Influence of combined functional resistance and endurance exercise over 12 weeks on matrix metalloproteinase-2 serum concentration in persons with relapsing-remitting multiple sclerosis - a community-based randomized controlled trial.
Functional exercise
Immune homeostasis
Inflammation
Kynurenine pathway
Matrix metalloproteinase-2
Relapsing-remitting multiple sclerosis
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
06 Dec 2019
06 Dec 2019
Historique:
received:
30
10
2019
accepted:
26
11
2019
entrez:
8
12
2019
pubmed:
8
12
2019
medline:
25
2
2020
Statut:
epublish
Résumé
The relevance of regular moderate to intense exercise for ameliorating psychomotor symptoms in persons with multiple sclerosis (pwMS) is becoming increasingly evident. Over the last two decades, emerging evidence from clinical studies and animal models indicate immune regulatory mechanisms in both periphery and the central nervous system that may underlie these beneficial effects. The integrity of the blood-brain barrier as the main structural interface between periphery and brain seems to play an important role in MS. Reducing the secretion of proteolytic matrix metalloproteinases (MMP), i.e. MMP-2, as disruptors of blood-brain barrier integrity could have profound implications for MS. In this two-armed randomized controlled trial 64 participants with relapsing-remitting MS (RRMS) (EDSS 0-4.0) will be allocated to either an intervention group or a passive wait list control group. The intervention group will perform 60 min of combined functional resistance and endurance exercises 3x per week over a period of 12 weeks in a community-based and publicly available setting. Changes in serum concentration of MMP-2 will be the primary outcome. Secondary outcomes are numbers of immune cell subsets, soluble (anti-) inflammatory factors, physical capacity, cognitive performance, physical activity behavior, gait performance, and patient-reported outcomes. All outcome measures will be assessed at baseline and after week 12 with an additional blood sampling before, during and immediately after a single training session in week 6. To our knowledge, this will be the first RCT to investigate both the acute and chronic effects of a community-based intense functional resistance and endurance exercise regimen in persons with RRMS. Combining analysis of biological and cognitive or psychological outcomes may provide a better understanding of the MS-specific symptomology. DRKS00017091; 05th of April, 2019; International Clinical Trials Registry Platform.
Sections du résumé
BACKGROUND
BACKGROUND
The relevance of regular moderate to intense exercise for ameliorating psychomotor symptoms in persons with multiple sclerosis (pwMS) is becoming increasingly evident. Over the last two decades, emerging evidence from clinical studies and animal models indicate immune regulatory mechanisms in both periphery and the central nervous system that may underlie these beneficial effects. The integrity of the blood-brain barrier as the main structural interface between periphery and brain seems to play an important role in MS. Reducing the secretion of proteolytic matrix metalloproteinases (MMP), i.e. MMP-2, as disruptors of blood-brain barrier integrity could have profound implications for MS.
METHODS
METHODS
In this two-armed randomized controlled trial 64 participants with relapsing-remitting MS (RRMS) (EDSS 0-4.0) will be allocated to either an intervention group or a passive wait list control group. The intervention group will perform 60 min of combined functional resistance and endurance exercises 3x per week over a period of 12 weeks in a community-based and publicly available setting. Changes in serum concentration of MMP-2 will be the primary outcome. Secondary outcomes are numbers of immune cell subsets, soluble (anti-) inflammatory factors, physical capacity, cognitive performance, physical activity behavior, gait performance, and patient-reported outcomes. All outcome measures will be assessed at baseline and after week 12 with an additional blood sampling before, during and immediately after a single training session in week 6.
DISCUSSION
CONCLUSIONS
To our knowledge, this will be the first RCT to investigate both the acute and chronic effects of a community-based intense functional resistance and endurance exercise regimen in persons with RRMS. Combining analysis of biological and cognitive or psychological outcomes may provide a better understanding of the MS-specific symptomology.
TRIAL REGISTRATION
BACKGROUND
DRKS00017091; 05th of April, 2019; International Clinical Trials Registry Platform.
Identifiants
pubmed: 31810462
doi: 10.1186/s12883-019-1544-7
pii: 10.1186/s12883-019-1544-7
pmc: PMC6898928
doi:
Substances chimiques
Matrix Metalloproteinase 2
EC 3.4.24.24
Types de publication
Clinical Trial Protocol
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
314Subventions
Organisme : Marga und Walter Boll-Stiftung
ID : Grant number: 210-06.01-19
Références
PLoS One. 2016 Apr 28;11(4):e0153617
pubmed: 27124720
Mult Scler. 2018 Oct;24(12):1635-1644
pubmed: 28825348
Ann Neurol. 2011 Feb;69(2):292-302
pubmed: 21387374
Sleep Med Rev. 2016 Feb;25:52-73
pubmed: 26163057
Nat Commun. 2019 Feb 6;10(1):621
pubmed: 30728360
Ann Neurol. 2017 Jun;81(6):857-870
pubmed: 28512753
Scand J Med Sci Sports. 2015 Dec;25 Suppl 3:1-72
pubmed: 26606383
J Clin Epidemiol. 2007 Dec;60(12):1234-8
pubmed: 17998077
Mult Scler. 2018 Jun;24(7):886-894
pubmed: 29889008
Mult Scler. 2009 Dec;15(12):1509-17
pubmed: 19995840
Arch Phys Med Rehabil. 2004 Oct;85(10):1694-704
pubmed: 15468033
Trends Neurosci. 2014 Jan;37(1):39-46
pubmed: 24239063
Front Physiol. 2016 Jun 02;7:194
pubmed: 27313534
Nat Rev Immunol. 2015 Sep 15;15(9):545-58
pubmed: 26250739
Annu Rev Psychol. 2015 Jan 3;66:769-97
pubmed: 25251492
J Cereb Blood Flow Metab. 2016 Sep;36(9):1481-507
pubmed: 27323783
Neuropsychol Rev. 2016 Sep;26(3):271-294
pubmed: 27447980
Clin Chem Lab Med. 2016 Oct 1;54(10):1655-61
pubmed: 27071153
Scand J Immunol. 2011 Jul;74(1):1-13
pubmed: 21338381
Am J Epidemiol. 2004 Jan 15;159(2):167-74
pubmed: 14718219
Neurology. 1983 Nov;33(11):1444-52
pubmed: 6685237
Nervenarzt. 2011 Oct;82(10):1281-9
pubmed: 21472450
Nat Rev Neurosci. 2012 Jul;13(7):465-77
pubmed: 22678511
Front Immunol. 2017 May 09;8:532
pubmed: 28536579
J Immunol. 2006 Jun 1;176(11):6752-61
pubmed: 16709834
Sultan Qaboos Univ Med J. 2014 Feb;14(1):e13-25
pubmed: 24516744
Eur J Haematol. 2016 Feb;96(2):152-9
pubmed: 25865148
Mult Scler. 2012 Jun;18(6):891-8
pubmed: 22190573
Arch Phys Med Rehabil. 2013 Dec;94(12):2342-2348
pubmed: 23906692
J Neurol Neurosurg Psychiatry. 2019 Jun;90(6):642-651
pubmed: 30683707
Nat Commun. 2019 Jun 24;10(1):2767
pubmed: 31235694
Behav Res Methods. 2007 May;39(2):175-91
pubmed: 17695343
Mult Scler. 2008 Jan;14(1):35-53
pubmed: 17881393
Front Neurosci. 2014 Feb 06;8:12
pubmed: 24567701
Clin Chim Acta. 2006 Feb;364(1-2):82-90
pubmed: 16139256
Clin Neuropsychol. 2010 Feb;24(2):189-202
pubmed: 19953426
Biometrics. 1975 Mar;31(1):103-15
pubmed: 1100130
Curr Sports Med Rep. 2013 Jul-Aug;12(4):215-7
pubmed: 23851406
Exp Clin Endocrinol Diabetes. 2013 Aug;121(8):475-82
pubmed: 24026829
Mult Scler. 2008 Mar;14(2):219-30
pubmed: 17942521
Eur J Neurol. 2019 May;26(5):711-721
pubmed: 30734989
Arch Phys Med Rehabil. 2013 Sep;94(9):1829-1836.e7
pubmed: 23770262
Mediators Inflamm. 2016;2016:6789276
pubmed: 26903712
Lancet Neurol. 2017 Oct;16(10):848-856
pubmed: 28920890
Science. 2017 Jul 28;357(6349):
pubmed: 28751584
J Allergy Clin Immunol. 2016 May;137(5):1607-1610.e8
pubmed: 26774657