Use of biomarkers to optimize physical rehabilitation programs in chronic obstructive pulmonary disease

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Abstract

Chronic obstructive pulmonary disease is characterized by pronounced clinical and biological heterogeneity. It determines a wide range of responses to therapeutic interventions, including pulmonary rehabilitation. Exercise training remains the primary non-pharmacological strategy capable of improving exercise tolerance, symptoms, and quality of life; however, individual responses to rehabilitation programs vary considerably. In recent years, there has been a rising interest in the use of biomarkers that reflect inflammatory, metabolic, and microbiome-related changes induced by physical activity, with the aim of advancing personalized rehabilitation approaches. This review summarizes current evidence on biomarkers of systemic inflammation, oxidative stress, and DNA damage, as well as alterations in gut and oral microbiota in patients with chronic obstructive pulmonary disease undergoing rehabilitation. It has been shown that the changes in the content of interleukin-6, C-reactive protein, 8-isoprostane, malondialdehyde, phosphorylated H2AX histone proteins, 8-OH-deoxyguanosine, and the profile of short-chain fatty acids may reflect the pattern of physiological adaptation to exercise and serve as objective indicators for the optimization of training programs. Particular attention is given to the role of omics technologies and the emerging field of rehabilomics, which enable integration of molecular data with clinical outcomes to develop individualized rehabilitation strategies. Despite the promise of these approaches, their implementation in clinical practice remains limited by insufficient methodological standardization and data heterogeneity. The need for large-scale longitudinal studies with unified protocols is emphasized. In the future, the integration of biomarkers and multi-omics approaches may enable the development of more precise, adaptive, and effective rehabilitation programs aimed at improving functional status and quality of life in patients with chronic obstructive pulmonary disease.

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About the authors

Zulfina A. Khazieva

Chusovskaya Hospital named after V.G. Lyubimov

Author for correspondence.
Email: khazulf1999@gmail.com
ORCID iD: 0009-0000-5449-1990
Russian Federation, Chusovoi

Alen A. Khachatryan

Ivanovo State Medical University

Email: alen200302@gmail.com
ORCID iD: 0009-0003-6199-8345
Russian Federation, Ivanovo

Adel D. Sibgatullina

I.N. Ulyanov Chuvash State University

Email: adelyasibgatullina@gmail.com
ORCID iD: 0009-0007-9759-0527
Russian Federation, Cheboksary

Iliza I. Yusaeva

I.N. Ulyanov Chuvash State University

Email: yusalina2002@gmail.com
ORCID iD: 0009-0004-0142-2501
Russian Federation, Cheboksary

Alena V. Goncharova

Ural State Medical University

Email: goncharova1.alena@gmail.com
ORCID iD: 0009-0007-0861-9659
Russian Federation, Ekaterinburg

Maksim A. Maslyanko

South-Ural State Medical University

Email: shampun50@mail.ru
ORCID iD: 0009-0005-4760-1019
Russian Federation, Chelyabinsk

Dilara I. Ishmukhametova

Bashkir State Medical University

Email: i.dilara_02@mail.ru
ORCID iD: 0009-0001-5588-0813
Russian Federation, Ufa

Timur R. Khaliullin

Bashkir State Medical University

Email: khaliullin2002t@gmail.com
ORCID iD: 0009-0006-8544-0022
Russian Federation, Ufa

Tatiana Yu. Malikova

N.I. Pirogov Russian National Research Medical University

Email: nemnatatyana@yandex.ru
ORCID iD: 0009-0000-6098-0029
Russian Federation, Moscow

Ekaterina M. Gorbunova

N.I. Pirogov Russian National Research Medical University

Email: gorbunovaekaterina426@gmail.com
ORCID iD: 0009-0001-6599-1971
Russian Federation, Moscow

Prokhor D. Molodtsov

N.I. Pirogov Russian National Research Medical University

Email: prohor.molodcov@mail.ru
ORCID iD: 0009-0008-2037-222X
Russian Federation, Moscow

Ekaterina I. Rumynina

N.I. Pirogov Russian National Research Medical University

Email: Melani.rei@inbox.ru
ORCID iD: 0009-0009-7679-9860
Russian Federation, Moscow

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