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Wilkinson TJ, O'Mahoney LL, Highton P, Viana JL, Ribeiro HS, Lightfoot CJ, Curtis F, Khunti K. Physical activity and the 'pediatric inactivity triad' in children living with chronic kidney disease: a narrative review. Ther Adv Chronic Dis 2022; 13:20406223221109971. [PMID: 35860687 PMCID: PMC9290151 DOI: 10.1177/20406223221109971] [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: 02/24/2022] [Accepted: 06/06/2022] [Indexed: 12/05/2022] Open
Abstract
The ‘paediatric inactivity triad’ (PIT) framework consists of three complex inter-related conditions that influence physical inactivity and related health risks. In those living with chronic kidney disease (CKD), a multi-factorial milieu of components likely confound the PIT elements, resulting in a cycle of decreased physical functioning and reduced physical activity. In this review, we explore and summarize previous research on each of the three principal PIT components (exercise deficit disorder, dynapenia, and physical illiteracy) in the pediatric CKD population. We found those living with CKD are significantly physically inactive compared to their peers. Physical inactivity occurs early in the disease process and progressively gets worse as disease burden increases. Although physical activity appears to increase post-transplantation, it remains lower compared to healthy controls. There is limited evidence on interventions to increase physical activity behaviour in this population, and those that have attempted have had negligible effects. Studies reported profound reductions in muscle strength, physical performance, and cardiorespiratory fitness. A small number of exercise-based interventions have shown favourable improvements in physical function and cardiorespiratory fitness, although small sample sizes and methodological issues preclude the generalization of findings. Physical activity must be adapted and individualized to the needs and goals of the children, particularly those with acute and chronic medical needs as is the case in CKD, and further work is needed to define optimal interventions across the life course in this population if we aim to prevent physical activity declining further.
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Affiliation(s)
- Thomas J Wilkinson
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester LE45PW, UK
| | - Lauren L O'Mahoney
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - Patrick Highton
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - Joao L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Heitor S Ribeiro
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Courtney J Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Ffion Curtis
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester, UK
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Watson EL, Baker LA, Wilkinson TJ, Gould DW, Xenophontos S, Graham-Brown M, Major RW, Ashford RU, Viana JL, Smith AC. Inflammation and physical dysfunction: responses to moderate intensity exercise in chronic kidney disease. Nephrol Dial Transplant 2021; 37:860-868. [PMID: 35090033 DOI: 10.1093/ndt/gfab333] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with chronic kidney disease (CKD) experience skeletal muscle wasting, reduced levels of physical function and performance, and chronic systemic inflammation. While it is known that a relationship exists between inflammation and muscle wasting, the association between inflammation and physical function or performance in CKD has not been well studied. Exercise has anti-inflammatory effects, but little is known regarding the effect of moderate intensity exercise. This study aimed to (i) compare systemic and intramuscular inflammation between CKD stage G3b-5 and non-CKD controls; (ii) establish whether a relationship exists between physical performance, exercise capacity and inflammation in CKD; (iii) determine changes in systemic and intramuscular inflammation following 12 weeks of exercise; and (iv) investigate whether improving inflammatory status via training contributes to improvements in physical performance and muscle mass. METHODS This is a secondary analysis of previously collected data. CKD patients stages G3b-5 (n = 84, n = 43 males) and non-CKD controls (n = 26, n = 17 males) underwent tests of physical performance, exercise capacity, muscle strength and muscle size. In addition, a subgroup of CKD participants underwent 12 weeks of exercise training, randomized to aerobic (AE, n = 21) or combined (CE, n = 20) training. Plasma and intramuscular inflammation and myostatin were measured at rest and following exercise. RESULTS Tumour necrosis factor-α was negatively associated with lower $^{^{^{.}}}{\rm V}$O2Peak (P = 0.01), Rectus femoris-cross sectional area (P = 0.002) and incremental shuttle walk test performance (P < 0.001). Interleukin-6 was negatively associated with sit-to-stand 60 performances (P = 0.006) and hand grip strength (P = 0.001). Unaccustomed exercise created an intramuscular inflammatory response that was attenuated following 12 weeks of training. Exercise training did not reduce systemic inflammation, but AE training did significantly reduce mature myostatin levels (P = 0.02). Changes in inflammation were not associated with changes in physical performance. CONCLUSIONS Systemic inflammation may contribute to reduced physical function in CKD. Twelve weeks of exercise training was unable to reduce the level of chronic systemic inflammation in these patients, but did reduce plasma myostatin concentrations. Further research is required to further investigate this.
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Affiliation(s)
- Emma L Watson
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK.,Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Luke A Baker
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Tom J Wilkinson
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK.,Leicester Biomedical Research Centre, Leicester, UK
| | - Doug W Gould
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK
| | - Soteris Xenophontos
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Matthew Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,John Walls Renal Unit, Leicester General Hospital, Leicester, UK
| | - Rupert W Major
- Department of Health Sciences, University of Leicester, Leicester, UK.,John Walls Renal Unit, Leicester General Hospital, Leicester, UK
| | - Robert U Ashford
- Leicester Orthopaedics, University Hospitals of Leicester, Leicester, UK.,Department of Cancer Studies, University of Leicester, Leicester, UK
| | - Joao L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Portugal
| | - Alice C Smith
- Leicester Kidney Lifestyle Team, University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK.,Leicester Biomedical Research Centre, Leicester, UK
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Sousa A, Viana JL, Milheiro J, Reis VM, Millet GP. Effect of hypoxia and nitrate supplementation on different high-intensity interval-training sessions. Eur J Appl Physiol 2021; 121:2585-2594. [PMID: 34097130 DOI: 10.1007/s00421-021-04726-0] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To test the hypothesis that interval-training (IHT) would be impaired by hypoxia to a larger extent than repeated-sprint training (RSH) and that dietary nitrate (NO3-) would mitigate the detrimental effect of hypoxia to a larger extent during IHT than RSH. METHODS Thirty endurance-trained male participants performed IHT (6 × 1 min at 90%∆ with 1 min active recovery) and RSH (2 sets of 6 × 10 s "all-out" efforts with 20 s active recovery) on a cycle ergometer, allocated in one of three groups: normobaric hypoxia (~ 13% FiO2) + NO3- - HNO, n = 10; normobaric hypoxia + placebo - HPL, n = 10; normoxia (20.9% FiO2) + placebo - CON, n = 10. Submaximal oxygen uptake ([Formula: see text]O2), time spent above 90% of maximal [Formula: see text]O2 (≥ 90 [Formula: see text]O2max) and heart rate (≥ 90 HRmax) were compared between IHT and RSH sessions and groups. Additionally, mean power output (MPO), decrement score and % of power associated with [Formula: see text]O2max (%p[Formula: see text]O2max) in RSH sessions were analyzed. RESULTS [Formula: see text]O2 at sub-maximal intensities did not differ between training protocols and groups (~ 27 ml kg-1 min-1). ≥ 90 HRmax was significantly higher in IHT compared to RSH session (39 ± 8 vs. 30 ± 8%, p = 0.03) but only in HNO group. MPO (range 360-490 W) and decrement score (10-13%) were similar between groups although %p[Formula: see text]O2max was significantly higher (p = 0.04) in CON (166 ± 16 W) compared with both HPL (147 ± 15 W) and HNO (144 ± 10 W) groups. CONCLUSION IHT responses were neither more impaired by hypoxia than RSH ones. Moreover, dietary NO3- supplementation impacted equally IHT and RSH training responses' differences between hypoxia and normoxia.
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Affiliation(s)
- A Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal. .,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal.
| | - J L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | - J Milheiro
- CMEP Exercise Medical Center & SPA, Porto, Portugal.,Olympic Committee of Portugal, Lisbon, Portugal
| | - V M Reis
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
| | - G P Millet
- ISSUL, Institute of Sport Sciences and Physical Education (ISSEP), University of Lausanne, Lausanne, Switzerland
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Vieira-Neta MRA, Soares-da-Silva J, Viana JL, Silva MC, Tadei WP, Pinheiro VCS. Strain of Bacillus thuringiensis from Restinga, toxic to Aedes (Stegomyia) aegypti (Linnaeus) (Diptera, Culicidae). BRAZ J BIOL 2020; 81:872-880. [PMID: 33053121 DOI: 10.1590/1519-6984.228790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
Bacillus thuringiensis is the most commonly used entomopathogen in the control of Aedes aegypti, which is a vector for different etiological agents that cause serious infections in humans. Several studies aim to isolate strains of this bacterium from different environments, with the perspective of selecting isolates with larvicidal activity for mosquitoes. Aiming at the insecticidal action of B. thuringiensis, the present study aimed to prospect B. thuringiensis of restinga and mangrove soils from the state of Maranhão, Brazil, with toxic potential for use in the biological control of Ae. aegypti. Bioassays were performed to determine the entomopathogenic activity of the bacilli against Ae. aegypti and lethal concentrations (LC50 and CL90) were estimated after the tests. Polymerase Chain Reaction and SDS-PAGE techniques were performed to verify the gene and protein content of the isolates, respectively. The soil of the mangrove and restinga ecosystems showed potential for obtaining B. thuringiensis. This isolate, in addition to having proteins with molecular mass similar to the toxins Cry and Cyt, also presented several diptera-specific genes cry and cyt, demonstrating that it has high potential to be used in the biological control of Ae. aegypti.
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Affiliation(s)
- M R A Vieira-Neta
- Universidade Estadual do Maranhão - UEMA, Programa de Pós-graduação em Biodiversidade, Ambiente e Saúde - PPGBAS, Caxias, MA, Brasil
| | - J Soares-da-Silva
- Universidade Federal do Maranhão - UFMA, Coordenação de Ciências Naturais/Biologia, Codó, MA, Brasil
| | - J L Viana
- Universidade do Estado do Amazonas - UEA, Programa de Pós-graduação em Biodiversidade e Biotecnologia da Rede BIONORTE - PPG BIONORTE, Manaus, AM, Brasil
| | - M C Silva
- Universidade Estadual do Maranhão - UEMA, Centro de Estudos Superiores de Caxias - CESC, Departamento de Química e Biologia, Caxias, MA, Brasil
| | - W P Tadei
- Instituto Nacional de Pesquisas da Amazônia - INPA, Laboratório de Malária e Dengue, Programa de Pós-graduação em Entomologia, Manaus, AM, Brasil
| | - V C S Pinheiro
- Universidade Estadual do Maranhão - UEMA, Centro de Estudos Superiores de Caxias - CESC, Departamento de Química e Biologia, Laboratório de Entomologia Médica - LABEM, Caxias, MA, Brasil
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5
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Viana JL, Soares-da-Silva J, Vieira-Neta MRA, Tadei WP, Oliveira CD, Abdalla FC, Peixoto CA, Pinheiro VCS. Isolates of Bacillus thuringiensis from Maranhão biomes with potential insecticidal action against Aedes aegypti larvae (Diptera, Culicidae). BRAZ J BIOL 2020; 81:114-124. [PMID: 32130286 DOI: 10.1590/1519-6984.223389] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
Entomopathogenic agents are viable and effective options due to their selective action against insects but benign effects on humans and the environment. The most promising entomopathogens include subspecies of Bacillus thuringiensis (Bt), which are widely used for the biological control of insects, including mosquito vectors of human pathogens. The efficacy of B. thuringiensis toxicity has led to the search for new potentially toxic isolates in different regions of the world. Therefore, soil samples from the Amazon, Cerrado and Caatinga biomes of the state of Maranhão were evaluated for their potential larvicidal action against Aedes aegypti. The isolates with high toxicity to mosquito larvae, as detected by bioassays, were subjected to histological evaluation under a light microscope to identify the genes potentially responsible for the toxicity. Additionally, the toxic effects of these isolates on the intestinal epithelium were assessed. In the new B. thuringiensis isolates toxic to A. aegypti larvae, cry and cyt genes were amplified at different frequencies, with cry4, cyt1, cry32, cry10 and cry11 being the most frequent (33-55%) among those investigated. These genes encode specific proteins toxic to dipterans and may explain the severe morphological changes in the intestine of A. aegypti larvae caused by the toxins of the isolates.
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Affiliation(s)
- J L Viana
- Programa de Pós-graduação em Biodiversidade e Biotecnologia da Rede BIONORTE - PPG BIONORTE, Universidade do Estado do Amazonas - UEA, Av. Carvalho Leal, 1777, Ed. Anexo, 4º andar, Cachoeirinha, CEP 69065-00, Manaus, AM, Brasil.,Laboratório de Entomologia Médica, Programa de Pós-graduação em Biodiversidade, Ambiente e Saúde, Centro de Estudos Superiores de Caxias - CESC, Universidade Estadual do Maranhão - UEMA, Praça Duque de Caxias, Morro do Alecrim, s/n, CEP 65604-380, Caxias, MA, Brasil
| | - J Soares-da-Silva
- Coordenação de Ciências Naturais/Biologia, Universidade Federal do Maranhão - UFMA, Campus VII, Av. Dr. José Anselmo, 2008, São Sebastião, CEP 65400-000, Codó, MA, Brasil
| | - M R A Vieira-Neta
- Universidade Federal de São Carlos - UFSCar, Campus Sorocaba, Rodovia João Leme dos Santos, SP-264, Km 110, Itinga, CEP 18052-780, Sorocaba, SP, Brasil
| | - W P Tadei
- Programa de Pós-graduação em Entomologia, Laboratório de Malária e Dengue, Instituto Nacional de Pesquisas da Amazônia - INPA, Av. André Araújo, 2936, Petrópolis, CEP 69067-375, Manaus, AM, Brasil
| | - C D Oliveira
- Grupo Mosquitos Vetores: Endosimbionte e Interação Patógeno Vetor, Centro de Pesquisa René Rachou, Av. Augusto de Lima, 1715, Barro Preto, CEP 30190-002, Belo Horizonte, MG, Brasil
| | - F C Abdalla
- Laboratório de Biologia Estrutural e Funcional - LABEF, Universidade Federal de São Carlos - UFSCar, Campus Sorocaba, Rodovia João Leme dos Santos, SP-264, Itinga, CEP 18052-780, Sorocaba, SP, Brasil
| | - C A Peixoto
- Laboratório de Ultraestrutura, Instituto de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz - FIOCRUZ, Av. Moraes Rego, s/n, Campus UFPE, Cidade Universitária, CEP 50740-465, Recife, PE, Brasil
| | - V C S Pinheiro
- Laboratório de Entomologia Médica, Departamento de Química e Biologia, Centro de Estudos Superiores de Caxias - CESC, Universidade Estadual do Maranhão - UEMA, Praça Duque de Caxias, s/n, Morro do Alecrim, CEP 65604-380, Caxias, MA, Brasil
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Gould DW, Watson EL, Wilkinson TJ, Wormleighton J, Xenophontos S, Viana JL, Smith AC. Ultrasound assessment of muscle mass in response to exercise training in chronic kidney disease: a comparison with MRI. J Cachexia Sarcopenia Muscle 2019; 10:748-755. [PMID: 31054219 PMCID: PMC6711420 DOI: 10.1002/jcsm.12429] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a catabolic condition associated with muscle wasting and dysfunction, which associates with morbidity and mortality. There is a need for simple techniques capable of monitoring changes in muscle size with disease progression and in response to interventions aiming to increase muscle mass and function. Ultrasound is one such technique; however, it is unknown how well changes in muscle cross-sectional area (CSA) measured using ultrasound relate to changes in whole muscle volume measured using magnetic resonance imaging. We tested whether rectus femoris CSA (RF-CSA) could be used as a valid indication of changes in quadriceps muscle volume as a single measure of muscle size and following a 12 week exercise intervention that resulted in muscle hypertrophy. METHODS Secondary analysis of data was collected from the ExTra CKD study (ISRCTN 36489137). Quadriceps muscle size was assessed from 36 patients with non-dialysis CKD before and after 12 weeks of supervised exercise that resulted in muscle hypertrophy. RESULTS Strong positive correlations were observed between RF-CSA and quadriceps volume at baseline (r2 = 0.815, CI 0.661 to 0.903; P < 0.001) and following 12 week exercise (r2 = 0.845, CI 0.700 to 0.923; P < 0.001). A moderate positive association was also observed between changes in RF-CSA and quadriceps following exercise training (rho = 0.441, CI 0.085 to 0.697; P = 0.015). Bland-Altman analysis revealed a small bias (bias 0.6% ± 12.5) between the mean percentage changes in RF-CSA and quadriceps volume but wide limits of agreement from -24 to 25. CONCLUSIONS Rectus femoris CSA appears to be a reliable index of total quadriceps volume as a simple measure of muscle size, both as a single observation and in response to exercise training in non-dialysis CKD patients.
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Affiliation(s)
| | - Emma L. Watson
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | | | | | | | - Joao L. Viana
- Research Center in Sports Sciences, Health Sciences and Human DevelopmentCIDESD, University Institute of MaiaISMAIMaiaPortugal
| | - Alice C. Smith
- Department of Health SciencesUniversity of LeicesterLeicesterUK
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Watson EL, Viana JL, Wimbury D, Martin N, Greening NJ, Barratt J, Smith AC. The Effect of Resistance Exercise on Inflammatory and Myogenic Markers in Patients with Chronic Kidney Disease. Front Physiol 2017; 8:541. [PMID: 28804461 PMCID: PMC5532513 DOI: 10.3389/fphys.2017.00541] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 02/13/2017] [Accepted: 07/12/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Muscle wasting is a common complication of Chronic Kidney Disease (CKD) and is clinically important given its strong association with morbidity and mortality in many other chronic conditions. Exercise provides physiological benefits for CKD patients, however the molecular response to exercise remains to be fully determined. We investigated the inflammatory and molecular response to resistance exercise before and after training in these patients. Methods: This is a secondary analysis of a randomized trial that investigated the effect of 8 week progressive resistance training on muscle mass and strength compared to non-exercising controls. A sub-set of the cohort consented to vastus lateralis skeletal muscle biopsies (n = 10 exercise, n = 7 control) in which the inflammatory response (IL-6, IL-15, MCP-1 TNF-α), myogenic (MyoD, myogenin, myostatin), anabolic (P-Akt, P-eEf2) and catabolic events (MuRF-1, MAFbx, 14 kDa, ubiquitin conjugates) and overall levels of oxidative stress have been studied. Results: A large inflammatory response to unaccustomed exercise was seen with IL-6, MCP-1, and TNF-α all significantly elevated from baseline by 53-fold (P < 0.001), 25-fold (P < 0.001), and 4-fold (P < 0.001), respectively. This response was reduced following training with IL-6, MCP-1, and TNF-α elevated non-significantly by 2-fold (P = 0.46), 2.4-fold (P = 0.19), and 2.5-fold (P = 0.06), respectively. In the untrained condition, an acute bout of resistance exercise did not result in increased phosphorylation of Akt (P = 0.84), but this was restored following training (P = 0.01). Neither unaccustomed nor accustomed exercise resulted in a change in myogenin or MyoD mRNA expression (P = 0.88, P = 0.90, respectively). There was no evidence that resistance exercise training created a prolonged oxidative stress response within the muscle, or increased catabolism. Conclusions: Unaccustomed exercise creates a large inflammatory response within the muscle, which is no longer present following a period of training. This indicates that resistance exercise does not provoke a detrimental on-going inflammatory response within the muscle.
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Affiliation(s)
- Emma L Watson
- Infection, Immunity and Inflammation, University of LeicesterLeicester, United Kingdom
| | - Joao L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAIPorto, Portugal.,School of Sport, Exercise and Health Sciences, Loughborough UniversityLoughborough, United Kingdom
| | - David Wimbury
- Infection, Immunity and Inflammation, University of LeicesterLeicester, United Kingdom
| | - Naomi Martin
- Infection, Immunity and Inflammation, University of LeicesterLeicester, United Kingdom.,School of Sport, Exercise and Health Sciences, Loughborough UniversityLoughborough, United Kingdom
| | - Neil J Greening
- Department of Respiratory Medicine, Institute for Lung Health, University Hospitals of Leicester NHS TrustLeicester, United Kingdom
| | - Jonathan Barratt
- Infection, Immunity and Inflammation, University of LeicesterLeicester, United Kingdom
| | - Alice C Smith
- Infection, Immunity and Inflammation, University of LeicesterLeicester, United Kingdom.,John Walls Renal Unit, University Hospitals of Leicester NHS TrustLeicester, United Kingdom
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Watson E, Wimbury D, Viana JL, Greening N, Barratt J, Smith AC. SP453RESISTANCE EXERCISE DOES NOT INCREASE MARKERS OF MUSCLE PROTEIN DEGRADATION IN PATIENTS WITH ADVANCED CKD. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv194.17] [Citation(s) in RCA: 3] [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: 11/13/2022] Open
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Watson EL, Greening NJ, Viana JL, Barratt J, Smith AC. Effects Of Resistance Exercise Training On Myogenic Response To Acute Exercise In Chronic Kidney Disease. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000494309.96845.e1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Being physically active and undertaking exercise on a regular basis are critical lifestyle behaviours which protect against the development of numerous chronic metabolic conditions. One of the key mechanisms by which physical activity exerts favourable health effects appears to be due to its capacity to reduce chronic low-grade inflammation. Single bouts of exercise have a potent anti-inflammatory influence with recent advances describing important effects of acute exercise on inflammatory mediators produced within skeletal muscle (myokines), adipose tissue (adipokines) and leucocytes. The accumulated effects of physical activity or exercise training on systemic inflammation have been studied widely within epidemiological research; however, information from intervention trials is still emerging. Current data suggest that the most marked improvements in the inflammatory profile are conferred with exercise performed at higher intensities, with combined aerobic and resistance exercise training potentially providing the greatest benefit. The purpose of this review is to describe recent advances in our understanding surrounding the acute and chronic effects of physical activity on key mediators of inflammation. Within this, particular attention is given to the interleukin-6 system owing to its apparent centrality in mediating the anti-inflammatory effects of exercise.
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Affiliation(s)
- M A Nimmo
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.
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Alves AJ, Goldhammer E, Ribeiro F, Eynon N, Ben-Zaken Cohen S, Duarte JA, Viana JL, Sagiv M, Oliveira J. GNAS A-1121G variant is associated with improved diastolic dysfunction in response to exercise training in heart failure patients. Int J Sports Med 2012; 34:274-80. [PMID: 23065660 DOI: 10.1055/s-0032-1316365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
β1-adrenergic receptors (ADRB1) and Gαs proteins (GNAS) play important roles in the regulation of cardiac function. The present study sought to investigate whether ADRB1 Arg389Gly (rs1801253), GNAS -1211 G/A (rs6123837) and GNAS 2291 C/T (rs6026584) variants are associated with left ventricular function and exercise tolerance in heart failure patients. 61 heart failure patients completed a 6-month exercise-training programme. Left ventricular ejection fraction (LVEF), mitral inflow velocities (deceleration time, and E/A ratio) and exercise tolerance (METs) were assessed at baseline and following exercise training. There were no associations between the studied variants and LVEF or E/A ratio measured at baseline and after exercise training. Deceleration time of early mitral flow was higher at baseline in GNAS -1211G allele carriers compared with -1211A allele homozygotes (P<0.05). Exercise training attenuated deceleration time in -1211G allele carriers (P<0.05) but not in -1211A allele homozygotes. Moreover, ADRB1 389Gly homozygotes had a greater training-induced increase in exercise tolerance than 389Arg homozygotes (P=0.04). This study shows that the functional GNAS -1121 G/A polymorphism is associated with diastolic function at baseline and in response to exercise training in heart failure patients. Furthermore, our data suggest that ADRB1 Arg389Gly polymorphism may influence exercise tolerance.
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Affiliation(s)
- A J Alves
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
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Kosmadakis GC, Bevington A, Smith AC, Clapp EL, Viana JL, Bishop NC, Feehally J. Physical exercise in patients with severe kidney disease. Nephron Clin Pract 2010; 115:c7-c16. [PMID: 20173344 DOI: 10.1159/000286344] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Patients with advanced chronic kidney disease (CKD), especially those on long-term dialysis, often suffer from muscle wasting and excessive fatigue. It is known that inactivity, muscle wasting and reduced physical functioning are associated with increased mortality in CKD. Known causes include uraemic myopathy and neuropathy, inactivity, and anaemia. Exercise in patients receiving regular dialysis treatment for end-stage renal disease was first introduced 3 decades ago, but is still only offered in a minority of renal units around the world, despite a significant body of evidence to support its use. Work is needed to increase awareness of the potential benefits of increased physical activity for patients with advanced CKD. This review summarizes the mechanisms of exercise intolerance and debility in advanced CKD patients, the methods used for the estimation of functional capacity, the options currently available for exercise training, and their influence on the well-being of this group of patients.
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Affiliation(s)
- G C Kosmadakis
- The John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
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