Study: Exercise May Decrease Inflammatory Cytokines in Patients With SLE

Serum levels of 4 key cytokines were decreased after 8 weeks of mild exercise, compared with controls.

Patients with systemic lupus erythematosus (SLE) may benefit from supervised aerobic and anaerobic exercise routines, according to a new report that found 8 weeks of exercise led to a decrease in certain inflammatory cytokines.

SLE is a chronic autoimmune disease that usually affects multiple organs, although it presents very differently from one patient to the next.

Corresponding author Mohammad Hossein Karimi, PhD, of the Shiraz University of Medical Sciences in Iran, and colleagues wrote that emerging evidence is giving scientists a better understanding of some of the factors at play in the pathogenesis of SLE. Among those factors are immune response dysregulation and cytokines such as type I interferons (IFN).

“Importantly, it is well-documented that the imbalance in the production of inflammatory cytokines such as IL-6, tumor necrosis factor-α (TNF-α), interleukin (IL)-1, type I and type II interferons and IL-10 contributes to immune dysfunction and also mediates inflammation of the tissues and organ damage,” they wrote.

The increasing evidence regarding cytokines and SLE caused Karimi and colleagues to wonder if exercise might be one potential way to counteract SLE. They noted that exercise has been shown to boost the immune system and decrease inflammatory factor levels, among other benefits.

The investigators decided to see what impact, if any, an 8-week course of exercise might have on people with SLE. Their findings were published in the journal Transplant Immunology.

Karimi and colleagues enrolled a cohort of 24 patients with SLE, and randomly assigned them into one of 2 groups, an exercise group (14 patients) and a control group (10 patients). The exercise group had an average age of 29 years, and the control group had an average age of 21.5 years.

The exercise group was asked to complete 60-minute exercise sessions 3 times per week for 8 weeks. The first week’s exercise regimen was less rigorous to allow for acclimation. The exercise regimens included a warm-up, cycling or running on a treadmill for 10 minutes, and then a Pilates training session.

Cytokine levels were collected at baseline and 24 hours following the last exercise session. Karimi and colleagues found that mean serum levels for a number of cytokines (IFN-γ, IL-6, IL- 9, IL-17A, IL-17F and IL-21) were not significantly different between the 2 groups. However, mean serum levels of TNF-α, IL2, IL-4, and IL-5 had decreased significantly in the intervention group compared with the control group. In addition, mean levels of IL-10, IL-13 and IL-22 had significantly increased in the control group, but not in the exercise group.

Karimi and colleagues noted that while SLE cannot be cured, lifestyle changes have been shown to have a meaningful impact. In the case of diseases like diabetes and cystic fibrosis, high-intensity exercise can worsen a patient’s inflammatory response.

“On the other hand, regular practice of moderate intensity exercise was demonstrated to improve the responsiveness of the immune system, leading to increased resistance against infections,” Karimi and colleagues said.

The investigators explained their study demonstrates that exercise can affect the immune systems of patients with SLE, potentially opening up therapeutic opportunities. However, they also noted some limitations, such as issues with patient compliance and the small sample size.

Reference:

Hashemi S, Habibagahi Z, Heidari M, Abdollahpour-Alitappeh M, and Karimi MH. Effects of combined aerobic and anaerobic exercise training on cytokine profiles in patients with systemic lupus erythematosus (SLE); a randomized controlled trial. Transpl Immunol. Published online December 16, 2021. doi:10.1016/j.trim.2021.101516