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Artese AL, Winthrop HM, Bohannon L, Lew MV, Johnson E, MacDonald G, Ren Y, Pastva AM, Hall KS, Wischmeyer PE, Macleod D, Molinger J, Barth S, Jung SH, Cohen HJ, Bartlett DB, Sung AD. A pilot study to assess the feasibility of a remotely monitored high-intensity interval training program prior to allogeneic hematopoietic stem cell transplantation. PLoS One 2023; 18:e0293171. [PMID: 38032994 PMCID: PMC10688680 DOI: 10.1371/journal.pone.0293171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 10/05/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Although allogeneic hematopoietic stem cell transplantation (HCT) can be a curative therapy for hematologic disorders, it is associated with treatment-related complications and losses in cardiorespiratory fitness and physical function. High-intensity interval training (HIIT) may be a practical way to rapidly improve cardiorespiratory fitness and physical function in the weeks prior to HCT. The primary aim of this study was to assess the feasibility of implementing a pre-HCT home-based HIIT intervention. The secondary aim was to evaluate pre to post changes in cardiorespiratory fitness and physical function following the intervention. METHODS This was a single-arm pilot study with patients who were scheduled to undergo allogeneic HCT within six months. Patients were instructed to complete three 30-minute home-based HIIT sessions/week between the time of study enrollment and sign-off for HCT. Sessions consisted of a 5-minute warm-up, 10 high and low intervals performed for one minute each, and a 5-minute cool-down. Prescribed target heart rates (HR) for the high- and low-intensity intervals were 80-90% and 50-60% of HR reserve, respectively. Heart rates during HIIT were captured via an Apple Watch and were remotely monitored. Feasibility was assessed via retention, session adherence, and adherence to prescribed interval number and intensities. Paired t-tests were used to compare changes in fitness (VO2peak) and physical function [Short Physical Performance Battery (SPPB), 30-second sit to stand, and six-minute walk test (6MWT)] between baseline and sign-off. Pearson correlations were used to determine the relationship between intervention length and changes in cardiorespiratory fitness or functional measures. RESULTS Thirteen patients (58.8±11.6 years) participated in the study, and nine (69.2%) recorded their training sessions throughout the study. Median session adherence for those nine participants was 100% (IQR: 87-107). Adherence to intervals was 92% and participants met or exceeded prescribed high-intensity HR on 68.8±34.8% of intervals. VO2peak improved from baseline to sign-off (14.6±3.1 mL/kg/min to 17.9±3.3 mL/kg/min; p<0.001). 30-second sit to stand and SPPB chair stand scores significantly improved in adherent participants. Improvements in 30-second sit to stand (13.8±1.5 to 18.3±3.3 seconds) and 6MWT (514.4±43.2 to 564.6±19.3) exceeded minimal clinically important improvements established in other chronic disease populations, representing the minimum improvement considered meaningful to patients. CONCLUSIONS Findings demonstrate that implementing a pre-HCT home-based remotely monitored HIIT program is feasible and may provide benefits to cardiorespiratory fitness and physical function.
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Affiliation(s)
- Ashley L. Artese
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Hilary M. Winthrop
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Lauren Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Meagan V. Lew
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Ernaya Johnson
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Grace MacDonald
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, United States of America
- Division of Medical Oncology, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Yi Ren
- Duke Cancer Institute Biostatistics Shared Resources, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Amy M. Pastva
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Katherine S. Hall
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Division of Geriatrics, Duke University, Durham, North Carolina, United States of America
| | - Paul E. Wischmeyer
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
| | - David Macleod
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Jeroen Molinger
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Stratton Barth
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Harvey Jay Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - David B. Bartlett
- Division of Medical Oncology, Duke University School of Medicine, Durham, North Carolina, United States of America
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Anthony D. Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
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Hanson ED, Sakkal S, Bates-Fraser LC, Que S, Cho E, Spielmann G, Kadife E, Violet JA, Battaglini CL, Stoner L, Bartlett DB, McConell GK, Hayes A. Acute exercise induces distinct quantitative and phenotypical T cell profiles in men with prostate cancer. Front Sports Act Living 2023; 5:1173377. [PMID: 37325799 PMCID: PMC10266416 DOI: 10.3389/fspor.2023.1173377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023] Open
Abstract
Background Reduced testosterone levels can influence immune system function, particularly T cells. Exercise during cancer reduces treatment-related side effects and provide a stimulus to mobilize and redistribute immune cells. However, it is unclear how conventional and unconventional T cells (UTC) respond to acute exercise in prostate cancer survivors compared to healthy controls. Methods Age-matched prostate cancer survivors on androgen deprivation therapy (ADT) and those without ADT (PCa) along with non-cancer controls (CON) completed ∼45 min of intermittent cycling with 3 min at 60% of peak power interspersed by 1.5 min of rest. Fresh, unstimulated immune cell populations and intracellular perforin were assessed before (baseline), immediately following (0 h), 2 h, and 24 h post-exercise. Results At 0 h, conventional T cell counts increased by 45%-64% with no differences between groups. T cell frequency decreased by -3.5% for CD3+ and -4.5% for CD4+ cells relative to base at 0 h with CD8+ cells experiencing a delayed decrease of -4.5% at 2 h with no group differences. Compared to CON, the frequency of CD8+CD57+ cells was -18.1% lower in ADT. Despite a potential decrease in maturity, ADT increased CD8+perforin+ GMFI. CD3+Vα7.2+CD161+ counts, but not frequencies, increased by 69% post-exercise while CD3+CD56+ cell counts increased by 127% and were preferentially mobilized (+1.7%) immediately following the acute cycling bout. There were no UTC group differences. Cell counts and frequencies returned to baseline by 24 h. Conclusion Following acute exercise, prostate cancer survivors demonstrate normal T cell and UTC responses that were comparable to CON. Independent of exercise, ADT is associated with lower CD8+ cell maturity (CD57) and perforin frequency that suggests a less mature phenotype. However, higher perforin GMFI may attenuate these changes, with the functional implications of this yet to be determined.
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Affiliation(s)
- Erik D. Hanson
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC, United States
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Samy Sakkal
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Lauren C. Bates-Fraser
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC, United States
| | - Shadney Que
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Eunhan Cho
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Guillaume Spielmann
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Elif Kadife
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - John A. Violet
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Claudio L. Battaglini
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC, United States
| | - Lee Stoner
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, United States
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC, United States
| | - David B. Bartlett
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Glenn K. McConell
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Alan Hayes
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, VIC, Australia
- Department of Medicine—Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
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Taylor JA, Greenhaff PL, Bartlett DB, Jackson TA, Duggal NA, Lord JM. Multisystem physiological perspective of human frailty and its modulation by physical activity. Physiol Rev 2023; 103:1137-1191. [PMID: 36239451 PMCID: PMC9886361 DOI: 10.1152/physrev.00037.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
"Frailty" is a term used to refer to a state characterized by enhanced vulnerability to, and impaired recovery from, stressors compared with a nonfrail state, which is increasingly viewed as a loss of resilience. With increasing life expectancy and the associated rise in years spent with physical frailty, there is a need to understand the clinical and physiological features of frailty and the factors driving it. We describe the clinical definitions of age-related frailty and their limitations in allowing us to understand the pathogenesis of this prevalent condition. Given that age-related frailty manifests in the form of functional declines such as poor balance, falls, and immobility, as an alternative we view frailty from a physiological viewpoint and describe what is known of the organ-based components of frailty, including adiposity, the brain, and neuromuscular, skeletal muscle, immune, and cardiovascular systems, as individual systems and as components in multisystem dysregulation. By doing so we aim to highlight current understanding of the physiological phenotype of frailty and reveal key knowledge gaps and potential mechanistic drivers of the trajectory to frailty. We also review the studies in humans that have intervened with exercise to reduce frailty. We conclude that more longitudinal and interventional clinical studies are required in older adults. Such observational studies should interrogate the progression from a nonfrail to a frail state, assessing individual elements of frailty to produce a deep physiological phenotype of the syndrome. The findings will identify mechanistic drivers of frailty and allow targeted interventions to diminish frailty progression.
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Affiliation(s)
- Joseph A Taylor
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Paul L Greenhaff
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - David B Bartlett
- Division of Medical Oncology, Department of Medicine, Duke University, Durham, North Carolina.,Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Thomas A Jackson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom
| | - Niharika A Duggal
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom
| | - Janet M Lord
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, https://ror.org/03angcq70University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
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Farley MJ, Bartlett DB, Skinner TL, Schaumberg MA, Jenkins DG. Immunomodulatory Function of Interleukin-15 and Its Role in Exercise, Immunotherapy, and Cancer Outcomes. Med Sci Sports Exerc 2023; 55:558-568. [PMID: 36730979 DOI: 10.1249/mss.0000000000003067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Exercise has been shown to improve physical and psychosocial outcomes for people across the cancer care continuum. A proposed mechanism underpinning the relationship between exercise and cancer outcomes is exercise-induced immunomodulation via secretion of anti-inflammatory myokines from skeletal muscle tissue. Myokines have the potential to impair cancer growth through modulation of natural killer (NK) cells and CD8+ T cells while improving the effectiveness of cancer therapies. Interleukin-15 (IL-15), one of the most abundant myokines found in skeletal muscle, has a key immunoregulatory role in supporting the proliferation and maturation of T cells and NK cells, which have a key role in the host's immune response to cancer. Furthermore, IL-15 is being explored clinically as an immunotherapy agent with doses similar to the IL-15 concentrations released by skeletal muscle during exercise. Here we review the role of IL-15 within the immune system, examine how IL-15 is produced as a myokine during exercise, and how it may improve outcomes for people with cancer, specifically as an adjuvant or neoadjuvant to immunotherapy. We summarize the available evidence showing changes in IL-15 in response to both acute exercise and training, and the results are inconsistent; higher quality research is needed to advance the understanding of how exercise-mediated increases in IL-15 potentially benefit those who are being treated for, or who have had, cancer.
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Affiliation(s)
- Morgan J Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, AUSTRALIA
| | - David B Bartlett
- School of Biosciences and Medicine, University of Surrey, Surrey, UNITED KINGDOM
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, AUSTRALIA
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Artese AL, Sitlinger A, MacDonald G, Deal MA, Hanson ED, Pieper CF, Weinberg JB, Brander DM, Bartlett DB. Effects of high-intensity interval training on health-related quality of life in chronic lymphocytic leukemia: A pilot study. J Geriatr Oncol 2023; 14:101373. [PMID: 36096873 DOI: 10.1016/j.jgo.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Chronic lymphocytic leukemia (CLL) is the most common incurable leukemia/lymphoma in the United States. Individuals with CLL are at risk for disability, frailty, and cancer-specific complications that negatively affect health-related quality of life (HRQOL). High-intensity interval training (HIIT) and resistance training (RT) are safe and feasible for individuals with chronic diseases and when combined, they may be beneficial for reducing cancer-related fatigue, symptom burden, and global quality of life. However, no studies have examined the impact of HIIT or RT on HRQOL in CLL. The purpose of this study was to investigate the effects of a 12-week HIIT and RT (HIIT+RT) intervention on HRQOL in adults with treatment naïve CLL. MATERIALS AND METHODS Changes in HRQOL was a secondary outcome in this pilot study. Individuals with CLL (63.9 ± 8.5 yrs) were non-randomly assigned to 12 weeks of HIIT+RT or a control group. The HIIT+RT protocol consisted of three 30-min sessions/week of HIIT and two sessions/week of RT. The control group maintained usual daily activities. We assessed pre and post HRQOL using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire with domains of physical (PWB), social (SWB), emotional (EWB), functional (FWB), and general (FACT-G) well-being as well as a lymphoma-specific subscale (LymS). We used a two-way mixed analysis of variance to assess changes in HRQOL. We calculated effect size (ES) using Cohen's d. RESULTS Fifteen participants (HIIT+RT: n = 9; Control: n = 6) completed the study and questionnaire. Scores for FWB improved following HIIT+RT (21.7 ± 3.4 to 23.9 ± 3.2; ES = 1.38) compared to controls (25.7 ± 2.2 to 25.7 ± 2.3). The HIIT+RT group experienced clinically meaningful improvements in total FACT-Lym, FWB, FACT-G, and LymS. The control group had clinically meaningful changes only in LymS. DISCUSSION The large effect sizes and clinically meaningful improvements associated with 12 weeks of HIIT+RT support the potential benefits of this type of exercise program for FWB, lymphoma-specific symptoms, and general well-being in CLL. A future randomized trial with an adequately powered sample size is needed to evaluate these findings. TRIAL REGISTRATION NCT04950452.
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Affiliation(s)
- Ashley L Artese
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Andrea Sitlinger
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA.
| | - Grace MacDonald
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Michael A Deal
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Erik D Hanson
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Carl F Pieper
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA
| | - J Brice Weinberg
- Division of Hematology, Duke University School of Medicine and VA Medical Center, Durham, NC, USA
| | - Danielle M Brander
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA; School of Bioscience and Medicine, University of Surrey, Guildford, UK.
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Artese AL, Sitlinger A, MacDonald G, Deal MA, Hanson ED, Pieper CF, Weinberg JB, Brander DM, Bartlett DB. Quality Of Life Changes Following High-intensity Interval Training In Older Adults With Chronic Lymphocytic Leukemia. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877004.38963.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sitlinger A, Deal MA, Garcia E, Connelly M, Thompson D, Stewart T, Macdonald G, Hanson ED, Neely M, Neely B, Artese A, Weinberg JB, Brander D, Bartlett DB. Associations of clinical and circulating metabolic biomarkers with low physical fitness and function in adults with chronic lymphocytic leukemia. Front Oncol 2022; 12:933619. [PMID: 35992862 PMCID: PMC9381973 DOI: 10.3389/fonc.2022.933619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022] Open
Abstract
Many patients with chronic lymphocytic leukemia (CLL) experience physical dysfunction and low overall fitness. It remains unknown what factors drive CLL physical dysfunction. We assessed physical function and metabolic lipoprotein panels in 106 patients with CLL. In univariate analyses of clinical factors, a longer time since diagnosis was associated with a higher likelihood of dysfunctional aerobic fitness (OR = 3.56, 95% CI: 1.37–9.22; p = 0.002) and physical performance (SPPB: OR = 2.03, 95% CI: 1.20–3.44; p = 0.004). Having received treatment was associated with a higher likelihood of dysfunctional aerobic fitness (OR = 1.57, 95% CI: 1.02–2.40; p = 0.036), SPPB (OR = 1.85, 95% CI: 1.13–3.03; p = 0.011) and grip strength (OR = 1.67, 95% CI: 1.10–2.55; p = 0.015). We found that several small HDL particle parameters, higher levels of citrate (OR = 2.01, 95% CI: 1.22–3.31; p = 0.030), and lower levels of hemoglobin (OR = 0.50, 95% CI: 0.31–0.82; p = 0.030) were associated with a higher likelihood of dysfunctional aerobic fitness. Multivariable least absolute shrinkage and selection operator (LASSO)-penalized regression analyses using variable importance measures (VIM) showed that 7.8-nm HDL particles (VIM = 1.000) and total HDL particle levels (VIM = 1.000) were more informative than clinical measures for the odds of dysfunctional aerobic fitness and 6-min walk functional fitness, respectively, while 10.3-nm HDL particles (VIM = 0.383) were more informative for grip strength. Time since diagnosis (VIM = 0.680) and having received treatment (VIM = 0.490) were more informative than lipoprotein measures for the odds of having dysfunctional SPPB. Taken together, we establish significant relationships between clinical and metabolic factors and physical characteristics that might prompt early use of ancillary support services.
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Affiliation(s)
- Andrea Sitlinger
- Hematologic Malignancies and Cellular Therapies, Duke University Medical Center, Durham, NC, United States
| | - Michael A. Deal
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, United States
| | - Erwin Garcia
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC, United States
| | - Margery Connelly
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC, United States
| | - Dana Thompson
- Division of Hematology, Duke University Medical Center and VA Medical Center, Durham, NC, United States
| | - Tiffany Stewart
- Division of Hematology, Duke University Medical Center and VA Medical Center, Durham, NC, United States
| | - Grace Macdonald
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, United States
| | - Erik D. Hanson
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, United States
| | - Megan Neely
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States
| | - Ben Neely
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States
| | - Ashley Artese
- Duke University Aging Center, Duke University Medical Center, Durham, NC, United States
| | - J. Brice Weinberg
- Division of Hematology, Duke University Medical Center and VA Medical Center, Durham, NC, United States
| | - Danielle Brander
- Hematologic Malignancies and Cellular Therapies, Duke University Medical Center, Durham, NC, United States
| | - David B. Bartlett
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, United States
- Duke University Aging Center, Duke University Medical Center, Durham, NC, United States
- School of Bioscience and Medicine, University of Surrey, Guildford, United Kingdom
- *Correspondence: David B. Bartlett,
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Lew MV, Ren Y, Lowder YP, Siamakpour-Reihani S, Ramalingam S, Romero KM, Thompson JC, Bohannon LM, McIntyre J, Tang H, Van Opstal J, Johnson E, Cohen HJ, Bartlett DB, Pastva AM, Morey M, Hall KS, Smith P, Peters KB, Somers TJ, Kelleher S, Smith SK, Wischmeyer PE, Lin PH, Wood WA, Thorpe G, Minor K, Wiggins K, Hennig T, Helms T, Welch R, Matthews B, Liu J, Burleson J, Aberant T, Engemann AK, Henshall B, Darby M, Proch C, Dellascio M, Pittman A, Suminguit J, Choi T, Gasparetto C, Long GD, Lopez RD, Sarantopoulos S, Horwitz ME, Chao NJ, Sung AD. Geriatric Assessment Reveals Actionable Impairments in Hematopoietic Stem Cell Transplantation Candidates Age 18 to 80 Years. Transplant Cell Ther 2022; 28:498.e1-498.e9. [PMID: 35595226 PMCID: PMC10042624 DOI: 10.1016/j.jtct.2022.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HCT) is a potentially curative treatment for both malignant and nonmalignant hematologic diseases; however, reported rates of treatment-related mortality approach 30%. Outcomes are worse in patients who begin HCT with functional impairments. To detect such impairments, a geriatric assessment (GA) is recommended in adults age ≥65 years. Younger HCT candidates also may be impaired because of chemotherapy regimens pre-HCT. Therefore, we hypothesized that GA can be beneficial for adult patients of all ages and subsequently created a clinical pretransplantation optimization program to assess all HCT candidates using a modified GA. One-hundred fifty-seven patients were evaluated in 4 functional domains- physical, cognitive, nutritional, and psychological-at 2 time points prior to HCT-new patient evaluation (NPE) and sign-off (SO)-between October 2017 and January 2020. At NPE, 80.9% of the patients had at least 1 domain with a functional impairment, and physical (P = .006), cognitive (P = .04), and psychological (P = .04) impairments were associated with an increased likelihood of not proceeding to HCT. In addition, patients age 18 to 39 years were more likely than older patients to have a physical function impairment (P = .001). Between NPE and SO, 51.9% of the patients had resolution of 1 or more impairments, and nutritional impairment at SO was predictive of worse overall survival (P = .01). Our study shows that GA can identify functional impairments in patients of all ages. Early identification of impairments could facilitate referrals to supportive care and resolution of impairments prior to HCT, suggesting that GA could be recommended for HCT candidates of all ages.
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Affiliation(s)
- Meagan V Lew
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Yi Ren
- Duke Cancer Institute Biostatistics Shared Resources, Durham, North Carolina
| | - Yen P Lowder
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Sharareh Siamakpour-Reihani
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Sendhilnathan Ramalingam
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | | | - Jillian C Thompson
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Lauren M Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Jackie McIntyre
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Helen Tang
- Duke University School of Medicine, Durham, North Carolina
| | - Jolien Van Opstal
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina; Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Ernaya Johnson
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Harvey Jay Cohen
- Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina
| | - David B Bartlett
- Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina; School of Biosciences and Medicine, University of Surrey, Surrey, United Kingdom
| | - Amy M Pastva
- Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina; Department of Orthopedic Surgery, Division of Physical Therapy, Duke University Medical Center, Durham, North Carolina
| | - Miriam Morey
- Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina; Geriatric Research, Education and Clinical Center, Durham VA Healthcare System, Durham, North Carolina
| | - Katherine S Hall
- Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina; Geriatric Research, Education and Clinical Center, Durham VA Healthcare System, Durham, North Carolina
| | - Patrick Smith
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Katherine B Peters
- Departments of Neurology and Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina
| | - Tamara J Somers
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Sarah Kelleher
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Sophia K Smith
- School of Nursing, Duke University Medical Center, Durham, North Carolina
| | - Paul E Wischmeyer
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Pao-Hwa Lin
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina
| | - William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Glynnis Thorpe
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Kerry Minor
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Kristi Wiggins
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Therese Hennig
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Tanya Helms
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Renee Welch
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Brittany Matthews
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - JoAnn Liu
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Jill Burleson
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Thomas Aberant
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Ashley K Engemann
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Bethany Henshall
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Maurisa Darby
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Christina Proch
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Michelle Dellascio
- Duke Health Department of Physical Therapy and Occupational Therapy, Durham, North Carolina
| | - Alyssa Pittman
- Duke Health Department of Physical Therapy and Occupational Therapy, Durham, North Carolina
| | - Jacob Suminguit
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Taewoong Choi
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Cristina Gasparetto
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Gwynn D Long
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Richard D Lopez
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Stefanie Sarantopoulos
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Mitchell E Horwitz
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Nelson J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Anthony D Sung
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina; Claude D. Pepper Older Americans Independence Center, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.
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9
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Andonian BJ, Koss A, Koves TR, Hauser ER, Hubal MJ, Pober DM, Lord JM, MacIver NJ, St Clair EW, Muoio DM, Kraus WE, Bartlett DB, Huffman KM. Rheumatoid arthritis T cell and muscle oxidative metabolism associate with exercise-induced changes in cardiorespiratory fitness. Sci Rep 2022; 12:7450. [PMID: 35523821 PMCID: PMC9076829 DOI: 10.1038/s41598-022-11458-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/18/2022] [Indexed: 11/09/2022] Open
Abstract
Rheumatoid arthritis (RA) T cells drive autoimmune features via metabolic reprogramming that reduces oxidative metabolism. Exercise training improves cardiorespiratory fitness (i.e., systemic oxidative metabolism) and thus may impact RA T cell oxidative metabolic function. In this pilot study of RA participants, we took advantage of heterogeneous responses to a high-intensity interval training (HIIT) exercise program to identify relationships between improvements in cardiorespiratory fitness with changes in peripheral T cell and skeletal muscle oxidative metabolism. In 12 previously sedentary persons with seropositive RA, maximal cardiopulmonary exercise tests, fasting blood, and vastus lateralis biopsies were obtained before and after 10 weeks of HIIT. Following HIIT, improvements in RA cardiorespiratory fitness were associated with changes in RA CD4 + T cell basal and maximal respiration and skeletal muscle carnitine acetyltransferase (CrAT) enzyme activity. Further, changes in CD4 + T cell respiration were associated with changes in naïve CD4 + CCR7 + CD45RA + T cells, muscle CrAT, and muscle medium-chain acylcarnitines and fat oxidation gene expression profiles. In summary, modulation of cardiorespiratory fitness and molecular markers of skeletal muscle oxidative metabolism during exercise training paralleled changes in T cell metabolism. Exercise training that improves RA cardiorespiratory fitness may therefore be valuable in managing pathologically related immune and muscle dysfunction.Trial registration: ClinicalTrials.gov, NCT02528344. Registered on 19 August 2015.
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Affiliation(s)
- Brian J Andonian
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, NC, 27701, USA.
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA.
| | - Alec Koss
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
| | - Timothy R Koves
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
| | - Elizabeth R Hauser
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
| | - Monica J Hubal
- Department of Kinesiology, Indiana University-Purdue University Indianapolis School of Health & Human Sciences, Indianapolis, IN, 46202, USA
| | | | - Janet M Lord
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Nancie J MacIver
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - E William St Clair
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, NC, 27701, USA
| | - Deborah M Muoio
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kim M Huffman
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, NC, 27701, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 22701, USA
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10
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MacDonald G, Sitlinger A, Deal MA, Hanson ED, Ferraro S, Pieper CF, Weinberg JB, Brander DM, Bartlett DB. A pilot study of high-intensity interval training in older adults with treatment naïve chronic lymphocytic leukemia. Sci Rep 2021; 11:23137. [PMID: 34848750 PMCID: PMC8633014 DOI: 10.1038/s41598-021-02352-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common leukemia in the USA, affecting predominantly older adults. CLL is characterized by low physical fitness, reduced immunity, and increased risk of secondary malignancies and infections. One approach to improving CLL patients' physical fitness and immune functions may be participation in a structured exercise program. The aims of this pilot study were to examine physical and immunological changes, and feasibility of a 12-week high-intensity interval training (HIIT) combined with muscle endurance-based resistance training on older adults with treatment naïve CLL. We enrolled eighteen participants with CLL aged 64.9 ± 9.1 years and assigned them to groups depending on distance lived from our fitness center. Ten participants (4 M/6F) completed HIIT and six participants (4 M/2F) completed a non-exercising control group (Controls). HIIT consisted of three 30-min treadmill sessions/week plus two concurrent 30-min strength training sessions/week. Physical and immunological outcomes included aerobic capacity, muscle strength and endurance, and natural killer (NK) cell recognition and killing of tumor cells. We confirmed feasibility if > 70% of HIIT participants completed > 75% of prescribed sessions and prescribed minutes, and if > 80% of high-intensity intervals were at a heart rate corresponding to at least 80% of peak aerobic capacity (VO2peak). Results are presented as Hedge's G effect sizes (g), with 0.2, 0.5 and 0.8 representing small, medium and large effects, respectively. Following HIIT, leg strength (g = 2.52), chest strength (g = 1.15) and seated row strength (g = 3.07) were 35.4%, 56.1% and 39.5% higher than Controls, respectively, while aerobic capacity was 3.8% lower (g = 0.49) than Controls. Similarly, following HIIT, in vitro NK-cell cytolytic activity against the K562 cell line (g = 1.43), OSU-CLL cell line (g = 0.95), and autologous B-cells (g = 1.30) were 20.3%, 3.0% and 14.6% higher than Controls, respectively. Feasibility was achieved, with HIIT completing 5.0 ± 0.2 sessions/week and 99 ± 3.6% of the prescribed minutes/week at heart rates corresponding to 89 ± 2.8% of VO2peak. We demonstrate that 12-weeks of supervised HIIT combined with muscle endurance-based resistance training is feasible, and that high adherence and compliance are associated with large effects on muscle strength and immune function in older adults with treatment naïve CLL.Trial registration: NCT04950452.
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Affiliation(s)
- Grace MacDonald
- Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA.,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Andrea Sitlinger
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA
| | - Michael A Deal
- Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA.,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Stephanie Ferraro
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Carl F Pieper
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA
| | - J Brice Weinberg
- Division of Hematology, Duke University School of Medicine and VA Medical Center, Durham, NC, USA
| | - Danielle M Brander
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA. .,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA. .,Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. .,Division of Medical Oncology, Department of Medicine, Duke Molecular Physiology Institute, Durham, NC, 27701, USA.
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11
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Bartlett DB, Hanson ED, Lee JT, Wagoner CW, Harrell EP, Sullivan SA, Bates LC, Alzer MS, Amatuli DJ, Deal AM, Jensen BC, MacDonald G, Deal MA, Muss HB, Nyrop KA, Battaglini CL. The Effects of 16 Weeks of Exercise Training on Neutrophil Functions in Breast Cancer Survivors. Front Immunol 2021; 12:733101. [PMID: 34777343 PMCID: PMC8578958 DOI: 10.3389/fimmu.2021.733101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022] Open
Abstract
Following therapy, breast cancer survivors (BCS) have an increased risk of infections because of age and cancer dysregulation of inflammation and neutrophil functions. Neutrophil functions may be improved by exercise training, although limited data exist on exercise and neutrophil functions in BCS.Sixteen BCS [mean age: 56 (SD 11) years old] completed 16 weeks of community-based exercise training and a 45-minute acute bout of cycling before (Base) and after (Final) the exercise training program. Exercise training consisted of 3 x 40 – 60 minute mixed mode aerobic exercises, comprising 10 – 30 minutes aerobic and 30 minutes resistance training. At Base and Final, we took BCS blood samples before (PRE), immediately after (POST), and 1 hour after (1Hr) acute exercise to determine neutrophil counts, phenotype, bacterial killing, IL-6, and IL-8 levels. Eleven healthy, age- and physical activity levels-matched women (Control) completed the acute bout of exercise once as a healthy response reference. Resting Responses. BCS and Controls had similar Base PRE absolute neutrophil counts [mean (SD): 3.3 (1.9) v 3.1 (1.2) x 109/L, p=0.801], but BCS had lower bacterial phagocytosis [3991 (1233) v 4881 (417) MFI, p=0.035] and higher oxidative killing [6254 (1434) v 4709 (1220) MFI, p=0.005], lower CD16 [4159 (1785) v 7018 (1240) MFI, p<0.001], lower CXCR2 [4878 (1796) v 6330 (1299) MFI, p=0.032] and higher TLR2 [98 (32) v 72 (17) MFI, p=0.022] expression, while IL-6 [7.4 (5.4) v 4.0 (2.7) pg/mL, p=0.079] levels were marginally higher and IL-8 [6.0 (4.7) v 7.9 (5.0) pg/mL, p=0.316] levels similar. After 16 weeks of training, compared to Controls, BCS Final PRE phagocytosis [4510 (738) v 4881 (417) MFI, p=0.146] and TLR2 expression [114 (92) v 72 (17) MFI, p=0.148] were no longer different. Acute Exercise Responses. As compared to Controls, at Base, BCS phagocytic Pre-Post response was lower [mean difference, % (SD): 12% (26%), p=0.042], CD16 Pre-Post response was lower [12% (21%), p=0.016] while CD16 Pre-1Hr response was higher [13% (25%), p=0.022], TLR2 Pre-Post response was higher [15% (4%) p=0.002], while IL-8 Pre-Post response was higher [99% (48%), p=0.049]. As compared to Controls, following 16 weeks of training BCS phagocytic Pre-Post response [5% (5%), p=0.418], CD16 Pre-1Hr response [7% (7%), p=0.294], TLR2 Pre-Post response [6% (4%), p=0.092], and IL-8 Pre-Post response [1% (9%), p=0.087] were no longer different. Following cancer therapy, BCS may have impaired neutrophil functions in response to an acute bout of exercise that are partially restored by 16 weeks of exercise training. The improved phagocytosis of bacteria in BCS may represent an exercise-induced intrinsic improvement in neutrophil functions consistent with a reduced risk of infectious disease.
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Affiliation(s)
- David B Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University, Durham, NC, United States.,Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jordan T Lee
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Chad W Wagoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Elizabeth P Harrell
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Stephanie A Sullivan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mohamdod S Alzer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Dean J Amatuli
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brian C Jensen
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Grace MacDonald
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University, Durham, NC, United States
| | - Michael A Deal
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University, Durham, NC, United States
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Claudio L Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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12
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Khosravi N, Hanson ED, Farajivafa V, Evans WS, Lee JT, Danson E, Wagoner CW, Harrell EP, Sullivan SA, Nyrop KA, Muss HB, Bartlett DB, Jensen BC, Haghighat S, Shamsi MM, Battaglini CL. Exercise-induced modulation of monocytes in breast cancer survivors. Brain Behav Immun Health 2021; 14:100216. [PMID: 34589753 PMCID: PMC8474256 DOI: 10.1016/j.bbih.2021.100216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/31/2021] [Accepted: 02/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background Exercise training reduces inflammation in breast cancer survivors; however, the mechanism is not fully understood. Objectives The effects of acute and chronic exercise on monocyte toll-like receptor (TLR2 and 4) expression and intracellular cytokine production were examined in sedentary breast cancer survivors. Methods Eleven women with stage I, II, or III breast cancer within one year of treatment completion performed an acute, intermittent aerobic exercise trial. Blood samples were obtained before, immediately, and 1 h after a 45-min acute exercise trial that was performed before and after 16 weeks of combined aerobic and resistance. LPS-stimulated intracellular IL-1ß, TNF, and IL-6 production, and TLR2 and TLR4 expression were evaluated in CD14+CD16- and CD14+CD16+ monocytes using flow cytometry. Results Exercise training decreased IL-1ß+CD14+CD16- proportion (24.6%, p=0.016), IL-1ß+CD14+CD16- mean fluorescence intensity (MFI) (-9989, p=0.014), IL-1ß+CD14+CD16+ MFI (-11101, p=0.02), and IL-6+CD14+CD16- proportion (16.9%, P=0.04). TLR2 and TLR4 expression did not change following exercise training but decreased 1 h after acute exercise in CD14+CD16- (-63, p=0.002) and CD14+CD16+ (-18, p=0.006) monocytes, respectively. Immediately after the acute exercise, both monocyte subgroup cell concentration increased, with CD14+CD16+ concentrations being decreased at 1 h post without changes in intracellular cytokine production. Conclusions Exercise training reduced monocyte intracellular pro-inflammatory cytokine production, especially IL-1ß, although these markers did not change acutely. While acute exercise downregulated the expression of TLR2 and TLR4 on monocytes, this was not sustained over the course of training. These results suggest that the anti-inflammatory effect of combined aerobic and resistance exercise training in breast cancer survivors may be, in part, due to reducing resting monocyte pro-inflammatory cytokine production.
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Affiliation(s)
- Nasim Khosravi
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA.,Physical Education & Sport Sciences Department, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Erik D Hanson
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Vahid Farajivafa
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA.,Physical Education & Sport Sciences Department, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - William S Evans
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Jordan T Lee
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Eli Danson
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Chad W Wagoner
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth P Harrell
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Stephanie A Sullivan
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.,Department of Hematology Oncology University of North Carolina, Chapel Hill, NC, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.,Department of Hematology Oncology University of North Carolina, Chapel Hill, NC, USA
| | | | - Brian C Jensen
- Division of Cardiology, University of North Carolina, Chapel Hill, NC, USA
| | - Shahpar Haghighat
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Mahdieh Molanouri Shamsi
- Physical Education & Sport Sciences Department, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Claudio L Battaglini
- Department of Exercise & Sport Science, Exercise Oncology Research Laboratory, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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13
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Hanson ED, Stopforth CK, Alzer M, Carver J, Lucas AR, Whang YE, Milowsky MI, Bartlett DB, Harrison MR, Hayes A, Bitting RL, Deal AM, Hackney AC, Battaglini CL. Body composition, physical function and quality of life in healthy men and across different stages of prostate cancer. Prostate Cancer Prostatic Dis 2021; 24:725-732. [PMID: 33495569 PMCID: PMC8310529 DOI: 10.1038/s41391-020-00317-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) for prostate cancer (PC) has detrimental effects on physical function and quality of life (QoL), but the addition of androgen receptor signalling inhibitors (ARSI) on these outcomes is unclear. PURPOSE To compare body composition, physical function, and QoL across progressive stages of PC and non-cancer controls (CON). METHODS In men with hormone sensitive PC (HSPC, n = 43) or metastatic castration-resistant PC (mCRPC, n = 22) or CON (n = 37), relative and absolute lean and fat mass, physical function (6 m walk, chair stands, timed up and go [TUG], stair climb), and QoL were determined. RESULTS Relative body composition differed amongst all groups, along with ~39% greater absolute fat mass in mCRPC vs. CON. TUG and chair stands were ~71% and ~33% slower in mCRPC compared to both CON and HSPC, whereas stair climb was ~29% and 6 m walk was ~18% slower in mCRPC vs. CON. Relative body composition was correlated with physical function (r = 0.259-0.385). Clinically relevant differences for mCRPC were observed for overall QoL and several subscales vs. CON, although body composition and physical function did not influence QoL. CONCLUSIONS PC progression is associated with deteriorations in body composition and physical function. As ADT length was similar between groups, ARSI use for mCRPC likely contributed in part to these changes. Given the difficulties of improving lean mass during ADT, interventions that reduce adiposity may lessen the side effects of hormone therapy.
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Affiliation(s)
- Erik D. Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC,Institute of Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Cameron K. Stopforth
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mohamdod Alzer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jackson Carver
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alexander R. Lucas
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC,Virginia Commonwealth University, Richmond, VA
| | - Young E. Whang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew I. Milowsky
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David B. Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Michael R. Harrison
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Alan Hayes
- Institute of Health and Sport, Victoria University, Melbourne, Vic, Australia,Australian Institute for Musculoskeletal Science, Victoria University, Melbourne, Vic, Australia
| | | | - Allison M. Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anthony C. Hackney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC,Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Claudio L. Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Hanson ED, Bates LC, Harrell EP, Bartlett DB, Lee JT, Wagoner CW, Alzer MS, Amatuli DJ, Jensen BC, Deal AM, Muss HB, Nyrop KA, Battaglini CL. Exercise Training Partially Rescues Impaired Mucosal Associated Invariant T-cell Mobilization In Women With Breast Cancer. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000763524.14874.f9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Andonian BJ, Johannemann A, Hubal MJ, Pober DM, Koss A, Kraus WE, Bartlett DB, Huffman KM. Altered skeletal muscle metabolic pathways, age, systemic inflammation, and low cardiorespiratory fitness associate with improvements in disease activity following high-intensity interval training in persons with rheumatoid arthritis. Arthritis Res Ther 2021; 23:187. [PMID: 34246305 PMCID: PMC8272378 DOI: 10.1186/s13075-021-02570-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/29/2021] [Indexed: 01/16/2023] Open
Abstract
Background Exercise training, including high-intensity interval training (HIIT), improves rheumatoid arthritis (RA) inflammatory disease activity via unclear mechanisms. Because exercise requires skeletal muscle, skeletal muscle molecular pathways may contribute. The purpose of this study was to identify connections between skeletal muscle molecular pathways, RA disease activity, and RA disease activity improvements following HIIT. Methods RA disease activity assessments and vastus lateralis skeletal muscle biopsies were performed in two separate cohorts of persons with established, seropositive, and/or erosive RA. Body composition and objective physical activity assessments were also performed in both the cross-sectional cohort and the longitudinal group before and after 10 weeks of HIIT. Baseline clinical assessments and muscle RNA gene expression were correlated with RA disease activity score in 28 joints (DAS-28) and DAS-28 improvements following HIIT. Skeletal muscle gene expression changes with HIIT were evaluated using analysis of covariance and biological pathway analysis. Results RA inflammatory disease activity was associated with greater amounts of intramuscular adiposity and less vigorous aerobic exercise (both p < 0.05). HIIT-induced disease activity improvements were greatest in those with an older age, elevated erythrocyte sedimentation rate, low cardiorespiratory fitness, and a skeletal muscle molecular profile indicative of altered metabolic pathways (p < 0.05 for all). Specifically, disease activity improvements were linked to baseline expression of RA skeletal muscle genes with cellular functions to (1) increase amino acid catabolism and interconversion (GLDC, BCKDHB, AASS, PYCR, RPL15), (2) increase glycolytic lactate production (AGL, PDK2, LDHB, HIF1A), and (3) reduce oxidative metabolism via altered beta-oxidation (PXMP2, ACSS2), TCA cycle flux (OGDH, SUCLA2, MDH1B), and electron transport chain complex I function (NDUFV3). The muscle mitochondrial glycine cleavage system (GCS) was identified as critically involved in RA disease activity improvements given upregulation of multiple GCS genes at baseline, while GLDC was significantly downregulated following HIIT. Conclusion In the absence of physical activity, RA inflammatory disease activity is associated with transcriptional remodeling of skeletal muscle metabolism. Following exercise training, the greatest improvements in disease activity occur in older, more inflamed, and less fit persons with RA. These exercise training-induced immunomodulatory changes may occur via reprogramming muscle bioenergetic and amino acid/protein homeostatic pathways. Trial registration ClinicalTrials.gov, NCT02528344. Registered on 19 August 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02570-3.
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Affiliation(s)
- Brian J Andonian
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. .,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - Andrew Johannemann
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Monica J Hubal
- Department of Kinesiology, Indiana University-Purdue University Indianapolis School of Health & Human Sciences, Indianapolis, IN, USA
| | | | - Alec Koss
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Kim M Huffman
- Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
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16
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Hanson ED, Bates LC, Harrell EP, Bartlett DB, Lee JT, Wagoner CW, Alzer MS, Amatuli DJ, Jensen BC, Deal AM, Muss HB, Nyrop KA, Battaglini CL. Exercise training partially rescues impaired mucosal associated invariant t-cell mobilization in breast cancer survivors compared to healthy older women. Exp Gerontol 2021; 152:111454. [PMID: 34146655 DOI: 10.1016/j.exger.2021.111454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022]
Abstract
Exercise may attenuate immunosenescence with aging that appears to be accelerated following breast cancer treatment, although limited data on specific cell types exists and acute and chronic exercise have been investigated independently in older adults. PURPOSE To determine the mucosal associated invariant T (MAIT) cell response to acute exercise before (PRE) and after (POST) 16 weeks of exercise training in breast cancer survivors (BCS) and healthy older women (CON). METHODS Age-matched BCS and CON performed 45 min of intermittent cycling at 60% peak power output wattage. Blood samples were obtained at rest, immediately (0 h) and 1 h after exercise to determine MAIT cell counts, frequency, and intracellular cytokine expression. RESULTS At PRE, MAIT cell counts were greater in CON (137%) than BCS at 0 h (46%, p < 0.001), with increased MAIT cell frequency in CON but not BCS. TNFα+ and IFNγ+ MAIT cell counts increased at 0 h by ~120% in CON (p < 0.001), while BCS counts and frequencies were unchanged. Similar deficits were observed in CD3+ and CD3+ CD8+ cells. At POST, exercise-induced mobilization and egress of MAIT cell counts and frequency showed trends towards improvement in BCS that approached levels in CON. Independent of group, TNFα frequency trended to improve (p = 0.053). CONCLUSIONS MAIT mobilization in older BCS following acute exercise was attenuated; however, exercise training may partially rescue these initial deficits, including greater sensitivity to mitogenic stimulation. Using acute exercise before and after interventions provides a unique approach to identify age- and cancer-related immuno-dysfunction that is less apparent at rest.
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Affiliation(s)
- Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Elizabeth P Harrell
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - David B Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Jordan T Lee
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Chad W Wagoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Mohamdod S Alzer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Dean J Amatuli
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Brian C Jensen
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Department of Hematology Oncology, University of North Carolina, Chapel Hill, NC, United States of America
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Department of Hematology Oncology, University of North Carolina, Chapel Hill, NC, United States of America
| | - Claudio L Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Schwartz AR, Bartlett DB, Johnson JL, Broadwater G, Channell M, Nolte KC, Wilkes PA, Huffman KM, Secord AA. A Pilot Study of Home-Based Exercise and Personalized Nutrition Counseling Intervention in Endometrial Cancer Survivors. Front Oncol 2021; 11:669961. [PMID: 34178654 PMCID: PMC8232933 DOI: 10.3389/fonc.2021.669961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/24/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction To assess the feasibility of a home-based aerobic exercise and nutrition counseling intervention and effect on cardiorespiratory fitness, cardiovascular disease risk profile, and immune response in obese endometrial cancer survivors. Methods A longitudinal pilot study assessed a 12-week home-based aerobic exercise and nutrition counseling intervention in obese endometrial cancer survivors. The primary outcome was feasibility defined as 80% adherence to weekly walking sessions calculated among individuals that completed the intervention. Secondary outcomes comprised pre- and post-intervention differences in cardiorespiratory fitness, cardiovascular risk factors, and T-cell function. Descriptive statistics summarized data. Wilcoxon sign tests identified differences between and pre and post-intervention variables. Results Nineteen women with stage 1 endometrial cancer consented; 9 withdrew and one was a screen failure. Median adherence to weekly walking sessions was 83.3%. Body composition was significantly altered with a reduction in median fat mass from 52.5 kg to 46.9 kg (p=0.04), and BMI from 37.5 kg/m2 to 36.2 kg/m2 (p = 0.004). There was no significant difference in cardiorespiratory fitness or cardiovascular parameters. The percentage of CD4+ and CD8+ T-cells producing IFNγ towards MAGE-A4 significantly increased from and 5.9% to 7.2% (p=0.043) and 13.9% to 14.8% (p=0.046), respectively. There were 3 related adverse events: hip pain, back sprain, and abdominal pain. Discussion Our home-based exercise and nutrition counseling program was feasible based on 80% adherence to walking sessions and favored altered body composition. However, the discontinuation rate was high and further research is needed to overcome barriers to implementation. Improvement in cardiovascular parameters will most likely require longer and more intensive programs.
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Affiliation(s)
- Amanda R Schwartz
- Department of Obstetrics and Gynecology, Duke University Hospital, Durham, NC, United States
| | - David B Bartlett
- Department of Medicine, Division of Medical Oncology, Duke University Hospital, Durham, NC, United States
| | - Johanna L Johnson
- Duke Molecular Physiology Institute, Duke Center for Living, Duke University, Durham, NC, United States
| | - Gloria Broadwater
- Department of Biostatistics and Bioinformatics, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | - Meghan Channell
- Department of Clinical Research, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | - Kimberly C Nolte
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University Health System, Durham, NC, United States
| | - Patricia A Wilkes
- Department of Nutrition Services, Duke University Hospital, Durham, NC, United States
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke Center for Living, Duke University, Durham, NC, United States.,Department of Medicine, Division of Rheumatology, Duke University Hospital, Durham, NC, United States
| | - Angeles Alvarez Secord
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University Health System, Durham, NC, United States
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18
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Hanson ED, Bates LC, Bartlett DB, Campbell JP. Does exercise attenuate age- and disease-associated dysfunction in unconventional T cells? Shining a light on overlooked cells in exercise immunology. Eur J Appl Physiol 2021; 121:1815-1834. [PMID: 33822261 DOI: 10.1007/s00421-021-04679-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/28/2021] [Indexed: 02/06/2023]
Abstract
Unconventional T Cells (UTCs) are a unique population of immune cells that links innate and adaptive immunity. Following activation, UTCs contribute to a host of immunological activities, rapidly responding to microbial and viral infections and playing key roles in tumor suppression. Aging and chronic disease both have been shown to adversely affect UTC numbers and function, with increased inflammation, change in body composition, and physical inactivity potentially contributing to the decline. One possibility to augment circulating UTCs is through increased physical activity. Acute exercise is a potent stimulus leading to the mobilization of immune cells while the benefits of exercise training may include anti-inflammatory effects, reductions in fat mass, and improved fitness. We provide an overview of age-related changes in UTCs, along with chronic diseases that are associated with altered UTC number and function. We summarize how UTCs respond to acute exercise and exercise training and discuss potential mechanisms that may lead to improved frequency and function.
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Affiliation(s)
- Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Lauren C Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David B Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
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Sung AD, Miller HM, Romero K, MacDonald G, Bohannon L, Molinger J, Ren Y, Bush A, Lew M, Cohen HJ, Pastva A, Jung SH, Shah NR, Smith PJ, Wischmeyer PE, Wood WA, Alyea E, Choi T, Gasparetto C, Horwitz ME, Long GD, Lopez RD, Rizzieri DA, Sarantopoulos S, Sullivan KM, Chao NJ, Bartlett DB. A Phase 1 Study of the Safety and Feasibility of Improving Cardiorespiratory Fitness through a Remotely Monitored, Mobile Health Supported High Intensity Interval Training Program (REMM-HIIT). Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Baht GS, Bareja A, Lee DE, Rao RR, Huang R, Huebner JL, Bartlett DB, Hart CR, Gibson JR, Lanza IR, Kraus VB, Gregory SG, Spiegelman BM, White JP. Author Correction: Meteorin-like facilitates skeletal muscle repair through a Stat3/IGF-1 mechanism. Nat Metab 2020; 2:794. [PMID: 32694832 DOI: 10.1038/s42255-020-0257-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Gurpreet S Baht
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Akshay Bareja
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - David E Lee
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Rajesh R Rao
- Genomics Institute of the Novartis Research Foundation, San Diego, CA, USA
| | - Rong Huang
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA
| | - Corey R Hart
- Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Jason R Gibson
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Ian R Lanza
- Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Simon G Gregory
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Bruce M Spiegelman
- Dana-Farber Cancer Institute, Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - James P White
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA.
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21
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Hanson ED, Sakkal S, Que S, Cho E, Spielmann G, Kadife E, Violet JA, Battaglini CL, Stoner L, Bartlett DB, McConell GK, Hayes A. Natural killer cell mobilization and egress following acute exercise in men with prostate cancer. Exp Physiol 2020; 105:1524-1539. [PMID: 32715550 DOI: 10.1113/ep088627] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/29/2020] [Indexed: 01/19/2023]
Abstract
NEW FINDINGS What is the central question of this study? What are the characteristics of the NK cell response following acute moderate-intensity aerobic exercise in prostate cancer survivors and is there a relationship between stress hormones and NK cell mobilization? What is the main finding and its importance? NK cell numbers and proportions changed similarly between prostate cancer survivors and controls following acute exercise. Consecutive training sessions can likely be used without adverse effects on the immune system during prostate cancer treatment. ABSTRACT Prostate cancer treatment affects multiple physiological systems, although the immune response during exercise has been minimally investigated. The objective was to characterize the natural killer (NK) cell response following acute exercise in prostate cancer survivors. Prostate cancer survivors on androgen deprivation therapy (ADT) and those without (PCa) along with non-cancer controls (CON) completed a moderate intensity cycling bout. NK cells were phenotyped before and 0, 2 and 24 h after acute exercise using flow cytometry. CD56 total NK cell frequency increased by 6.2% at 0 h (P < 0.001) and decreased by 2.5% at 2 h (P < 0.01) with similar findings in CD56dim cells. NK cell counts also exhibited a biphasic response. Independent of exercise, ADT had intracellular interferon γ (IFNγ) expression that was nearly twofold higher than CON (P < 0.01). PCa perforin expression was reduced by 11.4% (P < 0.05), suggesting these cells may be more prone to degranulation. CD57- NK cells demonstrated increased perforin and IFNγ frequencies after exercise with no change within the CD57+ populations. All NK and leukocyte populations returned to baseline by 24 h. NK cell mobilization and egress with acute exercise appear normal, as cell counts and frequencies in prostate cancer survivors change similarly to CON. However, lower perforin proportions (PCa) and higher IFNγ expression (ADT) may alter NK cytotoxicity and require further investigation. The return of NK cell proportions to resting levels overnight suggests that consecutive training sessions can be used without adverse effects on the immune system during prostate cancer treatment.
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Affiliation(s)
- Erik D Hanson
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Samy Sakkal
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Shadney Que
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Eunhan Cho
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Elif Kadife
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - John A Violet
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
| | - Claudio L Battaglini
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Lee Stoner
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - David B Bartlett
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Glenn K McConell
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia
| | - Alan Hayes
- Institute for Health and Sport, Victoria University, Melbourne, Vic, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Vic, Australia.,Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Vic, Australia
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Bartlett DB, Sitlinger A, Deal M, Connelly MA, Stewart T, Guadalupe E, MacDonald G, Kraus WE, Weinberg JB, Brander DB. Physical Fitness As A Determinant Of Leukemia Cell Biology In Treatment-Naive Chronic Lymphocytic Leukemia (CLL). Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686300.11363.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hanson ED, Bartlett DB, Moertl KM, Lee JT, Evans WS, Danson E, Wagoner CW, Harrell EP, Sullivan SA, Bates LC, Jensen BC, Muss HB, Battaglini CL. MONOCYTE FUNCTION FOLLOWING ACUTE EXERCISE IN BREAST CANCER SURVIVORS BEFORE AND AFTER EXERCISE TRAINING. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000671492.48800.4a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Stopforth CK, Alzer M, Carver J, Lucas A, Whang Y, Milowsky M, Bartlett DB, Harrison M, Hayes A, Bitting RL, Hackney AC, Battaglini CL, Hanson ED. BODY COMPOSITION, PHYSICAL FUNCTION AND QUALITY OF LIFE ACROSS DIFFERENT STAGES OF PROSTATE CANCER: A CROSS-SECTIONAL ANALYSIS. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686244.49780.ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bates LC, Hanson ED, Levitt MM, Richie B, Erickson E, Bartlett DB, Phillips MD. Mucosal-Associated Invariant T Cell Response To Acute Exercise In Overweight Older Women. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682380.99885.c8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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MacDonald GA, Bartlett DB, Hanson ED, Evans WS, Lee JT, Wagoner CW, Danson E, Harrell P, Sullivan S, Nyrop KA, Muss HB, Jensen BC, Battaglini CL. The Effects Of 16-weeks Of Exercise Training On Neutrophil Functions In Breast Cancer Survivors. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000670120.65864.a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Harrison MR, Alzer M, Giuliani HK, Carver J, Lucas AR, Bartlett DB, Milowsky MI, Whang Y, Bitting RL, Battaglini CL, Stoner L, Hackney AC, Ryan ED, Hanson ED. Muscle Cross-sectional Area Improves With Home-based Training During Metastatic Castration-resistant Prostate Cancer. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000671688.07645.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Andonian BJ, Bartlett DB, Hubal MJ, Willis L, Reaves MA, Kraus WE, Huffman KM. Skeletal Muscle Metabolic Gene Profile Associates With Rheumatoid Arthritis Improvements Following High Intensity Interval Training. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000671028.28151.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bartlett DB, Slentz CA, Willis LH, Hoselton A, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Muoio DM, Koves TR, Wu H, Huffman KM, Lord JM, Kraus WE. Rejuvenation of Neutrophil Functions in Association With Reduced Diabetes Risk Following Ten Weeks of Low-Volume High Intensity Interval Walking in Older Adults With Prediabetes - A Pilot Study. Front Immunol 2020; 11:729. [PMID: 32431698 PMCID: PMC7214668 DOI: 10.3389/fimmu.2020.00729] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/31/2020] [Indexed: 12/19/2022] Open
Abstract
Neutrophil dysfunction is a common feature of aging, and is associated with the pathogenesis of many age-related diseases, including type 2 diabetes mellitus (T2DM). Although exercise training improves metabolic health, decreases risk of T2DM, and is associated with improving neutrophil functions, involvement in regular physical activity declines with age. The aim of this study was to determine if neutrophil functions could be improved in association with changes in fitness and metabolic parameters in older adults at risk for T2DM using 10-weeks of low volume high-intensity interval exercise training (HIIT). Ten older (71 ± 5 years) sedentary adults with prediabetes (HbA1c: 6.1 ± 0.3%) completed 10 weeks of a supervised HIIT program. Three 30 min sessions/week consisted of ten 60 s intervals of low intensity [50–60% heart rate reserve (HRR)] separated with similar durations of high intensity intervals (80–90% HRR). Before and after training, glucose and insulin sensitivity, neutrophil chemotaxis, bacterial phagocytosis, reactive oxygen species (ROS) production, and mitochondrial functions were assessed. Exercise-mediated changes in cardiorespiratory fitness (VO2peak) and neutrophil functions were compared to six young (23 ± 1 years) healthy adults. Following training, significant reductions in fasting glucose and insulin were accompanied by improved glucose control and insulin sensitivity (all p < 0.05). Before exercise training, VO2peak in the old participants was significantly less than that of the young controls (p < 0.001), but increased by 16 ± 11% following training (p = 0.002) resulting in a 6% improvement of the deficit. Neutrophil chemotaxis, phagocytosis and stimulated ROS production were significantly less than that of the young controls, while basal ROS were higher before training (all p < 0.05). Following training, chemotaxis, phagocytosis and stimulated ROS increased while basal ROS decreased, similar to levels observed in the young controls (all p < 0.05) and reducing the deficit of the young controls between 2 and 154%. In five of the adults with prediabetes, neutrophil mitochondrial functions were significantly poorer than the six young controls before training. Following training, mitochondrial functions improved toward those observed in young controls (all p < 0.05), reducing the deficit of the young controls between 14.3 and 451%. Ten weeks of HIIT in older adults at risk for T2DM reduced disease risk accompanied by improved primary and bioenergetic neutrophil functions. Our results are consistent with a reduced risk of infections mediated by relationships in exercise induced systemic and cellular metabolic features. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02441205, registered on May 12th, 2015.
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Affiliation(s)
- David B Bartlett
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States.,Division of Medical Oncology, School of Medicine, Duke University, Durham, NC, United States.,MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Cris A Slentz
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Leslie H Willis
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Andrew Hoselton
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Janet L Huebner
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Jennifer Moss
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Michael J Muehlbauer
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Guillaume Spielmann
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Deborah M Muoio
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Timothy R Koves
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Helena Wu
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Kim M Huffman
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
| | - Janet M Lord
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham BRC in Inflammation, University Hospitals Birmingham, Birmingham, United Kingdom
| | - William E Kraus
- Duke Molecular Physiology Institute, School of Medicine, Duke University, Durham, NC, United States
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Bartlett DB, Duggal NA. Moderate physical activity associated with a higher naïve/memory T-cell ratio in healthy old individuals: potential role of IL15. Age Ageing 2020; 49:368-373. [PMID: 32221610 DOI: 10.1093/ageing/afaa035] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION ageing is accompanied by impairments in immune responses due to remodelling of the immune system (immunesenescence). Additionally, a decline in habitual physical activity has been reported in older adults. We have recently published that specific features of immunesenescence, such as thymic involution and naïve/memory T-cell ratio, are prevented by maintenance of a high level of physical activity. This study compares immune ageing between sedentary and physically active older adults. METHODS a cross-sectional study recruited 211 healthy older adults (60-79 years) and assessed their physical activity levels using an actigraph. We compared T- and B-cell immune parameters between relatively sedentary (n = 25) taking 2,000-4,500 steps/day and more physically active older adults (n = 25) taking 10,500-15,000 steps/day. RESULTS we found a higher frequency of naïve CD4 (P = 0.01) and CD8 (P = 0.02) and a lower frequency of memory CD4 cells (P = 0.01) and CD8 (P = 0.04) T cells in the physically active group compared with the sedentary group. Elevated serum IL7 (P = 0.03) and IL15 (P = 0.003), cytokines that play an essential role in T-cell survival, were seen in the physically active group. Interestingly, a positive association was observed between IL15 levels and peripheral CD4 naïve T-cell frequency (P = 0.023). DISCUSSION we conclude that a moderate level of physical activity may be required to give a very broad suppression of immune ageing, though 10,500-15,000 steps/day has a beneficial effect on the naïve T-cell pool.
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Affiliation(s)
- David B Bartlett
- Department of Medicine, Division of Medical Oncology, Duke University, Durham, NC 27701, USA
| | - Niharika A Duggal
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, Birmingham University, Birmingham B15 2TT, UK
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Baht GS, Bareja A, Lee DE, Rao RR, Huang R, Huebner JL, Bartlett DB, Hart CR, Gibson JR, Lanza IR, Kraus VB, Gregory SG, Spiegelman BM, White JP. Meteorin-like facilitates skeletal muscle repair through a Stat3/IGF-1 mechanism. Nat Metab 2020; 2:278-289. [PMID: 32694780 PMCID: PMC7504545 DOI: 10.1038/s42255-020-0184-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/17/2020] [Indexed: 01/14/2023]
Abstract
The immune system plays a multifunctional role throughout the regenerative process, regulating both pro-/anti-inflammatory phases and progenitor cell function. In the present study, we identify the myokine/cytokine Meteorin-like (Metrnl) as a critical regulator of muscle regeneration. Mice genetically lacking Metrnl have impaired muscle regeneration associated with a reduction in immune cell infiltration and an inability to transition towards an anti-inflammatory phenotype. Isochronic parabiosis, joining wild-type and whole-body Metrnl knock-out (KO) mice, returns Metrnl expression in the injured muscle and improves muscle repair, providing supportive evidence for Metrnl secretion from infiltrating immune cells. Macrophage-specific Metrnl KO mice are also deficient in muscle repair. During muscle regeneration, Metrnl works, in part, through Stat3 activation in macrophages, resulting in differentiation to an anti-inflammatory phenotype. With regard to myogenesis, Metrnl induces macrophage-dependent insulin-like growth factor 1 production, which has a direct effect on primary muscle satellite cell proliferation. Perturbations in this pathway inhibit efficacy of Metrnl in the regenerative process. Together, these studies identify Metrnl as an important regulator of muscle regeneration and a potential therapeutic target to enhance tissue repair.
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Affiliation(s)
- Gurpreet S Baht
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Akshay Bareja
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - David E Lee
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Rajesh R Rao
- Genomics Institute of the Novartis Research Foundation, San Diego, CA, USA
| | - Rong Huang
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA
| | - Corey R Hart
- Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Jason R Gibson
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Ian R Lanza
- Division of Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Simon G Gregory
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Bruce M Spiegelman
- Dana-Farber Cancer Institute, Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - James P White
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA.
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Campbell WW, Kraus WE, Powell KE, Haskell WL, Janz KF, Jakicic JM, Troiano RP, Sprow K, Torres A, Piercy KL, Bartlett DB. High-Intensity Interval Training for Cardiometabolic Disease Prevention. Med Sci Sports Exerc 2019; 51:1220-1226. [PMID: 31095079 PMCID: PMC6777577 DOI: 10.1249/mss.0000000000001934] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE The 2018 Physical Activity Guidelines Advisory Committee systematically searched existing literature reviews to assess the relationship between high-intensity interval training (HIIT) and reduction in cardiometabolic disease risk. METHODS Duplicate independent screenings of 260 articles identified from PubMed®, Cochrane Library, and CINAHL databases yielded suitable data from one systematic review and two meta-analyses. Search terms included a combination of "high intensity" "physical activity/exercise" and "interval training" and outcome-specific terms. The quality of the included reviews was assessed using a tailored version of the AMSTARExBP report on quality. Exposure Subcommittee members graded scientific evidence strength based on a five-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable. RESULTS Moderate evidence indicates that HIIT can improve insulin sensitivity, blood pressure, and body composition in adults with group mean ages ranging from ~20 to ~77 yr. These HIIT-induced improvements in cardiometabolic disease risk factors are comparable with those resulting from moderate-intensity continuous training, and they are more likely to occur in adults at higher risk of cardiovascular disease and diabetes than in healthy adults. Moderate evidence also indicates that adults with overweight or obesity classification are more responsive than adults with normal weight to HIIT-related improvements in insulin sensitivity, blood pressure, and body composition. Insufficient evidence was available to determine whether a dose-response relationship exists between the quantity of HIIT performed and several risk factors for cardiovascular disease and diabetes, or whether the effects of HIIT on cardiometabolic disease risk factors are influenced by age, sex, race/ethnicity, or socioeconomic status. CONCLUSIONS HIIT by adults, especially those with overweight and obesity classification, can improve insulin sensitivity, blood pressure, and body composition, comparable with those resulting from moderate-intensity continuous training.
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Affiliation(s)
- Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | | | | | | | - Kathleen F. Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
| | - John M. Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Richard P. Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, U.S. Department of Health and Human Services, Rockville, MD
| | - Kyle Sprow
- Division of Cancer Control and Population Sciences, National Cancer Institute, U.S. Department of Health and Human Services, Rockville, MD
| | | | - Katrina L. Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD
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Lee DE, Bareja A, Bartlett DB, White JP. Autophagy as a Therapeutic Target to Enhance Aged Muscle Regeneration. Cells 2019; 8:cells8020183. [PMID: 30791569 PMCID: PMC6406986 DOI: 10.3390/cells8020183] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/30/2019] [Accepted: 02/14/2019] [Indexed: 12/11/2022] Open
Abstract
Skeletal muscle has remarkable regenerative capacity, relying on precise coordination between resident muscle stem cells (satellite cells) and the immune system. The age-related decline in skeletal muscle regenerative capacity contributes to the onset of sarcopenia, prolonged hospitalization, and loss of autonomy. Although several age-sensitive pathways have been identified, further investigation is needed to define targets of cellular dysfunction. Autophagy, a process of cellular catabolism, is emerging as a key regulator of muscle regeneration affecting stem cell, immune cell, and myofiber function. Muscle stem cell senescence is associated with a suppression of autophagy during key phases of the regenerative program. Macrophages, a key immune cell involved in muscle repair, also rely on autophagy to aid in tissue repair. This review will focus on the role of autophagy in various aspects of the regenerative program, including adult skeletal muscle stem cells, monocytes/macrophages, and corresponding age-associated dysfunction. Furthermore, we will highlight rejuvenation strategies that alter autophagy to improve muscle regenerative function.
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Affiliation(s)
- David E Lee
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA.
| | - Akshay Bareja
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA.
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA.
- Division of Medical Oncology, Department of Medicine, Duke University School of Medicine, Durham, NC 27701, USA.
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC 27701, USA.
| | - James P White
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27701, USA.
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC 27701, USA.
- Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, NC 27701, USA.
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Andonian BJ, Bartlett DB, Huebner JL, Willis L, Hoselton A, Kraus VB, Kraus WE, Huffman KM. Effect of high-intensity interval training on muscle remodeling in rheumatoid arthritis compared to prediabetes. Arthritis Res Ther 2018; 20:283. [PMID: 30587230 PMCID: PMC6307310 DOI: 10.1186/s13075-018-1786-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/04/2018] [Indexed: 01/01/2023] Open
Abstract
Background Sarcopenic obesity, associated with greater risk of cardiovascular disease (CVD) and mortality in rheumatoid arthritis (RA), may be related to dysregulated muscle remodeling. To determine whether exercise training could improve remodeling, we measured changes in inter-relationships of plasma galectin-3, skeletal muscle cytokines, and muscle myostatin in patients with RA and prediabetes before and after a high-intensity interval training (HIIT) program. Methods Previously sedentary persons with either RA (n = 12) or prediabetes (n = 9) completed a 10-week supervised HIIT program. At baseline and after training, participants underwent body composition (Bod Pod®) and cardiopulmonary exercise testing, plasma collection, and vastus lateralis biopsies. Plasma galectin-3, muscle cytokines, muscle interleukin-1 beta (mIL-1β), mIL-6, mIL-8, muscle tumor necrosis factor-alpha (mTNF-α), mIL-10, and muscle myostatin were measured via enzyme-linked immunosorbent assays. An independent cohort of patients with RA (n = 47) and age-, gender-, and body mass index (BMI)-matched non-RA controls (n = 23) were used for additional analyses of galectin-3 inter-relationships. Results Exercise training did not reduce mean concentration of galectin-3, muscle cytokines, or muscle myostatin in persons with either RA or prediabetes. However, training-induced alterations varied among individuals and were associated with cardiorespiratory fitness and body composition changes. Improved cardiorespiratory fitness (increased absolute peak maximal oxygen consumption, or VO2) correlated with reductions in galectin-3 (r = −0.57, P = 0.05 in RA; r = −0.48, P = 0.23 in prediabetes). Training-induced improvements in body composition were related to reductions in muscle IL-6 and TNF-α (r < −0.60 and P <0.05 for all). However, the association between increased lean mass and decreased muscle IL-6 association was stronger in prediabetes compared with RA (Fisher r-to-z P = 0.0004); in prediabetes but not RA, lean mass increases occurred in conjunction with reductions in muscle myostatin (r = −0.92; P <0.05; Fisher r-to-z P = 0.026). Subjects who received TNF inhibitors (n = 4) or hydroxychloroquine (n = 4) did not improve body composition with exercise training. Conclusion Exercise responses in muscle myostatin, cytokines, and body composition were significantly greater in prediabetes than in RA, consistent with impaired muscle remodeling in RA. To maximize physiologic improvements with exercise training in RA, a better understanding is needed of skeletal muscle and physiologic responses to exercise training and their modulation by RA disease–specific features or pharmacologic agents or both. Trial registration ClinicalTrials.gov Identifier: NCT02528344. Registered on August 19, 2015.
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Affiliation(s)
- Brian J Andonian
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA. .,Division of Rheumatology, Duke University School of Medicine, 40 Duke Medicine Circle Drive, Durham, NC, 27710, USA.
| | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA
| | - Leslie Willis
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA
| | - Andrew Hoselton
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA.,Division of Rheumatology, Duke University School of Medicine, 40 Duke Medicine Circle Drive, Durham, NC, 27710, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke St, Durham, NC, 27701, USA.,Division of Rheumatology, Duke University School of Medicine, 40 Duke Medicine Circle Drive, Durham, NC, 27710, USA
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35
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Barber JL, Kraus WE, Church TS, Hagberg JM, Thompson PD, Bartlett DB, Beets MW, Earnest CP, Huffman KM, Landers-Ramos RQ, Leon AS, Rao DC, Seip RL, Skinner JS, Slentz CA, Wilund KR, Bouchard C, Sarzynski MA. Effects of regular endurance exercise on GlycA: Combined analysis of 14 exercise interventions. Atherosclerosis 2018; 277:1-6. [PMID: 30170218 PMCID: PMC6298739 DOI: 10.1016/j.atherosclerosis.2018.07.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/17/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS GlycA is a relatively new biomarker for inflammation as well as cardiometabolic disease risk. However, the effect of exercise on GlycA is largely unknown. Therefore, the purpose of this study was to examine the effects of regular exercise on the inflammatory marker GlycA across seven studies and 14 exercise interventions. METHODS Nuclear magnetic resonance spectroscopy, specifically signal amplitudes originating from the N-acetyl methyl group protons of the N-acetylglucosamine residues on the glycan branches of glycoproteins, was used to quantify GlycA concentrations. GlycA was measured before and after completion of an exercise intervention in 1568 individuals across seven studies and 14 exercise interventions. Random effects inverse variance weighting models were used to pool effects across interventions. RESULTS Combined analysis of unadjusted data showed that regular exercise significantly (p = 2 × 10-6) reduced plasma GlycA (-8.26 ± 1.8 μmol/L). This reduction remained significant (-9.12 ± 1.9 μmol/L, p = 1.22 × 10-6) following adjustment for age, sex, race, baseline BMI, and baseline GlycA. Changes in GlycA were correlated with changes in traditional inflammatory markers, C-reactive protein, interleukin-6, and fibrinogen, however, these correlations were relatively weak (range r: 0.21-0.38, p < 0.0001). CONCLUSIONS Regular exercise significantly reduced plasma GlycA across 14 different exercise interventions despite differences in exercise programs and study populations. The current study provides a greater understanding of the use of exercise as a potential therapy for the reduction of systemic inflammation. Further research is needed to understand the mechanisms behind the exercise-related reductions in GlycA.
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Affiliation(s)
- Jacob L Barber
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | | | - James M Hagberg
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | | | - David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Conrad P Earnest
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | | | - Arthur S Leon
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - D C Rao
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard L Seip
- Cardiology Division, Hartford Hospital, Hartford, CT, USA
| | - James S Skinner
- Professor Emeritus of Kinesiology, Indiana University, Bloomington, IN, USA
| | - Cris A Slentz
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL, USA
| | | | - Mark A Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA.
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Bartlett DB, Willis LH, Slentz CA, Hoselton A, Kelly L, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Kraus WE, Lord JM, Huffman KM. Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study. Arthritis Res Ther 2018; 20:127. [PMID: 29898765 PMCID: PMC6001166 DOI: 10.1186/s13075-018-1624-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic inflammatory disease in which adults have significant joint issues leading to poor health. Poor health is compounded by many factors, including exercise avoidance and increased risk of opportunistic infection. Exercise training can improve the health of patients with RA and potentially improve immune function; however, information on the effects of high-intensity interval training (HIIT) in RA is limited. We sought to determine whether 10 weeks of a walking-based HIIT program would be associated with health improvements as measured by disease activity and aerobic fitness. Further, we assessed whether HIIT was associated with improved immune function, specifically antimicrobial/bacterial functions of neutrophils and monocytes. Methods Twelve physically inactive adults aged 64 ± 7 years with either seropositive or radiographically proven (bone erosions) RA completed 10 weeks of high-intensity interval walking. Training consisted of 3 × 30-minute sessions/week of ten ≥ 60-second intervals of high intensity (80–90% VO2reserve) separated by similar bouts of lower-intensity intervals (50–60% VO2reserve). Pre- and postintervention assessments included aerobic and physical function; disease activity as measured by Disease Activity score in 28 joints (DAS28), self-perceived health, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR); plasma interleukin (IL)-1β, IL-6, chemokine (C-X-C motif) ligand (CXCL)-8, IL-10, and tumor necrosis factor (TNF)-α concentrations; and neutrophil and monocyte phenotypes and functions. Results Despite minimal body composition change, cardiorespiratory fitness increased by 9% (change in both relative and absolute aerobic capacity; p < 0.001), and resting blood pressure and heart rate were both reduced (both p < 0.05). Postintervention disease activity was reduced by 38% (DAS28; p = 0.001) with significant reductions in ESR and swollen joints as well as improved self-perceived health. Neutrophil migration toward CXCL-8 (p = 0.003), phagocytosis of Escherichia coli (p = 0.03), and ROS production (p < 0.001) all increased following training. The frequency of cluster of differentiation 14-positive (CD14+)/CD16+ monocytes was reduced (p = 0.002), with both nonclassical (CD14dim/CD16bright) and intermediate (CD14bright/CD16positive) monocytes being reduced (both p < 0.05). Following training, the cell surface expression of intermediate monocyte Toll-like receptor 2 (TLR2), TLR4, and HLA-DR was reduced (all p < 0.05), and monocyte phagocytosis of E. coli increased (p = 0.02). No changes were observed for inflammatory markers IL-1β, IL-6, CXCL-8, IL-10, CRP, or TNF-α. Conclusions We report for the first time, to our knowledge, that a high-intensity interval walking protocol in older adults with stable RA is associated with reduced disease activity, improved cardiovascular fitness, and improved innate immune functions, indicative of reduced infection risk and inflammatory potential. Importantly, the exercise program was well tolerated by these patients. Trial registration ClinicalTrials.gov, NCT02528344. Registered on 19 August 2015.
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Affiliation(s)
- David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA. .,Division of Medical Oncology, Duke University School of Medicine, Durham, NC, 27701, USA. .,MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
| | - Leslie H Willis
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Cris A Slentz
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Andrew Hoselton
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Leslie Kelly
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Moss
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Michael J Muehlbauer
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | | | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Janet M Lord
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre in Inflammation, University Hospital Birmingham, Birmingham, UK
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
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Bartlett DB, Slentz CA, Willis LH, Kraus WE, Lord JM, Huffman KM. High Intensity Interval Training Improves Disease Activity and Immune Function in Patients with Rheumaotid Arthritis. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518246.32259.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bartlett DB, Connelly MA, AbouAssi H, Bateman LA, Tune KN, Huebner JL, Kraus VB, Winegar DA, Otvos JD, Kraus WE, Huffman KM. A novel inflammatory biomarker, GlycA, associates with disease activity in rheumatoid arthritis and cardio-metabolic risk in BMI-matched controls. Arthritis Res Ther 2016; 18:86. [PMID: 27067270 PMCID: PMC4828830 DOI: 10.1186/s13075-016-0982-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/23/2016] [Indexed: 12/31/2022] Open
Abstract
Background RA and CVD both have inflammation as part of the underlying biology. Our objective was to explore the relationships of GlycA, a measure of glycosylated acute phase proteins, with inflammation and cardiometabolic risk in RA, and explore whether these relationships were similar to those for persons without RA. Methods Plasma GlycA was determined for 50 individuals with mild-moderate RA disease activity and 39 controls matched for age, gender, and body mass index (BMI). Regression analyses were performed to assess relationships between GlycA and important markers of traditional inflammation and cardio-metabolic health: inflammatory cytokines, disease activity, measures of adiposity and insulin resistance. Results On average, RA activity was low (DAS-28 = 3.0 ± 1.4). Traditional inflammatory markers, ESR, hsCRP, IL-1β, IL-6, IL-18 and TNF-α were greater in RA versus controls (P < 0.05 for all). GlycA concentrations were significantly elevated in RA versus controls (P = 0.036). In RA, greater GlycA associated with disease activity (DAS-28; RDAS-28 = 0.5) and inflammation (RESR = 0.7, RhsCRP = 0.7, RIL-6 = 0.3: P < 0.05 for all); in BMI-matched controls, these inflammatory associations were absent or weaker (hsCRP), but GlycA was related to IL-18 (RhsCRP = 0.3, RIL-18 = 0.4: P < 0.05). In RA, greater GlycA associated with more total abdominal adiposity and less muscle density (Rabdominal-adiposity = 0.3, Rmuscle-density = −0.3, P < 0.05 for both). In BMI-matched controls, GlycA associated with more cardio-metabolic markers: BMI, waist circumference, adiposity measures and insulin resistance (R = 0.3-0.6, P < 0.05 for all). Conclusions GlycA provides an integrated measure of inflammation with contributions from traditional inflammatory markers and cardio-metabolic sources, dominated by inflammatory markers in persons with RA and cardio-metabolic factors in those without.
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Affiliation(s)
- David B Bartlett
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA
| | - Margery A Connelly
- LipoScience, Laboratory Corporation of America® Holdings, Raleigh, NC, USA
| | - Hiba AbouAssi
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA
| | - Lori A Bateman
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K Noelle Tune
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Janet L Huebner
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA
| | - Virginia B Kraus
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA
| | - Deborah A Winegar
- LipoScience, Laboratory Corporation of America® Holdings, Raleigh, NC, USA
| | - James D Otvos
- LipoScience, Laboratory Corporation of America® Holdings, Raleigh, NC, USA
| | - William E Kraus
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA
| | - Kim M Huffman
- Department of Medicine and Duke Molecular Physiology Institute, Duke School of Medicine, Durham, NC, USA.
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Ludwig C, Williams DS, Bartlett DB, Essex SJ, McNee G, Allwood JW, Jewell E, Barkhuisen A, Parry H, Anandram S, Nicolson P, Gardener C, Seymour F, Basu S, Dunn WB, Moss PAH, Pratt G, Tennant DA. Alterations in bone marrow metabolism are an early and consistent feature during the development of MGUS and multiple myeloma. Blood Cancer J 2015; 5:e359. [PMID: 26473531 PMCID: PMC4635194 DOI: 10.1038/bcj.2015.85] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- C Ludwig
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D S Williams
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D B Bartlett
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - S J Essex
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - G McNee
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - J W Allwood
- School of Biosciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - E Jewell
- School of Biosciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - A Barkhuisen
- Department of Haematology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - H Parry
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - S Anandram
- Department of Haematology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - P Nicolson
- Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK
| | - C Gardener
- Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK
| | - F Seymour
- Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK
| | - S Basu
- Department of Haematology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - W B Dunn
- School of Biosciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - P A H Moss
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - G Pratt
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK
| | - D A Tennant
- School of Cancer Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Vitlic A, Lord JM, Taylor AE, Arlt W, Bartlett DB, Rossi A, Arora-Duggal N, Welham A, Heald M, Oliver C, Carroll D, Phillips AC. Neutrophil function in young and old caregivers. Br J Health Psychol 2015; 21:173-89. [DOI: 10.1111/bjhp.12156] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 07/17/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Ana Vitlic
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
| | - Janet M. Lord
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Angela E. Taylor
- Centre for Endocrinology Diabetes and Metabolism (CEDAM); University of Birmingham; UK
| | - Wiebke Arlt
- Centre for Endocrinology Diabetes and Metabolism (CEDAM); University of Birmingham; UK
| | - David B. Bartlett
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Alessandra Rossi
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Niharika Arora-Duggal
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
- School of Immunity and Infection; University of Birmingham; UK
| | - Alice Welham
- School of Psychology; University of Birmingham; UK
| | - Mary Heald
- School of Psychology; University of Birmingham; UK
| | - Chris Oliver
- School of Psychology; University of Birmingham; UK
| | - Douglas Carroll
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
| | - Anna C. Phillips
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research; University of Birmingham; UK
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Baylis D, Ntani G, Edwards MH, Syddall HE, Bartlett DB, Dennison EM, Martin-Ruiz C, von Zglinicki T, Kuh D, Lord JM, Aihie Sayer A, Cooper C. Inflammation, telomere length, and grip strength: a 10-year longitudinal study. Calcif Tissue Int 2014; 95:54-63. [PMID: 24858709 PMCID: PMC4098723 DOI: 10.1007/s00223-014-9862-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/17/2014] [Indexed: 12/25/2022]
Abstract
Telomere attrition has been associated with age-related diseases, although causality is unclear and controversial; low-grade systemic inflammation (inflammaging) has also been implicated in age-related pathogenesis. Unpicking the relationship between aging, telomere length (TL), and inflammaging is hence essential to the understanding of aging and management of age-related diseases. This longitudinal study explored whether telomere attrition is a cause or consequence of aging and whether inflammaging explains some of the associations between TL and one marker of aging, grip strength. We studied 253 Hertfordshire Ageing Study participants at baseline and 10-year follow-up (mean age at baseline 67.1 years). Participants completed a health questionnaire and had blood samples collected for immune-endocrine and telomere analysis at both time points. Physical aging was characterized at follow-up using grip strength. Faster telomere attrition was associated with lower grip strength at follow-up (β = 0.98, p = 0.035). This association was completely attenuated when adjusted for inflammaging burden (p = 0.86) over the same period. Similarly, greater inflammaging burden was associated with lower grip strength at follow-up (e.g., interleukin [IL]-1β: β = -2.18, p = 0.001). However, these associations were maintained when adjusted for telomere attrition (IL-1β, p = 0.006). We present evidence that inflammaging may be driving telomere attrition and in part explains the associations that have previously been reported between TL and grip strength. Thus, biomarkers of physical aging, such as inflammaging, may require greater exploration. Further work is now indicated.
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Affiliation(s)
- Daniel Baylis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
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Baylis D, Bartlett DB, Syddall HE, Ntani G, Gale CR, Cooper C, Lord JM, Sayer AA. Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people. Age (Dordr) 2013; 35:963-971. [PMID: 22388931 PMCID: PMC3636387 DOI: 10.1007/s11357-012-9396-8] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 02/13/2012] [Indexed: 05/31/2023]
Abstract
Frailty is a multidimensional geriatric syndrome characterised by a state of increased vulnerability to disease. Its causes are unclear, limiting opportunities for intervention. Age-related changes to the immune-endocrine axis are implicated. This study investigated the associations between the immune-endocrine axis and frailty as well as mortality 10 years later among men and women aged 65 to 70 years. We studied 254 participants of the Hertfordshire Ageing Study at baseline and 10-year follow-up. At baseline, they completed a health questionnaire and had collection of blood samples for immune-endocrine analysis. At follow-up, Fried frailty was characterised and mortality ascertained. Higher baseline levels of differential white cell counts (WCC), lower levels of dehydroepiandosterone sulphate (DHEAS) and higher cortisol:DHEAS ratio were all significantly associated with increased odds of frailty at 10-year follow-up. Baseline WCC and cortisol:DHEAS clearly discriminated between individuals who went on to be frail at follow-up. We present the first evidence that immune-endocrine biomarkers are associated with the likelihood of frailty as well as mortality over a 10-year period. This augments our understanding of the aetiology of frailty, and suggests that a screening programme at ages 60-70 years could help to identify individuals who are at high risk of becoming frail and who would benefit from early, targeted intervention, for example with DHEA supplementation or anti-inflammatory strategies. Progress towards the prevention of frailty would bring major health and socio-economic benefits at the individual and the population level.
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Affiliation(s)
- D Baylis
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.
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Baylis D, Bartlett DB, Patel HP, Roberts HC. Understanding how we age: insights into inflammaging. Longev Healthspan 2013; 2:8. [PMID: 24472098 PMCID: PMC3922951 DOI: 10.1186/2046-2395-2-8] [Citation(s) in RCA: 259] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 04/05/2013] [Indexed: 04/16/2023]
Abstract
Inflammaging is characterized by the upregulation of the inflammatory response that occurs with advancing age; its roots are strongly embedded in evolutionary theory.Inflammaging is believed to be a consequence of a remodelling of the innate and acquired immune system, resulting in chronic inflammatory cytokine production.Complex interrelated genetic, environmental and age-related factors determine an individual's vulnerability or resilience to inflammaging. These factors include polymorphisms to the promoter regions of cytokines, cytokine receptors and antagonists, age-related decreases in autophagy and increased adiposity. Anti-inflammaging describes the upregulation of the hypothalamic-pituitary axis in response to inflammaging, leading to higher levels of cortisol, which in turn may be detrimental, contributing to less successful ageing and frailty. This may be countered by the adrenal steroid dehydroepiandrosterone, which itself declines with age, leaving certain individuals more vulnerable. Inflammaging and anti-inflammaging have both been linked with a number of age-related outcomes, including chronic morbidity, functional decline and mortality. This important area of research offers unique insights into the ageing process and the potential for screening and targeted interventions.
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Affiliation(s)
- Daniel Baylis
- Department of Medicine for Older People, University Hospital Southampton, Southampton, UK
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - David B Bartlett
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Harnish P Patel
- Department of Medicine for Older People, University Hospital Southampton, Southampton, UK
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - Helen C Roberts
- Department of Medicine for Older People, University Hospital Southampton, Southampton, UK
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
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Greenwood H, Bartlett DB. Meeting report: British Society for Research on Ageing (BSRA) annual scientific meeting 2012, Aston University, Birmingham, 3rd to 4th July 2012. Longev Healthspan 2013; 2:6. [PMID: 24472617 PMCID: PMC3922932 DOI: 10.1186/2046-2395-2-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/20/2013] [Indexed: 11/23/2022]
Abstract
The focus of the British Society for Research on Ageing (BSRA) annual scientific meeting 2012 was aging mechanisms and mitigants. The themes covered included epigenetics, stem cells and regeneration, aging pathways and molecules, the aging bladder and bowel, as well as updates from the New Dynamics of Ageing (NDA) programme. The topics incorporated new directions for staple aging research in caloric restriction (CR), inflammation, immunesenescence, neurodegeneration, homeostasis and stress resistance, as well as newer research areas such as bioengineering of tissues, including the internal anal sphincter and thymus.
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Affiliation(s)
- Hannah Greenwood
- MRC-ARUK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT, UK.
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Bartlett DB, Firth CM, Phillips AC, Moss P, Baylis D, Syddall H, Sayer AA, Cooper C, Lord JM. The age-related increase in low-grade systemic inflammation (Inflammaging) is not driven by cytomegalovirus infection. Aging Cell 2012; 11:912-5. [PMID: 22708923 DOI: 10.1111/j.1474-9726.2012.00849.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aging is accompanied by the development of low-grade systemic inflammation, termed 'inflammaging', characterized by raised serum C-reactive protein (CRP) and pro-inflammatory cytokines. Importantly, inflammaging is implicated in the pathogenesis of several of the major age-related diseases including cardiovascular disease, type 2 diabetes, and dementia and is associated with increased mortality. The incidence of infection with the persistent herpes virus cytomegalovirus (CMV) also increases with age. Cross-sectional studies have proposed CMV infection as a significant driver of inflammaging, but a definitive case for CMV as a causative agent in inflammaging has not yet been made. We studied longitudinally 249 subjects (153 men, 96 women) who participated in the Hertfordshire Ageing Study at baseline (1993/5, mean age 67·5 years) and at 10 year follow-up. At both times, anthropometric measurements were made and subjects provided blood samples for analysis of inflammatory status and CMV seropositivity. In the cohort as a whole, serum CRP (P < 0·02) and pro-inflammatory cytokines TNFα (P < 0·001) and IL-6 (P < 0·001) were increased between baseline and follow-up sampling whereas levels of the anti-inflammatory cytokine IL-10 were decreased (P < 0·001). These changes to cytokine status over time occurred equally in the 60% of subjects who were seropositive for CMV at baseline and follow-up, the 8% who were CMV negative at baseline but who became CMV positive by the 10 year follow-up, and also in the 32% who were CMV seronegative throughout. We conclude that CMV infection is not a primary causative factor in the age-related increase in systemic inflammation.
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Affiliation(s)
- David B Bartlett
- MRC-ARUK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, UK
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Simpson RJ, Spielmann G, Bigley AB, Rector JL, Bartlett DB, Morrison MR. Latent CMV And EBV Infections And The Mobilization Of Viral-specific And Senescent T-cells With Exercise. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401343.81353.00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Simpson RJ, Cosgrove C, Chee MM, McFarlin BK, Bartlett DB, Spielmann G, O'Connor DP, Pircher H, Shiels PG. Senescent phenotypes and telomere lengths of peripheral blood T-cells mobilized by acute exercise in humans. Exerc Immunol Rev 2010; 16:40-55. [PMID: 20839490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Acute bouts of aerobic exercise are known to mobilize antigen-experienced CD8+ T-cells expressing the cell surface marker of senescence, KLRG1, into the blood. It is not known; however if this is due to a selective mobilization of terminally differentiated T-cells (i.e., KLRG1 +/CD28-/CD57+) or a population of effector memory T-cells (i.e., KLRG1+/CD28+/CD57-) that have not reached terminal differentiation. The aim of this study was to further characterize KLRG1 + T-cells mobilized by acute exercise by assessing the co-expression of KLRG1 with CD28 or CD57 and to determine telomere lengths in the CD4+ and CD8+ T-cell subsets. Nine moderately trained male subjects completed an exhaustive treadmill running protocol at 80%. Blood lymphocytes isolated before, immediately after and 1h after exercise were labelled with antibodies against KLRG1, CD28 or CD57, CD4 or CD8 and CD3 for 4-color flow cytometry analysis. Telomere lengths in CD3+, CD4+ and CD8+ T-cells were determined using Q-PCR. The relative proportion of KLRG1 + cells among the CD8+ T-cells increased by 40% immediately after exercise, returning to baseline 1h later. This was due to a mobilization of KLRG1+/CD28- (61% increase), KLRG1+/CD57+ (56% increase) and to a lesser extent, KLRG1+/CD57- cells (24% increase). Telomeres in CD8+ T-cells displayed an increased relative length immediately after exercise, whereas no change occurred for CD4+ or the overall CD3+ T-cells. In conclusion, the increased frequency of KLRG1 +/CD8+ T-cells in blood after acute exercise is predominantly due to a selective mobilization of terminally differentiated T-cells. The increased relative telomere length in CD8+ T-cells after exercise might indicate that KLRG1+ cells mobilized by exercise are under stress or aberrant signaling-induced senescence (STASIS). We postulate that a frequent mobilization of these cells by acute exercise might eventually allow naïve T-cells to occupy the "vacant" immune space and increase the naïve T-cell repertoire.
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Affiliation(s)
- Richard J Simpson
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3855 Holman Street, Houston, Texas 77204, USA.
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Bartlett DB, McFarlin BK, Cosgrove C, Spielmann G, Guy K, Simpson RJ. Exercise-induced T-cell Activation In Human Subjects Is Affected By The Mobilization Of Klrg1+ T-lymphocytes Into The Peripheral Blood. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000355400.88166.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Simpson RJ, Bartlett DB, Booth S, Florida-James GD, McFarlin BK. Resting Blood Lymphocytes Are Activated By Autologous Serum After A 40km Cycling Time Trial. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000353277.01938.3c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
OBJECTIVE To observe and describe site care for intravascular devices, to identify internurse variations in site care, and to compare written protocols for site care with actual practice in one geographic area. DESIGN Observational, descriptive study. SETTING Adult critical care units in one community, and one university teaching hospital in the Washington, D.C., metropolitan area. SAMPLE Direct observation of 86 central and 30 peripheral site care episodes. RESULTS A total of 116 site care episodes were observed on five critical care units. There were wide variations between units from the same hospital in gloving practices and use of aseptic technique. Significant differences across both hospitals, as well as between individual units, were noted for a number of other practices including: time since last site care, use of ointment and skin adhesive, type of dressing used, and duration of care. In both hospitals, compliance with all steps of the written protocol was similar-23.2% and 23.3%. Compliance with documentation requirements ranged from 53.3% to 85.7%, and was significantly different between the two hospitals with regard to recording the dressing change and whether the dressing label and chart agreed. CONCLUSIONS Intravascular site care varies significantly among critical care units within the same institution, as well as between different hospitals, and varies from written protocol. Standardized, well-defined site care protocols and education of staff, along with quality improvement surveillance systems are needed to ensure consistent quality intravascular site care.
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Affiliation(s)
- H Roach
- Georgetown University Hospital, Department of Nursing, Washington, DC 20007-2197, USA
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