Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), 06071, Badajoz, Spain.
Environ Sci Pollut Res Int. 2022 Feb;29(6):8054-8073. doi: 10.1007/s11356-021-17780-0. Epub 2021 Nov 29.
Balneotherapy (BT) is one of the most commonly used non-pharmacologic complementary therapies for different rheumatic diseases. Its beneficial properties probably derived from a combination of mechanical, thermal, and chemical effects, but the exact mechanism of action is not elucidated. This review aimed at summarizing the current knowledge about the effects of BT, and identifying its possible mechanism of action in different rheumatic diseases. Pubmed and Scopus were used to perform a search of the literature to extract articles including terms related to BT and rheumatic diseases published in the period from 2010 to 2021. We selected pre-clinical studies, randomized controlled trials, and clinical trials. The results of clinical studies confirmed the beneficial properties on different mediators and factors of inflammation, oxidative stress, cartilage metabolism, and humoral and cellular immune responses in patients affected by chronic degenerative musculoskeletal disorders. The data derived from OA and RA-induced murine models revealed the efficacy of different BT treatments in decreasing pain, inflammation, and improving mobility, as well as in reducing the expression of matrix-degrading enzymes and markers of oxidative stress damage. Different in vitro studies analyzed the potential effect of a mineral water, as a whole, or of a mineral element, demonstrating their anti-inflammatory, antioxidant, and chondroprotective properties in OA cartilage, synoviocytes and chondrocytes, and osteoblast and osteoclast cultures. The presented data are promising and confirm BT as an effective complementary approach in the management of several low-grade inflammation, degenerative, and stress-related pathologies, as rheumatic diseases.
水疗法（BT）是治疗各种风湿性疾病最常用的非药物补充疗法之一。其有益的特性可能源于机械、热和化学效应的结合，但确切的作用机制尚不清楚。本综述旨在总结 BT 的现有知识，并确定其在不同风湿性疾病中的可能作用机制。使用 Pubmed 和 Scopus 对文献进行了检索，以提取 2010 年至 2021 年期间发表的与 BT 和风湿性疾病相关的文章。我们选择了临床前研究、随机对照试验和临床试验。临床研究的结果证实了 BT 对慢性退行性肌肉骨骼疾病患者的不同炎症介质和因子、氧化应激、软骨代谢以及体液和细胞免疫反应具有有益的作用。从 OA 和 RA 诱导的小鼠模型中获得的数据表明，不同 BT 治疗在减轻疼痛、炎症和改善活动能力，以及降低基质降解酶和氧化应激损伤标志物的表达方面具有疗效。不同的体外研究分析了矿泉水整体或矿物质元素的潜在作用，证明了它们在 OA 软骨、滑膜细胞和软骨细胞以及成骨细胞和破骨细胞培养物中的抗炎、抗氧化和软骨保护特性。所呈现的数据很有前景，证实 BT 作为一种有效的补充方法，可用于治疗几种低水平炎症、退行性和应激相关的病理疾病，如风湿性疾病。
