Exercise can improve immune health and is beneficial for physical function in patients with rheumatoid arthritis (RA), but the immunological mechanisms are largely unknown. We evaluated the effect of moderate- to high intensity exercise with person-centred guidance on cells of the immune system, with focus on regulatory cell populations, in older adults with RA. Older adults (≥65 years) with RA were randomized to either 20-weeks of moderate – to high intensity aerobic and resistance exercise (n = 24) or to an active control group performing home-based exercise of light intensity (n = 25). Aerobic capacity, muscle strength, DAS28 and CRP were evaluated. Blood samples were collected at baseline and after 20 weeks. The frequency of immune cells defined as adaptive regulatory populations, CD4 + Foxp3 + CD25 + CD127- T regulatory cells (Tregs) and CD19 + CD24hiCD38hi B regulatory cells (Bregs) as well as HLA-DR−/lowCD33 + CD11b + myeloid derived suppressor cells (MDSCs), were assessed using flow cytometry. After 20 weeks of moderate- to high intensity exercise, aerobic capacity and muscle strength were significantly improved but there were no significant changes in Disease Activity Score 28 (DAS28) or CRP. The frequency of Tregs and Bregs decreased significantly in the intervention group, but not in the active control group. The exercise intervention had no effect on MDSCs. The reduction in regulatory T cells in the intervention group was most pronounced in the female patients. Moderate- to high intensity exercise in older adults with RA led to a decreased proportion of Tregs and Bregs, but that was not associated with increased disease activity or increased inflammation. Improved Ability to Cope With Everyday Life Through a Person-centered Training Program in Elderly Patients With Rheumatoid Arthritis - PEP-walk Study, NCT02397798. Registered at ClinicalTrials.gov March 19, 2015.

中文翻译：

---

中到高强度的有氧运动和抗阻运动可减少患有类风湿性关节炎的老年人的外周血调节细胞群。

运动可以改善免疫健康，并有利于类风湿关节炎 (RA) 患者的身体机能，但其免疫机制在很大程度上是未知的。我们评估了以人为中心的中高强度运动对免疫系统细胞的影响，重点是调节细胞群，对患有 RA 的老年人。患有 RA 的老年人（≥65 岁）被随机分配到为期 20 周的中度至高强度有氧和阻力运动（n = 24）或进行轻度强度家庭锻炼的积极对照组（n = 25） . 评估有氧能力、肌肉力量、DAS28 和 CRP。在基线和 20 周后收集血样。定义为适应性调节群体的免疫细胞的频率，使用流式细胞术评估 CD4 + Foxp3 + CD25 + CD127- T 调节细胞 (Tregs) 和 CD19 + CD24hiCD38hi B 调节细胞 (Bregs) 以及 HLA-DR-/lowCD33 + CD11b + 髓源性抑制细胞 (MDSC)。中高强度运动 20 周后，有氧能力和肌肉力量显着提高，但疾病活动评分 28 (DAS28) 或 CRP 没有显着变化。Tregs 和 Bregs 的频率在干预组中显着降低，但在活动对照组中没有。运动干预对 MDSC 没有影响。干预组中调节性 T 细胞的减少在女性患者中最为明显。在患有 RA 的老年人中进行中高强度运动导致 Tregs 和 Bregs 的比例降低，但这与疾病活动增加或炎症增加无关。通过以人为本的类风湿关节炎老年患者培训计划提高应对日常生活的能力 - PEP-walk 研究，NCT02397798。2015 年 3 月 19 日在 ClinicalTrials.gov 注册。