Martin Sarah-Jane, Schneider Raphael
BARLO MS Center, St. Michael's Hospital, Toronto, ON, Canada.
Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.
Front Neurol. 2023 Oct 10;14:1190208. doi: 10.3389/fneur.2023.1190208. eCollection 2023.
Research suggests that physical exercise can promote an anti-inflammatory and neuroprotective state. If so, increasing or optimizing exercise could be considered a 'disease-modifying intervention' in neuroinflammatory diseases, such as multiple sclerosis (MS). Exercise intervention studies conducted in animal models of MS are promising. Various aerobic and strength training regimes have been shown to delay disease onset and to reduce both the clinical and pathological disease severity in mice. However, fundamental differences between the physiology of animals and humans, the disease states studied, and the timing of exercise intervention are significant. In animal models of MS, most exercise interventions begin before disease initiation and before any clinical sign of disease. In contrast, studies in humans recruit participants on average nearly a decade after diagnosis and often once disability is established. If, as is thought to be the case for disease-modifying treatments, the immunomodulatory effect of exercise decreases with advancing disease duration, current studies may therefore fail to detect the true disease-modifying potential. Clinical studies in early disease cohorts are needed to determine the role of exercise as a disease-modifying intervention for people with MS.
研究表明，体育锻炼可促进抗炎和神经保护状态。如果是这样，增加或优化锻炼可被视为对多发性硬化症（MS）等神经炎症性疾病的一种“疾病改善干预措施”。在MS动物模型中进行的运动干预研究很有前景。各种有氧和力量训练方案已被证明可延缓疾病发作，并减轻小鼠的临床和病理疾病严重程度。然而，动物与人类生理学、所研究的疾病状态以及运动干预时机之间存在显著的根本差异。在MS动物模型中，大多数运动干预在疾病开始前以及任何疾病临床症状出现之前就开始了。相比之下，人类研究平均在诊断后近十年招募参与者，而且通常是在残疾已经确定之后。如果像疾病改善治疗那样，运动的免疫调节作用会随着疾病持续时间的延长而降低，那么目前的研究可能因此无法检测到运动真正的疾病改善潜力。需要对早期疾病队列进行临床研究，以确定运动作为MS患者疾病改善干预措施的作用。
