Introduction: Previous studies have shown that children with cystic fibrosi
s (CF) are capable of mounting a normal immune response after the stress of
exercise. However, few data are available regarding the underlying mechani
sms by which this immune modulation occurs. Methods: In this study, lymphoc
yte and leukocyte cell counts were measured before and immediately after a
single bout of exhaustive exercise in 25 children (ages 8-17 yr; 12 with CF
and 13 healthy controls). Catecholamine, cortisol, and insulin levels, age
, nutritional parameters, and static and dynamic lung function were measure
d as potential correlates for immune modulation. We hypothesized that catec
holamine levels would be associated with the immune changes seen after exer
cise in children with CF. Results: Our results demonstrated positive correl
ations between age and the change in cell counts after exercise for white b
lood cells (r = 0.44, P < 0.03), lymphocytes (r = 0.60, P < 0.002), monocyt
es (r = 0.43, P < 0.03), and CD3-CD16+CD56+ cells (r = 0.61, P < 0.002). Lo
wer increases in the lymphocyte and CD3-CD16+CD56+ cells were observed in t
he CF group. Changes in pre- and post-exercise norepinephrine levels were w
eakly correlated with the changes in granulocyte, lymphocyte, and monocyte
cell counts. Changes in cortisol levels correlated with lymphocyte and CD19
+ cell count changes for the CF group but not for the healthy controls. Wit
hin the CF group, the severity of lung disease (as indicated by a FEV,) was
negatively correlated with changes in lymphocyte (r = -0.66, P < 0.02) and
CD3-CD16+CD56+ cell counts (r = -0.67, P < 0.02). Conclusion: The results
suggest that postexercise changes in cell counts occur in an age dependent,
norepinephrine associated manner. Disease severity for children with CF al
so appears to enhance the postexercise leukocytosis with pronounced increas
es seen in natural killer cells.