Andersson Sofia E M, Lange Elvira, Kucharski Daniel, Svedlund Sara, Önnheim Karin, Bergquist Maria, Josefsson Elisabet, Lord Janet M, Mårtensson Inga-Lill, Mannerkorpi Kaisa, Gjertsson Inger
1Department of Rheumatology and Inflammation research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30 Göteborg, Sweden.
2University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden.
Immun Ageing. 2020 May 16;17:12. doi: 10.1186/s12979-020-00184-y. eCollection 2020.
Exercise can improve immune health and is beneficial for physical function in patients with rheumatoid arthritis (RA), but the immunological mechanisms are largely unknown. We evaluated the effect of moderate- to high intensity exercise with person-centred guidance on cells of the immune system, with focus on regulatory cell populations, in older adults with RA.
Older adults (≥65 years) with RA were randomized to either 20-weeks of moderate - to high intensity aerobic and resistance exercise ( = 24) or to an active control group performing home-based exercise of light intensity ( = 25). Aerobic capacity, muscle strength, DAS28 and CRP were evaluated. Blood samples were collected at baseline and after 20 weeks. The frequency of immune cells defined as adaptive regulatory populations, CD4 + Foxp3 + CD25 + CD127- T regulatory cells (Tregs) and CD19 + CD24hiCD38hi B regulatory cells (Bregs) as well as HLA-DR-/lowCD33 + CD11b + myeloid derived suppressor cells (MDSCs), were assessed using flow cytometry.
After 20 weeks of moderate- to high intensity exercise, aerobic capacity and muscle strength were significantly improved but there were no significant changes in Disease Activity Score 28 (DAS28) or CRP. The frequency of Tregs and Bregs decreased significantly in the intervention group, but not in the active control group. The exercise intervention had no effect on MDSCs. The reduction in regulatory T cells in the intervention group was most pronounced in the female patients.
Moderate- to high intensity exercise in older adults with RA led to a decreased proportion of Tregs and Bregs, but that was not associated with increased disease activity or increased inflammation.
Improved Ability to Cope With Everyday Life Through a Person-centered Training Program in Elderly Patients With Rheumatoid Arthritis - PEP-walk Study, NCT02397798. Registered at ClinicalTrials.gov March 19, 2015.
运动可改善免疫健康，对类风湿关节炎（RA）患者的身体功能有益，但免疫机制在很大程度上尚不清楚。我们评估了以患者为中心的指导下进行的中高强度运动对老年RA患者免疫系统细胞的影响，重点关注调节性细胞群体。
将老年（≥65岁）RA患者随机分为两组，一组进行20周的中高强度有氧运动和抗阻运动（n = 24），另一组为积极对照组，进行低强度的居家运动（n = 25）。评估有氧运动能力、肌肉力量、疾病活动评分28（DAS28）和C反应蛋白（CRP）。在基线和20周后采集血样。使用流式细胞术评估定义为适应性调节群体的免疫细胞频率，即CD4 + Foxp3 + CD25 + CD127 - T调节性细胞（Tregs）、CD19 + CD24hiCD38hi B调节性细胞（Bregs）以及HLA - DR - /lowCD33 + CD11b + 髓源性抑制细胞（MDSCs）。
经过20周的中高强度运动后，有氧运动能力和肌肉力量显著改善，但疾病活动评分28（DAS28）或CRP无显著变化。干预组中Tregs和Bregs的频率显著降低，但积极对照组未出现此情况。运动干预对MDSCs无影响。干预组中调节性T细胞的减少在女性患者中最为明显。
老年RA患者进行中高强度运动导致Tregs和Bregs比例降低，但这与疾病活动增加或炎症增加无关。
通过以患者为中心的训练计划提高老年类风湿关节炎患者应对日常生活的能力 - PEP - walk研究，NCT02397798。于2015年3月19日在ClinicalTrials.gov注册。
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