“…In addition, sphingosine-1-phosphat (S1P) -a sphingolipid metabolite known to modulate the CNS directly (Hla and Brinkmann, 2011;Soliven et al, 2011) or indirectly by facilitating BDNF expression (Fukumoto et al, 2014;Smith et al, 2018) -may also be involved in mediating exercise-induced neuroprotective effects in pwMS. Indeed, AT alone (Bansi et al, 2013;Briken et al, 2016;Castellano and White, 2008;Gold et al, 2003) or combined with pilates (Ozkul et al, 2018) or RT (Wens et al, 2016) can lead to acute and chronic increases in circulating BDNF levels in pwMS, although negative findings also exist (Bansi et al, 2013;Briken et al, 2016;Schulz et al, 2004;Zimmer et al, 2017). While little is known about circulating S1P levels in pwMS, AT has been shown to increase acute (Baranowski et al, 2015;Baranowski et al, 2011) and chronic circulating S1P levels in healthy young individuals (Ksiazek et al, 2018).…”