Azzolini Federica, Dolcetti Ettore, Bruno Antonio, Rovella Valentina, Centonze Diego, Buttari Fabio
Unit of Neurology, IRCCS Neuromed, Pozzilli, Italy.
Department of System Medicine, University of Tor Vergata, Rome, Italy.
Neural Regen Res. 2024 Aug 1;19(8):1768-1771. doi: 10.4103/1673-5374.389359. Epub 2023 Nov 8.
In multiple sclerosis, only immunomodulatory and immunosuppressive drugs are recognized as disease-modifying therapies. However, in recent years, several data from pre-clinical and clinical studies suggested a possible role of physical exercise as disease-modifying therapy in multiple sclerosis. Current evidence is sparse and often conflicting, and the mechanisms underlying the neuroprotective and antinflammatory role of exercise in multiple sclerosis have not been fully elucidated. Data, mainly derived from pre-clinical studies, suggest that exercise could enhance long-term potentiation and thus neuroplasticity, could reduce neuroinflammation and synaptopathy, and dampen astrogliosis and microgliosis. In humans, most trials focused on direct clinical and MRI outcomes, as investigating synaptic, neuroinflammatory, and pathological changes is not straightforward compared to animal models. The present review analyzed current evidence and limitations in research concerning the potential disease-modifying therapy effects of exercise in multiple sclerosis in animal models and human studies.
在多发性硬化症中，只有免疫调节和免疫抑制药物被认为是疾病修正疗法。然而，近年来，来自临床前和临床研究的一些数据表明，体育锻炼可能作为多发性硬化症的疾病修正疗法发挥作用。目前的证据稀少且常常相互矛盾，运动在多发性硬化症中发挥神经保护和抗炎作用的潜在机制尚未完全阐明。主要来自临床前研究的数据表明，运动可以增强长时程增强效应，从而促进神经可塑性，可以减轻神经炎症和突触病变，并抑制星形胶质细胞增生和小胶质细胞增生。在人类中，大多数试验集中在直接的临床和磁共振成像结果上，因为与动物模型相比，研究突触、神经炎症和病理变化并非易事。本综述分析了动物模型和人体研究中关于运动对多发性硬化症潜在疾病修正治疗效果的现有证据和研究局限性。
