Background/Purpose:

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease characterized by a chronic inflammation associated with worse cardiovascular outcome. Although a few studies have investigated the safety of physical exercise in this disease, none of them have assessed the underlying cytokine response, an important marker of inflammation. Therefore, the aim of this study was to evaluate the cytokines (INF-γ, IL-6, IL-10, TNF-α) and soluble TNF receptors (sTNFR1 and sTNFR2) response to either a moderate or an intense acute exercise session in inactive SLE patients.

Methods:

Twelve patients with SLE [age: 35.3 ± 5.7 yrs; body mass index (BMI): 25.6±3.4 kg/m²; SLEDAI: 1.4±1.0] and 10 healthy age- and BMI-matched controls (age: 30.6±5.2 yrs, P=0.12; BMI: 24.1±2.3 kg/m², P=1.00) performed 30min of moderate (~50% of VO₂max) and intense (~70% of VO₂max) exercises in a treadmill, on separate occasions. Serum cytokines (INF-γ, IL-10, IL-6, TNF-α) and sTNFRs were assessed at baseline, immediately after exercise, every 30 min during three hours of recovery, and 24h after the end of exercise. Serum cytokines and sTNFRs were evaluated by the multiplex technique.

Results:

At baseline, SLE had higher levels of TNF-α (P=0.001) and sTNFR2 (P=0.001) when compared with controls, whereas all other cytokines and sTNFR1 levels were comparable between groups (P>0.05). After the moderate exercise session, INF-γ, IL-10, IL-6, TNF-α, sTNFR1 and sTNFR2 levels remained stable in SLE when compared with baseline in all time points (P>0.05). Likewise, both the sTNFR2 and cytokines levels remained unchanged in healthy controls (P>0.05), except for the sTNFR1 levels, which showed a decrease at the 90^th (P=0.038), 120^th (P=0.028), 150^th (P=0.005) and 180^th (P=0.037) minute of recovery, returning to baseline levels 24h after the moderate exercise (P=0.093). After the intense exercise, only the sTNFR1 was altered in SLE patients, showing a decrease at the 150^th (P=0.041) and 180^th (P=0.034) minute of recovery, returning to baseline levels at the 24h time point. The sTNFR2 and all other cytokines remained unchanged (P>0.05). In healthy controls, IL-10, TNF-α, sTNFR1 and sTNFR2 did not change in response to the intense exercise session. Conversely, INF-γ decreased (P=0.05) and IL-6 increased at the end of exercise (P=0.028), with no differences observed at the post-24h time point (P>0.05).

Conclusion:

This study demonstrates that both moderate and intense acute exercise sessions results in mild and transient changes in cytokine levels in SLE, providing novel evidence that exercise does not trigger inflammation in this disease. This finding supports the safety and recommendation of physical exercise for these patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/inactive-systemic-lupus-erythematosus-cytokines-and-soluble-tumor-necrosis-factor-receptors-response-to-moderateintense-exercise/