Siciliano Gabriele, Chico Lucia, Lo Gerfo Annalisa, Simoncini Costanza, Schirinzi Erika, Ricci Giulia
Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy.
Front Physiol. 2020 May 20;11:451. doi: 10.3389/fphys.2020.00451. eCollection 2020.
Neuromuscular diseases (NMDs) are a group of often severely disabling disorders characterized by dysfunction in one of the main constituents of the motor unit, the cardinal anatomic-functional structure behind force and movement production. Irrespective of the different pathogenic mechanisms specifically underlying these disease conditions genetically determined or acquired, and the related molecular pathways involved in doing that, oxidative stress has often been shown to play a relevant role within the chain of events that induce or at least modulate the clinical manifestations of these disorders. Due to such a putative relevance of the imbalance of redox status occurring in contractile machinery and/or its neural drive in NMDs, physical exercise appears as one of the most important conditions able to positively interfere along an ideal axis, going from a deranged metabolic cell homeostasis in motor unit components to the reduced motor performance profile exhibited by the patient in everyday life. If so, it comes out that it would be important to identify a proper training program, suitable for load and type of exercise that is able to improve motor performance in adaptation and response to such a homeostatic imbalance. This review therefore analyzes the role of different exercise trainings on oxidative stress mechanisms, both in healthy and in NMDs, also including preclinical studies, to elucidate at which extent these can be useful to counteract muscle impairment associated to the disease, with the final aim of improving physical functions and quality of life of NMD patients.
神经肌肉疾病(NMDs)是一组常常导致严重残疾的疾病,其特征是运动单位的主要组成部分之一出现功能障碍,而运动单位是产生力量和运动的基本解剖功能结构。无论这些疾病状况是由遗传决定还是后天获得的不同致病机制,以及与之相关的分子途径如何,氧化应激在引发或至少调节这些疾病临床表现的一系列事件中常常被证明发挥着相关作用。由于收缩机制和/或其神经驱动中发生的氧化还原状态失衡在神经肌肉疾病中具有这种假定的相关性,体育锻炼似乎是能够沿着理想轴线产生积极干预的最重要条件之一,这条轴线从运动单位成分紊乱的代谢细胞稳态延伸到患者在日常生活中表现出的运动能力下降。如果是这样,那么确定一个适合负荷和运动类型的适当训练计划就很重要,该计划能够在适应和应对这种稳态失衡的过程中提高运动能力。因此,本综述分析了不同运动训练对健康人和神经肌肉疾病患者氧化应激机制的作用,还包括临床前研究,以阐明这些训练在多大程度上有助于抵消与疾病相关的肌肉损伤,最终目的是改善神经肌肉疾病患者的身体功能和生活质量。