Restricted accessResearch articleFirst published online 2018-6
Increased flexibility,pain reduction and unaltered levels of IL-10 and CD11b + lymphocytes in patients with systemic lupus erythematosus were associated with kinesiotherapy
The effect of physical activity on the immune system is still poorly understood in cases of systemic lupus erythematosus (SLE). Therefore, our aim was to investigate differences in the serum levels of cytokines (IL-2, IL-5, IL-6, IL-8, IL-10 and TNF-α) and the numbers of CD11b + and CXCR2 + neutrophils and lymphocytes in women with SLE undergoing drug treatment, without (n = 9) or with (n = 5) 4 months of kinesiotherapy. Parameters related to functional capacity were also analyzed. In the case of the patients who were not submitted to kinesiotherapy, there were reductions in the levels of IL-5, IL-6 and IL-10, and an increase in the number of CD11b + leukocytes, in addition to an increase in abdominal circumference after the monitoring time. Patients submitted to kinesiotherapy did not present changes in serum cytokines or in the numbers of CD11b + and CXCR2 + neutrophils and lymphocytes, but there were increases of flexibility and strength, as well as a reduction in pain sensation after the monitoring time. In conclusion, kinesiotherapy was able to increase flexibility and reduce pain in SLE patients without influencing immune parameters.
LiuZDavidsonA. Taming lupus - a new understanding of pathogenesis is leading to clinical advances. Nat Med2012; 18: 871–882.
2.
Fors NievesCEIzmirlyPM. Mortality in systemic lupus erythematosus: An updated review. Curr Rheumatol Rep2016; 18: 21.
3.
StypińskaBParadowska-GoryckaA. Cytokines and microRNAs as candidate biomarkers for systemic lupus erythematosus. Int J Mol Sci2015; 16: 24194–24218.
4.
WuSAYehKWLeeWIYaoTCKuoMLHuangBet al.Impaired phagocytosis and susceptibility to infection in pediatric-onset systemic lupus erythematosus. Lupus2013; 22: 279–288.
5.
MajaiGKissETarrTZahuczkyGHartmanZSzegediGet al.Decreased apoptophagocytic gene expression in the macrophages of systemic lupus erythematosus patients. Lupus2014; 23: 133–145.
6.
PerandiniLASales-de-OliveiraDAlmeidaDCAzevedoHMoreira-FilhoCACenedezeMAet al.Effects of acute aerobic exercise on leukocyte inflammatory gene expression in systemic lupus erythematosus. Exerc Immunol Rev2016; 22: 64–81.
7.
PradoDMBenattiFBde Sá-PintoALHayashiAPGualanoBPereiraRMet al.Exercise training in childhood-onset systemic lupus erythematosus: a controlled randomized trial. Arthritis Res Ther2013; 15: R46.
8.
PerandiniLASales-de-OliveiraDMelloSCamaraNOBenattiFBLimaFRet al.Inflammatory cytokine kinetics to single bouts of acute moderate and intense aerobic exercise in women with active and inactive systemic lupus erythematosus. Exerc Immunol Rev2015; 21: 174–185.
9.
PerandiniLASales-de-OliveiraDMelloSBCamaraNOBenattiFBLimaFRet al.Exercise training can attenuate the inflammatory milieu in women with systemic lupus erythematosus. J Appl Physiol (1985)2014; 117: 639–647.
Rodríguez HuertaMDTrujillo-MartínMMRúa-FigueroaÍCuellar-PompaLQuirós-LópezRSerrano-AguilarPet al.Healthy lifestyle habits for patients with systemic lupus erythematosus: A systemic review. Semin Arthritis Rheum2016; 45: 463–470.
12.
BoströmCElfvingBDupréBOpavaCHLundbergIEJanssonE. Effects of a one-year physical activity programme for women with systemic lupus erythematosus - a randomized controlled study. Lupus2016; 25: 602–616.
13.
BorbaEFLatorreLCBrenolJCTKayserCSilvaNAZimmermannAFet al.Consenso de lúpus eritematoso sistêmico. Rev Bras Reumatol2009; 48: 196–207.
14.
BalogunJAkomolafeCTAmusaLO. Grip strength: Effects of testing posture and elbow position. Arch Phys Med Rehabil1991; 72: 280–283.
15.
Gonzalez-SuarezCBCaralipioNGambitoEReyesJJEspinoRVMacatangayR. The association of physical fitness with body mass index and waist circumference in Filipino preadolescents. Asia Pac J Public Health2012; 25: 74–83.
16.
MantovaniLMTeixeiraALSalgadoJV. Functional capacity: A new framework for the assessment of everyday functioning in schizophrenia. Rev Bras Psiquiatr2015; 37: 249–255.
17.
CiconelliRMFerrazMBSantosWMeinãoIQuaresmaMR. Tradução para a língua portuguesa do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol1999; 39: 143–150.
18.
TinettiME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriat Soc1986; 34: 119–126.
19.
KöpkeSMeyerG. The Tinetti test: Babylon in geriatric assessment. Z Gerontol Geriatr2006; 39: 288–291.
20.
BarbosaMMFilgueiraVLSSantanaLA. Comparative study between universal goniometer and Sanny fleximeter in passive flexion measurement of elbow joint. Fisioter Bras2009; 10: 171–175.
21.
SignoriLUVoloskiFRSKerkhoffACBrignoniLPlentzRDM. Effect of thermal agents previously applied to a program of prolongations in the flexibility of the shortened isquiotibial muscles. Rev Bras Med Esporte2008; 14: 328–331.
22.
AlexandersonHDastmalchiMRnssonon-LiljedahlMEOpavaCHLundbergIE. Benefits of intensive resistance training in patients with chronic polymyositis or dermatomyositis. Arthritis Rheum2007; 57: 768–777.
23.
EnokaRM. Strength training for exercise performance and rehabilitation. Scand J Med Sci Sports2007; 17: 1.
24.
American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc2009; 41: 687–708.
25.
GarberCEBlissmerBDeschenesMRFranklinBALamonteMJLeeIMet al.American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc2011; 43: 1334–1359.
26.
BorbaEFLatorreLCBrenolJCTKayserCSilvaNAZimmermannAFet al.Consenso de lúpus eritematoso sistêmico. Rev Bras Reumatol2009; 48: 196–207.
27.
TimóteoRPMicheliDCTeodoroRBFreireMBertoncelloDCandido MurtaEFTavares-MurtaBM. Characterization of inflammatory markers associated with systemic lupus erythematosus patients undergoing treatment. Rev Bras Reumatol Engl Ed2016; 56: 497–503.
28.
ChenSJHuangSHChenJWWangKCYangYRLiuPFet al.Melatonin enhances interleukin-10 expression and suppresses chemotaxis to inhibit inflammation in situ and reduce the severity of experimental autoimmune encephalomyelitis. Int Immunopharmacol2016; 31: 169–177.
29.
IpWKEHoshiNShouvalDSSnapperSMedzhitovR. Anti-inflammatory effect of IL-10 mediated by metabolic reprogramming of macrophages. Science2017; 356: 513–519.
30.
ClarkDNMarkhamJLSloanCSPooleBD. Cytokine inhibition as a strategy for treating systemic lupus erythematosus. Clin Immunol2013; 148: 335–343.
31.
TehPPVasanthakumarAKalliesA. Development and function of effector regulatory T cells. Prog Mol Biol Transl Sci2015; 136: 155–174.
32.
KrukowskiKEijkelkampNLaumetGHackCELiYDoughertyPMet al.CD8 + T cells and endogenous IL-10 are required for resolution of chemotherapy-induced neuropathic pain. J Neurosci2016; 36: 11074–11083.
33.
ZychowskaMRojewskaEMakuchWLuvisettoSPavoneFMarinelliSet al.Participation of pro- and anti-nociceptive interleukins in botulinum toxin A-induced analgesia in a rat model of neuropathic pain. Eur J Pharmacol2016; 791: 377–388.
34.
AzizzadehFMahmoodiJSadigh-EteghadSFarajdokhtFMohaddesG. Ghrelin exerts analgesic effects through modulation of IL-10 and TGF-β levels in a rat model of inflammatory pain. Iran Biomed J2016; 21: 114–117.
35.
GalboHKallL. Circadian variations in clinical symptoms and concentrations of inflammatory cytokines, melatonin, and cortisol in polymyalgia rheumatica before and during prednisolone treatment: a controlled, observational, clinical experimental study. Arthritis Res Ther2016; 18: 174.
WallaceDJSilvermanSLConklinJBarkenDDervieuxT. Systemic lupus erythematosus and primary fibromyalgia can be distinguished by testing for cell-bound complement activation products. Lupus Sci Med2016; 3: e000127.
38.
ÖzelFArgonG. The effects of fatigue and pain on daily life activities in systemic lupus erythematosus. Agri2015; 27: 181–199.
39.
FischinJChehabGRichterJGFischer-BetzRWinkler-RohlfingBWillersRet al.Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: A cross-sectional study of the LuLa-cohort. Lupus Sci Med2015; 2: e000113.
40.
AndrewsJSTrupinLHoughCLDaikhDIYelinEHKatzPP. Serum biomarkers of inflammation and muscle strength among women with systemic lupus erythematosus. Cytokine2016; 90: 109–112.
41.
Motahari-TabariNShirvaniMAAlipourA. Comparison of the effect of stretching exercises and mefenamic acid on the reduction of pain and menstruation characteristics in primary dysmenorrhea: a randomized clinical trial. Oman Med J2017; 32: 47–53.
42.
FaridiMHKhanSQZhaoWLeeHWAltintasMMZhangKet al.CD11b activation suppresses TLR-dependent inflammation and autoimmunity in systemic lupus erythematosus. J Clin Invest2017; 3(127): 1271–1283.
RhodesBFurnrohrBGRobertsALet al.The rs1143679 (R77H) lupus associated variant of ITGAM (CD11b) impairs complement receptor 3 mediated functions in human monocytes. Ann Rheum Dis2012; 71: 2028–2034.
45.
MacPhersonMLekHSPrescottAFagerholmSC. A systemic lupus erythematosus-associated R77H substitution in the CD11b chain of the Mac-1 integrin compromises leukocyte adhesion and phagocytosis. J Biol Chem2011; 286: 17303–17310.
46.
FagerholmSCMacPhersonMJamesMJSevier-GuyCLauCS. The CD11b-integrin (ITGAM) and systemic lupus erythematosus. Lupus2013; 22: 657–663.
47.
ZouJRedmondAKQiZDooleyHSecombesCJ. The CXC chemokine receptors of fish: Insights into CXCR evolution in the vertebrates. Gen Comp Endocrinol2015; 1: 117–131.
48.
HeidemannJOgawaHDwinellMBRafieePMaaserCGockelHRet al.Angiogenic effects of interleukin 8 (CXCL8) in human intestinal microvascular endothelial cells are mediated by CXCR2. J Biol Chem2003; 278: 8508–8515.
49.
PoolAJWhippBJSkasickAJAlaviABlandJMAxfordJS. Serum cortisol reduction and abnormal prolactin and CD4+/CD8 + T-cell response as a result of controlled exercise in patients with rheumatoid arthritis and systemic lupus erythematosus despite unaltered muscle energetics. Rheumatology (Oxford)2004; 43: 43–48.
50.
TimóteoRPMarquesLSBertoncelloD. Physiotherapy intervention promotes better quality of life for individuals with pemphigus. Rev Soc Bras Med Trop2010; 43: 580–583.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
