Marzougui Houssem, Hammouda Omar, Ben Dhia Imen, Maaloul Rami, Agrebi Ikram, Chaker Hanen, Kammoun Khaoula, Ben Hmida Mohamed, Ayadi Fatma, Kallel Choumous, Driss Tarak, Turki Mouna, Masmoudi Hatem, Hachicha Hend
Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia.
Int Urol Nephrol. 2021 Mar;53(3):553-562. doi: 10.1007/s11255-020-02643-3. Epub 2020 Sep 23.
The present study aimed to investigate the effects of melatonin (MEL) intake on systemic inflammation and immune responses during intradialytic exercise.
Thirteen hemodialysis (HD) patients volunteered to participate in the current randomized-crossover study. Immunological responses were monitored in four HD sessions at different conditions: [Exercise (EX) + MEL], [EX + Placebo (PLA)], [Control (CON) + MEL] and [CON + PLA]. MEL (3 mg) or PLA was ingested 1 h before starting exercise or the equivalent time in CON condition. During all sessions, peripheral blood samples were collected to assess c-reactive protein, complete blood count, and immune cells phenotypes before HD (T0), immediately after exercise (T1) and 1 h after exercise (T2) or at corresponding times in the CON condition.
HD therapy induced a significant decrease in natural killer (NK) (p = 0.001, d = 0.85; p < 0.001, d = 1.19, respectively) and CD8 T-lymphocytes rates (p = 0.001, d = 0.57; p < 0.001, d = 0.75, respectively) at T1 and T2 compared to T0. MEL intake prevented the decrease in NK and CD8 T-lymphocytes, increased the proportion of CD4 T-lymphocytes at T1 and T2 compared to T0 (p = 0.002, d = 1.18; p = 0.001, d = 1.04, respectively) and decreased the proportion of CD14CD16 Monocytes at T2 compared to T0 (p = 0.02, d = 1.57) in peripheral blood during HD therapy. Similar results were found in [EX + MEL] and [EX + PLA] conditions.
This pilot study provides the first evidence that MEL intake alone or associated with intradialytic exercise displays potential immunoregulatory and anti-inflammatory effects. The combination of MEL with intradialytic exercise may be an appropriate anti-inflammatory therapy for HD patients.
本研究旨在探讨透析期间运动时摄入褪黑素（MEL）对全身炎症和免疫反应的影响。
13名血液透析（HD）患者自愿参与当前的随机交叉研究。在四种不同条件的HD治疗过程中监测免疫反应：[运动（EX）+MEL]、[EX+安慰剂（PLA）]、[对照（CON）+MEL]和[CON+PLA]。在开始运动前1小时或在CON条件下的相应时间摄入MEL（3毫克）或PLA。在所有治疗过程中，采集外周血样本，以评估HD治疗前（T0）、运动后立即（T1）、运动后1小时（T2）或CON条件下相应时间的C反应蛋白、全血细胞计数和免疫细胞表型。
与T0相比，HD治疗在T1和T2时导致自然杀伤（NK）细胞率（分别为p = 0.001，d = 0.85；p < 0.001，d = 1.19）和CD8 T淋巴细胞率（分别为p = 0.001，d = 0.57；p < 0.001，d = 0.75）显著降低。摄入MEL可防止NK和CD8 T淋巴细胞减少，与T0相比，在T1和T2时CD4 T淋巴细胞比例增加（分别为p = 0.002，d = 1.18；p = 0.001，d = 1.04），并且在HD治疗期间外周血中，与T0相比，T2时CD14CD16单核细胞比例降低（p = 0.02，d = 1.57）。在[EX+MEL]和[EX+PLA]条件下发现了类似结果。
这项初步研究提供了首个证据，即单独摄入MEL或与透析期间运动联合使用均显示出潜在的免疫调节和抗炎作用。MEL与透析期间运动相结合可能是HD患者合适的抗炎治疗方法。
