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Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study.

dc.contributor.author Bartlett, David
dc.contributor.author Kraus, Virginia
dc.contributor.author Kraus, William
dc.contributor.author Slentz, Cris
dc.contributor.author Huffman, Kim
dc.contributor.author Moss, Jennifer
dc.contributor.author Willis, Leslie H
dc.contributor.author Hoselton, Andrew
dc.contributor.author Kelly, Leslie
dc.contributor.author Huebner, Janet L
dc.contributor.author Muehlbauer, Michael J
dc.contributor.author Spielmann, Guillaume
dc.contributor.author Lord, Janet M
dc.date.accessioned 2019-02-02T15:29:56Z
dc.date.available 2019-02-02T15:29:56Z
dc.date.issued 2018-06-14
dc.identifier 10.1186/s13075-018-1624-x
dc.identifier.issn 1478-6354
dc.identifier.issn 1478-6362
dc.identifier.uri https://hdl.handle.net/10161/18046
dc.description.abstract BACKGROUND:Rheumatoid arthritis (RA) is a chronic inflammatory disease in which adults have significant joint issues leading to poor health. Poor health is compounded by many factors, including exercise avoidance and increased risk of opportunistic infection. Exercise training can improve the health of patients with RA and potentially improve immune function; however, information on the effects of high-intensity interval training (HIIT) in RA is limited. We sought to determine whether 10 weeks of a walking-based HIIT program would be associated with health improvements as measured by disease activity and aerobic fitness. Further, we assessed whether HIIT was associated with improved immune function, specifically antimicrobial/bacterial functions of neutrophils and monocytes. METHODS:Twelve physically inactive adults aged 64 ± 7 years with either seropositive or radiographically proven (bone erosions) RA completed 10 weeks of high-intensity interval walking. Training consisted of 3 × 30-minute sessions/week of ten ≥ 60-second intervals of high intensity (80-90% VO2reserve) separated by similar bouts of lower-intensity intervals (50-60% VO2reserve). Pre- and postintervention assessments included aerobic and physical function; disease activity as measured by Disease Activity score in 28 joints (DAS28), self-perceived health, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR); plasma interleukin (IL)-1β, IL-6, chemokine (C-X-C motif) ligand (CXCL)-8, IL-10, and tumor necrosis factor (TNF)-α concentrations; and neutrophil and monocyte phenotypes and functions. RESULTS:Despite minimal body composition change, cardiorespiratory fitness increased by 9% (change in both relative and absolute aerobic capacity; p < 0.001), and resting blood pressure and heart rate were both reduced (both p < 0.05). Postintervention disease activity was reduced by 38% (DAS28; p = 0.001) with significant reductions in ESR and swollen joints as well as improved self-perceived health. Neutrophil migration toward CXCL-8 (p = 0.003), phagocytosis of Escherichia coli (p = 0.03), and ROS production (p < 0.001) all increased following training. The frequency of cluster of differentiation 14-positive (CD14+)/CD16+ monocytes was reduced (p = 0.002), with both nonclassical (CD14dim/CD16bright) and intermediate (CD14bright/CD16positive) monocytes being reduced (both p < 0.05). Following training, the cell surface expression of intermediate monocyte Toll-like receptor 2 (TLR2), TLR4, and HLA-DR was reduced (all p < 0.05), and monocyte phagocytosis of E. coli increased (p = 0.02). No changes were observed for inflammatory markers IL-1β, IL-6, CXCL-8, IL-10, CRP, or TNF-α. CONCLUSIONS:We report for the first time, to our knowledge, that a high-intensity interval walking protocol in older adults with stable RA is associated with reduced disease activity, improved cardiovascular fitness, and improved innate immune functions, indicative of reduced infection risk and inflammatory potential. Importantly, the exercise program was well tolerated by these patients. TRIAL REGISTRATION:ClinicalTrials.gov, NCT02528344 . Registered on 19 August 2015.
dc.language eng
dc.publisher Springer Nature
dc.relation.ispartof Arthritis research & therapy
dc.relation.isversionof 10.1186/s13075-018-1624-x
dc.subject Disease activity
dc.subject High-intensity interval exercise
dc.subject Inflammation
dc.subject Innate immunity
dc.subject Rheumatoid arthritis
dc.title Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study.
dc.type Journal article
dc.date.updated 2019-02-02T15:29:55Z
pubs.begin-page 127
pubs.issue 1
pubs.organisational-group School of Medicine
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Duke Molecular Physiology Institute
pubs.organisational-group Medicine, Medical Oncology
pubs.organisational-group Medicine
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Orthopaedics
pubs.organisational-group Pathology
pubs.organisational-group Medicine, Rheumatology and Immunology
pubs.organisational-group Nursing
pubs.organisational-group School of Nursing
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group Faculty
pubs.publication-status Published
pubs.volume 20


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