Image: André Nyberg
Research project The overall aim of COPD-HIIT is to pave the way for new understanding of the development and treatment of extrapulmonary manifestations of COPD with a focus on brain health, muscle quality, and cardiac functions.
Given the substantial negative impact of extrapulmonary manifestations on vital clinical outcomes, including mortality, the need for new effective treatment modalities beyond the lungs has been highlighted as an urgent challenge in managing COPD. Within the COPD-HIIT project we will determine the effect and mechanisms of a novel concept of supramaximal High-Intensity Interval Training (HIIT). We will use state-of-the-art research infrastructures, in-vivo & in-vitro strategies, and combine quantitative and qualitative methods to fulfill our research objectives.
Internal
Strategic Research Area Health Care Science
Medical Faculty
External
Swedish Research Council
Swedish Heart and Lung Foundation
European Research Council
Heart and Lung Association
BACKGROUND
COPD is one of the deadliest societal diseases of the 21st century, affecting more than 384 million people, with prevalence rates still climbing. Although COPD is primarily a respiratory disease, extrapulmonary manifestations such as brain, muscle, and cardiac dysfunctions are, independent of the degree of lung impairment, closely linked to reduced quality of life, daily physical activity, healthcare use, exercise intolerance, increased symptoms, and increased mortality. Therefore, new effective treatment modalities beyond the lungs are urgently needed.
RESEARCH OBJECTIVES
The Research Objectives (ROs) of COPD-HIIT are to:
● RO1) Determine the feasibility and acute effects of supramaximal HIIT, including, but not limited to, exercise intensity, cardiorespiratory responses, and symptoms.
● RO2) Determine the effects and mechanisms of supramaximal HIIT on important clinical outcomes, including limb muscle, brain, cardiovascular and psychological function, and health.
● RO3) Determine how exercise training and inflammation impact the trajectories of neurodegeneration.
● RO4) Develop a novel model to determine signaling pathways in response to supramaximal HIIT and continuous loading regimes in normoxia and hypoxia.
METHODS
We will work with an international research alliance to conduct randomized controlled cross-sectional and interventional trials and experimental trials to determine the effect and mechanisms of supramaximal HIIT. The supramaximal HIIT intervention builds on work performed in the Umeå-HIT study, although further developed and adapted to patients with COPD. We will use advanced measurement techniques for muscle, brain, and heart evaluations, muscle biopsy analyses, in-vivo & in-vitro strategies, and combining quantitative and qualitative methods to fulfill our research objectives.
● RO1: Cross-sectional RCT on 16 COPD and 16 healthy matched individuals.
● RO2: International multicenter RCT with 3-month follow-up on 70 COPD and 70 healthy matched individuals.
● RO3: International multicenter RCT with 24-month follow-up on 138 persons with COPD.
● RO4: Experimental studies
EXPECTED OUTCOMES & SIGNIFICANCE
If successful completion of our ROs, the expected outcomes of the COPD-HIIT are
● a novel treatment modality that effectively and safely can overcome the barriers associated with traditional continuous exercise to optimize exercise intensities and, for the first time, enable multiple extrapulmonary benefits using the same treatment modality.
● new evidence on the impact of exercise at different intensities to reduce age-related neurodegeneration and to what extent inflammation impacts neurodegeneration and treatment responses over time.
● a valid in-vitro model and novel evidence on signaling pathways to different loading regimens in normoxia and hypoxia – findings that could be used to design new exercise modalities and identify novel targets for future treatment.
In summary, the goal of COPD-HIIT is to improve the treatment of extrapulmonary manifestations of the disease - ultimately improving prognosis, increasing quality of life, and reducing healthcare costs of one of the deadliest societal diseases of the 21st century.
