Department of Rheumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Department of General Practice, University of Helsinki, Helsinki, Finland.
Rheumatol Int. 2017 Sep;37(9):1481-1487. doi: 10.1007/s00296-017-3771-9. Epub 2017 Jul 11.
Patients with rheumatoid arthritis (RA) have increased oxidative stress, decreased antioxidant levels, and impaired antioxidant capacity. Cold treatments are used to relieve joint inflammation and pain. Therefore, we measured the effect of cold treatments on the antioxidative capacity of RA patients with active disease. Sixty patients were randomized to (1) whole body cryotherapy at -110 °C, (2) whole body cryotherapy at -60 °C, or (3) local cryotherapy. Each treatment was given three times daily for 7 consecutive days in addition to the conventional rehabilitation. Blinded rheumatologist evaluated disease activity before the first and after the last cryotherapy. We collected plasma samples daily immediately before the first and after the second cryotherapy and measured total peroxyl radical trapping antioxidant capacity of plasma (TRAP), which reflects global combined antioxidant capacity of all individual antioxidants in plasma. Baseline morning TRAP levels (mean, 95% CI), adjusted for age, body mass index, disease activity, and dose of prednisolone, were 1244 (1098-1391) µM/l in the local cryotherapy, 1133 (1022-1245) µM/l in the cryotherapy at -60 °C, and 989 (895-1082) µM/l in the cryotherapy at -110 °C groups (p = 0.006). After the first treatment, there was a rise in 1-h TRAP of 14.2 (-4.2 to 32.6) µM/l, 16.1 (-7.4 to 39.6) µM/l, and 23.6 (4.1-43.2) µM/l, respectively. The increase was significant in the whole-body cryotherapy -110 °C group (p < 0.001) but not significant between the groups (p = 0.78). When analyzed for the whole week, the daily morning TRAP values differed significantly between the treatment groups (p = 0.021), but there was no significant change within each treatment group. Whole-body cryotherapy at -110 °C induced a short-term increase in TRAP during the first treatment session with but not during other treatment modalities. The effect was short and the cold treatments did not cause a significant oxidative stress or adaptation during 1 week.
类风湿关节炎（RA）患者存在氧化应激增加、抗氧化水平降低和抗氧化能力受损。冷疗用于缓解关节炎症和疼痛。因此，我们测量了冷疗对活动期 RA 患者抗氧化能力的影响。60 名患者随机分为（1）全身冷冻治疗-110°C，（2）全身冷冻治疗-60°C，或（3）局部冷冻治疗。在常规康复治疗的基础上，每日三次，连续 7 天。盲法风湿病学家在第一次和最后一次冷冻治疗前评估疾病活动度。我们每天在第一次和第二次冷冻治疗前立即采集血浆样本，并测量血浆总过氧自由基捕获抗氧化能力（TRAP），反映血浆中所有单个抗氧化剂的综合抗氧化能力。局部冷冻治疗组、-60°C 冷冻治疗组和-110°C 冷冻治疗组的基线晨 TRAP 水平（平均值，95%CI），经年龄、体重指数、疾病活动度和泼尼松剂量校正后，分别为 1244（1098-1391）µM/L、1133（1022-1245）µM/L 和 989（895-1082）µM/L（p=0.006）。第一次治疗后，1 小时 TRAP 分别升高 14.2（-4.2 至 32.6）µM/L、16.1（-7.4 至 39.6）µM/L 和 23.6（4.1-43.2）µM/L。-110°C 全身冷冻治疗组的增加有显著意义（p<0.001），但组间差异无显著意义（p=0.78）。当分析整个星期时，治疗组之间的每日晨 TRAP 值差异有显著意义（p=0.021），但每个治疗组内无显著变化。-110°C 全身冷冻治疗在第一次治疗期间诱导了 TRAP 的短期增加，但在其他治疗方式期间没有增加。这种作用是短暂的，在 1 周内冷疗没有引起明显的氧化应激或适应。
