运动对膝关节骨性关节炎患者炎症标志物和脑源性神经营养因子的影响。荟萃分析的系统综述。

IF 3.5 4区 医学 Q2 IMMUNOLOGY Exercise Immunology Review Pub Date : 2023-01-01
Sofie Puts, Keliane Liberman, Laurence Leysen, Louis Forti, Eveline Muyldermans, Peter Vaes, Jo Nijs, David Beckwée, Ivan Bautmans
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引用次数: 0

摘要

背景:在膝关节骨关节炎(KOA)的发病过程中,炎症介质起着重要作用。然而,常规运动疗法(ET)对KOA患者免疫系统影响的确切潜在机制尚不清楚。目的:本系统综述的目的是研究ET对KOA患者炎症生物标志物和脑源性神经营养因子(BDNF)的基础和急性影响。方法:系统检索PubMed、Web Of Science和PEDro,寻找合适的研究。如果可能,进行荟萃分析或计算效应大小(ES)的近似值。偏倚风险评分采用Cochrane rob2.0或robins工具。结果:纳入21项研究,共1374名受试者。15篇文章关注基础运动效果,4篇关注急性效果,2篇关注两者。在滑液(n=4)或血清/血浆(n=17)中进行生物标志物分析(n=18)。一项荟萃分析显示,在ET后6-18周,KOA患者的基础CRP降低(MD: -0.17;95%CI[-0.31;-0.03]),而IL-6 (MD: 0.21;95%CI[-0.44;0.85])和TNF-α (MD: -0.57;95%CI[-1.47;0.32])水平无显著变化。此外,sTNFR1/2在ET后没有显著变化。对于其他生物标志物,没有足够的数据来进行荟萃分析。然而,IL-6降低(ES:-0.596 & -0.259 & -0.513), sTNFR1升高(ES:2.325), sTNFR2降低(ES:-0.997), BDNF升高(ES:1.412)的证据程度较低。局部,ET后关节内IL-10 (ES:9.163)升高,il -1 β (ES:-6.199)和TNF-α降低(ES:-2.322)。急性运动引起肌因子反应(ES - il:0.314), BDNF增加(无ES-数据)。无炎症作用(ES CRP:0.052;急性训练后ES TNF-α:-0.019 & 0.081)。然而,单次运动引起关节内IL-10的降低(无es数据)。结论:ET可诱导KOA患者的循环和关节内抗炎作用。抗炎特性对告知这些患者和临床医生ET的潜在作用具有重要意义。
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Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis.

Background: In the pathogenesis of knee osteoarthritis (KOA), inflammatory mediators play an important role. However, the precise underlying mechanism by which regular exercise therapy (ET) exert effects on the immune system in KOA patients is unknown.

Objectives: The aim of this systematic review was to investigate the basal and acute effects of ET on inflammatory biomarkers and brain derived neurotrophic factor (BDNF) in KOA patients.

Methods: PubMed, Web Of Science and PEDro were systematically searched for appropriate studies. If possible, a meta-analysis was performed or an approximation of the effect size (ES) was calculated. Risk of bias was scored using the Cochrane ROB 2.0 or ROBINS-tools.

Results: Twenty-one studies involving 1374 participants were included. Fifteen articles focused on basal exercise effects, four on acute effects, and two on both. Biomarker analysis (n=18) was performed in synovial fluid (n=4) or serum/plasma (n=17). A meta-analysis demonstrated that basal CRP was reduced in KOA patients 6-18 weeks weeks after ET (MD: -0.17;95%CI[-0.31;-0.03]), while IL-6 (MD: 0.21;95%CI[-0.44;0.85]), and TNF-α (MD: -0.57;95%CI[-1.47;0.32]), levels did not significantly change. Also, sTNFR1/2 did not change significantly after ET. For other biomarkers, insufficient data were available to perform a meta-analysis. Nevertheless, a low degree of evidence was found for a decrease in IL-6 (ES:-0.596 & -0.259 & -0.513), an increase in sTNFR1 (ES:2.325), a decrease in sTNFR2 (ES:-0.997) and an increase in BDNF (ES:1.412). Locally, intra-articular IL-10 (ES:9.163) increased, and IL1β (ES:-6.199) and TNF-α decreased (ES:-2.322) after ET. An acute exercise session elicited a myokine response (ES IL-6:0.314), and an increase in BDNF (no ES-data). No inflammatory effect (ES CRP:0.052; ES TNF-α:-0.019 & 0.081) following an acute bout of training was found. However, a single bout of exercise elicited a decrease in intra-articular IL-10 (no ES-data).

Conclusion: ET can induce circulatory and intra-articular anti-inflammatory effects in patients with KOA. The antiinflammatory properties have important implications for informing these patients and clinicians about the underlying effects of ET.

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来源期刊
Exercise Immunology Review
Exercise Immunology Review 医学-免疫学
CiteScore
16.00
自引率
0.00%
发文量
7
期刊介绍: Exercise Immunology Review (EIR) serves as the official publication of the International Society of Exercise and Immunology and the German Society of Sports Medicine and Prevention. It is dedicated to advancing knowledge in all areas of immunology relevant to acute exercise and regular physical activity. EIR publishes review articles and papers containing new, original data along with extensive review-like discussions. Recognizing the diverse disciplines contributing to the understanding of immune function, the journal adopts an interdisciplinary approach, facilitating the dissemination of research findings from fields such as exercise sciences, medicine, immunology, physiology, behavioral science, endocrinology, pharmacology, and psychology.
期刊最新文献
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