MULTİPL SKLEROZ'DA EGZERSİZİN NÖROİMMÜNOLOJİK ETKİLERİ

Year 2016, Volume: 1 Issue: 1, 32 - 48, 01.07.2016

İlke Keser , Rana Karabudak

Abstract

Egzersiz ve bağışıklık sistemi ilişkisini inceleyen çalışmalardan ulaşılabilen kanıtlar, egzersizin immün fonksiyonlar üzerinde önemli modülatuar etkilere sahip olduğunu göstermiştir. Egzersiz ile immünolojik etkilenmenin çok çeşitli faktörler tarafından yönetildiği bilinmektedir. Egzersizin hücresel immün sistem üzerindeki hem akut hem de kronik etkileri ile ayrı ayrı çalışılmıştır. Literatürde egzersizin immün sistem üzerindeki etkileriyle ilgili elde edilen sonuçların genellikle çelişkili olduğu gözlemlenmiştir. Bu değişikliklerin nedeninin uygulanan egzersiz eğitim programlarının yoğunluk, frekans ve durasyonundaki farklılıklara; çalışılan hastalık populasyonlarındaki heterojen dağılıma ve tercih edilen analiz yöntemlerindeki değişikliklere bağlı olduğu düşünülmüştür. Bu çelişkilerin giderilmesi için egzersiz ve bağışıklık sistemi ilişkisini inceleyen çalışmalara ihtiyaç vardır. Ayrıca, her bir hastalık durumu için uygulanacak egzersiz programının şiddet, yoğunluk, durasyon, frekans gibi parametrelerinin inflamatuar cevapları şiddetlendirmeden fayda sağlandığı koşullarının netleştirilmesi gerekmektedir. Bu değerlendirmede, egzersiz ve immün sistem ilişkisi ile yapılan çalışmalarda ortaya çıkan veri0,ler gözden geçirilmektedir.

Anahtar Kelimeler: Lenfosit, doğal öldürücü hücreler, nötrofil, lökosit, sitokinler

Keywords

Multipl Skleroz, egzersiz, lenfosit, doğal öldürücü hücreler, nötrofil, lökosit, sitokinler

References

• http://www.nationalmssociety.org/What-is-MS. Erişim tarihi Ocak.2016.
• http://www.nationalmssociety.org/Symptoms-Diagnosis Erişim tarihi Ocak.2016.
• http://www.nationalmssociety.org/Living-Well-With-MS/Health-Wellness/Exercise#section-3 Erişim tarihi Ocak.2016.
• http://www.who.int/mediacentre/factsheets/fs385/en/ Erişim tarihi Ocak.2016.
• Pedersen BK, Hoffman-Goetz L. Exercise and the Immune System: Regulation, Integration, and Adaptation. Physiol Rev. 2000;80 (3):1055–1081.
• Hoffman-Goetz L, Pedersen BK. Exercise and the immune system: a model of the stress response? Immunol Today. 1994;15(8):382–387.
• Randall-Simpson JA, Hoffman-Goetz L, Thorne R, Arumugam Y. Exercise stress alters the percentage of splenic lymphocyte subsets in response to mitogen but not in response to interleukin-1. Brain Behav Immun. 1989;3(2):119–128.
• Espersen ET, Stamp I, Jensen ML, Elbæk A, Ernst E, Kahr O et al. Lymphocyte redistribution in connection with physical activity in the rat. Acta Physiol Scand. 1995;155(3):313–321.
• Madden K, Felten DL. (1995) Experimental basis for neural-immune interactions. Physiol Rev. 1995;75(1):77–106.
• Pedersen BK, Steensberg A Exercise and hypoxia: effects on leukocytes and interleukin-6—shared mechanisms? Med Sci Sports Exerc. 2002;34(12):2004-13.
• McCarthy DA, Dale MM. The leucocytosis of exercise. A review and model. Sports Med. 1988;6(6):333–363.
• Kurokawa Y, Shinkai S, Torii J, Hino S, Shek PN. Exercise-induced changes in the expression of surface adhesion molecules on circulating granulocytes and lymphocytes subpopulations. Eur J Appl Physiol. 1995;71:245–252.
• Peake JM. Exercise-induced alterations in neutrophil degranulation and respiratory burst activity: possible mechanisms of action. Exerc Immunol Rev 8: 49-100, 2002.
• Rohde T, Maclean D, Pedersen BK. Effect of glutamine on changes in the immune system induced by repeated exercise. Med Sci Sports Exercise. 1998;30(6):856–862.
• Brines R, Hoffman-Goetz L, Pedersen BK. Can you exercise to make your immune system fitter? Immunol Today. 1996;17(6):252–254.
• Pedersen BK, Nieman DC. Exercise and immunology: integration and regulation. Immunol Today. 1998;19(5):204–206.
• Hakim FT, Cepeda R, Kaimei S, Mackall CL, Mcatee N, Zujewski J et al. Constraints on CD4 recovery post-chemotherapy in adults: thymic insufficiency and apoptotic decline of expanded peripheral CD4 cells. Blood. 1997;90(9):3789–3798.
• Nielsen HB, Pedersen BK. Lymphocyte proliferation in response to exercise. Eur J Appl Physiol Occup Physiol. 1997;75(5):375-9.
• Tvede N, Pedersen BK, Hansen FR, Bendix T, Christensen LD, Galbo H et al. Effect of physical exercise on blood mononuclear cell subpopulations and in vitro proliferative responses. Scand J Immunol. 1989;29(3):383–389.
• Deckx N, Wens I, Nuyts AH, Lee WP, Hens N, Koppen G, Goossens H, Van Damme P, Berneman ZN, Eijnde BO, Cools N. Rapid Exercise-Induced Mobilization of Dendritic Cells Is Potentially Mediated by a Flt3L- and MMP-9-Dependent Process in Multiple Sclerosis. Mediators Inflamm. 2015; ID: 158956.
• Gleeson M. Immune function in sport and exercise. J Appl Physiol. 2007;103(2):693–699.
• O’Shea J, Ortaldo JR. The biology of natural killer cells: insights into the molecular basis of function. In: The Natural Killer Cell, edited by C. E. Lewis and J. O. McGee. Oxford, UK: Oxford Univ. Press, 1992;1–40.
• Kastrukoff LF, Lau A, Wee R, Zecchini D, White R, Paty DW. Clinical relapses of multiple sclerosis are associated with ‘novel’ valleys in natural killer cell functional activity. J Neuroimmunol. 2003;145(1-2):103-14.
• Pedersen BK, Ullum H. NK cell response to physical activity: possible mechanisms of action. Med Sci Sports Exercise. 1994;26(2):140–146.
• Nieman DC, Miller AR, Henson DA, Warren BJ, Gusewitch G, Johnson RL, et al. Effects of high- vs moderate-intensity exercise on natural killer cell activity. Med Sci Sports Exercise. 1993;25(10):1126–1134.
• Palmø J, Asp S, Daugaard JR, Richter EA, Klokker M, Pedersen BK. Effect of eccentric exercise on natural killer cell activity. J Appl Physiol. 1995;78(4):1442–1446.
• Pedersen BK, Tvede N, Hansen FR, Andersen V, Bendix T, Bendıxen G et al. Modulation of natural killer cell activity in peripheral blood by physical exercise. Scand J Immunol. 1988;27(6):673–678.
• Tvede N, Kappel M, Halkjaer Kristensen J, Galbo H, Pedersen BK. The effect of light, moderate and severe bicycle exercise on lymphocyte subsets, natural and lymphokine activated killer cells, lymphocyte proliferative response and interleukin-2 production. Int J Sports Med. 1993;14(5):275–282.
• Pedersen BK, Tvede N, Klarlund K, Christensen LD, Hansen FR, Galbo H et al. Indomethacin in vitro and in vivo abolishes post-exercise suppression of natural killer cell activity in peripheral blood. Int J Sports Med. 1990;11(2):127–131.
• Rohde T, Maclean DA, Hartkopp A, Pedersen BK. The immune system and serum glutamine during a triathlon. Eur J Appl Physiol Occup Physiol. 1996;74(5):428–434.
• Camus G, Pincemail J, Ledent M, Juchmesferır A, Lamy M, Debydupont G et al. Plasma levels of polymorphonuclear elastase and myeloperoxidase after uphill walking and downhill running at similar energy cost. Int J Sports Med. 1992;13(6):443–446.
• Timmons BW ve Cieslak T. Human Natural Killer Cell Subsets and Acute Exercise: A Brief Review. Exerc Immunol Rev 2008;14:8-23.
• Shephard RJ, Shek PN. Effects of exercise and training on natural killer cell counts and cytolytic activity: ameta-analysis, Sports Med. 1999;28(3): 177–195.
• Robson PJ, Blannin AK, Walsh NP, Castell LM, Gleeson M. Effects of exercise intensity, duration and recovery on in vitro neutrophil function in male athletes, Int J Sports Med. 1999;20(2):128–135.
• Starkie RL, Rolland J, Angus DJ, Anderson MJ, Febbraio MA. Circulating monocytes are not the source of elevations in plasma IL-6 and TNF-alpha levels after prolonged running. Am J Physiol Cell Physiol. 2001;280(4):C769–C774.
• Lancaster GI, Khan Q, Drysdale P, Wallace F, Jeukendrup AE, Drayson MT,.et al. The physiological regulation of toll-like receptor expression and function in humans. J Physiol. 2005;563(3):945–955.
• Woods JA, Lu Q, Ceddia MA, Lowder T. Special feature for the Olympics: effects of exercise on the immune system: exercise-induced modulation of macrophage function. Immunol Cell Biol. 2000;78(5):545–553.
• Lancaster GI, Halson SL, Q. Khan, Drysdale P, Wallace F, Jeukendrup AE, et al. Effects of acute exhaustive exercise and chronic exercise training on type 1 and type 2 T lymphocytes. Exerc Immunol Rev.2004;10:91–106.
• Bruunsgaard H, Hartkopp A, Mohr T, Konradsen H, Heron I, Mordhorst CH et al. In vivo cellmediated immunity and vaccination response following rolonged, intense exercise. Med Sci Sports Exerc. 1997;29(9):1176–1181.
• Sprenger H, Jacobs C, Nain M, Gressner Am, Prinz H, Wesemann W, et al. Enhanced release of cytokines, interleukin-2 receptors, and neopterin after long-distance running. Clin Immunol Immunopathol 1992;63(2):188–195.
• Bruunsgaard H, Galbo H, Halkjaer-Krıstensen J, Johansen Tl, Maclean DA, Pedersen BK. Exercise-induced increase in interleukin-6 is related to muscle damage. J Physiol. 1997;499(3):833–841.
• Walsh NP, Gleeson M, Shephard RJ, Gleeson M, Woods JA, Bishop NC, Fleshner M, Green C, Pedersen BK, Hoffman-Goetz L, Rogers CJ, Northoff H, Abbasi A, Simon P. Position statement. Part one: Immune function and exercise. Review. Exerc Immunol Rev. 2011;17: 6-63.
• Ploeger HE, Takken T, de Greef MH, Timmons BW. The effects of acute and chronic exercise on inflammatory markers in children and adults with a chronic inflammatory disease: a systematic review. Exerc Immunol Rev. 2009;15:6-41.
• Papa S, Vitale M, Mazzotti G, Neri LM, Monti G, Manzoli FA. Impaired lymphocyte stimulation induced by long-term training. Immunol Lett. 1989;22(1):29–33.
• Nieman DC, Henson DA, Gusewitch G, Warren BJ, Dotson RC, Butterworth DE, et al. Physical activity and immune function in elderly women. Med Sci Sports Exer. 1993;25(7):823–831.
• Baj Z, Kantorsk, J, Majewska E, Zeman K, Pokoca L, Fornalczyk E et al. Immunological status of competitive cyclists before and after the training season. Int J Sports Med. 1994;15(6):319–324.
• Nieman DC, Brendle D, Henson DA, Suttles J, Cook VD, Warren BJ et al. Immune function in athletes versus nonathletes. Int J Sports Med 1995;16(5):329–333.
• Pyne DB. Regulation of neutrophil function during exercise. Sports Med. 1994;17(4):245–258.
• Hack V, Strobel G, Rau JP, Weicker H. The effect of maximal exercise on the activity of neutrophil granulocytes in highly trained athletes in a moderate training period. Eur J Appl Physiol Occup Physiol. 1992;65(6):520–524.
• Hack V, Strobel G, Weiss M, Weicker H. PMN cell counts and phagocytic activity of highly trained athletes depend on training period. J Appl Physiol. 1994;77(4):1731–1735.
• Castellano V ve White LJ. Serum brain-derived neurotrophic factor response to aerobic exercise in multiple sclerosis. J Neurol Sci. 2008;269(1-2):85–91.
• Carro E, Trejo JL, Busiguina S, Torres-Aleman I. Circulating insulinlike growth factor I mediates the protective effects of physical exercise against brain insults of different etiology and anatomy. J Neurosci. 2001;21(15):5678–84.
• Heesen C, Gold SM, Hartmann S, Mladek M, Reer R, Braumann KM et al. Endocrine and cytokine responses to standardized physical stress in multiple sclerosis. Brain Behav Immun. 2003;17(6):473–481.
• Mostert S, Kesselring J. Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Mult Scler. 2002;8(2):161–168.
• Petajan JH, Gappmaier E, White AT, Spencer MK, Mino L, Hicks RW. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol.1996;39(4):432–441.
• White LJ, Castellano V, Mc Coy SC. Cytokine responses to resistance training in people with multiple sclerosis. J Sports Sci. 2006;24(8):911-914.
• 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. Int Immunopharmacol. 2010;10(11):1415-1419.
• Motl RW, Gosney JL. Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis. Mult Scler. 2008;14(1):129–135.
• Waschbisch A, Wenny I, Tallner A, Schwab S, Pfeifer K, Mäurer M. Physical Activity in Multiple Sclerosis: A Comparative Study of Vitamin D, Brain-Derived Neurotrophic Factor and Regulatory T Cell Populations. Eur Neurol. 2012;68(2):122–128.
• Fischer A, Heesen C, Gold SM. Biological outcome measurements for behavioral interventions in multiple sclerosis. Ther Adv Neurol Disord. 2011;4(4):217-229.