiDA) for improved detection of early physiological /structural changes and predicting clinical outcomes.
Methods

This is the protocol of a multicenter, hypothesis-generating, single-arm study exploring the mechanisms for lung regeneration in subjects with COPD induced by exercise. The exercise protocol includes supervised and individually tailored moderate-intensity aerobic- and muscle strengthening exercise, performed three times per week for 12 weeks. Eighty sedentary adults with a clinically stable COPD will be recruited at two study sites. Included participants will be assessed at baseline and at 12 weeks by comprehensive pulmonary function testing (including spirometry, IOS, body plethysmography, diffusing capacity of the lung, single breath nitrogen wash-out, AiDA, questionnaires, physical capacity performance (including 6-minutes walking test (6MWT), one-minute sit-to-stand test, and cardiopulmonary exercise testing (CPET)), and collection of blood and urine samples and bronchoscopy. A mid-intervention assessment at week 6 will include medication use, health status, questionnaires, spirometry, and blood sampling.
Discussion

Understanding the molecular and cellular activities related to lung function induced by exercise provides insights into repair pathways, challenges the notion of irreversible lung damage in COPD, and paves the way for improved management strategies with potential identification of biomarkers and pharmacological interventions. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Respiratory Research
volume
27
pages
13 pages
publisher
BioMed Central (BMC)
ISSN
1465-9921
DOI
10.1186/s12931-025-03443-y
language
English
LU publication?
yes
id
8f8547cc-2973-4cef-a795-b7483144ab2e
date added to LUP
2026-01-09 17:34:13
date last changed
2026-01-15 12:30:37
@article{8f8547cc-2973-4cef-a795-b7483144ab2e,
  abstract     = {{Introduction<br/><br/>Although Chronic Obstructive Pulmonary Disease (COPD) is generally considered a progressive condition with limited reversibility, recent data suggests potential for lung function improvement with exercise. Mechanistic insights into exercise-induced benefits remain limited, but in vitro models offer promise for understanding cellular and molecular changes. This study aims to elucidate the mechanisms behind lung tissue regeneration in COPD through adapted exercise training as well as validating advanced lung function tests, such as Impulse Oscillometry (IOS) and Airspace Dimension Assessment (AiDA) for improved detection of early physiological /structural changes and predicting clinical outcomes.<br/>Methods<br/><br/>This is the protocol of a multicenter, hypothesis-generating, single-arm study exploring the mechanisms for lung regeneration in subjects with COPD induced by exercise. The exercise protocol includes supervised and individually tailored moderate-intensity aerobic- and muscle strengthening exercise, performed three times per week for 12 weeks. Eighty sedentary adults with a clinically stable COPD will be recruited at two study sites. Included participants will be assessed at baseline and at 12 weeks by comprehensive pulmonary function testing (including spirometry, IOS, body plethysmography, diffusing capacity of the lung, single breath nitrogen wash-out, AiDA, questionnaires, physical capacity performance (including 6-minutes walking test (6MWT), one-minute sit-to-stand test, and cardiopulmonary exercise testing (CPET)), and collection of blood and urine samples and bronchoscopy. A mid-intervention assessment at week 6 will include medication use, health status, questionnaires, spirometry, and blood sampling.<br/>Discussion<br/><br/>Understanding the molecular and cellular activities related to lung function induced by exercise provides insights into repair pathways, challenges the notion of irreversible lung damage in COPD, and paves the way for improved management strategies with potential identification of biomarkers and pharmacological interventions.}},
  author       = {{Larsson, Caroline and Elowsson, Linda and Tufvesson, Ellen and Cederberg, Anna and Öhrneman, Hugo and Falcones, Bryan and Karlsson, Lisa and Akbarshahi, Hamid and Ankerst, Jaro and Bjermer, Leif and Palm, Andreas and Löndahl, Jakob and Malinovschi, Andrei and Janson, Christer and Emtner, Margareta and Westergen-Thorsson, Gunilla}},
  issn         = {{1465-9921}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Respiratory Research}},
  title        = {{Activation of regenerative pathways by exercise intervention in subjects with chronic obstructive pulmonary disease : A study protocol}},
  url          = {{http://dx.doi.org/10.1186/s12931-025-03443-y}},
  doi          = {{10.1186/s12931-025-03443-y}},
  volume       = {{27}},
  year         = {{2025}},
}