Innovative treatment for extrapulmonary benefits in COPD: effects and mechanisms of supramaximal High-Intensity Training (COPD-HIT)

BACKGROUND

Given the substantial negative impact of extrapulmonary manifestations on key clinical outcomes, including quality of life, dyspnea, exercise tolerance, healthcare use and even mortality, the need for new effective treatment modalities beyond the lungs has been highlighted as an urgent challenge in managing COPD, one of the most common and deadliest chronic diseases of the 21st century.

OBJECTIVE

The overreaching objective of COPD-HIT is to establish how to enable extrapulmonary benefits of COPD most effectively by

• AIM 1) determining the effect of a genuinely novel concept of supramaximal High-Intensity Training (supramaximal HIT) versus moderate continuous intensity training (MICT) for improved muscle, brain, and cardiorespiratory function

• AIM 2) provide a detailed picture of the pathophysiology of extrapulmonary manifestations in COPD by establishing how muscle, brain, and cardiovascular function are linked and by comparing treatments effects and mechanisms of effects between patients with COPD and healthy age, sex and activity matched individuals.

• AIM 3) explore signalling pathways in response to supramaximal HIT and MICT loading regimes in normoxia and hypoxia.

To achieve these objective, I will collaborate with an international interdisciplinary team of junior and senior researcher with vast and diverse research and clinical knowledge including physiotherapists, cell- & molecular biologists, neuroscientists, and physicians. WORKPLAN

About AIM 1-2), 136 individuals, including an equal amount of people with COPD & matched controls, will be enrolled in an international, randomized controlled multicenter trial. Participants will be randomized to three-months (two times /week) of supramaximal HIT or MICT with blinded outcome assessment at three and six months.

About AIM 3), signalling pathways of supramaximal HIT and MICT loading regimens is investigated in-vitro in hypoxia and normoxia. SIGNIFICANCE

COPD-HIT has a unique potential to provide substantial scientific evidence on the effect and mechanisms of a genuinely novel supramaximal HIT regimen on several important extrapulmonary manifestations among people with COPD, which is of utmost importance considering the clinical and prognostic relevance of these manifestations within the disease.

Altogether, we are in a strong position to perform an international novel project that will determine how to enable extrapulmonary benefits in COPD in a hitherto unprecedented way.