AB0074

THE EFFECT OF PHYSICAL EXERCISE IN THE CYTOKINES LEVELS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

A. E. Silva ^1,*E. T. Reis-Neto ¹N. P. Silva ¹E. I. Sato ¹

¹Medicine, Universidade Federal De São Paulo, São Paulo, Brazil

Background: The literature shows that acute exercise increases IL-6 [1,2] and IL-10 [3,4] and TNF-a [5,6] serum levels in healthy subjects and can worse the inflammatory response in patients with diabetes mellitus type I, cystic fibrosis and obstructive pulmonary disease [7]. Some studies showed resting SLE patients have higher levels of IL-6 [8,9] and IL-10 [8,10] compared to healthy controls.  Although being established in the literature that SLE patients have benefits with the aerobic training [11] mainly related to cardiovascular risk factors, there is no study evaluating the effect of acute exercise on the cytokines levels in SLE patients what could cause some concerning about the risk of worsening inflammatory cytokines

Objectives: To assess the levels of IL-10, IL-6 and TNF-a at baseline and after acute exercise in SLE patients

Methods: Thirty female SLE patients (≥4 ACR criteria) with inactive or mild disease activity, and 30 age-and gender-matched healthy controls were included. At baseline and soon after the ergospirometric test 10 ml of peripheral blood were collected for IL-10, IL-6 and TNF-a measurement by ELISA technique (R&D Systems, Inc.-Minneapolis, USA). The disease activity was evaluated by SLEDAI. The Student's t-tests and Mann-Whitney test were used for intra and inter-group comparisons.  P values < 0.05 were considered significant. All participants signed Institutional Ethic Committee approved consent form.

Results: The mean age of patients and controls were comparable (32.58 ± 7.44 y.o vs 30.43 ± 7.76 y.o, p=0,275). The mean disease duration was 105.5 ± 85.55 months and the mean SLEDAI score was 1.96±2.32. SLE patients presented worst ergospirometric parameters compared to controls: VO2máx (ml/kg/min) (25.27± 5.20 vs 32.74±5.85, P<0.001); VO2max (l/min) (1.61± 0.36 vs 1.98±0.36 P<0.001); maximum heart rate (174.75±2.34 vs 185.15±2.07 P=0.002); maximum ventilation (VEmax) (66.33±15.68 vs 80.48±18.98, P=0.001) and maximum speed (Km/h) (7.68± 1.24 vs 9.4±1.22 P<0.001). At baseline SLE patients presented higher levels of IL-6 [2.85±2,68 vs 1.58±1.62 p=0.005] and IL-10 [1.00±2.1 vs -0.44 ±1.20 p=0.002] comparing to controls. The acute exercise did not significantly alter the levels of IL-6, IL-10 and TNF-a in SLE patients. On the other hand, in the control group, the acute exercise increased IL-6 level [1.8±1.62 vs 1.91±1.52; p=0.001] without significant  change on IL-10 and TNF-α levels.

Conclusions: IL-6 and IL-10 levels were higher in SLE patients than in controls. Acute physical exercise increased IL-6 levels in healthy women, but, in SLE patients did not significantly changed the levels of IL-6, IL-10 or TNF-a. We concluded does not appear that acute exercise increase inflammatory cytokines and disease exacerbation in SLE patients with inactive or mild disease activity.

References: 1.Nieman et al. Med. Sci. Sports Exerc., 2005 2. Pedersen. J Exp Biol. 2011. 3.Yakeu et al. Atherosclerosis. 2010. 4. Paalani et al. Ethn Dis 2011. 5. Sandri et al. Eur J Cardiovasc Prev Rehabil. 2011 6. Hallberg et al. J Affect Disord. 2010 7. Ploeger et AL. Exerc Immunol Rev, 2009  8. Avrămescu et al. Rom J Morphol Embryol. 2010. 9. Mellor-Pita  et al. Cytometry B. Clin Cytom. 2009 10. Gigante et al. Eur Rev Med Pharmacol Sci. 2011. 11. Carvalho et al Arthritis Care Res 2005.

Disclosure of Interest: None Declared