دانشور پزشکی

دانشور پزشکی

تاثیر یک دوره طولانی مدت تمرینات ورزشی در منزل بر سایتوکاین های اینترلوکین 6 و اینترلوکین 17 و وضعیت بیماری در افراد مبتلا به بیماری ام اس

نوع مقاله : مقاله پژوهشی

نویسندگان
مهدی حمزه شلمزاری 1
مهدیه ملانوری شمسی 1
مریم ابوالحسنی 2
مطهره مختارزاده 1
مژگان رضوانی 1
1 گروه تربیت بدنی و علوم ورزشی، دانشکده علوم انسانی، دانشگاه تربیت مدرس، تهران، ایران
2 پژوهشکده بازتوانی عصبی، دانشگاه علوم پزشکی تهران؛ تهران، ایران
10.22070/daneshmed.2023.17075.1296
چکیده
مقدمه و هدف: بیماری ام اس یک بیماری مرتبط با سیستم عصبی است که با نارسایی در پاسخ های سیستم ایمنی همراه است. فعالیت های ورزشی در فرایند درمان این بیماران مورد توجه بوده است. با توجه به اثرات شاخص های سیستم ایمنی به ویژه سایتوکاین در بیماری ام اس هدف از مطالعه حاضر بررسی تاثیر تمرینات ورزشی  ترکیبی در منزل بر سایتوکاین های اینترلوکین-6 (IL-6) و IL-17 در بیماران مبتلا به مالتیپل اسکلروزیس بود.
مواد و روش ها: 42 بیمار مبتلا به بیماری ام اس به صورت تصادفی به دو گروه آزمون و کنترل تقسیم شدند. آزمودنی های گروه تجربی، در یک دوره برنامه تمرینات ورزشی ترکیبی 6 ماهه در منزل شرکت کردند. قبل و بعد از دوره تمرین شاخص های خونی برای اندازه گیری سایتوکاین ها گرفته شد و وضعیت ناتوانی جسمانی توسعه یافته (EDSS) ارزیابی شد. از نرم افزار آماری SPSS برای تحلیل نتایج استفاده شد و سطح معناداری P<0.05 در نظر گرفته شد.
نتایج: پژوهش حاضر نشان داد که بهبود شاخص EDSS و بهبود در عملکرد راه رفتن مشاهده می شود (P<0.05). همچنین، سطوح سرمی سایتوکاین های التهابی IL-6 و IL-17 به صورت معناداری در گروه تمرین کاهش یافت (P<0.05).
نتیجه‌گیری: تمرینات ورزشی طولانی مدت در منزل با کاهش سایتوکاین های التهابی و بهبود عملکرد بیماران مبتلا به ام اس همراه بود. به نظر می رسد این نوع تمرینات ورزشی می تواند در بهبود احتمالی پاسخ های سیستم ایمنی به ویژه پاسخ های التهابی موثر باشد و به عنوان یک درمان مکمل در نظر گرفته شود.
کلیدواژه‌ها
ام اس
اینترلوکین-6
اینترلوکین-17
وضعیت ناتوانی جسمانی توسعه یافته
فعالیت های ورزشی
موضوعات
  1. Mayr N, Baumgartner C, Zeitlhofer J, Deecke L. The sensitivity of transcranial cortical magnetic stimulation in detecting pyramidal tract lesions in clinically definite multiple sclerosis. Neurology. 1991;41(4):566-.
  2. Bizzoco E, Lolli F, Repice AM, Hakiki B, Falcini M, Barilaro A, et al. Prevalence of neuromyelitis optica spectrum disorder and phenotype distribution. Journal of neurology. 2009;256(11):1891-8.
  3. Ryan M, Piascik P. Providing pharmaceutical care to the multiple sclerosis patient. Journal of the American Pharmaceutical Association (1996). 2002;42(5):753-67.
  4. García-Muñoz C, Cortés-Vega M-D, Heredia-Rizo AM, Martín-Valero R, García-Bernal M-I, Casuso-Holgado MJ. Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020;9(2):590.
  5. Kantarci O, Wingerchuk D. Epidemiology and natural history of multiple sclerosis: new insights. Current opinion in neurology. 2006;19(3):248-54.
  6. Döring A, Pfueller CF, Paul F, Dörr J. Exercise in multiple sclerosis--an integral component of disease management. Epma journal. 2012;3(1):2.
  7. Huntley A, Ernst E. Complementary and alternative therapies for treating multiple sclerosis symptoms: a systematic review. Complementary therapies in medicine. 2000;8(2):97-105.
  8. White L, McCoy S, Castellano V, Gutierrez G, Stevens J, Walter G, et al. Resistance training improves strength and functional capacity in persons with multiple sclerosis. Multiple Sclerosis Journal. 2004;10(6):668-74.
  9. McCabe MP. Mood and self-esteem of persons with multiple sclerosis following an exacerbation. Journal of psychosomatic research. 2005;59(3):161-6.
  10. Li Y. Multiple sclerosis and other demyelinating diseases.  Imaging of CNS Infections and Neuroimmunology: Springer; 2019. p. 155-64.
  11. Zhang J-M, An J. Cytokines, inflammation and pain. International anesthesiology clinics. 2007;45(2):27.
  12. Imitola J, Chitnis T, Khoury SJ. Cytokines in multiple sclerosis: from bench to bedside. Pharmacology & therapeutics. 2005;106(2):163-77.
  13. Hirano T, Kishimoto T. Interleukin-6.  Peptide growth factors and their receptors I: Springer; 1990. p. 633-65.
  14. Rietberg MB, Brooks D, Uitdehaag BM, Kwakkel G. Exercise therapy for multiple sclerosis. Cochrane database of systematic reviews. 2005(1).
  15. Brück W. The pathology of multiple sclerosis is the result of focal inflammatory demyelination with axonal damage. Journal of neurology. 2005;252(5):v3-v9.
  16. Ryba-Stanisławowska M, Skrzypkowska M, Myśliwska J, Myśliwiec M. The serum IL-6 profile and Treg/Th17 peripheral cell populations in patients with type 1 diabetes. Mediators of inflammation. 2013;2013.
  17. Chen Y-C, Yang X, Miao L, Liu Z-G, Li W, Zhao Z-X, et al. Serum level of interleukin-6 in Chinese patients with multiple sclerosis. Journal of neuroimmunology. 2012;249(1-2):109-11.
  18. Stelmasiak Z, Koziol-Montewka M, Dobosz B, Rejdak K, Bartosik-Psujek H, Mitosek-Szewczyk K, et al. Interleukin-6 concentration in serum and cerebrospinal fluid in multiple sclerosis patients. Medical Science Monitor. 2000;6(6):1104-8.
  19. Ferreira TB, Hygino J, Barros PO, Teixeira B, Kasahara TM, Linhares UC, et al. Endogenous interleukin‐6 amplifies interleukin‐17 production and corticoid‐resistance in peripheral T cells from patients with multiple sclerosis. Immunology. 2014;143(4):560-8.
  20. Negaresh R, Motl RW, Mokhtarzade M, Dalgas U, Patel D, Shamsi MM, et al. Effects of exercise training on cytokines and adipokines in multiple sclerosis: a systematic review. Multiple sclerosis and related disorders. 2018;24:91-100.
  21. Luchtman DW, Ellwardt E, Larochelle C, Zipp F. IL-17 and related cytokines involved in the pathology and immunotherapy of multiple sclerosis: current and future developments. Cytokine & growth factor reviews. 2014;25(4):403-13.
  22. Faramarzi M, Banitalebi E, Raisi Z, Samieyan M, Saberi Z, Ghahfarrokhi MM, et al. Effect of combined exercise training on pentraxins and pro-inflammatory cytokines in people with multiple sclerosis as a function of disability status. Cytokine. 2020;134:155196.
  23. Mokhtarzade M, Ranjbar R, Majdinasab N, Patel D, Shamsi MM. Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life. Endocrine. 2017;57(2):262-71.
  24. Majdinasab N, Motl RW, Mokhtarzade M, Zimmer P, Ranjbar R, Keytsman C, et al. Acute responses of cytokines and adipokines to aerobic exercise in relapsing vs. remitting women with multiple sclerosis. Complementary therapies in clinical practice. 2018;31:295-301.
  25. Kjølhede T, Dalgas U, Gade AB, Bjerre M, Stenager E, Petersen T, et al. Acute and chronic cytokine responses to resistance exercise and training in people with multiple sclerosis. Scandinavian journal of medicine & science in sports. 2016;26(7):824-34.
  26. Mokhtarzade M, Ranjbar R, Majdinasab N, Patel D, Molanouri Shamsi M. Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life. Endocrine. 2017;57(2):262-71.
  27. Schulz K-H, Gold SM, Witte J, Bartsch K, Lang UE, Hellweg R, et al. Impact of aerobic training on immune-endocrine parameters, neurotrophic factors, quality of life and coordinative function in multiple sclerosis. Journal of the neurological sciences. 2004;225(1-2):11-8.
  28. Galassetti PR, Iwanaga K, Crisostomo M, Zaldivar FP, Larson J, Pescatello A. Inflammatory cytokine, growth factor and counterregulatory responses to exercise in children with type 1 diabetes and healthy controls. Pediatric diabetes. 2006;7(1):16-24.
  29. White LJ, Castellano V, Mc Coy SC. Cytokine responses to resistance training in people with multiple sclerosis. Journal of sports sciences. 2006;24(8):911-4.
  30. Castellano V, Patel DI, White LJ. Cytokine responses to acute and chronic exercise in multiple sclerosis. Journal of Applied Physiology. 2008;104(6):1697-702.
  31. Bansi J, Bloch W, Gamper U, Kesselring J. Training in MS: influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial. Multiple Sclerosis Journal. 2013;19(5):613-21.
  32. Rezaee S, Kahrizi S, Nabavi SM, Hedayati M. VEGF and TNF-α Responses to Acute and Chronic Aerobic Exercise in the Patients with Multiple Sclerosis. Asian J Sports Med. 2020;11:98312.
  33. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-.
  34. Frost R, Levati S, McClurg D, Brady M, Williams B. What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability, and acceptability of measures. Archives of physical medicine and rehabilitation. 2017;98(6):1241-56. e45.
  35. Snook EM, Motl RW. Effect of exercise training on walking mobility in multiple sclerosis: a meta-analysis. Neurorehabilitation and neural repair. 16-108: (2)23;2009
  36. Marrie R, Goldman M. Validity of performance scales for disability assessment in multiple sclerosis. Multiple Sclerosis Journal. 2007;13(9):1176-82.
  37. White LJ, Castellano V. Exercise and brain health—implications for multiple sclerosis. Sports medicine. 2008;38(2):91-100.
  38. Briken S, Rosenkranz SC, Keminer O, Patra S, Ketels G, Heesen C, et al. Effects of exercise on Irisin, BDNF and IL-6 serum levels in patients with progressive multiple sclerosis. Journal of neuroimmunology. 8-299: 53;2016.
  39. Berkowitz S, Achiron A, Gurevich M, Sonis P, Kalron A. Acute effects of aerobic intensities on the cytokine response in women with mild multiple sclerosis. Multiple sclerosis and related disorders. 2019;31:82-6.
  40. Alvarenga-Filho H, Sacramento PM, Ferreira TB, Hygino J, Abreu JEC, Carvalho SR, et al. Combined exercise training reduces fatigue and modulates the cytokine profile of T-cells from multiple sclerosis patients in response to neuromediators. Journal of neuroimmunology. 9-293: 91; 2016.
  41. Deckx N, Wens I, Nuyts AH, Hens N, De Winter BY, Koppen G, et al. 12 weeks of combined endurance and resistance training reduces innate markers of inflammation in a randomized controlled clinical trial in patients with multiple sclerosis. Mediators of inflammation. 2016;2016.
  42. Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nature reviews immunology. 15-607: (9)11; 2011.
  43. Olson TP, Dengel D, Leon A, Schmitz K. Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. International journal of obesity. 2007;31(6):996-1003.
  44. Beecham AH, Patsopoulos NA, Xifara DK, Davis MF, Kemppinen A, Cotsapas C, et al. Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis. Nature genetics. 2013;45(11):1353.
  45. Steinman L. A brief history of TH17, the first major revision in the TH1/TH2 hypothesis of T cell–mediated tissue damage. Nature medicine. 2007;13(2):139-45.
  46. Harrington LE, Hatton RD, Mangan PR, Turner H, Murphy TL, Murphy KM, et al. Interleukin 17–producing CD4+ effector T cells develop via a lineage distinct from the T helper type 1 and 2 lineages. Nature immunology. 2005;6(11):1123-32.
  47. Korn T, Bettelli E, Oukka M, Kuchroo VK. IL-17 and Th17 Cells. Annual review of immunology. 2009;27:485-517.
  48. Golzari Z, Shabkhiz F, Soudi S, Kordi MR, Hashemi SM. Combined exercise training reduces IFN-γ and IL-17 levels in the plasma and the supernatant of peripheral blood mononuclear cells in women with multiple sclerosis. International immunopharmacology. 2010;10(11):1415-9.
  49. Rahimi A. Eight weeks resistance training reduces interlukin-17 in women with multiple sclerosis. Journal of Physical Activity and Hormones. 2019;2(4):27-38.
  50. Ghorbanian B, Mahmoudpoor A. The effect of Pilates training and massage therapy on plasma serum levels of IL-17 and IFN-β as pro-Inflammatory cytokines in patients with Multiple Sclerosis (MS). Journal of Sport Biosciences. 2020;12(1):79-92.
دانشور پزشکی
دوره 31، شماره 3 - شماره پیاپی 166
مرداد و شهریور 1402
صفحه 81-94