Abstract
Fibromyalgia (FM) is characterized in part by an elevated inflammatory status, and “modified exercise” is currently proposed as being a good therapeutic help for these patients. However, the mechanisms involved in the exercise-induced benefits are still poorly understood. The objective was to evaluate the effect of a single bout of moderate cycling (45 min at 55% VO2 max) on the inflammatory (serum IL-8; chemotaxis and O2 − production by neutrophils; and IL-1β, TNF-α, IL-6, IL-10, and IL-18 release by monocytes) and stress (cortisol; NA; and eHsp72) responses in women diagnosed with FM compared with an aged-matched control group of healthy women (HW). IL-8, NA, and eHsp72 were determined by ELISA. Cytokines released by monocytes were determined by Bio-Plex® system (LUMINEX). Cortisol was determined by electrochemoluminiscence, chemotaxis was evaluated in Boyden chambers and O2 − production by NBT reduction. In the FM patients, the exercise induced a decrease in the systemic concentration of IL-8, cortisol, NA, and eHsp72; as well as in the neutrophil’s chemotaxis and O2 − production and in the inflammatory cytokine release by monocytes. This was contrary to the completely expected exercise-induced increase in all those biomarkers in HW. In conclusion, single sessions of moderate cycling can improve the inflammatory status in FM patients, reaching values close to the situation of aged-matched HW at their basal status. The neuroendocrine mechanism seems to be an exercise-induced decrease in the stress response of these patients.
Highlights
Fibromyalgia is a form of non-articular rheumatism defined by the presence of chronic widespread pain and allodynia to pressure in more than 11 of 18 specified sites or tender points [1]
Previous studies from our laboratory have found that, compared with healthy women, FM patients have higher circulating levels of IL-8, cortisol, and noradrenaline (NA), together with an increased release of pro-inflammatory cytokines by monocytes; and that these inflammatory and stress biomarkers improve after habitual aquatic exercise [7,8,9]
Many aspects of the exercise-induced activation of the inflammatory response are mediated by stress hormones and proteins, especially by glucocorticoids [16], catecholamines [17], and eHsp72 [18,19], with NA and eHsp72 being of particular importance during acute sessions of moderate exercise [20,21]
Summary
Fibromyalgia is a form of non-articular rheumatism defined by the presence of chronic widespread pain and allodynia to pressure in more than 11 of 18 specified sites or tender points [1]. Contraindications for exercise performance in FM patients have not been described, it is necessary to define the duration and intensity of exercise programs to obtain anti-inflammatory responses that lead to an optimized inflammatory cytokines-HPA axis-sympathetic response feedback, avoiding pro-inflammatory responses that could exacerbate the pathology [7]. This is important in female, because even in their basal state healthy women have higher circulating levels of IL-8, NA, and eHsp, as well as a greater activity of neutrophils than men [22], and these inflammatory/stress biomarkers increase after single bouts of both moderate and intense exercise [15]. The question arises as to whether exercise, performed in single sessions, might exacerbate rather than improve the inflammatory and stress status in FM women
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