Home-Based Exercise Training in Childhood-Onset Takayasu Arteritis: A Multicenter, Randomized, Controlled Trial.

Autor:	Astley C; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Clemente G; Division of Pediatric Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, São Paulo, Brazil., Terreri MT; Division of Pediatric Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, São Paulo, Brazil., Carneiro CG; Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Lima MS; Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Buchpiguel CA; Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Leão Filho H; Radiology Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., de Sá Pinto AL; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil.; Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Silva CA; Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Campos LMA; Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Aikawa NE; Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil.; Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Gil S; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Pereira RMR; Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil., Roschel H; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Gualano B; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2021 Jul 28; Vol. 12, pp. 705250. Date of Electronic Publication: 2021 Jul 28 (Print Publication: 2021).
DOI:	10.3389/fimmu.2021.705250
Abstrakt:	Introduction: Childhood-onset Takayasu Arteritis (c-TA) is a rare, large-vessel vasculitis seen in children that could predisposing patients to a high risk of mortality. Exercise has the potential to improve overall health in several diseases, but evidence remains scant in c-TA. The main objective of this study was to investigate the safety and potential therapeutic effects of exercise in c-TA. Methods: This was a 12-week, multicenter, randomized, controlled trial, to test the effects of a home-based, exercise intervention vs . standard of care in c-TA patients in remission. The primary outcomes were arterial inflammation, assessed by [ 18 F] FDG- PET/MRI and systemic inflammatory markers. Secondary outcomes included, physical activity levels, functionality, body composition, disease-related parameters, and quality of life. Results: Thirty-seven patients were assessed for eligibility, which represents the total number of c-TA patients being followed by the three specialized medical ambulatory services in Sao Paulo. After exclusions, fourteen c-TA patients (71.4% females) aged 12-25 years were randomly allocated into exercised (n=5) and non-exercised groups (n=9). Exercise did not exacerbate arterial inflammation. In fact, exercised patients had a reduction in the frequency of vessel segments with severe inflammation, whereas the non-exercised patients had an opposite response ( P =0.007). Greater improvements in visceral fat, steps per day, functionality and physical component SF-36 were observed in the exercised patients ( P ≤ 0.05). Conclusions: Exercise is safe and may improve visceral fat, physical activity levels, functionality, and physical component SF-36 in c-TA patients. Thus, exercise arises as a novel, evidence-based intervention to improve general health in c-TA. Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/NCT03494062?term=NCT03494062&draw=2&rank=1, identifier NCT03494062. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Astley, Clemente, Terreri, Carneiro, Lima, Buchpiguel, Leão Filho, de Sá Pinto, Silva, Campos, Aikawa, Gil, Pereira, Roschel and Gualano.)
Databáze:	MEDLINE
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