Clinical effect and biological mechanism of exercise for rheumatoid arthritis: A mini review

Abstract

Rheumatoid arthritis (RA) is a common systematic, chronic inflammatory, autoimmune, and polyarticular disease, causing a range of clinical manifestations, including joint swelling, redness, pain, stiffness, fatigue, decreased quality of life, progressive disability, cardiovascular problems, and other comorbidities. Strong evidence has shown that exercise is effective for RA treatment in various clinical domains. Exercise training for relatively longer periods (e.g., ≥ 12 weeks) can decrease disease activity of RA. However, the mechanism underlying the effectiveness of exercise in reducing RA disease activity remains unclear. This review first summarizes and highlights the effectiveness of exercise in RA treatment. Then, we integrate current evidence and propose biological mechanisms responsible for the potential effects of exercise on immune cells and immunity, inflammatory response, matrix metalloproteinases, oxidative stress, and epigenetic regulation. However, a large body of evidence was obtained from the non-RA populations. Future studies are needed to further examine the proposed biological mechanisms responsible for the effectiveness of exercise in decreasing disease activity in RA populations. Such knowledge will contribute to the basic science and strengthen the scientific basis of the prescription of exercise therapy for RA in the clinical routine.

Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study

“…It improves cholesterol metabolism by reducing body fat and weight, enhancing hormone and enzyme activity, and increasing 'good' high-density lipoprotein cholesterol [17]. Exercise also benefits cardiovascular health by reducing heart attack risks through antiatherogenic adaptations and myocardial regeneration [18], and aids autoimmune disease management by modulating immune cell functions and reducing inflammation [19]. Additionally, cardiovascular fitness, improved by exercise, is positively correlated with better hearing through enhanced inner ear blood circulation [20].…”

Research progress of targeted therapy regulating Th17/Treg balance in bone immune diseases

“…Further, patients with RA are worried that exercise aggravates joint inflammation and pain and accelerates joint injury; therefore, exercise is limited. Studies have confirmed that routine exercise in patients with RA has the benefits of relieving pain, improving muscle function, and delaying disability attacks and does not have harmful effects on joints ( 9 ). In addition to the factors that induce the occurrence and development of RA and associated declines in the quality of life of patients with RA, a series of complications caused by RA also seriously reduce the quality of life of patients with RA, such as fatigue, corneal diseases, and sleep disorders.…”

“…Clinically, joint pain, tenderness, and rigidity are often accompanied by immune osteoporosis. Irreversible joint injury gradually appears, with joint movement disorders and deformities occurring at later stages ( 9 ). Epidemiological investigations have shown that the total incidence of RA worldwide is 1–2%.…”

High Humidity Aggravates Collagen-induced Arthritis in Mice by Increasing the Expression of Splenic Myeloid-derived Suppressor Cells

“…This condition typically leads to in ammation and bone destruction in multiple joints, resulting in long-term disability and signi cantly impacting patients' the quality of life [1][2] [3]. RA affects approximately 0.5-1% of the global population, making it a prevalent cause of severe disability [4] [5]. The exact cause of RA remains unclear, but it is believed to involve genetic [6], autoimmune [7], and environmental factors [8].…”