Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors

Agata Stanek,Tomasz Wielkoszyński,Ewa Romuk,Armand Cholewka,Aleksander Sieroń

doi:10.1155/2018/8592532

Agata Stanek, Tomasz Wielkoszyński + Show 3 more

Open Access

https://doi.org/10.1155/2018/8592532

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Abstract

Objective The aim of the study was to estimate the impact of whole-body cryotherapy (WBC) on cardiovascular risk factors in patients with ankylosing spondylitis (AS). Material and Methods We investigated the effect of WBC with subsequent kinesiotherapy on markers of inflammation, oxidative stress, lipid profile, and atherosclerosis plaque in male AS patients (WBC group). To assess the disease activity, the BASDAI and BASFI were also calculated. The results from the WBC group were compared with results from the kinesiotherapy (KT) group. Results The results showed that in the WBC group, the plasma hsCRP level decreased without change to the IL-6 level. The ICAM-1 level showed a decreasing tendency. The CER concentration, as well as the BASDAI and BASFI, decreased in both groups, but the index changes of disease activity were higher in the WBC than KT patients. Additionally, in the WBC group, we observed a decrease in oxidative stress markers, changes in the activity of some antioxidant enzymes and nonenzymatic antioxidant parameters. In both groups, the total cholesterol and LDL cholesterol, triglycerides, sCD40L, PAPP-A, and PLGF levels decreased, but the parameter changes were higher in the WBC group. Conclusion WBC appears to be a useful method of atherosclerosis prevention in AS patients.

Highlights

Patients with ankylosing spondylitis (AS) have a higher risk of cardiovascular morbidity and mortality in comparison to the general population, which may be connected with the disease’s activity, the functional and mobility limitations, structural damage, and inflammation [1, 2]
The study involved a total of 32 nonsmoking male patients with ankylosing spondylitis who were divided randomly by a physician into two groups with an allocation ratio 1 : 1. The first group consisted of 16 AS patients exposed to whole-body cryotherapy procedures with subsequent kinesiotherapy (WBC group, mean age 46.63 ± 1.5 years)
There was no significant difference in the mean age, BMI, carotid intima-media thickness (IMT), Bath Ankylosing Spondylitis Diseases Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and comorbiding disorders and distribution of classical cardiovascular risk factors between these groups

Summary

Introduction

Patients with ankylosing spondylitis (AS) have a higher risk of cardiovascular morbidity and mortality in comparison to the general population, which may be connected with the disease’s activity, the functional and mobility limitations, structural damage, and inflammation [1, 2]. Even AS patients without concomitant classical cardiovascular risk factors yet, but in an active phase of the disease, are characterized by increased levels of oxidative stress, inflammatory states, higher serum concentrations of soluble CD40 ligand (sCD40L), and increased carotid intima-media thickness (IMT) in comparison to the general population. These factors may accelerate atherosclerosis in this group of patients [3, 4]. Over the last several years, a revolution in the treatment of AS has taken place through the introduction of biological and disease-modifying antirheumatic drugs (DMARDs). Exercise and physiotherapy still play a very important role [5, 6].

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