Autoimmune disorders, physical activity, and training, with particular reference to rheumatoid arthritis.
Rheumatoid arthritis arises from a reaction of the immune system to normal body components, sometimes triggered by bacterial or viral infection. The synovia of affected joints are infiltrated by CD4+, CD19-, and plasma cells. The synovial fluid shows a sterile inflammation, with high neutrophil counts and increased concentrations of proinflammatory cytokines (particularly IL-1, IL-8, TNF-alpha and JFN-gamma). The plasma shows increased CD4+ counts and a pro-inflammatory shift in T cell populations with high titers of rheumatoid factors. Traditional treatment has included rest of the affected part, which can cause a reduction of physical condition. However, exercise induces changes in circulating immune function (including a decrease of CD4+ count) that would appear helpful in regulating inflammation. Further, there is evidence that patients can tolerate a program of regular moderate aerobic exercise. Moreover, empirical data suggest that such a prescription substantially enhances physical performance, without exacerbating either clinical or immunological markers of the disease process.
Shephard
R J
RJ
School of Physical and Health Education, University of Toronto, ON Canada.
Shek
P N
PN
D000328:Adult; D000368:Aged; D000818:Animals; D001169:Arthritis, Experimental / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000276:immunology* / Q000628:therapy; D001327:Autoimmune Diseases / Q000097:blood / Q000276:immunology* / Q000628:therapy; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000502:physiology; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010805:Physical Conditioning, Animal; D005082:Physical Exertion / Q000502:physiology*
D016207:Cytokines