Effects of combined aerobic and anaerobic exercise training on cytokine profiles in patients with systemic lupus erythematosus (SLE); a randomized controlled trial

Background: Systemic lupus erythematosus (SLE) is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. Physical activity could be considered one of the factors that affect the immune system status and function. The aim of the present study was to evaluate the effects of an 8-week supervised aerobic and anaerobic training program on the immune system of SLE patients through evaluation of serum cytokine levels. Methods: This cross-sectional study included 24 SLE patients selected between September 2015 and March 2016. The patients were randomly divided into two groups, including exercise (n = 14) and control (n = 10) groups. The exercise group participated in an 8-week combined supervised exercise training program consisting of three times per week in 60-min exercise sessions. After collection of whole peripheral blood, peripheral blood mononuclear cells (PBMCs) were isolated from the blood samples. Following RNA extraction and cDNA synthesis, the expression levels of IFN-gamma, TNF-alpha, IL-6, IL-2, IL-4, IL-5, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, and IL22 were determined using in-house SYBER Green-based real-time polymerase chain reaction (PCR). Lastly, the data obtained were analyzed using t-test. Results: The mean and standard deviation of age were 29.00 +/- 3.19 and 21.50 +/- 5.52 in the intervention and control groups, respectively. No significant differences were found among the mean serum levels of IFN-gamma, IL6, IL9, IL-17A, IL-17F and IL-21 among SLE patients in the intervention and control groups. The mean serum levels of TNF-alpha, IL2, IL-4, and IL-5 decreased significantly in the intervention as compared with the control group. The mean serum levels of IL-10, IL-13 and IL-22 significantly increased in the control group after eight weeks, as compared with the intervention group. Conclusions: Our findings indicated that the 8-week supervised aerobic and anaerobic training program could result in decreased inflammatory cytokines.