Elevated serum IL-6 levels predict treatment interruption in patients with moderate to severe psoriasis: a 6-year real-world cohort study

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01-1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29-3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Elevated serum IL-6 levels predict treatment interruption in patients with moderate to severe psoriasis: a 6-year real-world cohort study.

BACKGROUND: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. OBJECTIVE: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. METHODS: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. RESULTS: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01‒1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29‒3.08; p = 0.002) were associated with treatment interruption. STUDY LIMITATIONS: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. CONCLUSIONS: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Behavior of female judo weight divisions on approach and grip phases in different judo rules: The top 20 athletes from the 2016 and 2020 Olympic cycles.

In judo combat, the approach and gripping phases play a crucial role in determining victory, and it is believed that they can be influenced by the current rules. The objective of this study was to compare the technical-tactical actions executed by female judokas in the approach and gripping subphases during international competitions held in the 2016 and 2020 Olympic cycles, which featured different rules. We analyzed 1332 combat videos from the top 20 female judo athletes in the world rankings. These videos were equally distributed across weight divisions in the 2016 and 2020 Olympic cycles (48 kg = 132; 52 kg = 72; 57 kg = 109; 63 kg = 96; 70 kg = 69; 78 kg = 106; >78 kg = 82; total = 666 combats per cycle). The athletes in the 2020 cycle spent more time executing approach actions without contact with the judogi (formless: 2020 = 26.9; 2016 = 21.3 s; p < 0.001) and less time attempting grips (2020 = 24.6; 2016 = 31.2 s; p < 0.001) than the 2016 athletes. Additionally, the 2020 athletes spent less time on one-handed grips (left collar: 2020 = 7.1; 2016 = 7.9 s; p = 0.017; right sleeve: 2020 = 4.6; 2016 = 5.6 s; p = 0.018; left sleeve: 2020 = 4.7; 2016 = 5.2 s; p = 0.031) compared to the 2016 athletes. In both Olympic cycles, athletes devoted the most time to traditional grips (left collar right sleeve: 2016 = 12.3 ± 19.9; 2020 = 12.2 ± 17.5; right collar left sleeve: 2016 = 11.5 ± 20.6; 2020 = 12.3 ± 19.9 s). Differences in the approach subphases between Olympic cycles had varying impacts on different weight divisions (formless = 52 kg, 57 kg, 78 kg; right anteroposterior = 52 kg, 57 kg, 70 kg; grip attempts = 57 kg, 63 kg, 70 kg, 78 kg, >78 kg; p < 0.05), as did changes in grip types (right collar; left collar; left sleeve = 70 kg; right sleeve = >78 kg; right dorsal = 63 kg; left dorsal = 63 kg, 78 kg; right collar left sleeve = 48 kg, 52 kg; right dorsal left sleeve = 78 kg; right dorsal left collar = 48 kg, 70 kg; right dorsal left dorsal = 48 kg, 63 kg; p < 0.05). There were notable technical-tactical shifts in the behavior of female athletes between the Olympic cycles with different rules, and these findings should be taken into account for specialized training in female judo.

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy.

Background: SARS-CoV-2 infection and perinatal neurologic outcomes are still not fully understood. However, there is recent evidence of white matter disease and impaired neurodevelopment in newborns following maternal SARS-CoV-2 infection. These appear to occur as a consequence of both direct viral effects and a systemic inflammatory response, with glial cell/myelin involvement and regional hypoxia/microvascular dysfunction. We sought to characterize the consequences of maternal and fetal inflammatory states in the central nervous system of newborns following maternal SARS-CoV-2 infection. Methods: We conducted a longitudinal prospective cohort study from June 2020 to December 2021, with follow-up of newborns born to mothers exposed or not exposed to SARS-CoV-2 infection during pregnancy. Brain analysis included data from cranial ultrasound scans (CUS) with grayscale, Doppler studies (color and spectral), and ultrasound-based brain elastography (shear-wave mode) in specific regions of interest (ROIs): deep white matter, superficial white matter, corpus callosum, basal ganglia, and cortical gray matter. Brain elastography was used to estimate brain parenchymal stiffness, which is an indirect quantifier of cerebral myelin tissue content. Results: A total of 219 single-pregnancy children were enrolled, including 201 born to mothers exposed to SARS-CoV-2 infection and 18 from unexposed controls. A neuroimaging evaluation was performed at 6 months of adjusted chronological age and revealed 18 grayscale and 21 Doppler abnormalities. Predominant findings were hyperechogenicity of deep brain white matter and basal ganglia (caudate nuclei/thalamus) and a reduction in the resistance and pulsatility indices of intracranial arterial flow. The anterior brain circulation (middle cerebral and pericallosal arteries) displayed a wider range of flow variation than the posterior circulation (basilar artery). Shear-wave US elastography analysis showed a reduction in stiffness values in the SARS-CoV-2 exposed group in all analyzed regions of interest, especially in the deep white matter elasticity coefficients (3.98 ± 0.62) compared to the control group (7.76 ± 0.77); p-value < 0.001. Conclusion: This study further characterizes pediatric structural encephalic changes associated with SARS-CoV-2 infection during pregnancy. The maternal infection has been shown to be related to cerebral deep white matter predominant involvement, with regional hyperechogenicity and reduction of elasticity coefficients, suggesting zonal impairment of myelin content. Morphologic findings may be subtle, and functional studies such as Doppler and elastography may be valuable tools to more accurately identify infants at risk of neurologic damage.

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study.

Introduction: SARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators. Methods: A sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array. Results: In the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester. Discussion and conclusion: From an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women.

Negative impact of SARS-CoV-2 infection in acute coronary syndrome mortality in a Latin American cohort study.

Purpose: COVID-19 infection has been associated with a high risk of complications and death among patients with acute coronary syndrome (ACS). However, there is little information on the simultaneous involvement in Latin American countries. Methods: In the period between May 2020 and February 2021, an observational, longitudinal, prospective cohort study with two parallel branches was conducted in private and public hospitals in Brasilia, Brazil, including patients with ACS with and without a positive SARS-CoV-2 test result during hospitalization. Results: A total of 149 patients with ACS were included (75 with COVID-19 and 74 controls). Patients with COVID-19 exhibited an average of 62 years of age, 57% men, 40% diabetics, 67% hypertensive, 48% had an ACS with ST-segment elevation, Killip I was predominant, a low Syntax Score in 72%, with an average Grace Score of 117, and a length of hospitalization of 43 days in average. The control branch was similar in clinical characteristics, except for a lower proportion of ST-segment elevation ACS (16%, p < 0.01) and a higher incidence of arrhythmias (8 vs. 20 %, p = 0.03). Using the Cox regression method of analysis of covariates collected in the study, it was identified that patients with COVID-19 had a risk of death 2.34 times higher than patients without COVID-19 (p = 0.049). Conclusion: In this study conducted in a Latin American capital, SARS-CoV-2 infection predicted a higher chance of death in patients admitted with ACS, which is a finding that reinforces the need for greater care when diseases develop in overlapping ways.

The Presence of Leishmania braziliensis DNA in the Nasal Mucosa of Cutaneous Leishmaniasis Patients and the Search for Possible Clinical and Immunological Patterns of Disease Progression: A Cross Sectional Study.

Leishmania braziliensis is the most important causal agent of American tegumentary leishmaniasis (ATL), and 3 to 5% of patients develop mucosal lesions. The mechanisms related to parasite and host immune interactions and the parasite life cycle that lead to dissemination to the mucosa are poorly understood. We aimed to detect L. braziliensis DNA in the nasal mucosa of cutaneous leishmaniasis (CL) patients with early mucous dissemination and to relate those findings to specific inflammatory responses. Nasal swabs were collected from patients with the cutaneous form of ATL. L. braziliensis DNA was investigated using TaqMan-based real-time PCR. The levels of serum cytokines (IL-12, IL-6, TNF-α, IL-10, IL-1ß and IL-8) were measured by a multiplex cytometric array. A Poisson regression model was used to test prevalence ratios (PRs) and multivariate interactions of clinical and laboratory characteristics. Of the 79 CL patients, 24 (30%) had L. braziliensis DNA in the nasal mucosa. In the multivariate model, parasite DNA presence in mucosa was associated with a reduction in IL-12 levels (PR = 0.440; p=0.034), increased IL-6 levels (PR = 1.001; p=0.002) and a higher number of affected body segments (PR = 1.65; p<0.001). In this study, we observed a higher rate of early dissemination to the nasal mucosa than what was previously described. We suggest that an enhanced Th1 profile characterized by higher IL-12 is important for preventing dissemination of L. braziliensis to the mucosa. Further evaluation of parasite-related interactions with the host immunological response is necessary to elucidate the dissemination mechanisms of Leishmania.

Novel Possible Protein Targets in Neovascular Age-Related Macular Degeneration: A Pilot Study Experiment.

Age-related macular degeneration (AMD) is among the world's leading causes of blindness. In its neovascular form (nAMD), around 25% of patients present further anatomical and visual deterioration due to persistence of neovascular activity, despite gold-standard treatment protocols using intravitreal anti-VEGF medications. Thus, to comprehend, the molecular pathways that drive choroidal neoangiogenesis, associated with the vascular endothelial growth factor (VEGF), are important steps to elucidate the mechanistic events underneath the disease development. This is a pilot study, a prospective, translational experiment, in a real-life context aiming to evaluate the protein profiles of the aqueous humor of 15 patients divided into three groups: group 1, composed of patients with nAMD, who demonstrated a good response to anti-VEGF intravitreal injections during follow-up (good responsive); group 2, composed of patients with anti-VEGF-resistant nAMD, who demonstrated choroidal neovascularization activity during follow-up (poor/non-responsive); and group 3, composed of control patients without systemic diseases or signs of retinopathy. For proteomic characterization of the groups, mass spectrometry (label-free LC-MS/MS) was used. A total of 2,336 proteins were identified, of which 185 were distinctly regulated and allowed the differentiation of the clinical conditions analyzed. Among those, 39 proteins, including some novel ones, were analyzed as potential disease effectors through their pathophysiological implications in lipid metabolism, oxidative stress, complement system, inflammatory pathways, and angiogenesis. So, this study suggests the participation of other promising biomarkers in neovascular AMD, in addition to the known VEGF.

Walking performance is associated with coronary artery calcification in very old adults.

BACKGROUND: Coronary artery calcification (CAC) scores have good predictive value for atherosclerosis-related outcomes in the geriatric population. The low availability of cardiac computed tomography is an obstacle to assess CAC in clinical practice. Thus, clinical signs with a good degree of association with CAC can help to estimate cardiovascular risk, particularly in low-income populations. OBJECTIVES: To assess whether clinical, biochemical and functional measures explain the CAC scores in older individuals. METHODS: We characterized 89 non-institutionalized older volunteers (≥ 80 years old) by means of a comprehensive biochemical and anthropometric evaluation along with assessments of CAC scores determined by computerized tomography, and tested their association with walking speed test (WS) and handgrip strength (HS) performance. RESULTS: Analyses of variance showed that body mass index (BMI) and waist circumference (WC) differed significantly (p ≤ 0.01 and p ≤ 0.03; respectively) across quartiles, so that subsequent tests were adjusted for anthropometry. ANCOVA revealed that the two lower quartiles of CAC had better performance in WS compared to the third and fourth quartiles (p ≤ 0.04). Multinomial logistic regression analysis showed that WS scores exhibit enough power (R2 = 0.379, p = 0.05) to explain CAC scores. There were no significant differences for HS between quartiles (p = 0.87). CONCLUSION: WS is associated and explain CAC scores, and may be useful to stratify atherosclerotic burden in apparently healthy very old individuals regardless of body composition.

Associação entre eventos estressores e citocinas inflamatórias e anti-inflamatórias em pessoas idosas longevas / Association between stressor events and inflammatory and anti-inflammatory cytokines in long-lived older people

Resumo Objetivo investigar a associação entre a frequência de eventos estressores e citocinas em pessoas idosas longevas. Métodos os participantes responderam a um questionário constituído de variáveis sociodemográficas, indicaram quais eventos estressores constantes no Inventário de Eventos Estressores de vida ocorreram nos últimos cinco anos e responderam a escala de depressão geriátrica (GDS). Foram dosados por citometria de fluxo: interleucina (IL) 10, IL-6, IL-4, IL-2, fator de necrose tumoral (TNF-α) e interferon gama (IFN-γ). A análise descritiva foi realizada para a caracterização da amostra. Para investigar a associação entre as variáveis foi desenvolvido um modelo de regressão linear múltipla, utilizando o método Backward. Resultados Participaram da pesquisa 91 pessoas idosas com média de idade de 82 anos. Mais da metade da amostra relatou morte de ente querido como o evento estressor mais prevalente (61%). Nessa amostra foi possível perceber que quanto mais eventos estressores foram relatados, menor o nível de IL-4 (p=0,046), da mesma forma que o estado civil viuvez, onde os dados mostraram que quem é viúvo tem menos eventos estressores em comparação a quem é casado (p=0,037). Conclusão Evidenciou-se a importância de um olhar mais cuidadoso dos profissionais de saúde na avaliação multidimensional da pessoa idosa, de forma que se obtenham subsídios para a implementação de programas e intervenções específicos que possam amenizar a percepção dos eventos estressores vivenciados, colaborando com menores danos decorrentes da imunossenescência.

Abstract Objective To investigate the association between the frequency of stressor events and cytokines in long-lived older people. Methods The participants answered a questionnaire consisting of sociodemographic variables, indicated which stressor events included in the Stressor Life Events Inventory occurred in the last five years and answered the Geriatric Depression Scale (GDS). The following were measured by flow cytometry: interleukin (IL) 10, IL-6, IL-4, IL-2, tumor necrosis factor (TNF-α) and interferon gamma (IFN-γ). We carried out a descriptive statistical analysis in order to characterize the sample. To investigate the association between the variables, a multiple linear regression model was developed, using the Backward method. Results 91 older people with an age average of 82 years participated in the research. More than half of the sample reported the death of a loved one as the most prevalent stressor event (61%). In this sample, it was possible to notice that the more stressor events were reported, the lower the level of IL-4 (p=0.046), as well as the marital status of widowhood, where data showed that those who are widowed have fewer stressor events in comparison to who is married (p=0.037). Conclusion The importance of a more careful look by health professionals in older people multidimensional assessment was evidenced, so that subsidies are obtained for the implementation of specific programs and interventions that can ease the perception of the stressor events experienced, collaborating with less resulting damage of immunosenescence.

Functional and traditional training improve muscle power and reduce proinflammatory cytokines in older women: A randomized controlled trial.

BACKGROUND: Aging is a natural process that, even in the nonattendance of complex diseases, is associated with a numerous behavioral change that attributes reduced muscle mass, power, strength and function. In addition, aging linked to low-grade inflammatory status, characterized by increased plasma concentrations of inflammatory cytokines such as TNF-α and IL-6. Physical exercise is the main non-pharmacological strategy for improving the physical fitness of the aged individuals. However, it is still controversial whether exercise can reduce aging-mediated inflammation. OBJECTIVE: To analyze the effects of functional (FT) and traditional (TT) training practice on muscle power and inflammatory profile in physically active older women. METHODS: The study has been performed for twenty-six weeks in which twenty-four weeks utilized for training sessions and two weeks for physical and biochemical assessments. Forty-three older women (age FT: 64.25 ± 4.70, range: 60-75; TT: 64.90 ± 3.03, range: 60-71; Control: 65.91 ± 5.79, range: 60-75) were randomly divided into three groups: Functional (FT; n = 16); Traditional (TT; n = 16) training groups; and Control Group (CG; n = 11) respectively. Muscle power tests were performed by push (Bench press) and squatting (Squat) actions. The jumping ability was performed through Counter Movement Jump (CMJ). In addition, isometric strength were assessed by Hand Grip Test. Plasma cytokine concentration was measured using flow cytometry. RESULTS: Functional and traditional training sessions subjected to aged women demonstrated a significant enhancement in their physical activity and muscle power. The trained individuals from above two groups showed significant improvements in all analyzed parameters excluding hand-grip. Functional and traditional training exercise reduced the plasma concentrations of TNF-α (FT: p = 0.0001; TT: p = 0.0410) and whereas FT group has reduced IL-6 (p = 0.0072), but did not affect the alterations of pre and post measurements of IL-2 (FT: p = 0.0651; TT: p = 0.2146) and IL-10 values (FT: p = 0.2658; TT: p = 0.3116). There was no significant difference in any of the test parameters between FT and TT groups. CONCLUSION: The functional and traditional training practices showed equivalent beneficial outcomes by increasing muscle power and reducing systemic markers associated with inflammation.

Doadores de sangue envelhescentes e idosos: prevalência e reações adversas / Aging and elderly blood donors: prevalence and adverse reactions / Envejecimiento y donantes de sangre elderly: prevalencia y reacciones adversas

Verificou-se a prevalência e reações adversas às doações de sangue em doadores envelhescentes e idosos. Estudo retrospectivo, com dados do sistema informatizado de Hemocentro em Brasília. Do total de 55636 doadores, 6,3% eram envelhescentes; e 0,8%, idosos. Houve menor prevalência de reações adversas nos idosos, sem diferença significativa. Quanto à intensidade das reações, foram leves nos idosos, leves e moderados nos envelhescentes, também sem diferença significativa.

Prevalence and adverse reactions to blood donations were found in aging and elderly donors. Retrospective study with data from the computerized system of Hemocenter in Brasília. Of the 55636 donors, 6.3% were aging and 0.8% elderly. There was a lower prevalence of adverse reactions in the elderly, with no significant difference. Regarding the intensity of the reactions, they were mild in the elderly, mild and moderate in the aging, also without significant difference.

La prevalencia y las reacciones adversas a las donaciones de sangre se encontraron en donantes envejecimiento y ancianos. Estudio retrospectivo con datos del sistema computarizado de Hemocentro en Brasilia. De los 55636 donantes, 6.3% estaban envejeciendo y 0.8% ancianos. Hubo una menor prevalencia de reacciones adversas en los ancianos, sin diferencias significativas. En cuanto a la intensidad de las reacciones, fueron leves en los ancianos, leves y moderados en el envejecimiento, también sin diferencias significativas.

Corrigendum: Two Consecutive Days of Extreme Conditioning Program Training Affects Pro and Anti-inflammatory Cytokines and Osteoprotegerin without Impairments in Muscle Power.

[This corrects the article DOI: 10.3389/fphys.2016.00260.].

Multiple Cold-Water Immersions Attenuate Muscle Damage but not Alter Systemic Inflammation and Muscle Function Recovery: A Parallel Randomized Controlled Trial.

The aim of this study was to investigate the effects of multiple cold-water immersions (CWIs) on muscle function, markers of muscle damage, systemic inflammation and ECM degradation following exercise-induced muscle damage (EIMD). Thirty physically active males were randomly assigned to either a control (n = 15) or cold-water immersion (CWI) group (n = 15). The CWI group performed one immersion (10 °C for 20 min) at post-exercise and every 24 h for the following 72 h, while the control group remained in a seated position during these corresponding periods. Muscle strength, vertical jump height, muscle thickness, delayed-onset muscle soreness (DOMS), systemic creatine kinase (CK), C-reactive protein (CRP), inflammatory cytokines and matrix metalloproteinase-2 (MMP-2) activity were assessed at Pre, Post, 24, 48, 72, 96 and 168 h following EIMD. No significant time × group interaction was obtained for muscle strength, vertical jump height recovery and MMP-2 activity (p > 0.05). At 24 h, muscle thickness from the CWI group returned to baseline and was lower than the control (p = 0.04). DOMS returned to baseline at 168 h for the CWI group (p = 0.109) but not for the control (p = 0.008). At 168 h, CK showed a time-group difference with a greater peak for the control group (p = 0.016). In conclusion, multiple CWIs attenuated muscle damage, but not altered systemic inflammation and muscle function recovery.

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly.

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted.

Estudo comparativo do ângulo da cifose torácica e da força dos músculos respiratórios de mulheres idosas / A comparative study of thoracic kyphosis angles and respiratory muscle strength of elderly women

Objetivo: O aumento da cifose torácica e a diminuição da força dos músculos respiratórios estão entre as alterações fisiológicas mais observadas em idosos. O objetivo deste estudo foi comparar medidas do ângulo da cifose torácica e da força dos músculos respiratórios entre idosas praticantes e não praticantes de atividade física. Método: Foram avaliadas 54 idosas entre 60 e 80 anos, distribuídas em dois grupos: Grupo 1, com 27 idosas praticantes de atividade física (71,3 ± 5,1 anos); e Grupo 2, com 27 idosas não praticantes de atividade física (70,2 ± 4,8 anos). A força dos músculos respiratórios foi avaliada por meio da pressão inspiratória máxima (Pimáx) e da pressão expiratória máxima (Pemáx); e o grau de cifose torácica, por meio do método Flexicurva. Para a análise dos dados, foram utilizados correlação de Pearson e teste t de Student, com nível de significância p < 0,05. Resultados: As idosas do Grupo 1 exibiram valores maiores na Pimáx e na Pemáx quando comparadas com as idosas do Grupo 2. Esse resultado poderia ser explicado pelos efeitos do tempo da prática de atividade física regular e da especificidade do esporte. Conclusão: Os resultados sugerem que a prática regular de atividade física contribui para a manutenção da força dos músculos respiratórios e para retardar o aumento do ângulo da cifose torácica em idosas fisicamente ativas.

Objective: The increase in thoracic kyphosis and the decrease in respiratory muscle strength are among the most frequently observed physiological changes in the elderly. The aim of this study was to compare thoracic kyphosis angle and respiratory muscle strength measurements among women who do physical activity with those who do not. Method: We evaluated 54 elderly women aged between 60 and 80 years old, and distributed them into two groups: Group 1, with 27 physically active elderly women (71.3 ± 5.1 years old); and Group 2, with 27 elderly women who do not do physical activity (70.2 ± 4.8 years old). Respiratory muscle strength was assessed by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), and the angle degree of the thoracic kyphosis was measured using the Flexicurva method. For data analysis, we used Pearson's correlation test and Student's t-test, with a significance level set at p < 0.05. Results: Group 1participants showed higher values of MIP and MEP when compared to those in Group 2. A possible reason for this result could be the effects of regular physical activity and, specifically, the sport practiced. Conclusion: Results suggest that regular participation in physical activity contributes to the maintenance of respiratory muscle strength and delays the increase of the thoracic kyphosis angle in physically active elderly women.

Two Consecutive Days of Crossfit Training Affects Pro and Anti-inflammatory Cytokines and Osteoprotegerin without Impairments in Muscle Power.

The aim of this study was to investigate the effects of two consecutive Crossfit® training sessions (24 h apart) designed to enhance work-capacity that involved both cardiovascular and muscular exercises on cytokines, muscle power, blood lactate and glucose. Nine male members of the CrossFit® community (age 26.7 ± 6.6 years; body mass 78.8 ± 13.2 kg; body fat 13.5 ± 6.2%; training experience 2.5 ± 1.2 years) completed two experimental protocols (24 h apart): (1) strength and power exercises, (2) gymnastic movements, and (3) metabolic conditioning as follows: 10 min of as many rounds as possible (AMRAP) of 30 double-unders and 15 power snatches (34 kg). The same sequence as repeated on session 2 with the following metabolic conditioning: 12 min AMRAP of: row 250 m and 25 target burpees. Serum interleukin-6 (IL-6), IL-10, and osteoprotegerin were measured before, immediately post and 24 h after workout of the day (WOD) 1, immediately post, 24 and 48 h after WOD 2. Peak and mean power were obtained for each repetition (back squat with 50% of 1 repetition maximum) using a linear position transducer measured before, immediately post and 24 h after WOD 1, immediately post and 24 h after WOD 2. Blood lactate and glucose were measured pre and immediately post WOD 1 and 2. Although both sessions of exercise elicited an significant increase in blood lactate (1.20 ± 0.41 to 11.84 ± 1.34 vs. 0.94 ± 0.34 to 9.05 ± 2.56 mmol/l) and glucose concentration (81.59 ± 10.27 to 114.99 ± 12.52 vs. 69.47 ± 6.97 to 89.95 ± 19.26 mg/dL), WOD 1 induced a significantly greater increase than WOD 2 (p ≤ 0.05). The training sessions elicited significant changes (p ≤ 0.05) in IL-6, IL-10 and osteoprotegerin concentration over time. IL-6 displayed an increase immediately after training WOD 1 [197 ± 109%] (p = 0.009) and 2 [99 ± 58%] (p = 0.045). IL-10 displayed an increase immediately after only WOD 1 [44 ± 52%] (p = 0.046), and decreased 24 and 48 h following WOD 2 (~40%; p = 0.018) as compared to pre-exercise values. Osteoprotegerin displayed a decrease 48 h following WOD 2 (~25%; p = 0.018) as compared with pre intervention. In conclusion, two consecutive Crossfit® training sessions increase pro/anti-inflammatory cytokines with no interference on muscle performance in the recovery period.

FTO gene variant and association with overweight in Brazilian male students / Variante do gene FTO e associação com excesso de peso em estudantes brasileiros do sexo masculino

Abstract Obesity is considered a disease with multiple etiologies. Recent advances in technology have pointed candidate genes that are related to weight gain in several populations. However, in countries with ethnic miscegenation, such as Brazil, studies of this nature with students are still scarce. The aim of the present study was to compare anthropometric variables of Brazilian male students according to the genotypes of the rs9939609 of the FTO gene. In order to do so, 205 participants underwent body mass, height, waist circumference and skinfold thickness measurements. Body mass index (BMI), waist-to-height ratio and body fat percentage were calculated. Volunteers were characterized as overweight according to the BMI-for-age z-score. Participants were genotyped according to the single nucleotide polymorphism rs9939609 of the FTO gene (AA, AT and TT). ANOVA one-way with Bonferroni’s post hoc was performed to compare genotypes and anthropometric variables. Odds Ratio was calculated to reveal increased chances of presenting higher body mass index z-score, waist-to-height ratio and body fat percentage. Participants homozygous for the A allele presented significantly higher values of BMI-for-age z-score (0.38±1.01 vs. -0.29±1.15), waist circumference (77.15±6.51 vs. 72.85±7.36 cm) and waist-to-height ratio (0.44±0.04 vs. 0.42±0.04) when compared to individuals with the TT genotype. The A allele of the rs9939609 of the FTO gene seems to influence in the adiposity of male students.

Resumo A obesidade é considerada doença com múltipla etiologia. Avanços recentes na tecnologia têm apontado genes candidatos que estão relacionados ao ganho de massa corporal em diversas populações. Entretanto, em países com miscigenação étnica, como o Brasil, estudos dessa natureza com escolares ainda são escassos. Objetivou-se comparar variáveis antropométricas em estudantes brasileiros do sexo masculino de acordo com os genótipos do rs9939609 do gene FTO. Para tanto, 205 participantes tiveram sua massa corporal, estatura, circunferência da cintura e dobras cutâneas medidos. Índice de massa corporal (IMC), relação cintura-estatura e percentual de gordura foram calculados. Os voluntários foram classificados como com excesso de peso de acordo com o escore-z de IMC por idade. Ademais, os participantes foram genotipados conforme o polimorfismo de nucleotídeo único rs9939609 do gene FTO (AA, AT e TT). ANOVA de uma entrada com post hoc de Bonferroni foi realizada para comparar as variáveis antropométricas entre os genótipos. Odds ratio foi calculada no intuito de revelar chances aumentadas de apresentar maior escore-z de IMC por idade, razão cintura-estatura e percentual de gordura. Os indivíduos homozigotos para o alelo A apresentaram valores significativamente mais altos para escore-z de IMC por idade (0,38±1,01 vs. -0,29±1,15), circunferência da cintura (77,15±6,51 vs. 72,85±7,36 cm) e relação cintura-estatura (0,44±0,04 vs. 0,42±0,04) quando comparados aos indivíduos com genótipo TT. O alelo A do rs9939609 do gene FTO parece influenciar a adiposidade de estudantes do sexo masculino.

Endothelial nitric oxide synthase Glu298Asp gene polymorphism influences body composition and biochemical parameters but not the nitric oxide response to eccentric resistance exercise in elderly obese women.

Both endothelial nitric oxide synthase (eNOS) gene polymorphism and nitric oxide (NO) are involved in important cardiovascular, muscular and inflammatory physiological mechanisms during ageing and response to exercise. The aim of this study was to investigate the NO kinetic response following an acute eccentric resistance exercise (ERE) session and the possible effect of the Glu298Asp eNOS gene polymorphism in elderly obese women. Eighty-seven women (age 69·4 ± 6·1 years, body weight 74·9 ± 12·7 kg, height 151·9 ± 6·0 cm and BMI 32·5 ± 5·7 kg m-2 ) completed seven sets of ten eccentric repetitions at 110% of the ten repetitions maximum (10RM). NO concentrations remained elevated up to 48 h following the acute ERE session as compared with baseline, for GG and GT/TT groups (P<0·05), with no differences between genotypes. The GG genotype group had higher body weight, prevalence of obesity (BMI classification - 81% versus 56%), BMI and higher relative muscle strength, while they had significantly lower triglycerides, VLDL and urea concentrations as compared with TT/TG group. In conclusion, NO remains elevated for up to 48 h after an acute ERE session, without genotype interaction. The TT/TG genotype had a negative impact on triglycerides, VLDL and urea concentrations. Thus, T carriers should increase their attention to cardiovascular risk factor and metabolic disorders.

Enhancing of women functional status with metabolic syndrome by cardioprotective and anti-inflammatory effects of combined aerobic and resistance training.

These data describe the effects of combined aerobic plus resistance training (CT) with regards to risk factors of metabolic syndrome (MetS), quality of life, functional capacity, and pro- and anti-inflammatory cytokines in women with MetS. In this context, thirteen women (35.4 ± 6.2 yr) completed 10 weeks of CT consisting of three weekly sessions of ~60 min aerobic training (treadmill at 65-70% of reserve heart rate, 30 min) and resistance training (3 sets of 8-12 repetitions maximum for main muscle groups). Dependent variables were maximum chest press strength; isometric hand-grip strength; 30 s chair stand test; six minute walk test; body mass; body mass index; body adiposity index; waist circumference; systolic (SBP), diastolic and mean blood pressure (MBP); blood glucose; HDL-C; triglycerides; interleukins (IL) 6, 10 and 12, osteoprotegerin (OPG) and serum nitric oxide metabolite (NOx); quality of life (SF-36) and Z-Score of MetS. There was an improvement in muscle strength on chest press (p = 0.009), isometric hand-grip strength (p = 0.03) and 30 s chair stand (p = 0.007). There was a decrease in SBP (p = 0.049), MBP (p = 0.041), Z-Score of MetS (p = 0.046), OPG (0.42 ± 0.26 to 0.38 ± 0.19 ng/mL, p<0.05) and NOx (13.3 ± 2.3 µmol/L to 9.1 ± 2.3 µmol/L; p<0.0005). IL-10 displayed an increase (13.6 ± 7.5 to 17.2 ± 12.3 pg/mL, p < 0.05) after 10 weeks of training. Combined training also increased the perception of physical capacity (p = 0.011). This study endorses CT as an efficient tool to improve blood pressure, functional capacity, quality of life and reduce blood markers of inflammation, which has a clinical relevance in the prevention and treatment of MetS.