SIRT1-related inhibition of pro-inflammatory responses and oxidative stress are involved in the mechanism of nonspecific low back pain relief after exercise through modulation of Toll-like receptor 4.
Low back pain is a common clinical problem that causes disability and impaired quality of life. While the reason behind low back pain was largely considered to be of musculoskeletal origin, the contribution of inflammatory cytokines and oxidative stress could never be overlooked. Exercise has been proven to be an effective approach to treat low back pain. However, the mechanism of the exercise effect on the inflammatory cytokines and oxidative stress is still largely unknown. In this study, we revealed that exercise intervention reduces Toll-like receptor 4 (TLR-4) pathway and enhances Sirtuin 1 (SIRT1) expression in low back pain patients. We also confirmed that exercise up-regulates the expression of peroxisome proliferator-activated receptor-gamma, PPAR-γ coactivator-1 and FoxOs family proteins and also increases the activity of catalase and superoxide dismutase in patients with low back pain. Furthermore, we found that exercise intervention attenuates the oxidative stress, pro-inflammatory cytokine concentrations and p53 expression in patients with low back pain. This study demonstrates that exercise intervention improves low back pain symptoms through regulation of the SIRT1 axis with repression of oxidative stress and TLR-4 inhibition.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taiwan;
Yuan-Yang
YY
Cheng
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan;
Chung-Lan
CL
Kao
Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; and.
Hsin-I
HI
Ma
Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ching-Hsia
CH
Hung
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan;
Chin-Tien
CT
Wang
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan;
Ding-Hao
DH
Liu
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan;
Po-Yin
PY
Chen
Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan kunlingtsai@mail.ncku.edu.tw.
Kun-Ling
KL
Tsai
D000328:Adult; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D005260:Female; D000071161:Forkhead Box Protein O1; D000071316:Forkhead Box Protein O3; D051858:Forkhead Transcription Factors / Q000235:genetics / Q000378:metabolism; D005786:Gene Expression Regulation; D006801:Humans; D017116:Low Back Pain / Q000097:blood / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D018384:Oxidative Stress; D047495:PPAR gamma / Q000235:genetics / Q000378:metabolism; D010147:Pain Measurement; D055070:Resistance Training; D056564:Sirtuin 1 / Q000235:genetics / Q000378:metabolism*; D013624:Taiwan; D051197:Toll-Like Receptor 4 / Q000235:genetics / Q000378:metabolism*
D016207:Cytokines; C085126:FOXO1 protein, human; C499517:FOXO3 protein, human; D000071161:Forkhead Box Protein O1; D000071316:Forkhead Box Protein O3; D051858:Forkhead Transcription Factors; D047495:PPAR gamma; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; C447939:SIRT1 protein, human; D056564:Sirtuin 1
SIRT1; exercise; genes; low back pain; toll like receptor 4