Nicholas A Young
Department of Internal Medicine Division of Rheumatology and Immunology, The Ohio State University Wexner Medical Center, Columbus, Ohio, 43210, USA
Title: Stress moderation impacting lupus with exercise (S.M.I.L.E.): effects of moderate exercise and stress modification on autoimmune-mediated inflammation in mice and humans with lupus
Biography
Biography: Nicholas A Young
Abstract
Despite studies indicating the positive effects of exercise and psychological stress reduction in patients with autoimmune disease, this therapeutic modality is underemphasized due to the absence of comprehensive immunological characterization and regimen standardization. In order to examine the influence on the immune system at the cellular and tissue level, disease pathology was analyzed in the NZM2410 mouse model of lupus nephritis. Mice were either exercised daily at moderate intensity by treadmill walking or exposed to a previously established model of psychosocial stress induction. Psychosocial stress induction significantly exacerbated and daily moderate exercise significantly reduced lupus nephritis disease pathology, as measured by blood urea nitrogen levels, IgG and complement component 3 complex deposition in glomeruli, macrophage infiltration, and histopathological grading of H&E-stained kidney sections. Furthermore, stressors induced levels of IL-6, TNF-α, and IL-1β, while exercise suppressed IL-6, TNF-α, IL-10, and CXCL1. To translate these results and begin to characterize a standardized treatment regimen for patients, a pilot cohort with active systemic lupus erythematosus (SLE) was enrolled into a daily Tai Chi program, which emphasized moderate exercise levels with meditative breathing to provide daily physical activity and stress reduction. Compared to baseline data, questionnaires confirmed a significant reduction in perceived social stress and an increase in overall physical activity. Furthermore, fitness activity tracker data showed a significant increase in steps, distance, and activity calories with no changes in body mass index or vigorous activity levels. Interestingly, this correlated with an increased time in bed each night. Analysis of pro-inflammatory serum cytokines revealed suppression of IL-6 by 23%, IL-8 by 30%, TNF-α by 11%, and IFN-É£ by 21% with Tai Chi. These data suggest that moderate exercise and stress management can have potent immunoregulatory effects on the chronic inflammation associated with SLE and indicate that Tai Chi can be an effective adjunct therapy.