Changes in pro-inflammatory markers and leucine concentrations in response to Nordic Walking training combined with vitamin D supplementation in elderly women

High-Intensity Interval Training Decreases Circulating HMGB1 in Individuals with Insulin Resistance: Plasma Lipidomics Correlate with Associated Cardiometabolic Benefits

BACKGROUND

Bodyweight high-intensity interval training (BW-HIIT) is an effective, time-efficient exercise method that reduces cardiovascular risk factors and improves muscle endurance without requiring external equipment. High mobility group box 1 (HMGB1) is a proinflammatory protein involved in insulin resistance. Previous studies revealed that HMGB1 knockout mice show improved insulin sensitivity and hyperglycemia. This study investigates whether BW-HIIT exercise can reduce proinflammatory markers, such as HMGB1, in individuals with insulin resistance.

METHODS

In total, 14 adults (2 male/12 female) aged 18 to 55 were subject to six weeks of BW-HIIT. Additionally, 10-week-old mice were subject to exercise conditioning (5 mice per group (all male)) for 4 weeks of treadmill exercise or sedentary. Human and mouse pre- and post-exercise serum/plasma samples were analyzed for lipidomics, hormonal, and cytokine multiplex assays. Cardiometabolic parameters were also performed on human subjects.

RESULTS

Post-exercise decreased systolic blood pressure (SBP), cholesterol, triglycerides, high-density lipoprotein (HDL), and cholesterol/HDL ratio in human patients with insulin resistance. Meanwhile, hormones such as amylin, glucagon, and insulin all increased post-BW-HIIT or treadmill exercise in both human and mouse models. Moreover, circulating HMBG1 levels were reduced in insulin-resistant individuals and mice after exercise. Furthermore, treadmill exercise by the animal model increased anti-inflammatory cytokines, including interleukin (IL)-10, IL-12p40, and IL-12p70, and reduced proinflammatory cytokines: eotaxin, IL-2, and macrophage inflammatory protein (MIP)-2 or CXCL2.

CONCLUSIONS

Six weeks of BW-HIIT exercise can improve cardiometabolic health, anti-inflammatory markers, hormones, and insulin sensitivity in human and mouse models undergoing exercise. Changes in circulating HMBG1 levels following BW-HIIT exercise make HMGB1 a suitable marker for cardiometabolic disease, potentiating its role beyond an alarmin. Further studies are needed to confirm these effects and to elucidate the underlying physiological mechanisms.

Understanding the Role of Irisin in Longevity and Aging: A Narrative Review

Irisin is a protein resulting from a proteolytic cleavage of fibronectin type III domain-containing protein 5 (FND5). The ability of irisin to modulate adipocyte and control glucose metabolism in human metabolic diseases gave rise to the hypothesis that irisin could have a pivotal role in aging-related diseases. Although in animal models, increased levels of irisin have been positively associated with better health outcomes, in humans, its role remains controversial. To provide an overview of the main finding on irisin in older adults, a comprehensive search was performed through the MEDLINE-PubMed, Web of Science, Scopus, and Cochrane databases for studies conducted in older adults (≥60 years) published since 2012. After grouping and analyzing the articles based on diseases associated with older adults, the main conclusion of this narrative review is that the included studies did not yield consistent evidence regarding the association between irisin and health or disease in older adults. Further studies are necessary to clarify the effective role of this protein in promoting health and longevity.

An examination of exercise intensity and its impact on the acute release of irisin across obesity status: a randomized controlled crossover trial

Limited data exist regarding the impact of exercise intensity on irisin release and its association with insulin sensitivity in individuals of differing obesity status. The objective of this study was to investigate the impact of exercise intensity on the acute release of irisin in healthy-weight individuals and individuals with obesity, and whether irisin release during acute exercise was associated with greater insulin sensitivity across obesity status. A randomized controlled crossover study was conducted on 26 non-overweight/obese (non-OW/OB) (BMI: 22.2 ± 1.5  kg/m2) and 26 overweight/obese (OW/OB) (BMI: 33.9 ± 6.5  kg/m2) adults who performed an acute bout of moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), and rest. Irisin was quantified via ELISA and western blotting, and insulin sensitivity (Si) was estimated using the Matsuda index. OW/OB displayed a significantly lower level of circulating irisin and protein expression compared to non-OW/OB (p < 0.01). Insulin sensitivity was positively correlated with irisin release during MICT and HIIT in non-OW/OB (all p < 0.05), but not in OW/OB. Regarding irisin expression, non-OW/OB with high Si had a 2.03-fold (p < 0.05) increase during HIIT, while OW/OB with high Si had only a 1.54-fold increase (p < 0.05). These results suggest that irisin is released differently according to obesity status and varying exercise intensities. OW/OB individuals have a blunted irisin response to acute exercise and lower baseline irisin concentrations compared to non-OW/OB individuals. Although exercise stimulates irisin release in non-OW/OB individuals, only a greater exercise intensity stimulates irisin release in OW/OB individuals. These findings are clinically relevant, as irisin is associated with greater insulin sensitivity. This trial was registered at clinicaltrials.gov (NCT03514238).

Unlocking the potential of exercise: harnessing myokines to delay musculoskeletal aging and improve cognitive health

Objectives

This review aims to summarize the common physiological mechanisms associated with both mild cognitive impairment (MCI) and musculoskeletal aging while also examining the relevant literature on how exercise regulation influences the levels of shared myokines in these conditions.

Methods

The literature search was conducted via databases such as PubMed (including MEDLINE), EMBASE, and the Cochrane Library of Systematic Reviews. The searches were limited to full-text articles published in English, with the most recent search conducted on 16 July 2024. The inclusion criteria for this review focused on the role of exercise and myokines in delaying musculoskeletal aging and enhancing cognitive health. The Newcastle‒Ottawa Scale (NOS) was utilized to assess the quality of nonrandomized studies, and only those studies with moderate to high quality scores, as per these criteria, were included in the final analysis. Data analysis was performed through narrative synthesis.

Results

The primary outcome of this study was the evaluation of myokine expression, which included IL-6, IGF-1, BDNF, CTSB, irisin, and LIF. A total of 16 studies involving 633 older adults met the inclusion criteria. The current exercise modalities utilized in these studies primarily consisted of resistance training and moderate-to high-intensity cardiovascular exercise. The types of interventions included treadmill training, elastic band training, aquatic training, and Nordic walking training. The results indicated that both cardiovascular exercise and resistance exercise could delay musculoskeletal aging and enhance the cognitive functions of the brain. Additionally, different types and intensities of exercise exhibited varying effects on myokine expression.

Conclusion

Current evidence suggests that exercise mediates the secretion of specific myokines, including IL-6, IGF-1, BDNF, CTSB, irisin, and LIF, which establish self-regulatory circuits between the brain and muscle. This interaction enhances cognitive function in the brain and improves skeletal muscle function. Future research should focus on elucidating the exact mechanisms that govern the release of myokines, the correlation between the intensity of exercise and the secretion of these myokines, and the distinct processes by which myokines influence the interaction between muscle and the brain.

High-Intensity Interval Training Decreases Circulating HMGB1 in Individuals with Insulin Resistance; Plasma Lipidomics Identifies Associated Cardiometabolic Benefits

Background: Exercise is a fundamental primary standard of care for cardiometabolic health. Body Weight (BW) High-Intensity Interval Training (HIIT) is an effective strategy for reducing cardiometabolic markers in individuals with insulin resistance and Type-2 diabetes (T2D). High-mobility group box 1 (HMGB1), a ubiquitous nuclear factor, plays an ample role beyond an alarmin in T2D development and progression. Our group has described this novel role previously, showing the beneficial effect of whole body HMGB1 silencing in decreasing hyperglycemia in diabetic mice. In the present study we tested the hypothesis that BW-HIIT as an effective exercise training modality will decrease cardiometabolic risk with a concomitant decrease in circulating HMGB1 more prominently in insulin resistant individuals compared to non-insulin resistant individuals contrasting to what we can evidence in a preclinical murine model of insulin resistance; Methods: Human and mouse pre- and post-exercise serum/plasma samples were analyzed for Lipidomics as well as Metabolic and Cytokine Multiplex assays. Standard of care, as well as cardiometabolic parameters, was also performed in human subjects; Results: insulin resistant individuals had the most positive effect, primarily with a decrease in the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). as an index of insulin resistance as well as decreased HMGB1 post-exercise. Lipidomic analysis illustrated the highly beneficial effect of exercise training using a modified HIIT program, showing an enhanced panel of circulating lipids post-exercise exclusively in insulin resistant individuals. Plasma multiplex revealed significant translational heterogeneity in our studies with distinct metabolic hormone responses to exercise conditioning with a decrease in inflammatory markers in insulin resistant individuals; Conclusions: The current study demonstrated that 6-week BW-HIIT training improves cardiometabolic, anti-inflammatory markers, metabolic hormones, and insulin sensitivity in humans, strongly associated with decreased circulating HMGB1. Overall, these experiments reinforce the potential of HMGB1 as a marker of changes in insulin resistance and the positive effect of exercise training on insulin resistance possibly preventing the development of T2D and associated complications.

Iron status determined changes in health measures induced by nordic walking with time-restricted eating in older adults- a randomised trial

BACKGROUND AND AIMS

This study evaluated whether stored iron determines the adaptive response induced by Nordic walking (NW) training combined with 10 hours' time-restricted eating (TRE) in older adults.

TRIAL DESIGN AND METHODS

Twenty-four participants underwent 12-week NW training supported by 10 h of TRE. The group was divided due to baseline ferritin concentration low < 75 ng/ml (LF) and high level ≥ 75 ng/ml (HF). Body composition, physical fitness and blood collection were assessed at baseline and post-intervention.

RESULTS

NW + TRE induced a statistically significant decrease in ferritin levels in all participants (p = 0.01). Additionally, statistically significant intergroup differences in the LF vs. HF in the reduction of serum ferritin levels (p = 0.04) were observed. The procedure NW + TRE diminished HbA1c levels (p < 0.01) and glucose in all participants (p = 0.05). The range of HbA1c drop was more pronounced among those participants who experienced a greater decrease in the stored iron (p = 0.04, [Formula: see text]=0.17, F=4.59). Greater changes in body weight and percent of body fat were recorded in the HF group (for both p<0.01).

CONCLUSION

Body iron stores determine the effects of a 12-week NW + TRE intervention on serum ferritin. The changes in HbA1c are more pronounced in subjects with a higher decrease in serum ferritin.

TRIAL REGISTRATION

All experimental protocols were approved by the Bioethical Committee of the Regional Medical Society in Gdansk, Poland (NKBBN/330/2021) according to the Declaration of Helsinki. We confirm that all methods were carried out in accordance with relevant guidelines and regulations. The trial was registered as a clinical trial (NCT05229835, date of first registration: 14/01/2022, direct link: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT05229835 ). Informed consent was obtained from all subjects.

Regular moderate physical activity potentially accelerates and strengthens both the pro-inflammatory and pro-resolving lipid mediator response after acute exercise stress

The PUFA-derived lipid mediator response shifts from pro-inflammatory to inflammation resolution over time and may be modified by regular moderate exercise. This pre-post-test study aimed to compare the expression of PTGES2 (COX2) and ALOX15 in leucocytes and the plasma 5- and 15-HETE, 18-HEPE and 17-HDHA responses after unaccustomed resistance exercise between 18-35-year-old male recreational runners (n = 18) and less-active controls (n = 15). One repetition maximum (1RM) was determined for squats, 45° leg presses and leg extensions. Subsequently three sets of 8-10 repetitions were performed at 80 % 1RM and blood collected over 72 hours. PTGES2 and ALOX15 expression changed over time in runners (P = 0.016, P = 0.007) but not controls (P = 0.631, P = 0.539). 5- and 15-HETE changed over time in runners (P < 0.001, P = 0.022), but not controls (P = 0.457, P = 0.985). 18-HEPE changed in runners and controls (P < 0.001, P = 0.024), 17-HDHA changed borderline in runners (P = 0.076). In conclusion, pro-inflammatory and inflammation-resolving lipid mediators may respond sooner and more robust in recreational runners than less-active controls after strenuous resistance exercise.

Highlighting the idea of exerkines in the management of cancer patients with cachexia: novel insights and a critical review

BACKGROUND

Exerkines are all peptides, metabolites, and nucleic acids released into the bloodstream during and after physical exercise. Exerkines liberated from skeletal muscle (myokines), the heart (cardiokines), liver (hepatokines), white adipose tissue (adipokines), brown adipose tissue (batokines), and neurons (neurokines) may benefit health and wellbeing. Cancer-related cachexia is a highly prevalent disorder characterized by weight loss with specific skeletal muscle and adipose tissue loss. Many studies have sought to provide exercise strategies for managing cachexia, focusing on musculoskeletal tissue changes. Therefore, understanding the responses of musculoskeletal and other tissue exerkines to acute and chronic exercise may provide novel insight and recommendations for physical training to counteract cancer-related cachexia.

METHODS

For the purpose of conducting this study review, we made efforts to gather relevant studies and thoroughly discuss them to create a comprehensive overview. To achieve this, we conducted searches using appropriate keywords in various databases. Studies that were deemed irrelevant to the current research, not available in English, or lacking full-text access were excluded. Nevertheless, it is important to acknowledge the limited amount of research conducted in this specific field.

RESULTS

In order to obtain a comprehensive understanding of the findings, we prioritized human studies in order to obtain results that closely align with the scope of the present study. However, in instances where human studies were limited or additional analysis was required to draw more robust conclusions, we also incorporated animal studies. Finally, 295 studies, discussed in this review.

CONCLUSION

Our understanding of the underlying physiological mechanisms related to the significance of investigating exerkines in cancer cachexia is currently quite basic. Nonetheless, this demonstrated that resistance and aerobic exercise can contribute to the reduction and control of the disease in individuals with cancer cachexia, as well as in survivors, by inducing changes in exerkines.

Nordic Walking training in BungyPump form improves cognitive functions and physical performance and induces changes in amino acids and kynurenine profiles in older adults

Introduction

Although impacts of physical activity on cognitive functions have been intensively investigated, they are still far from being completely understood. The aim of this study was to evaluate the effect of 12 weeks of the Nordic Walking training with BungyPump resistance poles (NW-RSA) on the amino acid and kynurenine profiles as well as selected myokine/exerkine concentrations, which may modify the interface between physical and cognitive functions.

Methods

A group of 32 older adults participated in the study. Before and after the intervention, body composition, cognitive functions, and physical performance were assessed. Blood samples were taken before and 1 h after the first and last sessions of the NW-RSA training, to determine circulating levels of exercise-induced proteins, i.e., brain-derived neurotrophic factor (BDNF), irisin, kynurenine (KYN), metabolites, and amino acids.

Results

The NW-RSA training induced a significant improvement in cognitive functions and physical performance as well as a reduction in fat mass (p = 0.05). Changes were accompanied by a decline in resting serum BDNF (p = 0.02) and a slight reduction in irisin concentration (p = 0.08). Still, changes in irisin concentration immediately after the NW-RSA intervention depended on shifts in kynurenine-irisin dropped as kynurenine increased. The kynurenine-to-tryptophan and phenylalanine-to-tyrosine ratios decreased significantly, suggesting their possible involvement in the amelioration of cognitive functions. No changes of glucose homeostasis or lipid profile were found. Shifts in the concentrations of selected amino acids might have covered the increased energy demand in response to the NW-RSA training and contributed to an improvement of physical performance.

Conclusion

Regular Nordic Walking training with additional resistance (BungyPump) improved cognitive functions and physical performance. These positive effects were associated with a reduced BDNF concentration and kynurenine-to-tryptophan ratio as well as changes in the amino acid profile.

Inflammatory Profile of Older Adults in Response to Physical Activity and Diet Supplementation: A Systematic Review

Chronic, low-grade inflammation in the elderly, usually known as inflammaging, accelerates the development of age-related diseases, including cancer, obesity, sarcopenia, and cardio-metabolic diseases. Two of the most studied interventions against inflammation are diet supplementation and the regular practice of exercise. The search for this systematic review was performed in Scopus, EBSCO, and PubMed databases within the last 10 years. Only randomized controlled trials that evaluated the effect of supplementation and exercise against inflammatory markers in older adults were included. After applying eligibility criteria and risk-of-bias assessment, 11 studies were included in the systematic review. In total, 638 participants were analyzed and the main supplements evaluated were amino acid or protein supplementation from different sources. In the counterpart, the exercise applied in the evaluations included strengthening exercises or aerobic training. The interventions had a range of duration between 4 and 24 weeks, and the effects on inflammation markers in most of the studies showed a decrease in pro-inflammatory cytokines and non- or slightly significant change in anti-inflammatory cytokines. However, these results suggest that exercise and supplement interventions can contribute to diminishing the inflammation process in the elderly. We can also conclude that further well-designed randomized controlled trials are needed to confirm the possible synergistic effects of exercise and food supplementation against inflammation in the elderly due to the limited studies that currently exist. This systematic review was registered in PROSPERO, ID CRD42023387184.

High-mobility group box 1 protein, receptor for advanced glycation end products and nucleosomes increases after marathon

Background: Prolonged and strenuous exercise has been linked to potential exercise-induced myocardial damages. One potential key to unmask the discussed underlying mechanisms of this subclinical cardiac damage could be markers of immunogenic cell damage (ICD). We investigated the kinetics of high-mobility group box 1 protein (HMGB1), soluble receptor for advanced glycation end products (sRAGE), nucleosomes, high sensitive troponin T (hs-TnT) and high sensitive C-reactive protein (hs-CRP) before and up to 12 weeks post-race and described associations with routine laboratory markers and physiological covariates. Methods: In our prospective longitudinal study, 51 adults (82% males; 43 ± 9 years) were included. All participants underwent a cardiopulmonary evaluation 10-12 weeks pre-race. HMGB1, sRAGE, nucleosomes, hs-TnT and, hs-CRP were analysed 10-12 weeks prior, 1-2 weeks before, immediately, 24 h, 72 h, and 12 weeks post-race. Results: HMGB1, sRAGE, nucleosomes and hs-TnT increased significantly from pre- to immediately post-race (0.82-2.79 ng/mL; 1132-1388 pg/mL; 9.24-56.65 ng/mL; 6-27 ng/L; p < 0.001) and returned to baseline within 24-72 h. Hs-CRP increased significantly 24 h post-race (0.88-11.5 mg/L; p < 0.001). Change in sRAGE was positively associated with change in hs-TnT (rs = 0.352, p = 0.011). Longer marathon finishing time was significantly associated with decreased levels of sRAGE [-9.2 pg/mL (β = -9.2, SE = 2.2, p < 0.001)]. Conclusion: Prolonged and strenuous exercise increases markers of ICD immediately post-race, followed by a decrease within 72 h. An acute marathon event results in transient alterations of ICD, we assume that this is not solely driven by myocyte damages.

The Potential of Exerkines in Women's COVID-19: A New Idea for a Better and More Accurate Understanding of the Mechanisms behind Physical Exercise

The benefits of physical exercise are well-known, but there are still many questions regarding COVID-19. Chow et al.'s 2022 study, titled Exerkines and Disease, showed that a special focus on exerkines can help to better understand the underlying mechanisms of physical exercise and disease. Exerkines are a group of promising molecules that may underlie the beneficial effects of physical exercise in diseases. The idea of exerkines is to understand the effects of physical exercise on diseases better. Exerkines have a high potential for the treatment of diseases and, considering that, there is still no study of the importance of exerkines on the most dangerous disease in the world in recent years, COVID-19. This raises the fundamental question of whether exerkines have the potential to manage COVID-19. Most of the studies focused on the general changes in physical exercise in patients with COVID-19, both during the illness and after discharge from the hospital, and did not investigate the basic differences. A unique look at the management of COVID-19 by exerkines, especially in obese and overweight women who experience high severity of COVID-19 and whose recovery period is long after discharge from the hospital, can help to understand the basic mechanisms. In this review, we explore the potential of exerkines in COVID-19 by practicing physical exercise to provide compelling practice recommendations with new insights.

Impact of 12-Week Moderate-Intensity Aerobic Training on Inflammasome Complex Activation in Elderly Women

Aging often associates with a chronic low-grade inflammatory status that can be consequent to the activation of Toll-like receptors (TLRs) and the downstream NLR family pyrin domain containing 3 (NLRP3) inflammasome and causes a chronic secretion of pro-inflammatory cytokines. Since exercise has known anti-inflammatory effects, we investigated the effect of Nordic walking training on inflammasome activation and downstream effectors in elderly women. A population of elderly women was divided into EXP (n = 29) that completed 12 weeks of the moderate-intensity aerobic training program and CTRL (n = 29), performing no activity. Blood samples were taken before and after the first (T1-pre and T1-post, respectively) and last (T2-pre and T2-post, respectively) exercise unit. Inflammasome activation status was assessed by whole blood NLRP3 and TLR4 expression by RT-qPCR. Serum levels of IL-1β, IL-6, TNFα, and IL-18 cytokines were assayed by multiplex fluorescent beads-based immunoassays or ELISA. NLRP3 and TLR4 levels were reduced 2 folds between T1-pre and T2-pre and induced at T2-post, compared to T2-pre, by 2.6- and 2.9-fold, respectively. A single exercise bout elicited a 1. 38-, 1. 5-, and 1.36-fold rise of IL-1β, TNFα, and IL-6 concentration, respectively, although not significant, at the beginning of the training (T1-pre vs. T1-post), a 1.4-fold decrease for IL-1β and TNFα at the end of the training (T1-pre vs. T2-pre), and a 2-, 1.8- and 1.26-fold increase after the last exercise session (T2-pre vs. T2-post) for the three cytokines. When stratifying the population based on BMI in normal weight (NW) and overweight (OW), NLRP3 and TLR4 expression was affected only in NW. As for inflammatory cytokines, IL-1β was modulated in NW at the beginning of the training, whereas in OW at the end of the training; for TNFα, this time-dependent modulation was significant only in OW. Applied aerobic training affected the resting expression of inflammasome constituents (NLRP3 and TLR4) and levels of downstream effectors (IL-1β, TNFα, and IL-6). However, at the end of the program, participants acquire an acute inflammatory response to exercise that was absent at baseline. Future studies would have to define the molecular mechanisms associated with, and how to potentiate, the exercise-associated inflammatory response.

Effects of Resistance Training Intervention along with Leucine-Enriched Whey Protein Supplementation on Sarcopenia and Frailty in Post-Hospitalized Older Adults: Preliminary Findings of a Randomized Controlled Trial

Resistance training and protein supplementation are expected to exert the greatest effect in counteracting muscle-wasting conditions. Myokines might play a key role, but this remains to be elucidated. The aim of this study (NCT03815201) was to examine the effects of a resistance training program with post-exercise leucine-enriched protein supplementation on sarcopenia and frailty status and on the plasma myokine concentrations of post-hospitalized older adults. A total of 41 participants were included in this 12-week resistance training intervention and randomized either to the placebo group or the protein group. Sarcopenia, frailty, body composition and blood-based myokines were measured at baseline and after 12 weeks. Both groups improved in terms of physical performance (p < 0.005) and frailty (p < 0.07) following the resistance training intervention, but without any difference between groups. Myokine concentrations did not change after the intervention in either group. Changes in myostatin concentrations were associated with greater improvements in appendicular skeletal muscle mass at the end of the intervention (p < 0.05). In conclusion, the implementation of resistance training programs after hospitalization in older adults should be prioritized to combat sarcopenia and frailty immediately. The results regarding myostatin should be taken as preliminary findings.

Nordic Walking Rather Than High Intensity Interval Training Reduced Myostatin Concentration More Effectively in Elderly Subjects and the Range of This Drop Was Modified by Metabolites of Vitamin D

The COVID-19 pandemic and subsequent self-isolation exacerbated the problem of insufficient amounts of physical activity and its consequences. At the same time, this revealed the advantage of vitamin D. Thus, there was a need to verify the effects of those forms of training that can be performed independently. In this study, we examined the effects of Nordic walking (NW) and high intensity interval training (HIIT) with regard to the impact of the metabolite vitamin D. We assigned 32 overweight adults (age = 61 ± 12 years) to one of two training groups: NW = 18 and HIIT = 14. Body composition assessment and blood sample collection were conducted before starting the training programs and a day after their completion. NW training induced a significant decrease in myostatin (p = 0.05) concentration; however, the range was dependent on the baseline concentrations of vitamin D metabolites. This drop was accompanied by a significant negative correlation with the decorin concentration. Unexpectedly, NW caused a decrement in both forms of osteocalcin: undercarboxylated (Glu-OC) and carboxylated-type (Gla-OC). The scope of Glu-OC changes was dependent on a baseline concentration of 25(OH)D₂ (r = −0.60, p = 0.01). In contrast, the HIIT protocol did not induce any changes. Overall results revealed that NW diminished the myostatin concentration and that this effect is more pronounced among adults with a sufficient concentration of vitamin D metabolites.

Irisin and Vascular Inflammation: Beneficial Effects of a Healthy Lifestyle Beyond Physical Activity

Vascular inflammation is responsible for many cardiovascular diseases and endothelial dysfunction is often the first trigger. Many factors can contribute to altering vascular homeostasis and despite that some risk factors cannot be changed, some lifestyle changes might dramatically improve vascular function. In this regard, physical activity has been identified as one of the most important interventions that can positively affect endothelial dysfunction. In recent years, the discovery of irisin, a novel myokine with pleiotropic effects, has caught the attention of many researchers. This review summarizes the most relevant intervention trials, evaluating irisin modifications in subjects with or without cardiovascular risk factors assigned to physical activity programs, to improve cardiovascular risk markers.

Regular physical activity reduces the proinflammatory response in older women with diabetes and hypertension in the postmenopausal phase

Aging in women is characterized by extreme hormonal changes leading them to develop a chronic low-grade inflammation that is linked to the development of systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM). In this scenario, physical activity emerges as an interesting methodology, since it seems to be connected to a decrease in serum levels of some pro-inflammatory cytokines. Nevertheless, most studies evaluate these cytokines in an isolated manner not considering the influence of comorbidities on the responsiveness of participants to the benefits of physical activity. So, this study aimed to assess the influence of physical activity on body composition, anthropometric parameters, lipid profile, and inflammatory markers of diabetic and hypertensive older postmenopausal women. We evaluated 163 women aged from 60 to 80 years, diagnosed with T2DM and SAH that were assisted by the Family Health Units in Vitória da Conquista, Bahia, Brazil. The pratice of physical activity was measured by the International Physical Activity Questionnaire with the participants being classified as active or sedentary individuals. Active older women presented better body composition, lipid profile and inflammatory balance. This was connected to a better correlation profile between these factors in active older women, characteristics that were not noticed in sedentary older women. Moreover, IL-17A and the relationship between IL-10 and the other pro-inflammatory cytokines examined was greatly influenced by physical activity. Consequently, physical activity is linked to a global improvement in T2DM and SAH risk factors and with a positive inflammatory modulation in diabetic and hypertensive older women.

Increased Circulating H3 Histone in Response to Repeated Bouts of Exercise Does Not Associate with Parallel Alterations of Cell-Free DNA

Numerous studies have shown that cf nDNA significantly rises in stress caused by exercise. However, during nuclear decondensation, released DNA is followed by histones. Histones are also a common disease marker. After PAD4 mediated hypercitrullination extracellular H3Cit exhibits high toxicity contributing to tissue damage which, in cases of systemic inflammation, may lead to multiorgan failure and finally to death. We tested whether circulating histones rise in response to strenuous exercise. Eleven average-trained men performed three treadmill exercise tests to exhaustion at speed corresponding to 70% VO2max separated by 72 h of resting. Blood was collected before and just after each bout of exercise and plasma proteins were measured using enzyme-linked immunosorbent assay, whereas platelet activity was estimated with Light Transmission Aggregometry. Both, circulating histones and PAD4 raised in response to exercise. Plasma citrullinated histones increased from 3.1 ng/mL to 5.96 ng/mL (p = 0.0059), from 3.65 ng/mL to 6.37 ng/mL (p = 0.02), and from 3.86 ng/mL to 4.75 ng/mL (p = 0.033) after the first, second, and third treadmill run, respectively. However despite the parallel increase, no significant correlation between citrullinated histone and aggregation or cell-free nDNA was found. Furthermore, positive correlations of cf nDNA with aggregation and PAD4, lactate with aggregation, and lactate with citrullinated histone have been observed.

Irisin: A New Code Uncover the Relationship of Skeletal Muscle and Cardiovascular Health During Exercise

Exercise not only produces beneficial effects on muscle itself via various molecular pathways, but also mediates the interaction between muscles and other organs in an autocrine/paracrine manner through myokines, which plays a positive role in maintaining overall health. Irisin, an exercise-derived myokine, has been found involved in the regulation of some cardiovascular diseases. However, the relationship between irisin and cardiovascular health is not fully elucidated and there are some divergences on the regulation of irisin by exercise. In this review, we present the current knowledge on the origin and physiology of irisin, describe the regulation of irisin by acute and chronic exercises, and discuss the divergences of the related research results. Importantly, we discuss the role of irisin as a biomarker in the diagnosis of cardiovascular diseases and describe its treatment and molecular mechanism in some cardiovascular diseases. It is expected that irisin will be used as a therapeutic agent to combat cardiovascular diseases or other disorders caused by inactivity in the near future.

Exercise for slowing the progression of atherosclerotic process: effects on inflammatory markers

Atherosclerosis is a dynamic process driven by all cardiovascular risk factors that can be briefly divided into an early and a late phase. Inflammation is one of the fundamental substrates that initiates the atherosclerotic process in the early stages and promotes and maintains it in the final stages. In the last decades, clinical and experimental data have shown that inflammation is supported by mediators that respond to physical activity. The present review aimed at investigating the effect of physical exercise on inflammatory mediators, both the positive ones that have a proinflammatory effect (interleukin 6, c-reactive protein and tumor necrosis factor α, interferon γ, high-mobility group box-1), and the negative ones which have an anti-inflammatory effect (interleukin 10). Pooled data support the evidence that physical exercise can directly modulate the activity of inflammatory cytokines slowing down or preventing the formation of the atherosclerotic stage.

Plasma irisin and its associations with oxidative stress in athletes suffering from overtraining syndrome

Irisin is a novel exercise-induced myokine that may be involved in regulating energy metabolism. We determined whether overtraining syndrome (OTS) and its biochemical markers are associated with plasma irisin levels in athletes. Seven severely overtrained athletes (OA) and 10 healthy control athletes (CA) were recruited and examined at the time of diagnosis (baseline) and after 6- and 12-months follow-up. Training volume and intensity were initially restricted but progressively increased in OA as OTS symptoms alleviated; CA continued their normal training routine. A maximal cycle ergometer test was performed with irisin analyzed before and after the test. Before the exercise test, irisin levels tended to be lower in OA than in CA at baseline (154.5 ± 28.5 vs. 171.7 ± 58.7 ng/mL). In both groups, at rest irisin levels changed only marginally during follow-up and were not affected by maximal exercise, nor were they associated with physical performance or body fat percentage. Irisin concentration at rest correlated positively with an oxidative stress marker, malondialdehyde (MDA) and negatively with an antioxidant protection marker, oxygen radical absorbance capacity (ORAC) in response to the exercise test in OA at baseline. Our findings help to clarify the possible contribution of irisin and its association with oxidative stress in the pathophysiology of OTS.

Compound amino acid combined with high-dose vitamin B6 attenuate traumatic coagulopathy via inhibiting inflammation by HMGB1/TLR4/NF-κB pathway

BACKGROUND

Traumatic coagulopathy (TC) arises primarily from coagulation system failure to maintain adequate hemostasis after serious blood loss or trauma. Circulatory homeostasis restoration is the mainstay of the therapeutic approach to TC, but the effects are significantly inhibited by coagulopathy.

OBJECTIVE

To identify the therapeutic effects and underlying mechanism of compound amino acid (CAA) combined with high-dosage of vitamin B6 (VB6) on TC.

METHODS

Rabbit traumatic model and cellular model were used to evaluate the effect of CAA combined with high-dosage of VB6 in TC. Blood concentrations of AST and ALT were measured using the Vitros 250 device while blood APTT, PT and TT concentrations were measured using commercial diagnostics kits. Furthermore, qRT-PCR, ELISA and Western blotting were used to determine the expression of clotting factor (II, VII, IX, X and XI), inflammatory factors (TNF-α, IL-6 and IL-1β) and HMGB1/TLR4/NF-κB signaling-related proteins, respectively.

RESULTS

In the rabbit traumatic model, CAA combined with high-dosage of VB6 therapy inhibited the high expression of AST and ALT, but increased the expression of coagulation factors. Additionally, in both the rabbit trauma model and cellular injury model, CAA combined with high-dosage of VB6 inhibited the expression of inflammatory factors (IL-6, TNF-α and IL-1β) and proteins (HMGB1, TLR4 and p-p65) in HMGB1/TLR4/NF-κB pathway. Most importantly, over-expression of HMGB1 reversed the effect of CAA and VB6 in HUVECs and EA.hy926 cells injury model.

CONCLUSION

CAA combined with high-dosage of VB6 alleviated TC and inhibited the expression and secretion of inflammatory factors by inhibiting HMGB1-mediated TLR4/NF-κB pathway.

Effect of HFE Gene Mutation on Changes in Iron Metabolism Induced by Nordic Walking in Elderly Women

Background

Excess iron accumulation in human tissue is associated with the diet, lack of exercise, or genetic factors. Iron accumulation increases the risk of acute myocardial infarction, diabetes, and cancer. On the other hand, exercise reduces the risk of several morbidities and influences iron metabolism. Here, we evaluated changes in iron metabolism induced by exercise in elderly women bearing the H63A HFE mutation.

Purpose

To identify a factor that modulates the effect of exercise on iron metabolism. We investigated whether regular exercise induces similar changes in iron metabolism, mainly manifested by lowered body iron stores, in individuals bearing the wild-type (WT) and mutated HFE gene.

Subjects and Methods

Seventy-six women (average age 69.2±5.6 years old) were enrolled in the study. Thirty-nine women participated in 12 weeks of Nordic walking (NW) training; the remaining participants were assigned to the control group. Based on the H63A HFE mutation status, the NW group was divided into women bearing the mutation (HET, n=12) and women with the WT gene (WT, n=27).

Results

The training resulted in a statistically significant reduction in the serum iron (p=0.03) and ferritin levels (p=0.001); hepcidin levels remained unchanged. No differences in these parameters were noted between the HET and WT groups.

Conclusion

These observations suggest that a reduction in body iron stores might constitute an important aspect of the health-promoting effect of exercise, regardless of the genetic background.

Dietary protein and exercise for preservation of lean mass and perspectives on type 2 diabetes prevention

Sedentary lifestyle and aging favor the increasing prevalence of obesity and type 2 diabetes and their comorbidities. The loss of lean body mass reduces muscle strength, resulting in impaired functional capacity and leading to increased risks of chronic diseases with advancing age. Besides aging, conditions such as inappetence, social isolation, and inadequate dietary intake cause the loss of lean body mass and increased abdominal fatty mass, resulting in sarcopenic obesity and predisposition to type 2 diabetes. Compared to younger people, this condition is more common in the elderly owing to natural changes in body composition associated with aging. Lifestyle changes such as increased physical activity and improved dietary behaviors are effective for preventing the occurrence of comorbidities. Regarding muscle nutrition, besides caloric adequacy, meeting the requirements for the consumption of dietary amino acids and proteins is important for treating sarcopenia and sarcopenic obesity because muscle tissue mainly consists of proteins and is, therefore, the largest reservoir of amino acids in the body. Thus, this review discusses the effects of dietary protein on the preservation of lean body mass, improvements in the functional capacity of muscle tissue, and prevention of chronic diseases such as type 2 diabetes. In addition, we address the effects of regular physical training associated with dietary protein strategies on lean body mass, body fat loss, and muscle strength in the elderly at a risk for type 2 diabetes development.

Physical Activity and Bone Health: What Is the Role of Immune System? A Narrative Review of the Third Way

Bone tissue can be seen as a physiological hub of several stimuli of different origin (e.g., dietary, endocrine, nervous, immune, skeletal muscle traction, biomechanical load). Their integration, at the bone level, results in: (i) changes in mineral and protein composition and microarchitecture and, consequently, in shape and strength; (ii) modulation of calcium and phosphorous release into the bloodstream, (iii) expression and release of hormones and mediators able to communicate the current bone status to the rest of the body. Different stimuli are able to act on either one or, as usual, more levels. Physical activity is the key stimulus for bone metabolism acting in two ways: through the biomechanical load which resolves into a direct stimulation of the segment(s) involved and through an indirect load mediated by muscle traction onto the bone, which is the main physiological stimulus for bone formation, and the endocrine stimulation which causes homeostatic adaptation. The third way, in which physical activity is able to modify bone functions, passes through the immune system. It is known that immune function is modulated by physical activity; however, two recent insights have shed new light on this modulation. The first relies on the discovery of inflammasomes, receptors/sensors of the innate immunity that regulate caspase-1 activation and are, hence, the tissue triggers of inflammation in response to infections and/or stressors. The second relies on the ability of certain tissues, and particularly skeletal muscle and adipose tissue, to synthesize and secrete mediators (namely, myokines and adipokines) able to affect, profoundly, the immune function. Physical activity is known to act on both these mechanisms and, hence, its effects on bone are also mediated by the immune system activation. Indeed, that immune system and bone are tightly connected and inflammation is pivotal in determining the bone metabolic status is well-known. The aim of this narrative review is to give a complete view of the exercise-dependent immune system-mediated effects on bone metabolism and function.

Vitamin D Supplementation and Nordic Walking Training Decreases Serum Homocysteine and Ferritin in Elderly Women

The aim of the study was to verify if coupling 12 weeks of vitamin D supplementation and Nordic walking training favoured lowering the homocysteine (Hcy) level. Ninety-four elderly women were divided into three groups: Nordic walking (NW), supplemented (SG) and control (CG). The NW and SG groups received a weekly dose of 28,000 IU of vitamin D3. A blood analysis was performed at baseline, 1h after the first training session and at the end of the experiment. The amino acid profile (methionine and cysteine) and homocysteine concentration were determined. Additionally, the concentration of myokine was assessed. The first session of NW training reduced serum homocysteine, particularly among women with baseline homocysteine above 10 µmol·L⁻¹: 12.37 ± 2.75 vs. 10.95 ± 3.94 µmol·L⁻¹ (p = 0.05). These changes were accompanied by shifts in the cysteine (p = 0.09) and methionine (p = 0.01) concentration, regardless of the Hcy concentration. Twelve weeks of training significantly decreased the homocysteine (9.91 ± 2.78, vs. 8.90 ± 3.14 µmol·L⁻¹, p = 0.05) and ferritin (94.23 ± 62.49 vs. 73.15 ± 47.04 ng·mL⁻¹, p = 0.05) concentrations in whole NW group. Also, in the NW group, ferritin correlated with the glucose level (r = 0.51, p = 0.00). No changes in the myokine levels were observed after the intervention. Only the brain-derived neurotrophic factor dropped in the NW (42.74 ± 19.92 vs. 31.93 ± 15.91 ng·mL⁻¹, p = 0.01) and SG (37.75 ± 8.08 vs. 16.94 ± 12.78 ng·mL⁻¹, p = 0.00) groups. This study presents a parallel decrease of homocysteine and ferritin in response to regular training supported by vitamin D supplementation.

The Effect of Nordic Walking Training Combined with Vitamin D Supplementation on Postural Control and Muscle Strength in Elderly People-A Randomized Controlled Trial

Nordic Walking (NW) and Vitamin D concentration (Vit D) alone have been shown to contribute to the health and performance of elderly people. However, the interaction between these two factors has yet to be explored. In this study 42 women over 60 years of age (69.02 ± 5.56 years) were recruited and divided in two NW groups: a high-intensity interval training group (HI-NW) and a moderate-intensity continuous training group (MI-NW). Individuals from each group completed a 12-week NW training program (3 times a week/2 hours) combined with randomized Vitamin D supplementation (HD = high dose: 4000 IU/day or LD = low dose: 800 IU/day). Body composition, postural control, muscle strength and Vitamin D serum concentration were measured twice; before and after the intervention. To investigate the interaction between supplementation and training a mixed-design analysis of variance (ANOVA) was performed. The HI-NW group, regardless of supplementation dose, increased their Vit D and elbow torque performance. On the other hand, in the MI-NW group the same Vit D outcome was seen only with HD supplementation and was also associated with increased leg muscle mass. In conclusion, beneficial effects of both HI-NW and MI-NW training regimes were seen. The impact of the dose supplementation on Vit D and body composition was related to the type of NW training.

Exercise alarms the immune system: A HMGB1 perspective

The "danger" model of immunology states that the immune system detects and responds to danger by releasing endogenous molecules called alarmins. Strenuous exercise perturbs physiological homeostasis, increasing circulating alarmins to drive the inflammatory response. We describe a working concept of exercise-induced High Mobility Group Box (HMGB)1, a prototypical alarmin, in modulating immune responses and adaptations.

Nordic Walking Training Causes a Decrease in Blood Cholesterol in Elderly Women Supplemented with Vitamin D

OBJECTIVE

Different studies have demonstrated that regular exercise can induce changes in the lipid profile, but results remain inconclusive. Available data suggest that correction of vitamin D deficiency can improve the lipid profile. In this study, we have hypothesized that Nordic Walking training will improve lipid profile in elderly women supplemented with vitamin D.

METHODS

A total of 109 elderly women (68 ± 5.12 years old) took part in the study. First group [experimental group (EG): 35 women] underwent 12 weeks of Nordic Walking (NW) training combined with vitamin D supplementation (4,000 IU/day), second group [supplementation group (SG): 48 women] was only supplemented with vitamin D (4,000 IU/day), and third group [control group (CG): 31 women] was not subject to any interventions. Blood analysis of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and 25-OH-D₃ was performed at baseline and after the 12 weeks of NW training. Additionally, a battery of field tests specifically developed for older adults was used to assess the components of functional fitness. The same blood analysis was repeated for the EG 6 months after the main experiment.

RESULTS

After 12 weeks of NW training and vitamin D supplementation, in the EG a decrease in TC, LDL-C, and TG was observed. In the SG, no changes in the lipid profile were observed, whereas in the CG an increase in the HDL-C level was noticed. Positive physical fitness changes were only observed in the EG.

CONCLUSION

Our obtained data confirmed baseline assumption that regular exercise induces positive alternations in lipid profile in elderly women supported by supplementation of vitamin D.

Nordic Walking Can Be Incorporated in the Exercise Prescription to Increase Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to summarize and analyze the effects of Nordic Walking on physical fitness, body composition, and quality of life in the elderly. Keyword "Nordic Walking" associated with "elderly" AND/OR "aging" AND/OR "old subjects" AND/OR "aged" AND/OR "older adults" were used in the online database MEDLINE, Embase, PubMed, Scopus, PsycINFO, and SPORTDiscus. Only studies written in English language and published in peer-reviewed journals were considered. A meta-analysis was performed and effect sizes calculated. Fifteen studies were identified; age of participants ranged from 60 to 92 years old. Comparing with a sedentary group, effect sizes showed that Nordic Walking was able to improve dynamic balance (0.30), functional balance (0.62), muscle strength of upper (0.66) and lower limbs (0.43), aerobic capacity (0.92), cardiovascular outcomes (0.23), body composition (0.30), and lipid profile (0.67). It seemed that Nordic Walking had a negative effect on static balance (-0.72). Comparing with a walking (alone) training, effect sizes showed that Nordic Walking improved the dynamic balance (0.30), flexibility of the lower body (0.47), and quality of life (0.53). Walking training was more effective in improving aerobic capacity (-0.21). Comparing Nordic Walking with resistance training, effect sizes showed that Nordic Walking improved dynamic balance (0.33), muscle strength of the lower body (0.39), aerobic capacity (0.75), flexibility of the upper body (0.41), and the quality of life (0.93). Nordic Walking can be considered as a safe and accessible form of aerobic exercise for the elderly population, able to improve cardiovascular outcomes, muscle strength, balance ability, and quality of life.

Is irisin the new player in exercise-induced adaptations or not? A 2017 update

Irisin is produced by a proteolytic cleavage of fibronectin type III domain-containing protein 5 (FNDC5) and has emerged as a potential mediator of exercise-induced energy metabolism. The purpose of this study was to review the results of studies that investigated irisin responses to acute and chronic exercise and provide an update. A comprehensive search in the databases of MEDLINE was performed (74 exercise studies). The focus of the analysis was on data concerning FNDC5 mRNA expression in skeletal muscle and circulating irisin concentration relatively to exercise mode, intensity, frequency and duration and the characteristics of the sample used. Circulating irisin levels may either not relate to FNDC5 transcription or expression of the later precedes irisin rise in the blood. Acute speed/strength and endurance exercise protocols represent potent stimuli for irisin release if they are characterized by adequate intensity and/or duration. There are no reports regarding irisin responses to field sport activities. Although animal studies suggest that irisin may also respond to systematic exercise training, the majority of human studies has produced contradictory results. Certain methodological issues need to be considered here such as the analytical assays used to measure irisin concentration in the circulation. Results may also be affected by subjects’ age, conditioning status and exercise intensity. The role of irisin as a moderator of energy metabolism during exercise remains to be seen.

1,25-Dihydroxyvitamin D Inhibits LPS-Induced High-Mobility Group Box 1 (HMGB1) Secretion via Targeting the NF-E2-Related Factor 2-Hemeoxygenase-1-HMGB1 Pathway in Macrophages

1,25-Dihydroxyvitamin D [1,25(OH)₂D₃] is recognized as a key mediator of inflammatory diseases, including sepsis. Clinical studies demonstrate that 1,25 (OH)₂D₃ protects patients from sepsis, but clinical treatment with 1,25(OH)₂D₃ is rare. In this study, we report that 1,25(OH)₂D₃ treatment has beneficial effects and improves the survival rate in LPS-induced mouse sepsis model by blocking the secretion of high-mobility group box 1 (HMGB1), a key late regulator of sepsis. LPS-induced HMGB1 secretion is attenuated by 1,25(OH)₂D₃via blocking HMGB1 translocation from the nucleus to the cytoplasm in macrophages. 1,25(OH)₂D₃ can induce the expression of hemeoxygenase-1 (HO-1), which is essential for blocking HMBG1 nuclear translocation and its secretion. When siHO-1 or an HO-1 inhibitor are used, the effect of 1,25(OH)₂D₃ on inhibition of HMGB1 secretion is suppressed. Considering that HO-1 is a downstream gene of NF-E2-related factor 2 (Nrf2), we further confirm that Nrf2 activation can be activated by 1,25(OH)₂D₃ upon LPS exposure. Together, we provide evidence that 1,25(OH)₂D₃ attenuates LPS-induced HMGB1 secretion via the Nrf2/HO-1 pathway in macrophages.