Moderate-intensity endurance-exercise training in patients with sickle-cell disease without severe chronic complications (EXDRE): an open-label randomised controlled trial

Ischaemia‐induced muscle metabolic abnormalities are poorly alleviated by endurance training in a mouse model of sickle cell disease

“…Overall, the fact that spleen weight and congestion were reduced as a result of endurance training in the basal state but not in response to an I/R protocol implies that regular physical activity could be considered as a valuable strategy aiming to diminish the rate of VOC occurrence, but not to reduce the deleterious effects of VOCs. In accordance, in a very recent study investigating the effects of endurance training in adults with SCD, all the major adverse events occurred in untrained control patients, suggesting that endurance training could be protective against adverse events, particularly the occurrence of VOC (Gellen et al, 2018).…”

“…Moreover, although our results and others in patients (Gellen et al., ) suggest a lower risk of VOC occurrence as the result of an endurance training intervention, we have not measured this parameter directly. An alternative model, provoking VOC using other methods (such as inflammatory cytokines), might potentially detect a difference between trained and untrained SCD mice.…”

“…In this context, regular physical activity has been associated with several beneficial effects in SCD mice, especially regarding energetics in exercising muscle (particularly, reducing acidosis; Chatel et al, 2018a), inflammation (Charrin et al, 2017), haemorheological characteristics (Aufradet et al, 2014;Faes, Charrin, Connes, Pialoux, & Martin, 2015) and oxidative stress Chatel et al, 2018a). These beneficial effects have been confirmed by the lower spleen weight and congestion reported in SCD mice submitted to training in comparison to their sedentary counterparts (Charrin et al, 2017;Chatel et al, 2018a) and in a very recent study conducted in patients in whom moderate-intensity endurance-exercise training seemed to be safe and improved the functional capacity of adults with SCD (Gellen et al, 2018). Given that oxidative stress (Charles et al, 2017;Lejay et al, 2014) and acidosis (Jubrias, Crowther, Shankland, Gronka, & Conley, 2003) largely impact mitochondrial respiration, it might be hypothesized that endurance training could also reduce the I/R-induced mitochondrial dysfunction we previously reported in SCD mice (Chatel et al, 2018c).…”

Impact of A Six Week Training Program on Ventilatory Efficiency, Red Blood Cell Rheological Parameters and Red Blood Cell Nitric Oxide Signaling in Young Sickle Cell Anemia Patients: A Pilot Study

“…However, the authors noted that adherence to prescribed training sessions decreased in the second half of their program, suggesting that higher efforts need to be made to motivate SCA to practice physical activities on a regular basis. The increase in activity levels might be beneficial for the health of SCA patients [21,46] but a higher number of patients involved in such a training program is needed to better answer this question.…”

“…However, physicians are often reluctant to promote regular physical activity in SCA patients [14][15][16] The main reason is that the metabolic changes occurring during exercise may promote HbS polymerization, RBC sickling, oxidative stress and inflammation, and ultimately lead to vaso-occlusive crises. Nevertheless, several studies showed that a moderate exercise of 10-20 min duration is well tolerated by both adults and children with SCA and does not cause further alterations in RBC rheology, hemolysis or inflammation [17][18][19][20][21][22] In addition, recent works in transgenic sickle cell mice (SAD and Townes models) showed that regular physical activity decreased oxidative stress and inflammation, and improved blood rheology [23][24][25][26]. These data support the fact that SCA patients are able to exercise [27] and that regular moderate physical activity could be beneficial for their health.…”