Exercise training can attenuate the inflammatory milieu in women with systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation. This study sought to assess the effects of an exercise training program on cytokines and soluble TNF receptors (sTNFRs) in response to acute exercise in SLE women. Eight SLE women and 10 sex-, age-, and body mass index-comparable healthy controls (HC) participated in this study. Before and after a 12-wk aerobic exercise training program, cytokines and sTNFRs were assessed at rest and in response to single bouts of acute moderate/intense exercise. HC performed the acute exercise bouts only at baseline. After the exercise training program, there was a decrease in resting TNFR2 levels (P = 0.025) and a tend to reduction interleukin (IL)-10 levels (P = 0.093) in SLE. The resting levels of IL-6, IL-10, and TNF-α after the exercise training in SLE reached HC levels (P > 0.05). In response to a single bout of acute moderate exercise, the area under the curve (AUC) of IL-10 was significantly reduced after the exercise training program in SLE (P = 0.043), and the AUC of IL-10, IL-6, TNF-α, and sTNFR1 of SLE approached control values (P > 0.05). In response to a single bout of acute intense exercise, the AUC of IL-10 was significantly reduced in SLE (P = 0.015). Furthermore, the AUC of sTNFR2 tended to decrease after exercise training program in SLE (P = 0.084), but it did not reach control values (P = 0.001). An aerobic exercise training program attenuated the inflammatory milieu in SLE women, revealing a novel homeostatic immunomodulatory role of exercise in an autoimmunity condition.

Increased Insulin Resistance and Glucagon Levels in Mild/Inactive Systemic Lupus Erythematosus Patients Despite Normal Glucose Tolerance

“…As expected, the SLE group showed 40-50% higher circulating TNF and leptin levels, reinforcing previous findings (13,38). Infusion studies revealed that TNF induces IR in skeletal muscle via direct (direct inhibitory effects on insulin signaling) and indirect effects (via the increase release of free fatty acids from the adipose tissue) (40).…”

“…SLE patients, even with mild disease, show higher levels of inflammatory cytokines (13). However, although 1 study has observed an association between circulating inflammatory cytokines and IR in SLE patients with mild disease (14), others have not confirmed this finding (2,15).…”

Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation

“…Evidence from a longitudinal study of patients with inactive disease from the Perandini et al 123 study indi cates that a 12week, moderateintensity, aerobic exercise programme for patients with SLE in remission is anti inflammatory. 81 After 3 months of training, sTNFR2 levels and IL10 resting levels were decreased; in addi tion, statistically insignificant decreases in resting levels of IL6 and TNF were detected. Moreover, the 24 h res ponse of IL10 to an acute session of exercise after the intervention was substantially reduced when compared with the response before the intervention; the responses of IL6, TNF and sTNFR1 were also decreased, although these data were also not statistically significant.…”

“…Nonetheless, future prospective studies that focus on the specific effects of exercise on systemic and local inflammation (for example, in the joints of patients with RA) in each disease are necessary in order to confirm the still preliminary but optimistic data from currently available studies. 81,103,123,125 Review criteria A search for original articles published between 1970 and June 2014 and focusing on physical activity and inflammatory rheumatic diseases and the role of myokines was performed in MEDLINE and PubMed. The search terms used were "muscle", "exercise", "physical activity", "endocrine", "cytokine", "myokine", "inflammation", "insulin resistance", "cardiovascular risk", "lipid profile", "endothelial function", "atherosclerosis", "rheumatoid arthritis", "systemic lupus erythematous (SLE)", "systemic sclerosis", "idiopathic inflammatory myopathies", "dermatomyositis", "polymyositis", "body inclusion myositis" and "ankylosing spondylitis".…”

“…Unchanged or improved inflammatory markers ■ Unchanged or improved disease activity scores and markers of systemic inflammation (erythrocyte sedimentation rate and C-reactive protein) in response to aerobic, 72 Improved cardiovascular function ■ Improved endothelial function and lipid profile in response to aerobic 80 and aerobic plus resistance exercise programmes, 106 and shown by cross-sectional studies 80,103,104,106 ■ Improved autonomic function in response to aerobic plus resistance exercise programmes in in adult SLE 108 and in response to aerobic exercise programmes in juvenile-onset SLE 82,108 Unchanged or decreased levels of inflammatory markers ■ No changes in disease activity scores or markers of systemic inflammation (erythrocyte sedimentation rate and C-reactive protein) in response to aerobic plus resistance exercise in adult SLE 106,108 and to aerobic exercise programmes in adult [78][79][80][81] and juvenile-onset SLE 81 ■ Unchanged or improved levels of selected proinflammatory and anti-inflammatory cytokines and soluble receptors at rest and after exercise (IL-6, IL-10, IFN-γ, TNF, sTNFR1, sTNFR2) in response to aerobic exercise programmes 78…”