Abstract

Multiple Sclerosis (MS), an idiopathic progressive immune-mediated neurological disorder of the central nervous system (CNS), is characterized by recurrent episodes of inflammatory demyelination and consequent axonal deterioration. It accounts for functional deterioration and lasting disability among young adults. A body of literature demonstrates that physical activity counteracts fatigue and depression and may improve overall quality of life in MS patients. Furthermore, much data indicates that exercise ameliorates chronic neuroinflammation and its related pathologies by tipping cytokine profiles toward an anti-inflammatory signature. Recent data has focused on the direct impact of exercise training on the innate immune system by targeting toll-like receptors (TLRs), signaling pattern recognition receptors that govern the innate immune response, shedding light on the physiological role of TLRs in health and disease. Indeed, TLRs continue to emerge as players in the neuroinflammatory processes underpinning MS. This review will highlight evidence that physical activity and exercise are potential immunomodulatory therapies, targeting innate signaling mechanism(s) to modulate MS symptom development and progression.

Highlights

  • Specialty section: This article was submitted to Exercise Physiology, a section of the journal Frontiers in Physiology

  • Multiple Sclerosis (MS) is a chronic disease accounting for lasting disability among young adults and MS rehabilitation is essential for patients to maintain an independent lifestyle and to ensure an improved quality of life

  • MS patients demonstrate difficulties with gait imbalance and muscle weakness, which is associated with restricted levels of physical activity

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Summary

MULTIPLE SCLEROSIS

Multiple Sclerosis (MS) is an immune-mediated demyelinating disorder of the central nervous system (CNS; Calabresi, 2004; Goldenberg, 2012), which is the most common cause of acquired non-traumatic neurological disability among young adults (Compston and Coles, 2002; Zipp and Aktas, 2006), predominantly affecting those between the age of 20–40 years (Comabella and Khoury, 2012). MS is regarded as an autoimmune disease since inflammatory lesions associated with the disease are well-characterized by blood brain barrier (BBB) leakage and massive lymphocytic infiltration, principally the participation of the CD4+ T cells (Brück, 2005; Comabella and Khoury, 2012). Both white and gray matter are affected by neurodegenerative and inflammatory mechanisms (Kutzelnigg et al, 2005; Crespy et al, 2011). It is clear that MS is economically, medically and societally burdensome

Etiology and Pathogenesis
Current Therapeutic Strategies in MS
Injectable Medications
Oral Medications
Route of administration
Infused Medications
General Overview
TLR Signaling
Extracellular Extracellular Intracellular Intracellular Intracellular
Veriscan Self RNA Self RNA Self RNA
Role of Innate Immunity in MS
IMMUNE SYSTEM
Acute and Chronic Exercise in Animal
EXERCISE AND MS
Exercise and MS Clinical Characteristics
Findings
CONCLUSION
Full Text
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