RESUMEN
BACKGROUND: Chronic lymphedema is a progressive and inflammatory disease caused by impaired lymphatic transport. PURPOSE: This study evaluates the effects of complex decongestive therapy (CDT) and aquatic physiotherapy on markers of the inflammatory process and lower limb volumes in individuals with lymphedema. METHODS: A randomized controlled clinical trial was carried out with three groups: patients with lymphedema submitted to CDT, patients with lymphedema submitted to aquatic physiotherapy, and control group of individuals without lymphedema. The evaluation was performed through blood count, CRP measurements, C3, C4 complement, measurement of serum levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukins 4 (IL-4), 6 (IL-6), and 10 (IL-10), and the volume of a lower limb using the volume formula of a truncated cone. The study was registered with the Brazilian Clinical Trials Registry (RBR-4tpkszn). RESULTS: Our work showed a reduction in the TNF-α levels of patients in the CDT group (p = .028). Significant differences were found between the control group and the CDT group for IL-10 (p = .049) and Monocytes (p = .039). No significant reduction in limb volume was found. CONCLUSION: Our results show that CDT was able to significantly reduce the inflammatory marker TNF-α in patients with lymphedema, suggesting an anti-inflammatory effect of the therapy.
RESUMEN
RESUMO Objetivou-se avaliar alterações imunes, entre obesidade e exercício (natação). Ratas Wistar foram alocadas, conforme regime dietético: Grupo Labina (GL) e Grupo Hiperlipídico (GH); e, aos 60 dias, segundo o exercício. Após protocolo de exercício, avaliaram-se parâmetros murinométricos, gordura visceral, série branca do sangue e cultura de macrófagos. Observamos aumento nos parâmetros murinométricos, na gordura visceral do GH sedentário e nos linfócitos, neutrófilos e basófilos do GH exercitado. A taxa de fagocitose e a produção de óxido nítrico estimulado com lipopolissacarídeos aumentaram nos ratos exercitados. A natação parece reverter o fenótipo de sobrepeso, promovido pela dieta hiperlipídica, atenuou os efeitos dessa no sistema imune e melhorou sua resposta.
ABSTRACT The aim was to evaluate immune changes between obesity and swimming. Wistar rats were allocated according to dietary regimen: Labina Group (LG) and Hyperlipid Group (HG); and at 60 days, according to the exercise. After exercise protocol, murinometric parameters, visceral fat, white blood series and macrophage culture were evaluated. We observed an increase in the murinometric parameters and visceral fat of the sedentary HG, and in the lymphocytes, neutrophils and basophils of the exercised HG. The rate of phagocytosis and the production of nitric oxide stimulated with lipopolysaccharides increased in the exercised rats. Swimming seems to reverse the overweight phenotype promoted by the hyperlipid diet and attenuated the effects it on the immune system, improving its response.
RESUMEN El objetivo de este artículo fue evaluar cambios inmunológicos entre obesidad y ejercicio (natación). Se distribuyó a ratas Wistar según el régimen dietético: grupo labina (GL) y grupo hiperlipídico (GH). Y a los 60 días, según el ejercicio. Después del protocolo de ejercicio, se evaluaron los parámetros murinométricos, grasa visceral, serie blanca de la sangre y cultivo de macrófagos. Se observó un aumento de los parámetros murinométricos y de la grasa visceral del GH sedentario, así como en los linfocitos, neutrófilos y basófilos del GH ejercitado. La tasa de fagocitosis y la producción de óxido nítrico estimulado con lipopolisacárido aumentaron en las ratas ejercitadas. Parece que la natación revierte el fenotipo de sobrepeso promovido por la dieta hiperlipídica y atenúa los efectos de esta en el sistema inmunitario, por lo que mejora su respuesta.
