Exercise in systemic sclerosis intensifies systemic inflammation and oxidative stress.
OBJECTIVE
Exercise testing can be used (i) to evaluate functional limitations of systemic sclerosis (SSc) and (ii) to study whether the inflammatory and oxidative systems are activated after a physical stimulus. The aim of this study was to determine exercise-induced inflammatory and oxidative responses in SSc compared with healthy subjects.


METHODS
Eleven patients with SSc and pulmonary involvement and 10 healthy subjects underwent maximal cardiopulmonary exercise testing (CPET). Physiological responses were followed continuously during cycling. Blood samples were taken at rest, during and after maximal exercise to measure inflammatory and oxidative markers.


RESULTS
In nine of the 11 SSc patients, cardiocirculatory limitation and gas exchange impairment limited exercise capacity. Basal inflammatory cells, interleukin (IL)-6, and oxidative stress were increased in SSc compared to healthy subjects and intensified after exercise. Basal and exercise-induced inflammation and oxidative stress were correlated with the modified Rodnan skin score.


CONCLUSIONS
Although exercise capacity is impaired in patients with SSc, physical activity intensifies the already increased basal levels of systemic inflammation and oxidative stress. These data support the concept of a role for systemic inflammation and oxidative stress in the ongoing systemic effects of SSc.
Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, The Netherlands.
H
H
Hargardóttir
H A C
HA
van Helvoort
M C
MC
Vonk
F H J
FH
van den Hoogen
P N R
PN
Dekhuijzen
Y F
YF
Heijdra
D000328:Adult; D000367:Age Factors; D000368:Aged; D001774:Blood Chemical Analysis; D016022:Case-Control Studies; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007964:Leukocytosis / Q000503:physiopathology; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology*; D017382:Reactive Oxygen Species / Q000097:blood*; D012016:Reference Values; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000097:blood / Q000175:diagnosis*; D012720:Severity of Illness Index; D012737:Sex Factors
D018836:Inflammation Mediators; D015850:Interleukin-6; D017382:Reactive Oxygen Species