The role of exercise-induced myokines in muscle homeostasis and the defense against chronic diseases

The role of resistance exercise-induced local metabolic stress in mediating systemic health and functional adaptations: could condensed training volume unlock greater benefits beyond time efficiency?

The majority of "specialised" exercise configurations (e.g., supersets, drop sets, blood flow restriction) are being assessed as "shortcuts" to hypertrophy and strength improvements. However, these advanced training techniques may also offer significant benefits for systemic health and functional outcomes across recreational and clinical populations via locally induced metabolic responses. Stress-regulating mechanisms are known to enhance the body's resilience by facilitating allostasis, the process of coordinating adaptive processes in reaction to stressors such as physical training. Yet, the role of the local metabolic stress provoked by resistance exercise has not gained much research attention despite its wide potential. Positive effects are not only linked to improved muscular endurance, hypertrophy and strength via primary and secondary mechanisms, but also to the release of myokines, hormones, microRNAs, immune factors, inflammatory substances and other endocrine molecules that initiate numerous health-promoting modifications on a systemic level. Resistance exercise strategies that maximise the local accumulation of metabolites are not well defined, although high volume, close proximity to failure and shorter rests seem to be a necessity. Additionally, blood flow restriction training provides a potent alternative for inducing local acidosis, thereby triggering several pathways associated with improved immunity and physical function even in remote muscle tissues. Future research is warranted to further explore advanced resistance training techniques, as these approaches may offer comparable benefits for physical and mental health to those seen with other forms of exercise such as high-intensity interval training and heavy resistance training.

Short-time resistance training enhances sleep quality in obese and non-obese young women

PURPOSE

The purpose of this study was to examine the effects of short-term resistance training on sleep quantity and quality in young women, according to their body fat.

METHODS

Thirty-five young women were randomly assigned based on their body fat levels, using the 90th percentile of fat mass as a criterion, with a threshold set at ≥ 21 kg of fat mass for the obese group (n = 16) and < 21 kg of fat mass for the non-obese group (n = 19). Subjective sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at pre and post a progressive six-week full-body resistance training (RT).

RESULTS

Post-intervention analysis showed a reduction in the overall sleep score (p = 0.006, η2 = 0.21), improvement in subjective sleep quality (p < 0.001; η2 = 0.357) and a decrease in sleep disturbances (p = 0.034; η2 = 0.129). However, no interaction between group x training for sleep parameters and body composition was observed (p > 0.05). There were no significant correlations between sleep quality, fat mass and fat-free mass in both groups investigated (p > 0.05).

CONCLUSION

Six-weeks of RT improved subjective sleep quality and reduced sleep disturbances in young women, regardless of the amount of fat mass. Sleep variables were not associated with changes in body composition.

Muscle Strength and Cardiovascular Health in MASLD: A Prospective Study

Background and Objectives: The pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) remains incompletely understood. However, recent studies highlight the interactions between muscle, liver, and adipose tissue. This study aimed to explore the relationships between clinical indicators of MASLD and sarcopenia, cardiorespiratory fitness, fatigue, and mood. Materials and Methods: The study involved 60 participants, including 28 healthy controls and 32 with MASLD, categorized into two disease subgroups: 15 with MASL and 17 with metabolic dysfunction-associated steatohepatitis (MASH). Participants completed an incremental speed shuttle walk test to evaluate cardiorespiratory fitness, a hand-held dynamometer assessment for appendicular muscle strength, and the timed up and go test for physical performance. Physical activity level, fatigue, quality of life, and emotional state were assessed using questionnaires. The test results were compared between groups and with disease characteristics. Results: MASL and MASH groups showed reduced cardiorespiratory fitness (p < 0.001). The knee extensors were significantly weaker in both MASL and MASH groups (p < 0.001 and p = 0.001, respectively). The MASH group reported higher levels of depression and negative health perception (p = 0.006 and p = 0.03, respectively). Muscle strength in patients with MASLD showed a significant negative association with depression (OR = -0.384, 95% CI: -3.10 to -0.74, p = 0.003), intrahepatic triglyceride content (OR = -0.287, 95% CI: -1.31 to -0.11, p = 0.023), and LDL (OR = -0.286, 95% CI: -0.02 to -0.33, p = 0.03). In contrast, a positive association was observed between VO2 and muscle strength (OR = 0.531, 95% CI 1.27 to 3.47, p < 0.001). Conclusions: This study suggests that muscle strength is linked to key metabolic parameters, such as hepatic fat, LDL levels, and aerobic capacity, that may contribute to the development and progression of MASLD. Interventions aimed at preserving or enhancing muscle strength in MASLD patients may be essential for preventing liver damage and improving metabolic health.

Irisin and Metastatic Melanoma: Selective Anti-Invasiveness Activity in BRAF Wild-Type Cells

Irisin is a newly discovered 12 kDa messenger protein involved in energy metabolism. Irisin affects signaling pathways in several types of cancer; however, the role of irisin in metastatic melanoma (MM) has not been described yet. We explored the biological effects of irisin in in vitro models of MM cells (HBLwt/wt, LND1wt/wt, Hmel1V600K/wt and M3V600E/V600E) capable of the oncogenic activation of BRAF. We treated MM cells with different concentrations of r-irisin (10 nM, 25 nM, 50 nM, 100 nM) for 24 h-48 h. An MTT assay highlighted that r-irisin did not affect the proliferation of MM cells. We subsequently treated MM cells with 10 nM r-irisin, corresponding to the dose exhibiting biological activity in vitro. Irisin reduced the invasive ability of only LND1wt/wt (p < 0.05), which highly expressed αv gene levels, but did not affect the invasion of BRAFmut cells. Gelatin zymography analysis showed a reduction in the enzymatic activity of MMP-2 and MMP-9 in BRAFwt/wt cells treated with 10 nM r-irisin. Moreover, gene expression analysis (qPCR) of MMP-2 and MMP-9 and of the fibrinolytic system (uPAR, uPA and PAI-1) highlighted a crucial role of 10 nM r-irisin treatment in the inhibition of pro-invasive systems in BRAFwt/wt. In conclusion, our results may suggest a possible differential role of irisin in melanoma cells.

CT-based sarcopenia assessment: Predicting outcomes in acute infection patients

In this retrospective cohort study, we investigated the prognostic value of sarcopenia evaluated by Computed Tomography (CT)-based indices for adverse hospitalization outcomes in patients with acute infections. We analyzed data from 225 patients admitted to the hospital for acute infections between 2019 and 2020. Patients who had undergone an abdominal CT scan either up to 1 month before or within the first 3 days of hospitalization were included. CT image analysis was used to evaluate skeletal muscle mass (by skeletal muscle index (SMI)) and muscle quality (by psoas muscle density, pMD). Low pMD was associated with higher in-hospital mortality (31% vs 11.4% p < 0.001) as well as higher longer-term mortality rates (p = 0.008 for 30 days and <0.001 for 90- and 1-year mortality). Low pMD remained an independent poor prognostic factor after controlling for confounders, with an adjusted odds ratio (aOR) of 2.74, (95% CI 1.33-5.67, p = 0.006) for 1-year mortality, and aOR of 2.61, (95% CI 1.23-5.55) for a prolonged hospital stay. Low SMI was associated with adverse outcomes, although this association was not independent after controlling for confounders. Notably, patients with both low SMI and pMD exhibited the poorest hospitalization outcomes: aOR for 1-year mortality 5.015 (95% CI 1.767-14.23, p = 0.002), and prolonged length of stay aOR 3.197, (95% CI 1.159-8.821, p = 0.025). CT-based muscle indices serve as independent prognostic factors in medical patients admitted with acute infection. Incorporating radiological assessments of sarcopenia into routine care for hospitalized patients with acute infection may enable risk stratification and early intervention in reversible conditions.

The impact of COVID-19 on accelerating of immunosenescence and brain aging

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has profoundly impacted global health, affecting not only the immediate morbidity and mortality rates but also long-term health outcomes across various populations. Although the acute effects of COVID-19 on the respiratory system have initially been the primary focus, it is increasingly evident that the virus can have significant impacts on multiple physiological systems, including the nervous and immune systems. The pandemic has highlighted the complex interplay between viral infection, immune aging, and brain health, that can potentially accelerate neuroimmune aging and contribute to the persistence of long COVID conditions. By inducing chronic inflammation, immunosenescence, and neuroinflammation, COVID-19 may exacerbate the processes of neuroimmune aging, leading to increased risks of cognitive decline, neurodegenerative diseases, and impaired immune function. Key factors include chronic immune dysregulation, oxidative stress, neuroinflammation, and the disruption of cellular processes. These overlapping mechanisms between aging and COVID-19 illustrate how the virus can induce and accelerate aging-related processes, leading to an increased risk of neurodegenerative diseases and other age-related conditions. This mini-review examines key features and possible mechanisms of COVID-19-induced neuroimmune aging that may contribute to the persistence and severity of long COVID. Understanding these interactions is crucial for developing effective interventions. Anti-inflammatory therapies, neuroprotective agents, immunomodulatory treatments, and lifestyle interventions all hold potential for mitigating the long-term effects of the virus. By addressing these challenges, we can improve health outcomes and quality of life for millions affected by the pandemic.

Long-term impact of adherence to muscle-strengthening guidelines on inflammation markers: a 17-year follow-up study with obesity parameters as mediators

Objective

To evaluate the relationship between adherence to muscle-strengthening guidelines in young adulthood and inflammation markers over a 17-year follow-up period. Additionally, it aims to examine whether body mass index (BMI) and waist circumference (WC) act as mediators in this relationship.

Methods

The study analysed data from young adults aged 18-26 years who participated in waves III (2001-2002), IV (2008-2009) and V (2016-2018) of the Add Health Study. Adherence to muscle-strengthening guidelines was self-reported, and participants were classified as adherent if they engaged in strength training ≥2 days per week across all waves. Venous blood samples were collected at participants' homes to measure high-sensitivity C reactive protein (hs-CRP) levels and various cytokine concentrations, including interleukin (IL)-6, IL-1beta, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-α). A global inflammation score was also calculated using z-scores of these markers.

Results

A total of 2320 individuals participated (60.8% females). Participants adhering to muscle-strengthening guidelines exhibited significant reductions in hs-CRP, IL-6 and the inflammation z-score, with mean difference (MD) of -1.556 mg/L (95% CI BCa -2.312 to -0.799), -0.324 pg/mL (95% BCa CI -0.586 to -0.062), and -0.400 (95% BCa CI -0.785 to -0.035), respectively. Mediation analysis revealed that BMI and WC levels at wave V significantly mediated the relationship between strength training and inflammation z-score, with significant indirect effects of -0.142 (95% CI -0.231 to -0.055) for BMI and -0.210 (95% CI -0.308 to -0.124) for WC.

Conclusion

Adherence to muscle-strengthening guidelines alone may not be sufficient to achieve a notable decrease in inflammation without concurrent reductions in these obesity parameters.

Challenges in tendon-bone healing: emphasizing inflammatory modulation mechanisms and treatment

Tendons are fibrous connective tissues that transmit force from muscles to bones. Despite their ability to withstand various loads, tendons are susceptible to significant damage. The healing process of tendons and ligaments connected to bone surfaces after injury presents a clinical challenge due to the intricate structure, composition, cellular populations, and mechanics of the interface. Inflammation plays a pivotal role in tendon healing, creating an inflammatory microenvironment through cytokines and immune cells that aid in debris clearance, tendon cell proliferation, and collagen fiber formation. However, uncontrolled inflammation can lead to tissue damage, and adhesions, and impede proper tendon healing, culminating in scar tissue formation. Therefore, precise regulation of inflammation is crucial. This review offers insights into the impact of inflammation on tendon-bone healing and its underlying mechanisms. Understanding the inflammatory microenvironment, cellular interactions, and extracellular matrix dynamics is essential for promoting optimal healing of tendon-bone injuries. The roles of fibroblasts, inflammatory cytokines, chemokines, and growth factors in promoting healing, inhibiting scar formation, and facilitating tissue regeneration are discussed, highlighting the necessity of balancing the suppression of detrimental inflammatory responses with the promotion of beneficial aspects to enhance tendon healing outcomes. Additionally, the review explores the significant implications and translational potential of targeted inflammatory modulation therapies in refining strategies for tendon-bone healing treatments.

How Can Promoting Skeletal Muscle Health and Exercise in Children and Adolescents Prevent Insulin Resistance and Type 2 Diabetes?

Skeletal muscle secretome, through its paracrine and endocrine functions, contributes to the maintenance and regulation of overall physiological health. We conducted a narrative review on the role of skeletal muscle and exercise in maintaining glucose homeostasis, driving insulin resistance (IR), and preventing type 2 diabetes in pediatric populations, especially in the context of overweight and obesity. Myokines such as interleukin (IL)-6, IL-8, and IL-15, as well as irisin, myonectin, and myostatin, appear to play a crucial role in IR. Skeletal muscle can also become a target of obesity-induced and IR-induced inflammation. In the correlation between muscle, IR, and inflammation, the role of infiltration of the immune cells and the microvasculature may also be considered. It remains unclear which exercise approach is the best; however, combining aerobic exercise with resistance training seems to be the most effective strategy for managing IR, with high-intensity activities offering superior metabolic benefits and long-term adherence. Encouraging daily participation in enjoyable and engaging exercise is key for long-term commitment and effective glucose metabolism management. Promoting physical activity in children and adolescents must be a top priority for public health, not only in terms of individual quality of life and well-being but also for community health.

Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability

Background/Objectives: Hospital-associated disability (HAD), a functional decline following acute hospitalization, is a common complication associated with mortality and unfavorable prognoses in patients admitted to acute care hospitals. However, few studies have investigated mortality and associated factors in patients with HAD and have been limited by inconsistent HAD assessment tools and criteria. This study investigated mortality and risk factors in patients with HAD using specific criteria. Methods: This retrospective study evaluated patients referred to the Department of Rehabilitation Medicine with suspected HAD between June 2022 and March 2023. The collected data included medical histories, diagnostic tests for HAD (including muscle strength, balance, and modified Barthel Index), and bioelectrical impedance analysis (BIA). Multivariate logistic regression analysis was conducted to identify factors associated with mortality. Kaplan-Meier survival curves were constructed for mortality at 3 and 7 months. Results: A total of 455 patients were identified, among which 206 patients diagnosed with HAD (73.1 ± 12.5 years) were included in the analysis. The 3-month mortality rate was 27.2%. In the multivariate analysis, male sex (odds ratio (OR), 3.23; p < 0.01), a history of cancer (OR, 2.18; p < 0.05), and a low phase angle (OR, 0.69; p < 0.05) were significantly associated with mortality. A phase angle < 2.9° on BIA was associated with a significant increase in 3-month (hazard ratio (HR), 1.85; 95% confidence interval (CI), 1.06-3.23) and 7-month (HR, 2.80; 95% CI, 1.75-4.98) mortality. Conclusions: Patients with HAD had a high mortality rate, with several factors, particularly low BIA phase angles, associated with increased mortality.

Prognostic significance of preoperative osteosarcopenia on patient' outcomes after emergency surgery for gastrointestinal perforation

PURPOSE

Sarcopenia is a prognostic predictor in emergency surgery. However, there are no reports on the relationship between osteopenia and in-hospital mortality. This study clarified the effect of preoperative osteosarcopenia on patients with gastrointestinal perforation after emergency surgery.

METHODS

We included 216 patients with gastrointestinal perforations who underwent emergency surgery between January 2013 and December 2022. Osteopenia was evaluated by measuring the pixel density in the mid-vertebral core of the 11th thoracic vertebra. Sarcopenia was evaluated by measuring the area of the psoas muscle at the level of the third lumbar vertebra. Osteosarcopenia is defined as the combination of osteopenia and sarcopenia.

RESULTS

Osteosarcomas were identified in 42 patients. Among patients with osteosarcopenia, older and female patients and those with an American Society of Anesthesiologists Physical Status of ≥ 3 were significantly more common, and the body mass index, hemoglobin value, and albumin level were significantly lower in these patients than in patients without osteosarcopenia. Furthermore, the osteosarcopenia group presented with more postoperative complications than patients without osteosarcopenia (P < 0.01). In the multivariate analysis, age ≥ 74 years old (P = 0.04) and osteosarcopenia (P = 0.04) were independent and significant predictors of in-hospital mortality.

CONCLUSION

Preoperative osteosarcopenia is a risk factor of in-hospital mortality in patients with gastrointestinal perforation after emergency surgery.

Effects of Exercise-Induced Changes in Myokine Expression on the Tumor Microenvironment

In this narrative review, we summarize the direct and indirect effects that myokines have on the tumor microenvironment. We took studies of various cancer types and species into account. Systematic reviews and meta-analyses that matched the search terms were also considered. We searched databases for six months. As a narrative approach was chosen, no data was analyzed or reanalyzed. The goal of this narrative review is to create an overview on the topic to identify research gaps and answer the questions as to whether myokine expression may be relevant in cancer research in regard to the tumor microenvironment. Six commonly known myokines were chosen. We found strong links between the influence exercise has on interleukin-6, oncostatin M, secreted protein acidic and rich in cysteine, and irisin in the context of tumor progression and inhibition via interactions with the tumor microenvironment. It became clear that the effects of myokines on the tumor microenvironment can vary and contribute to disease progression or regression. Interactions among myokines and immune cells must also be considered and require further investigation. To date, no study has shown a clear connection, while multiple studies suggest further investigation of the topic, similar to the effects of exercise on myokine expression.

Biochemical and Histological Effects of Moringa oleifera Extract against Valproate-Induced Kidney Damage

Valproic acid is an effective treatment for generalized seizure and related neurological defects. Despite its efficacy and acceptability, its use is associated with adverse drug effects. Moringa oleifera leaves are rich in phytochemical and nutritional components. It has excellent antioxidant and ethnobotanical benefits, thus popular among folk medicines and nutraceuticals. In the present study, 70% ethanol extract of moringa leaves was assessed for its in vivo biochemical and histological effects against valproate-induced kidney damage. Female Sprague-Dawley rats were randomly divided into four groups: Group I: control animals given physiological saline (n = 8); Group II: Moringa extract-administered group (0.3 g/kg b.w./day, n = 8); Group III: valproate-administered animals (0.5 g/kg b.w./day, n = 15); and Group IV: valproate + moringa extract (given similar doses of both valproate and moringa extract, n = 12) administered group. Treatments were administered orally for 15 days, the animals were fasted overnight, anesthetized, and then tissue samples harvested. In the valproate-administered experimental group, serum urea and uric acid were elevated. In the kidney tissue of the valproate rats, glutathione was depleted, antioxidant enzyme activities (superoxide dismutase, catalase, glutathione reductase, glutathione S-transferase, and glutathione peroxidase) disrupted, while oxidative stress biomarker, inflammatory proteins (Tumor necrosis factor-alpha and interleukin-6), histological damage scores, and the number of PCNA-positive cells were elevated. M. oleifera attenuated all these biochemical defects through its plethora of diverse antioxidant and therapeutic properties.

The association between inflammatory biomarkers and low back disorder: a systematic review and meta-analysis

INTRODUCTION

Low back disorder (LBD) is a major cause of disability worldwide. Inflammation results in proliferation of cytokines or consequent degradation products (collectively known as inflammatory biomarkers) that activate pain pathways which can result in non-specific LBD. This systematic review and meta-analysis aim to evaluate the relationship between inflammatory biomarkers and clinical outcomes in patients with LBD.

METHODS

The PRISMA guideline was followed for the systematic reivew. Three online databases were searched. Four RCTs and sixteen observational studies with 1142 LBD patients were analysed. The primary outcomes were back and leg pain scores, back-specific disability scores and expression of inflammatory biomarkers. Standardized mean difference (SMD) and their 95% confidence intervals (CI) were evaluated. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to summarize the strength of evidence.

RESULTS

Four RCTs and sixteen observational studies were included in the analysis of 1142 patients with LBD. There was a statistically significant reduction in back pain score and IL-1 beta and increase in the expression of CTX-1 and IL-10 levels post treatment. There was a significant relationship between increase in the expression of MCP- and reduction in the expression of hsCRP with increase in back pain. Significant relationship was also observed between increase in the expression of MCP-1 and reduction in the expression of IL-6 with increase in leg pain. Increase in the expression of IL-8 and reduction in the expression of hsCRP was also associated with increased disability score.

CONCLUSION

Inflammatory biomarkers play a significant role in the pathogenesis of LBD. CTX-1, IL-10 and IL-1 beta may be responsible for the decrease in back pain scores post treatment. There is a relationship between MCP-1, IL-6, IL-8 and hsCRP with clinical and functional assessments for LBD. Further studies will improve understanding of the pathogenesis of LBD and aid in targeted management strategies.

Exploring exercise-driven exerkines: unraveling the regulation of metabolism and inflammation

Exercise has many beneficial effects that provide health and metabolic benefits. Signaling molecules are released from organs and tissues in response to exercise stimuli and are widely termed exerkines, which exert influence on a multitude of intricate multi-tissue processes, such as muscle, adipose tissue, pancreas, liver, cardiovascular tissue, kidney, and bone. For the metabolic effect, exerkines regulate the metabolic homeostasis of organisms by increasing glucose uptake and improving fat synthesis. For the anti-inflammatory effect, exerkines positively influence various chronic inflammation-related diseases, such as type 2 diabetes and atherosclerosis. This review highlights the prospective contribution of exerkines in regulating metabolism, augmenting the anti-inflammatory effects, and providing additional advantages associated with exercise. Moreover, a comprehensive overview and analysis of recent advancements are provided in this review, in addition to predicting future applications used as a potential biomarker or therapeutic target to benefit patients with chronic diseases.

Are women with endometriosis more likely to experience reduced physical performance compared to women without the condition?

Background

Endometriosis is a condition of the female reproductive system associated with pelvic pain. Chronic pain can affect physical performance by limiting the functional activities, thus, it is hypothesized that women with endometriosis may also present decreased functional capacity, decreased strength, and mobility. The objective of this study is to compare physical performance in women with and without endometriosis.

Methods

This is a cross-sectional study composed of 115 women equally divided into two groups: the endometriosis group (EG), composed of women with a confirmed diagnosis of the disease by magnetic resonance imaging, and the comparator group (CG), consisting of women without suspicion of the disease. Physical performance (dependent variable) was assessed using hand dynamometry, the 6-min walk test (6MWT), gait speed, and the chair stands test. CG participants performed the tests during the luteal phase of the menstrual cycle. Descriptive statistics, unpaired t-tests, and chi-square tests were used to describe and compare the groups. Multiple linear regression tested the associations adjusted for covariates (age, income, education, age at menarche, and body mass index).

Results

The EG had worse gait speed (mean difference: -0.11; 95% CI: [-0.18 to -0.04]), weaker grip strength (mean difference: -3.32; 95% CI: [-5.30 to -1.33]), shorter distance covered in the 6MWT (mean difference: -83.46; 95% CI: [-121.38 to -45.53]), and a lower number of repetitions in the chair stands test (mean difference: -8.44; 95% CI: [-10.64 to -6.25]) than the CG, even after adjusting for covariates.

Conclusion

Grip strength, lower limb strength, mobility, and functional capacity were worse in women diagnosed with endometriosis. Women with endometriosis should be encouraged to engage in physical exercise, adopt healthy lifestyle habits, and participate in rehabilitation activities to control pain, with the aim of reducing functional impairments.

Can Muscular Parameters Predict Symptoms of Anxiety and Depression?

Major depressive disorder and anxiety disorders are among the major public health issues. Therefore, identifying predictors of symptoms of depression and anxiety holds fundamental importance to avoid the aggravation of these conditions. Muscle strength and function (e.g., handgrip strength and timed-stands test) are widely recognized predictors of health outcomes; however, their association with symptoms of depression and anxiety is still not completely understood. This study investigated the associations between handgrip strength and timed-stands test scores with symptoms of depression and anxiety. In addition, we examined whether individuals exhibiting greater strength levels demonstrate reduced symptoms of anxiety and depression compared to those with lower levels of strength. This is a community-based, cross-sectional study. Participants were recruited through social media and underwent a semi-structured interview to record sociodemographic characteristics, comorbidities, use of tobacco and medication, and symptoms of anxiety (Beck's Anxiety Inventory [BAI]) and depression (Beck's Depressive Inventory [BDI]). Subsequently, anthropometric characteristics, handgrip strength, and functionality (i.e., timed-stands test) were assessed. In all, 216 individuals were evaluated. The adjusted regression model showed an inverse association between handgrip strength and anxiety (β = -0.22; 95% CI [-0.38, -0.07]; R2 = 0.07, p = .005) and depression symptoms (β = -0.25; 95% CI [-0.42, -0.07]; R2 = 0.05, p = .006). Similarly, timed-stands test scores were associated with anxiety (β = -0.33; 95% CI [-0.54, -0.13]; R2 = 0.09, p = .002) and depression (β = -0.32; 95% CI [-0.56, -0.09]; R2 = 0.06, p = .008). Furthermore, the low-strength group showed higher values on the BAI (9.5 vs. 5.9 arbitrary units; p = .0008) and BDI than the high-strength group (10.8 vs. 7.9 arbitrary units; p = .0214). When individuals were stratified by the timed-stands test, the low timed-stands group demonstrated higher values on the BAI (9.9 vs. 5.5 arbitrary units; p = .0030) and BDI than the high timed-stands group (11.2 vs. 7.5 arbitrary units; p < .0001). The results highlight muscular parameters as significant predictors associated with anxiety and depression symptoms.

Impact of rehabilitation dose on body mass index change in older acute patients with stroke: a retrospective observational study

Background

It is established that a low body mass index (BMI) correlates with a diminished home discharge rate and a decline in activities of daily living (ADL) capacity among elderly stroke patients. Nevertheless, there exists a paucity of knowledge regarding strategies to mitigate BMI reduction during the acute phase. This investigation seeks to elucidate the impact of rehabilitation dose, as determined by both physical and occupational therapy, on BMI alterations, positing that a heightened rehabilitation dose could thwart BMI decline.

Methods

This retrospective, observational study was conducted in the stroke unit of a university hospital. Enrollees comprised individuals aged ≥65 years, hospitalized for stroke, and subsequently relocated to rehabilitation facilities between January 2019 and November 2020. The percentage change in BMI (%ΔBMI) was calculated based on BMI values at admission and discharge. Multivariate multiple regression analysis was employed to ascertain the influence of rehabilitation dose on %ΔBMI.

Results

A total of 187 patients were included in the analysis, of whom 94% experienced a reduction in BMI during acute hospitalization. Following adjustment for sociodemographic and clinical factors, multivariable analyzes revealed a positive association between rehabilitation dose and %ΔBMI (β = 0.338, p < 0.001).

Conclusion

The findings of this study suggest that, in the context of acute stroke treatment, an augmented rehabilitation dose is associated with a diminished decrease in BMI.

Endometriosis and physical activity: A narrative review

Endometriosis is a painful gynecological disorder that affects many women. Constant treatments and contraception changes affect women looking for solutions to treat and limit the problems caused by endometriosis. The current narrative review discusses the effects of physical activity on the management, pain, and quality of life in patients with endometriosis. Findings suggest that body awareness practices such as Hatha yoga, the Jacobson method, and progressive muscle relaxation reduce pain and stress and improve the quality of life associated with endometriosis. It also highlights the current knowledge gap on available evidence and future research. Moreover, care must be taken when considering patients' physical abilities and goals and avoiding intense physical activities. The forms of endometriosis and its symptoms vary from one woman to another, so it is important to perform studies with various nonmedicinal or surgical techniques. It is important to continue randomized controlled trials to obtain more data on the benefits of physical activity in women with endometriosis and also to identify what types of activities could be beneficial to combat pain symptoms and improve the daily lives of women with endometriosis.

Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA)

BACKGROUND

There are many factors associated with functioning and disability in older adults and these relationships are not clear.

OBJECTIVE

To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF).

METHODS

This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome.

RESULTS

Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices.

CONCLUSION

Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.

All you need to know about sarcopenia: a short guide for an internal medicine physician in questions and answers

Sarcopenia is associated with social, economic, and individual burdens, including loss of independence, poor quality of life, and disability. In a short period of time, ideas about sarcopenia transformed from geriatric syndrome to disease. Initially, sarcopenia was considered in the context of gradual age-related deterioration in the functioning of all physiological systems. Over the years, it became clear that it can develop a second time, as a consequence of various diseases and pathological conditions.

To date, there have been no generally accepted diagnostic criteria for sarcopenia. There are several tests and tools available for screening sarcopenia, the choice of which depends on physical capabilities of the patient, capabilities of the medical institution, and the purpose for which it is detected (research or clinical practice).

From the point of view of human health, sarcopenia increases the risk of falls and fractures; impairs the ability to perform daily activities; is associated with the progression of major diseases and cognitive impairments; leads to movement disorders; contributes to a decrease in the quality of life, loss of independence or a need for long-term care. The presence of sarcopenia increases both the risk of hospitalization and hospitalization costs.

The aim of the literature review is to provide an analysis of up-to-date information on the causes, pathogenesis, screening, diagnosis, treatment, and consequences of sarcopenia, myosteatosis, and sarcopenic obesity. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar by the following keywords: sarcopenia, dynapenia, myosteatosis, sarcopenic obesity, nutritional status, malnutrition.

Effects of Treadmill Running at Different Light Cycles in Mice with Metabolic Disorders

Type 2 diabetes mellitus accounts for about 90% of cases of diabetes and is considered one of the most important problems of our time. Despite a significant number of studies on glucose metabolism, the molecular mechanisms of its regulation in health and disease remain insufficiently studied. That is why non-drug treatment of metabolic disorders is of great relevance, including physical activity. Metabolic changes under the influence of physical activity are very complex and are still difficult to understand. This study aims to deepen the understanding of the effect of physical exercise on metabolic changes in mice with diabetes mellitus. We studied the effect of forced treadmill running on body weight and metabolic parameters in mice with metabolic disorders. We developed a high-fat-diet-induced diabetic model of metabolic disorders. We exposed mice to forced treadmill running for 4 weeks. We determined glucose and insulin levels in the blood plasma biochemically and analyzed Glut-4 and citrate synthase in M. gastrocnemius muscle tissue using Western blotting. The research results show that daily treadmill running has different effects on different age groups of mice with metabolic disorders. In young-age animals, forced running has a more pronounced effect on body weight. At week 12, young obese mice had a 17% decrease in body weight. Body weight did not change in old mice. Moreover, at weeks 14 and 16, the decrease in body weight was more significant in the young mice (by 17%) compared to the old mice (by 6%) (p < 0.05). In older animals, it influences the rate of glucose uptake. At 60 min, the blood glucose in the exercised older mice decreased to 14.46 mmol/L, while the glucose concentration in the non-exercised group remained at 17 mmol/L. By 120 min, in mice subjected to exercise, the blood glucose approached the initial value (6.92 mmol/L) and amounted to 8.35 mmol/L. In the non-exercised group, this difference was 45%. The effects of physical activity depend on the time of day. The greater effect is observed when performing shift training or exercise during the time when animals are passive (light phase). In young mice, light phase training had a significant effect on increasing the content of Glut-4 in muscle tissue (84.3 ± 11.3%, p < 0.05 with control group-59.3 ± 7.8%). In aged mice, shift training caused an increase in the level of Glut-4 in muscle tissue (71.3 ± 4.1%, p < 0.05 with control group-56.4 ± 10,9%). In the group of aged mice, a lower CS level was noticed in all groups in comparison with young mice. It should also be noted that we observed that CS increased during exercise in the group of young mice, especially during light phase training. The CS content in the light phase subgroup (135.8 ± 7.0%) was higher than in the dark phase subgroup (113.3 ± 7.7%) (p = 0.0006). The CS decreased in aged chow-fed mice and increased in the high-fat-fed group. The CS content in the chow diet group (58.2 ± 5.0%) was 38% lower than in the HFD group (94.9 ± 8.8%).

Thigh-hip ratio is significantly associated with all-cause mortality among Japanese community-dwelling men

Anthropometric evaluation is a simple yet essential indicator of muscle and fat mass when studying life prognosis in aging. This study aimed to investigate the contributions of anthropometric measurements, independent of body mass index, to measures of all-cause mortality. We examined data for 1,704 participants from the 2014 Nomura Cohort Study who attended follow-ups for the subsequent eight years (follow-up rate: 93.0%). Of these, 765 were male (aged 69 ± 11 years) and 939 were female (aged 69 ± 9 years). The Japanese Basic Resident Registry provided data on adjusted relative hazards for all-cause mortality. The data were subjected to a Cox regression analysis, wherein the time variable was age and the risk factors were gender, age, anthropometric index, smoking habits, drinking habits, exercise habits, cardiovascular history, hypertension, lipid levels, diabetes, renal function, and serum uric acid. Of the total number of participants, 158 (9.3%) were confirmed to have died, and of these, 92 were male (12.0% of all male participants) and 66 were female (7.0% of all female participants). The multivariable Cox regression analysis revealed that a smaller thigh-hip ratio predicted eight-year all-cause mortality in male participants, but only baseline body mass index was associated with all-cause mortality in female participants. Thigh-hip ratio is a useful predictor of death in Japanese community-dwelling men.

Association between creatinine to body weight ratio and all-cause mortality: a cohort study of NHANES

Research on the relationship between the weight-adjusted skeletal muscle mass index and all-cause mortality is rare, and even rarer is the relationship between the creatinine/body weight (Cre/BW) ratio and all-cause mortality. Therefore, this study aimed to investigate the relationship between the Cre/BW ratio and mortality in individuals with normal renal function. This prospective study used data from the National Health and Nutrition Examination Survey (NHANES) database. A Cox hazard model was used to analyze the relationship between the Cre/BW ratio and mortality risk. In total, 45,459 participants were included, of which 49.97% were women, with an average age of 45.68 ± 18.08 years. The incidence of all-cause mortality was 10.9% among these participants during the median (interquartile range) follow-up of 9.6 (5.2, 14.2) years. After adjusting for all covariates, a U-shaped relationship was found between the Cre/BW ratio and all-cause mortality (P for nonlinearity <0.001), with the lowest risk observed at Cre/BW ratios (×100) between 0.821 and 0.987. In the threshold effect analysis, the Cre/BW ratio (×100) had a threshold value of 0.96. When the Cre/BW ratio (×100) was <0.96, all-cause mortality was negatively associated with the Cre/BW ratio (×100) (0.63 (0.41, 0.97)). In contrast, when the Cre/BW ratio (×100) was ≥0.96, the higher Cre/BW ratio was associated with a greater hazard ratio of all-cause mortality (1.67 (1.41, 1.97)). In conclusion, we report a U-shaped relationship between the Cre/BW ratio and all-cause mortality. Controlling the Cre/BW ratio within a certain range may reduce the risk of all-cause mortality.

Respiratory issues in patients with multiple sclerosis as a risk factor during SARS-CoV-2 infection: a potential role for exercise

Coronavirus disease-2019 (COVID-19) is associated with cytokine storm and is characterized by acute respiratory distress syndrome (ARDS) and pneumonia problems. The respiratory system is a place of inappropriate activation of the immune system in people with multiple sclerosis (MS), and this may cause damage to the lung and worsen both MS and infections.The concerns for patients with multiple sclerosis are because of an enhance risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MS patients pose challenges in this pandemic situation, because of the regulatory defect of autoreactivity of the immune system and neurological and respiratory tract symptoms. In this review, we first indicate respiratory issues associated with both diseases. Then, the main mechanisms inducing lung damages and also impairing the respiratory muscles in individuals with both diseases is discussed. At the end, the leading role of physical exercise on mitigating respiratory issues inducing mechanisms is meticulously evaluated.

Effect of electrochemotherapy on myogenesis of mouse C2C12 cells in vitro

Electrochemotherapy (ECT) is a local ablative therapy for the treatment of different skin and subcutaneous tumors and certain tumors in internal organs. Skeletal muscle represents a major tumor- surrounding tissue, exposed to side effects of ECT. At the cellular level, side-effects of ECT on skeletal muscle and underlying mechanisms have not been examined yet. Thus, we aimed to determine the effect of ECT in the mouse muscle cell line C2C12 during in vitro myogenesis. We evaluated the electroporation efficiency and viability of C2C12 myotubes at increasing voltages (200-1300 V/cm) using propidium iodide (PI). Permeabilization of PI into the cells was voltage-dependent accounting up to 97 % efficiency at the highest voltage. High cell viability and myotube integrity were maintained until 4 days after electroporation. ECT with the cytostatic drugs bleomycin and cisplatin decreased the viability of C2C12 myoblasts and myotubes in a dose-dependent manner. However, myoblasts were more sensitive to ECT than myotubes. Increased secretion of IL-6, observed 3 days after ECT, confirming its effects on early myogenesis. Only minor effects of ECT were observed in treated myotubes. These results contribute to the safety profile of ECT in tumor treatment.

Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional interventions

Advanced age is one of the significant risk determinants for coronavirus disease 2019 (COVID-19)-related mortality and for long COVID complications. The contributing factors may include the age-related dynamical remodeling of the immune system, known as immunosenescence and chronic low-grade systemic inflammation. Both of these factors may induce an inflammatory milieu in the aged brain and drive the changes in the microenvironment of neurons and microglia, which are characterized by a general condition of chronic inflammation, so-called neuroinflammation. Emerging evidence reveals that the immune privilege in the aging brain may be compromised. Resident brain cells, such as astrocytes, neurons, oligodendrocytes and microglia, but also infiltrating immune cells, such as monocytes, T cells and macrophages participate in the complex intercellular networks and multiple reciprocal interactions. Especially changes in microglia playing a regulatory role in inflammation, contribute to disturbing of the brain homeostasis and to impairments of the neuroimmune responses. Neuroinflammation may trigger structural damage, diminish regeneration, induce neuronal cell death, modulate synaptic remodeling and in this manner negatively interfere with the brain functions.In this review article, we give insights into neuroimmune interactions in the aged brain and highlight the impact of COVID-19 on the functional systems already modulated by immunosenescence and neuroinflammation. We discuss the potential ways of these interactions with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and review proposed neuroimmune mechanisms and biological factors that may contribute to the development of persisting long COVID conditions. We summarize the potential mechanisms responsible for long COVID, including inflammation, autoimmunity, direct virus-mediated cytotoxicity, hypercoagulation, mitochondrial failure, dysbiosis, and the reactivation of other persisting viruses, such as the Cytomegalovirus (CMV). Finally, we discuss the effects of various interventional options that can decrease the propagation of biological, physiological, and psychosocial stressors that are responsible for neuroimmune activation and which may inhibit the triggering of unbalanced inflammatory responses. We highlight the modulatory effects of bioactive nutritional compounds along with the multimodal benefits of behavioral interventions and moderate exercise, which can be applied as postinfectious interventions in order to improve brain health.

Endocrine responses of the stress system to different types of exercise

Physical activity is an important part of human lifestyle although a large percentage of the population remains sedentary. Exercise represents a stress paradigm in which many regulatory endocrine systems are involved to achieve homeostasis. These endocrine adaptive responses may be either beneficial or harmful in case they exceed a certain threshold. The aim of this review is to examine the adaptive endocrine responses of hypothalamic-pituitary-adrenal axis (HPA), catecholamines, cytokines, growth hormone (GH) and prolactin (PRL) to a single bout or regular exercise of three distinct types of exercise, namely endurance, high-intensity interval (HIIE) and resistance exercise. In summary, a single bout of endurance exercise induces cortisol increase, while regular endurance exercise-induced activation of the HPA axis results to relatively increased basal cortisolemia; single bout or regular exercise induce similar GH peak responses; regular HIIE training lowers basal cortisol concentrations, while catecholamine response is reduced in regular HIIE compared with a single bout of HIIE. HPA axis response to resistance exercise depends on the intensity and volume of the exercise. A single bout of resistance exercise is characterized by mild HPA axis stimulation while regular resistance training in elderly results in attenuated inflammatory response and decreased resting cytokine concentrations. In conclusion, it is important to consider which type of exercise and what threshold is suitable for different target groups of exercising people. This approach intends to suggest types of exercise appropriate for different target groups in health and disease and subsequently to introduce them as medical prescription models.

Myokine, a key cytokine for physical exercise to alleviate sarcopenic obesity

Skeletal muscle has a robust endocrine function as a powerful organ and can secrete and release cytokines or polypeptides known as myokines. These myokines have significant regulatory effects on signal transduction in skeletal muscle and the metabolism of peripheral tissues and organs and exert biological effects via autocrine, paracrine, or endocrine forms. Obesity and aging cause myokine secretion dysregulation, and hastening sarcopenic obesity (SO) development. Exercise is currently an excellent intervention and prevention method for SO. Meanwhile, exercise impacts many organs and tissues. These organs and tissues will produce various myokines in response to movement and metabolism throughout the body to govern muscle differentiation, growth, and remodeling. According to accumulating data, exercise can increase the release of myokines from diverse tissues into the blood and postpone the SO onset and progression by influencing protein metabolism, inflammation, mitochondrial quality control, and other mechanisms.

Single 30 min treadmill exercise session suppresses the production of pro-inflammatory cytokines and oxidative stress in obese female adolescents

OBJECTIVES

Regular treadmill exercise may result in changes in pro-inflammatory cytokines and oxidative stress. However, the way acute treadmill exercise mechanisms affect the changes in pro-inflammatory cytokines and oxidative stress in obese has not been comprehensively exposed. This study aimed to analyze the pro-inflammatory cytokines and oxidative stress between 30 min before treadmill exercise and 24 h after treadmill exercise in obese adolescents.

METHODS

A total of 20 obese females aged 19-24 years were recruited from female students and given one session of treadmill exercise with an intensity of 60-70% HR_max. Thiobarbituric acid reactive substance (TBARS) was used to analyze serum levels of MDA, while enzyme-linked immunosorbent assay (ELISA) was used to analyze serum levels of TNF-α and IL-6. Moreover, the independent samples t-test with a significance level of 5% was employed to have the statistical analysis.

RESULTS

The results on 24 h after treadmill exercise and delta (Δ) between CTRL and TREG showed a significant difference (p<0.001).

CONCLUSIONS

This study found a decrease in pro-inflammatory cytokines and oxidative stress 24 h after treadmill exercise in obese adolescents. Therefore, treadmill exercise can be a promising strategy for preventing adolescents from obesity as well as preventing disease risks associated with oxidative stress and chronic inflammation.

Physical activity as a promising alternative for young people with juvenile idiopathic arthritis: Towards an evidence-based prescription

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in young people. Although biologics now enable most children and adolescents with JIA to enjoy clinical remission, patients present lower physical activity and spend more time in sedentary behavior than their healthy counterparts. This impairment probably results from a physical deconditioning spiral initiated by joint pain, sustained by apprehension on the part of both the child and the child's parents, and entrenched by lowered physical capacities. This in turn may exacerbate disease activity and lead to unfavorable health outcomes including increased risks of metabolic and mental comorbidities. Over the past few decades, there has been growing interest in the health benefits of increased overall physical activity as well as exercise interventions in young people with JIA. However, we are still far from evidence-based physical activity and / or exercise prescription for this population. In this review, we give an overview of the available data supporting physical activity and / or exercise as a behavioral, non-pharmacological alternative to attenuate inflammation while also improving metabolism, disease symptoms, poor sleep, synchronization of circadian rhythms, mental health, and quality of life in JIA. Finally, we discuss clinical implications, identify gaps in knowledge, and outline a future research agenda.

The role of nutrition rehabilitation in the recovery of survivors of critical illness: underrecognized and underappreciated

Many survivors of critical illness face significant physical and psychological disability following discharge from the intensive care unit (ICU). They are often malnourished, a condition associated with poor outcomes, and nutrition remains problematic particularly in the early phases of ICU recovery. Yet nutrition rehabilitation, the process of restoring or optimizing nutritional status following illness, is seldom prioritized, possibly because it is an underrecognized and underappreciated area in critical care rehabilitation and research. To date, 16 original studies have been published where one of the objectives includes measurement of indices relating to nutritional status (e.g., nutrition intake or factors impacting nutrition intake) in ICU survivors. The primary aim of this narrative review is to provide a comprehensive summary of key themes arising from these studies which form the basis of our current understanding of nutritional recovery and rehabilitation in ICU survivors. ICU survivors face a multitude of barriers in achieving optimal nutrition that are of physiological (e.g., poor appetite and early satiety), functional (e.g., dysphagia, reduced ability to feed independently), and psychological (e.g., low mood, body dysmorphia) origins. Organizational-related barriers such as inappropriate feeding times and meal interruptions frequently impact an ICU survivor’s ability to eat. Healthcare providers working on wards frequently lack knowledge of the specific needs of recovering critically ill patients which can negatively impact post-ICU nutrition care. Unsurprisingly, nutrition intake is largely inadequate following ICU discharge, with the largest deficits occurring in those who have had enteral nutrition prematurely discontinued and rely on an oral diet as their only source of nutrition. With consideration to themes arising from this review, pragmatic strategies to improve nutrition rehabilitation are explored and directions for future research in the field of post-ICU nutrition recovery and rehabilitation are discussed. Given the interplay between nutrition and physical and psychological health, it is imperative that enhancing the nutritional status of an ICU survivor is considered when developing multidisciplinary rehabilitation strategies. It must also be recognized that dietitians are experts in the field of nutrition and should be included in stakeholder meetings that aim to enhance ICU rehabilitation strategies and improve outcomes for survivors of critical illness.

The growing field of immunometabolism and exercise: Key findings in the last 5 years

This perspective review highlights the impact of physical exercise on immunometabolic responses in the past 5 years. Understanding immunometabolism as a part of immunological research is essential. Furthermore, the roles of both acute and chronic effects of physical exercise on health, aging, and chronic diseases in immunometabolic changes should be elaborated. In immune cells, β2 adrenergic signaling stimulates the preferential mobilization of inflammatory phenotypes, such as CD16⁺ monocytes and CD8⁺ T cells, into the bloodstream after a physical exercise session. The mobilization of immune cells is closely related to the availability of energetic substrates for the cell and mechanisms associated with the uptake and oxidation of fatty acids and glucose. These cells, especially senescent T cells, are mobilized to the peripheral tissues and undergo apoptotic signaling, stimulating the creation of a "vacant space" where new cells will be matured and replaced in the circulation. This results in the upregulation of the expression and secretion of anti-inflammatory cytokines (IL-10 and IL-1ra), leading to increased regulatory immune cells that provide immunoregulatory properties. Thus, we suggest that a significant nutrient available to the cell will favor oxidative metabolism, augment ATP production, and consequently maintain the immune cells in their quiescent state, as well as promote rapid activation function. Therefore, based on the studies discussed in this perspective review, we highlight the importance of performing moderate-intensity continuous and high-intensity intermittent aerobic exercises, due to a higher magnitude of energetic demand and release of anti-inflammatory cytokines (IL-6 and IL-10).

Irisin reduces inflammatory signaling pathways in inflammation-mediated metabolic syndrome

Irisin is an exercise induced myokine first shown to induce the browning of white adipose tissue (WAT) which increases energy expenditure, improves glucose tolerance, and reduces insulin resistance. Among irisin's involvement in lipid homeostasis, osteoblast proliferation, and muscle growth, it also acts as a mediator of many inflammatory pathways throughout the body. This review aims to describe the role of irisin in inflammatory processes and understand how targeting irisin can alter the inflammatory response in metabolic syndrome (MetS). The mechanisms involved in irisin's anti-inflammatory functions include reducing production of pro-inflammatory cytokines while increasing production of anti-inflammatory cytokines, reducing macrophage proliferation, inducing alternatively activated (M2-type) macrophage polarization, inhibiting pathways of increased vascular permeability, and preventing the formation of inflammasomes. While there are some contradictory results, most studies found reduced levels of irisin in MetS and type II diabetes mellitus (T2DM). Irisin treatment of cells exposed to inflammatory stimuli ameliorates the inflammatory response and promotes cellular viability. Numerous methods have been studied to increase plasma irisin levels including dietary, behavioral, and pharmaceutical. Further investigation is necessary to understand how irisin can be targeted for disease modification.

Echocardiographic Assessment of Left Ventricular Function 10 Years after the Ultra-Endurance Running Event Eco-Trail de Paris® 2011

Background: Regular and moderate physical activity is beneficial for physical and mental health, resulting in an increase in life expectancy for both sexes. From a cardiovascular point of view, although the benefits of regular moderate physical exercise have been established, the long-term effects of repeated ultra-endurance running events are still unknown. Hypothesis: The aim of our study is to evaluate the 10-year evolution of the parameters of the left ventricular systolic and diastolic functions of amateur subjects regularly practising ultra-endurance running events using resting echocardiography. Study design: Cross-sectional study. Level of evidence: Level 3—non-randomized controlled cohort/follow-up study. Methods: The 66 participants who participated in the 2011 edition of the Eco-Trail de Paris® were contacted by e-mail. Demographic data, sports practice, and the results of an echocardiography scan carried out during the year 2021 evaluating left ventricular systolic and diastolic function variables were collected. Echographic variables from 2011 and 2021 were compared using the paired Student’s t-test. Results: Forty-six (70%) participants responded positively. Twenty (30%) participants could not be reached and were not analysed. Of the 46 respondents, 42 (91%) provided data from a trans-thoracic cardiac ultrasound performed in 2021. Over the past 10 years, the participants reported having completed an average of 4 ± 2 ultra-trails per year. No significant differences were observed between left ventricular diastolic and systolic echocardiographic parameters between the years 2011 and 2021. Conclusions: Among amateur participants, long-distance running is not associated with an alteration in the echocardiographic parameters of resting left ventricular systolic and diastolic function after 10 years of practice. Clinical relevance: Long-term long-distance running practice is not associated with left ventricular cardiac function alteration. These results suggest a potential adaptation role of the cardiovascular system to regular and moderate long-distance running practice.

A Single Bout of Fatiguing Aerobic Exercise Induces Similar Pronounced Immunological Responses in Both Sexes

Introduction: Physical exercise can acutely and chronically modulate immunological responses. Women and men have different innate and adaptive immune responses, and in this sense, these two groups may also have different acute immunological responses induced by exercise. In addition, it is essential to understand further whether the effects of physical exercise on the immune system responses depend on sex because limited scientific evidence on this topic is available. This information may allow athletes and coaches to improve the training process, mainly to understand if the physiological impact of given training stimuli in women is similar to that in men.

Objective: The present study aimed to investigate the acute effects of continuous submaximal exercise until fatigue on physiological and immunological parameters in amateur female and male runners.

Methods: This study included 18 female and 15 male volunteers. Each participant visited the laboratory on four consecutive days. The first visit consisted of medical history taking and explaining the study design. On the second visit, the participants were subjected to an incremental test to determine their maximal rate of oxygen consumption (VO_2max) that was required to prescribe the intensity of the submaximal exercise protocol. On the third visit, the fatiguing exercise protocol was performed at 77%–80% of the VO_2max. During this submaximal exercise, the heart rate, rating of perceived exertion (RPE), and blood lactate were recorded. Blood samples were collected before, immediately after, and 1 h after the fatiguing protocol to analyze the plasma levels of cytokines and creatine kinase (CK) and to count leukocytes. Finally, on the fourth visit, the participants underwent physical evaluations to measure their body composition using dual-energy X-ray absorptiometry (DXA) imaging.

Results: The average ages of the female and male groups were 34.2 ± 3.7 and 30.5 ± 4.3 years old, respectively. The female group ran 57 ± 27 min, while the male group ran 52 ± 15 min before fatiguing. In the female group, when comparing before and after the submaximal exercise, marked increases were observed in the following variables: heart rate (from 68.5 to 180.4 bpm), RPE (from 3.6 to 8.2), lactate (from 2.1 to 4.49 mmol/L), and CK (from 89.5 to 126.3 U/L). In addition, the female group showed an increased number of total leukocytes (from 7222.3 to 11162.9 × 10⁶/μl), neutrophils (from 4,403 to 6,480 × 10⁶/μl), and lymphocytes (from 2,342 ± to 3,562 × 10⁶/μl) from pre- to post-submaximal exercise. In the male group, similar elevations in psychophysiological variables were observed, as evidenced by comparing the heart rate (from 52.8 to 184.1 bpm), RPE (from 0.0 to 8.9), lactate (from 2.7 to 7.2 mmol/L), and CK (from 106.2 to 165 U/L) before and after the submaximal exercise. The male group also showed an augmented number of total leukocytes (from 6,245 to 8,050 × 10⁶/μl), neutrophils (from 3,335 to 4,128 × 10⁶/), and lymphocytes (from 2,191 to 3,212 × 10⁶/μl) when comparing pre- and post-submaximal exercise. There were no differences in the changes between women and men for these parameters.

Conclusion: The aerobically fatiguing exercise protocol induced pronounced changes in the heart rate, plasma levels of lactate and CK, total leukocyte count, especially the number of neutrophils and lymphocytes, in both sexes. The fatiguing exercise protocol also changed the plasma levels of IL-6 and IL-10 in the female and male groups. Under the present conditions, the physiological changes induced by fatiguing submaximal exercise, including the immunological changes, were not influenced by sex. This study shows that the same aerobic physical exercise can alter immunological parameters in women and men, and this response is similar between sexes.

Identification of sarcopenic obesity in adults undergoing orthopaedic surgery: Relationship between “a body shape index” (ABSI) and fat-free mass. A cross -sectional study

Background

Sarcopenic obesity is a condition characterised by the coexistence of low muscle mass and function (sarcopenia) and excessive fat mass (obesity). The aim of this study was to determine the prevalence of this condition in patients undergoing orthopaedic surgery by gender and type of orthopaedic surgery. In addition, this study investigated the suitability of a waist circumference-based anthropometric measure, body shape index (ABSI), for predicting sarcopenic obesity and the predictive power of ABSI for fat-free mass index (FFMI), a surrogate marker of lean body mass.

Methods and findings

A cross-sectional study of overweight and obese orthopaedic patients undergoing knee or hip and spine surgery was conducted between October 2019 and March 2020 in Orthopaedic Hospital Valdoltra, Slovenia. General anthropometric parameters body mass index (BMI) and ABSI = (WC/(BMI^2/3x height^½) as well as body composition data (fat mass FM, fat-free mass FFM, FFMI, and the ratio FM/FFM as an index of sarcopenic obesity) were determined in 120 women (aged 66.5 ± 9.6 years) and 89 men (aged 65.5 ± 7.8 years) with overweight (25 kg/m² ≤ BMI < 30 kg/m²) and obesity (BMI ≥ 30 kg/m²) by bioelectrical impedance analysis (BIA). Sarcopenic obesity phenotypes based on FM/FFM ratio > 0.80 was present in 15.3% of patients, mainly in female patients undergoing knee surgery. ABSI was significantly associated with age in all women and obese men and with waist circumference (WC) in all patients. ABSI did not correlate with BMI in women and men; however, multiple linear regression analysis showed that BMI independently predicted FFMI (R = 0.83 and 0.70, respectively, p < 0.001) in women and men (β-coefficients: 0.801 and 0.686, respectively) and ABSI in women only (β-coefficient: -0.104). Women with a lower ABSI had a significantly higher FFMI than the group with a higher ABSI.

Conclusions

Sarcopenic obesity was most prevalent in obese women scheduled for knee surgery. In addition, ABSI, independently predicted FFMI in women and represents a significant predictor of sarcopenic obesity.

Molecular Basis of Irisin Regulating the Effects of Exercise on Insulin Resistance

Insulin resistance is recognized as one major feature of metabolic syndrome, and frequently emerges as a difficult problem encountered during long-term pharmacological treatment of diabetes. Insulin resistance often causes organs or tissues, such as skeletal muscle, adipose, and liver, to become less responsive or resistant to insulin. Exercise can promote the physiological function of those organs and tissues and benefits insulin action via increasing insulin receptor sensitivity, glucose uptake, and mitochondrial function. This is done by decreasing adipose tissue deposition, inflammatory cytokines, and oxidative stress. However, understanding the mechanism that regulates the interaction between exercise and insulin function becomes a challenging task. As a novel myokine, irisin is activated by exercise, released from the muscle, and affects multi-organ functions. Recent evidence indicates that it can promote glucose uptake, improve mitochondrial function, alleviate obesity, and decrease inflammation, as a result leading to the improvement of insulin action. We here will review the current evidence concerning the signaling pathways by which irisin regulates the effect of exercise on the up-regulation of insulin action in humans and animals.

Use of Physical Activity and Exercise to Reduce Inflammation in Children and Adolescents with Obesity

Childhood obesity is a leading public health problem worldwide, as it is increasingly prevalent and therefore responsible for serious obesity-related comorbidities, not only in childhood but also in adulthood. In addition to cardio-metabolic obesity-related disorders, recent evidence suggests that excess adipose tissue in turn is associated with immune cell infiltration, increased adipokine release, and the development of low-grade systemic inflammation obesity. Exercise is considered a non-pharmacological intervention that can delay obesity-related comorbidities, improving cardiovascular fitness and modulating the inflammatory processes. It has been reported that the anti-inflammatory effect of regular exercise may be mediated by a reduction in visceral fat mass, with a subsequent decrease in the release of adipokines from adipose tissue (AT) and/or by the induction of an anti-inflammatory environment. In this narrative review, we discuss the role of AT as an endocrine organ associated with chronic inflammation and its role in obesity-related complications, focusing on the effect of exercise in reducing inflammation in children and adolescents with obesity. Regular physical exercise must be considered as a natural part of a healthy lifestyle, and promoting physical activity starting from childhood is useful to limit the negative effects of obesity on health. The crucial role of the immune system in the development of obesity-induced inflammatory processes and the efficacy of exercise as an anti-inflammatory, non-pharmacological intervention may provide possible targets for the development of new treatments and early preventive strategies.

Effects of age and gender on body composition indices as predictors of mortality in middle-aged and old people

To determine whether body composition indices interact with age and gender as a predictor of all-cause mortality, 1200 participants at least 40 years of age were recruited in 2009 and 2010. A multi-frequency bioelectrical impedance analysis device was used to measure each participant's body composition indices, including the fat mass index (FMI), fat free mass index (FFMI), skeletal muscle mass index (SMMI), and visceral fat area index (VFAI). A baseline questionnaire was used to collect demographic information about lifestyle habits, socioeconomic status, and medical conditions. All claimed records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. The all-cause mortality rate was 8.67% after a mean follow-up period of 5.86 ± 2.39 person-years. The Cox proportional hazard model analysis showed significantly negative associations between FFMI or SMMI with all-cause mortality in the total group and those aged ≥ 65 y/o. The FFMI and SMMI were negative predictors of mortality in both genders. The FMI and VFAI were positive predictors of mortality exclusively in females. In conclusion, the SMMI is a better predictor of mortality than the BMI, FMI, and FFMI, especially in older adults. A higher fat mass or visceral fat distribution may predict higher mortality in females.

Multimodal Benefits of Exercise in Patients With Multiple Sclerosis and COVID-19

Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.

Transcriptome profiling reveals stress-responsive gene networks in cattle muscles

In meat-producing animals, preslaughter operations (e.g., transportation, mixing unfamiliar animals, food and water deprivation) may be a source of stress with detrimental effects on meat quality. The objective of this work was to study the effect of emotional and physical stress by comparing the transcriptomes of two muscles (M. longissimus thoracis, LT and M. semitendinosus, ST) in Normand cows exposed to stress (n = 16) vs. cows handled with limited stress (n = 16). Using a microarray, we showed that exposure to stress resulted in differentially expressed genes (DEGs) in both muscles (62 DEGs in LT and 32 DEGs in ST, of which eight were common transcription factors (TFs)). Promoter analysis of the DEGs showed that 25 cis transcriptional modules were overrepresented, of which nine were detected in both muscles. Molecular interaction networks of the DEGs targeted by the most represented cis modules helped identify common regulators and common targets involved in the response to stress. They provided elements showing that the transcriptional response to stress is likely to (i) be controlled by regulators of energy metabolism, factors involved in the response to hypoxia, and inflammatory cytokines; and (ii) initiate metabolic processes, angiogenesis, corticosteroid response, immune system processes, and satellite cell activation/quiescence. The results of this study demonstrate that exposure to stress induced a core response to stress in both muscles, including changes in the expression of TFs. These factors could relay the physiological adaptive response of cattle muscles to cope with emotional and physical stress. The study provides information to further understand the consequences of these molecular processes on meat quality and find strategies to attenuate them.

Initial Muscle Quality Affects Individual Responsiveness of Interleukin-6 and Creatine Kinase following Acute Eccentric Exercise in Sedentary Obese Older Women

This study aimed to evaluate the time course and responsiveness of plasma interleukin-6 (IL-6) and creatine kinase (CK) levels following acute eccentric resistance exercise in sedentary obese older women with a different muscle quality index (MQI). Eighty-eight participants (69.4 ± 6.06 years) completed an acute eccentric resistance exercise (7 sets of 10 repetitions at 110% of 10-repetition maximum with 3 min rest interval). Participants were divided into two groups: high or low MQI according to 50th percentile cut-off. The responsiveness was based on minimal clinical important difference. There were no differences between groups and time on IL-6 and CK levels (p > 0.05). However, the high MQI group displayed a lower proportion of low responders (1 for laboratory and 2 for field-based vs. 5 and 4) and a higher proportion of high responders for IL-6 (7 for laboratory and 6 for field-based vs. 4 and 5) compared to low MQI group. In addition, the high MQI group showed a higher proportion of high responders for CK (11 for laboratory and 9 for field-based vs. 6 and 6) compared to low MQI. A prior MQI screening can provide feedback to understand the magnitude response. Individual responsiveness should be taken into consideration for maximizing eccentric exercise prescription.

Inflammatory markers in response to interval and continuous exercise in obese women

Obesity is strongly associated with the degree of inflammation characterised by proinflammatory cytokines, such as tumour necrosis factor-α (TNF-α). Lifestyle modification with exercise is the right strategy because it can stimulate interleukin 6 (IL-6) secretion which acts as an anti-inflammatory. This study aimed to analyse the response of interval and continuous exercise to inflammatory markers in obese women. Twenty-four women participated in this study and were randomly divided into 3 groups: CONG (n=8, control group without any intervention): MCEG (n=8, continuous exercise group) and MIEG (n=8, interval exercise group). ELISA was used to measure the levels of IL-6 and TNF-α, pre-exercise and post-exercise. The data were analysed using the paired sample t-test. The mean levels of TNF-α, pre-exercise and post-exercise, were 19.35±2.73 vs 19.36±2.23 pg/ml (P=0.989) in CONG, 19.42±2.79 vs 16.63±0.82 pg/ml (P=0.017) in MCEG, and 19.46±3.08 vs 16.96±2.11 pg/ml (P=0.079) in MIEG. Mean levels of IL-6, pre-exercise and post-exercise, were 7.56±2.88 vs 7.66±4.12 pg/ml (P=0.957) for CONG, 7.68±3.41 vs 13.97±2.38 pg/ml (P=0.001) for MCEG, and 7.78±1.99 vs 13.66±3.55 pg/ml (P=0.001) for MIEG. We concluded that interval and continuous exercise decreased pro-inflammatory and increased anti-inflammatory cytokines.

The Inflammatory Pattern of Chronic Limb-Threatening Ischemia in Muscles: The TNF-α Hypothesis

Background: Vascular inflammation plays a crucial role in peripheral arterial disease (PAD), although the role of the mediators involved has not yet been properly defined. The aim of this work is to investigate gene expression and plasma biomarkers in chronic limb-threating ischemia (CLTI). Methods: Using patients from the GHAS trial, both blood and ischemic muscle samples were obtained to analyze plasma markers and mRNA expression, respectively. Statistical analysis was performed by using univariate (Spearman, t-Student, and X²) and multivariate (multiple logistic regression) tests. Results: A total of 35 patients were available at baseline (29 for mRNA expression). Baseline characteristics (mean): Age: 71.4 ± 12.4 years (79.4% male); TNF-α: 10.7 ± 4.9 pg/mL; hsCRP:1.6 ± 2.2 mg/dL; and neutrophil-to-lymphocyte ratio (NLR): 3.5 ± 2.8. Plasma TNF-α was found elevated (≥8.1) in 68.6% of patients, while high hsCRP (≥0.5) was found in 60.5%. Diabetic patients with a high level of inflammation showed significantly higher levels of NOX4 expression at baseline (p = 0.0346). Plasma TNF-α had a negative correlation with NOS3 (eNOS) expression (−0.5, p = 0.015) and plasma hsCRP with VEGFA (−0.63, p = 0.005). The expression of NOX4 was parallel to that of plasma TNF-α (0.305, p = 0.037), especially in DM. Cumulative mortality at 12 months was related to NLR ≥ 3 (p = 0.019) and TNF-α ≥ 8.1 (p = 0.048). The best cutoff point for NLR to predict mortality was 3.4. Conclusions: NOX4 and TNF-α are crucial for the development and complications of lower limb ischemia, especially in DM. hsCRP could have a negative influence on angiogenesis too. NLR and TNF-α represent suitable markers of mortality in CLTI. These results are novel because they connect muscle gene expression and plasma information in patients with advanced PAD, deepening the search for new and accurate targets for this condition.

Cytokines and parturition: investigating adiponectin, TNF-α, and IL-6 in mother-newborn pairs

OBJECTIVE

Cytokines are reported to be associated with various pregnancy complications and health outcomes of the offspring. However, reference values during pregnancy have not been established, effects of clinical and obstetric factors have not been examined, and interactions between different cytokines have not yet been reported.

METHODS

In this cross-sectional study, we recruited 120 mother-newborn pairs. Maternal venous blood samples (6 mL) were taken on admission to the labor ward; newborn venous blood samples (6 mL) were drawn from the placental part of the umbilical cord (UC). Adiponectin, TNF-α, and IL-6 serum concentrations were measured by commercial immunoassays. Clinical and obstetric variables were analyzed for their association with maternal and UC cytokine concentrations.

RESULTS

Forty-six adiponectin pairs, 55 TNF-α pairs, and 14 IL-6 pairs were available for analysis. Correlation between UC and maternal adiponectin-, IL-6-, and TNF-α levels was low. We found a significant correlation of UC adiponectin with maternal brain-derived neurotrophic factor (BDNF) and maternal adiponectin, and between maternal leptin and maternal TNF-α.

CONCLUSIONS

Clinical and obstetric variables as well as interactions between cytokines may have an impact on serum concentrations of the respective cytokines in maternal and UC blood. Further studies are required to confirm our findings.

Co-Administration of Iron and Bioavailable Curcumin Reduces Levels of Systemic Markers of Inflammation and Oxidative Stress in a Placebo-Controlled Randomised Study

Ferrous sulphate (FS) is widely used as an iron supplement to treat iron deficiency (ID), but is known to induce inflammation causing gastric side-effects resulting in poor adherence to supplement regimens. Curcumin, a potent antioxidant, has been reported to suppress inflammation via down regulation of NF-κB. The aim of the present double blind, placebo-controlled randomised trial was to assess whether co-administration of FS with a formulated, bioavailable form of curcumin (HydroCurc™) could reduce systemic inflammation and/or gastrointestinal side-effects. This study recruited 155 healthy participants (79 males; 26.42 years ± 0.55 and 76 females; 25.82 years ± 0.54), randomly allocated to one of five different treatment groups: iron and curcumin placebo (FS0_Plac), low dose (18 mg) iron and curcumin placebo (FS18_Plac), low dose iron and curcumin (FS18_Curc), high dose (65 mg) iron and curcumin placebo (FS65_Plac), and high dose iron and curcumin (FS65_Curc). Completed questionnaires and blood samples were collected from all participants at baseline (day 1), mid-point (day 21), and at end-point (day 42). Results showed a significant reduction in IL-6 in the FS65_Curc group (0.06 pg/mL ± 0.02, p = 0.0073) between the mid-point and end-point. There was also a significant reduction in mean plasma TNF levels in the FS65_Curc (0.65 pg/mL ± 0.17, p = 0.0018), FS65_Plac (0.39 pg/mL ± 0.15, p = 0.0363), and FS18_Curc (0.35 pg/mL ± 0.13, p = 0.0288) groups from mid-point to end-point. A significant increase was observed in mean plasma TBARS levels (0.10 µM ± 0.04, p = 0.0283) in the F18_Plac group from baseline to end-point. There was a significant association with darker stools between FS0_Plac vs. FS65_Plac (p = 0.002, Fisher's exact test) suggesting that high iron dose in the absence of curcumin leads to darker stools. A reduction in inflammation-related markers in response to co-administering supplemental iron alongside formulated curcumin suggests a reduction in systemic inflammation. This supplementation approach may therefore be a more cost effective and convenient alternative to current oral iron-related treatments, with further research to be conducted.