TNF and chronic obstructive pulmonary disease: Lymphocytes: NK, NKT-like and CD8+ T-cells expression of intracellular perforin and granzyme B Pro-inflammatory cytokines: interferon-γ (IFN-γ), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β), tumour necrosis factorα (TNF-α) and C-reactive protein (CRP) COPD-associated factors: pulmonary and activation-regulated chemokine (PARC/CCL-18), surfactant protein D (SP-D) and tissue inhibitor of metalloproteinase (TIMP-1) Stress hormones: serum cortisol and epinephrineMeasurements before and after the intervention