Lau Keith K, Obeid Joyce, Breithaupt Peter, Belostotsky Vladimir, Arora Steven, Nguyen Thanh, Timmons Brian W
Division of Nephrology, Department of Pediatrics, McMaster University, 1280 Main Street West, HSC 3A50, Hamilton, Ontario, Canada, L8S 4K1,
Pediatr Nephrol. 2015 Apr;30(4):615-21. doi: 10.1007/s00467-014-2971-8. Epub 2014 Oct 10.
Children and adolescents with chronic kidney disease (CKD) are chronically exposed to high levels of inflammation, placing them at an increased risk of secondary health complications. Regular exercise may represent an effective therapy to reduce inflammation. The aims of this pilot study were to determine the effects of acute exercise on inflammation and immune cell counts in CKD.
Nine children and adolescents (4 males) with CKD stages III-V performed a graded exercise test to determine peak oxygen uptake (VO2peak). Following a 10-min break, participants cycled for 20 min at 50 % of VO2peak. Blood samples were collected before and after the exercise period for the determination of complete blood counts, natural killer cells (NK(bright), NK(dim)) and circulating progenitor cell (CPC) counts, as well as interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) concentrations.
Complete blood counts and NK(dim) cell and CPC counts were unchanged with exercise. Following exercise, NK(bright) cell counts increased (7.4 ± 4.3 vs. 12.2 ± 8.3 × 10(6) cells/L; p = 0.02), while trends were observed for an increase in IL-6 (2.1 ± 2.2 vs. 2.7 ± 2.6 pg/mL; p = 0.08), decrease in TNF-α (4.5 ± 1.2 vs. 4.2 ± 1.0 pg/mL; p = 0.08) and an increase in the IL-6:TNF-α ratio (0.6 ± 0.7 vs. 0.8 ± 0.8; p = 0.07).
Our findings suggest that acute exercise may create an anti-inflammatory environment in children and adolescents with CKD stages III-V.
患有慢性肾脏病（CKD）的儿童和青少年长期处于高水平炎症状态，使其出现继发性健康并发症的风险增加。规律运动可能是一种减轻炎症的有效疗法。这项初步研究的目的是确定急性运动对CKD患者炎症和免疫细胞计数的影响。
9名CKD III - V期的儿童和青少年（4名男性）进行了分级运动试验以确定峰值摄氧量（VO2peak）。休息10分钟后，参与者以VO2peak的50%进行20分钟的骑行。在运动前后采集血样，以测定全血细胞计数、自然杀伤细胞（NK(bright)、NK(dim)）和循环祖细胞（CPC）计数，以及白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度。
全血细胞计数、NK(dim)细胞和CPC计数在运动后未发生变化。运动后NK(bright)细胞计数增加（7.4±4.3对12.2±8.3×10(6)个细胞/L；p = 0.02），同时观察到IL-6有增加趋势（2.1±2.2对2.7±2.6 pg/mL；p = 0.08），TNF-α有降低趋势（4.5±1.2对4.2±1.0 pg/mL；p = 0.08），以及IL-6:TNF-α比值有增加趋势（0.6±0.7对0.8±0.8；p = 0.07）。
我们的研究结果表明，急性运动可能在CKD III - V期的儿童和青少年中营造一种抗炎环境。
