Effects of whole body cryotherapy in patients with rheumatoid arthritis considering immune parameters
Open Access
- 31 December 2019
- journal article
- Published by Termedia Sp. z.o.o. in Rheumatology
- Vol. 57 (6), 320-325
- https://doi.org/10.5114/reum.2019.90825
Abstract
Objectives: Whole body cryotherapy (WBC) is widely used in inflammatory diseases of the joints, including rheumatoid arthritis (RA), but the mechanism(s) of its action is not fully understood. The aim of the study was to compare the effects of WBC and conventional rehabilitation (CR) on the clinical and immune status of RA patients.Material and methods: Rheumatoid arthritis patients were classified into 2 groups according to the rehabilitation method used: the study group (CT, n = 25) and control group (CR, n = 25). To measure disease activity, the disease activity score (DAS28) was used, while to assess the morning stiffness and pain intensity, the visual analogue scale (VAS) was applied. Selected laboratory parameters, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, were also determined. The serum concentrations of pro- (interleukin 6 [IL-6], tumor necrosis factor a [TNF-a], macrophage migration inhibitory factor [MIF]) and anti-inflammatory (IL-10) cytokines were measured to assess the patient’s immune status.Results: After rehabilitation disease activity (DAS28), morning stiffness and pain intensity (VAS) decreased in both patient groups and no statistically significant differences were observed between them. However, statistically significant improvement in the CRP serum level was observed in the CT group only. No differences were observed in the serum concentrations of tested cytokines either before and after rehabilitation, or between patient groups.Conclusions: We report that regardless of the type of therapy, comprehensive rehabilitation improves the patient’s clinical status, but has no effect on the levels of circulating cytokines, such as IL-6, IL-10, TNF-a, and MIF, despite significant reduction of a systemic inflammatory marker (CRP), especially in the CT group.Keywords
This publication has 16 references indexed in Scilit:
- The immunobiology of MIF: function, genetics and prospects for precision medicineNature Reviews Rheumatology, 2019
- The beneficial effects of rehabilitation on hand function in patients with rheumatoid arthritisRheumatology, 2016
- Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?Disability and Rehabilitation, 2015
- IL-6 inhibitors for treatment of rheumatoid arthritis: past, present, and futureArchives of Pharmacal Research, 2015
- Interleukin-10 paradox: A potent immunoregulatory cytokine that has been difficult to harness for immunotherapyCytokine, 2014
- Cryotherapy in inflammatory rheumatic diseases: a systematic reviewExpert Review of Clinical Immunology, 2013
- Effects of different local cryotherapies on systemic levels of TNF-α, IL-6, and clinical parameters in active rheumatoid arthritisRheumatology International, 2013
- IL-6/IL-6 receptor system and its role in physiological and pathological conditionsClinical Science, 2011
- Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis. A randomised single blinded controlled trial.2006
- Tumor necrosis factor-α antagonists for the treatment of rheumatic diseasesCurrent Opinion in Rheumatology, 2002