背景:研究证实运动对多发性硬化症具有潜在的改善作用,但具体机制尚不完全清楚。目的:总结多发性硬化症患者的生理功能变化,探讨运动改善多发性硬化症患者生理功能的机制。方法:应用计算机检索Web of Science、PubMed、中国知网、万方...背景:研究证实运动对多发性硬化症具有潜在的改善作用,但具体机制尚不完全清楚。目的:总结多发性硬化症患者的生理功能变化,探讨运动改善多发性硬化症患者生理功能的机制。方法:应用计算机检索Web of Science、PubMed、中国知网、万方和维普数据库等,中文检索词为“多发性硬化症,脱髓鞘自身免疫疾病,运动,体育锻炼,神经退行性疾病”等,英文检索词为“Multiple sclerosis,Demyelinating Autoimmune Diseases,Exercise,Physical activity,Neurodegenerative diseases”等,文献检索时限为各数据库建库至2024年6月,根据预定的纳入和排除标准,最终筛选出81篇文献进行综述。结果与结论:多发性硬化症患者的生理和功能变化复杂多样,严重影响患者的生活质量和独立生活能力。运动作为一种非药物干预方式,在改善多发性硬化症患者的生理和功能状态方面显示出显著潜力,运动可以缓解疲劳、调节免疫反应、降低压力激素水平、增强血脑屏障功能及促进神经可塑性。然而,当前关于运动治疗多发性硬化症的具体机制研究仍然不足,需要更多高质量、系统性的研究来进一步验证和完善相关结论。未来的研究应聚焦于以下几个方面:进一步探索不同类型和强度运动对多发性硬化症患者生理功能和病情进展的具体影响,找出最适合多发性硬化症患者的运动方案;开展大规模、长期随访的临床试验,验证运动对多发性硬化症患者的长期效果和安全性;结合现代科技手段,如功能性磁共振成像和神经电生理技术,深入揭示运动干预对多发性硬化症患者神经系统的具体作用机制;考虑患者个体差异,制定个性化的运动干预方案,以最大程度地提高干预效果和患者依从性。展开更多
In order to elucidate the differences between systemic and central nervous system (CNS) immunity that are relevant to exacerbations of multiple sclerosis (MS), paired peripheral blood and cerebrospinal fluid (CSF) sam...In order to elucidate the differences between systemic and central nervous system (CNS) immunity that are relevant to exacerbations of multiple sclerosis (MS), paired peripheral blood and cerebrospinal fluid (CSF) samples obtained from 36 nontreated patients with relapsing-remitting MS (RRMS) were simultaneously examined using flow cytometry to determine the percentages of functional lymphocyte subsets, as well as enzyme-linked immunosorbent assays for measu- ring soluble immune mediators.Active RRMS patients (n = 27) were characterized by an increase in CD4+CXCR3+Th1 cells in blood as compared with inactive patients (n = 9), and this parameter was inversely correlated with plasma levels of IL-10 and IL-12p70. In contrast, an increase in the percentage of CD4+CD25+cells and a decrease in the percentage of CD8+CD11ahigh cells were features of CSF samples from those with active RRMS. Further, CSF CD4+CD25+cells had a close association with leukocyte counts as well as albumin and CXCL10 levels in the CSF, and, thus, could be useful as a measure for inflammatory reactions in the CNS. On the other hand, CD8+CD11ahigh cells may function as immunoregulatory cells, as their percentage in the CSF showed a positive correlation with CSF levels of the anti-inflammatory cytokine IL-4. These findings suggest that MS relapses occur in a combination with altered cell-mediated immunity that differs between the peripheral blood and CSF compartments, while measurement of lymphocyte subsets may be helpful for monitoring disease status.展开更多
文摘In order to elucidate the differences between systemic and central nervous system (CNS) immunity that are relevant to exacerbations of multiple sclerosis (MS), paired peripheral blood and cerebrospinal fluid (CSF) samples obtained from 36 nontreated patients with relapsing-remitting MS (RRMS) were simultaneously examined using flow cytometry to determine the percentages of functional lymphocyte subsets, as well as enzyme-linked immunosorbent assays for measu- ring soluble immune mediators.Active RRMS patients (n = 27) were characterized by an increase in CD4+CXCR3+Th1 cells in blood as compared with inactive patients (n = 9), and this parameter was inversely correlated with plasma levels of IL-10 and IL-12p70. In contrast, an increase in the percentage of CD4+CD25+cells and a decrease in the percentage of CD8+CD11ahigh cells were features of CSF samples from those with active RRMS. Further, CSF CD4+CD25+cells had a close association with leukocyte counts as well as albumin and CXCL10 levels in the CSF, and, thus, could be useful as a measure for inflammatory reactions in the CNS. On the other hand, CD8+CD11ahigh cells may function as immunoregulatory cells, as their percentage in the CSF showed a positive correlation with CSF levels of the anti-inflammatory cytokine IL-4. These findings suggest that MS relapses occur in a combination with altered cell-mediated immunity that differs between the peripheral blood and CSF compartments, while measurement of lymphocyte subsets may be helpful for monitoring disease status.
