Physical Exercise, Endothelial Function and Progenitor Endothelial Cells in Systemic Lupus Erythematosus Patients

Federal University of São Paulo38 enrolled

Overview

The purpose of this study is to evaluate the effect of supervised physical exercise on endothelial function and number of endothelial progenitor cells (EPCs) in patients with systemic lupus erythematosus, as well as evaluate the effect of supervised physical exercise on endothelium derived growth factor (VEGF) levels, disease activity, quality of life, fatigue, perceived exertion and cardiopulmonary exercise test variables.

Several studies have shown that cardiovascular morbimortality is more frequent and early in SLE patients than in the general population and cardiovascular disease is an important cause of morbidity and mortality in systemic lupus erythematosus patients. Disturbances in endothelial function are implicated in its pathogenesis. Endothelial function also depends on endothelial progenitor cells (EPCs) that enhance angiogenesis, promote vascular repair and have potential as a marker of cardiovascular disease. Systemic lupus erythematosus patients have endothelial dysfunction and fewer EPCs. There are studies showing improvement of endothelial function and EPCs after physical exercise program in individuals with heart failure, diabetes and coronary arterial disease, but there isn't studies evaluating endothelial function and EPCs after.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Systemic Lupus Erythematosus

Interventions

Supervised physical exerciseBEHAVIORAL

Women with systemic lupus erythematosus with availability to perform physical exercise were allocated in exercise group (EG) to practice supervised physical exercise for one hour, three times a week for 16 weeks. Those who were not available for this activity were allocated in the control group (CG). Intervention consisted of walking at speed of the ventilatory threshold-1 heart rate obtained from cardiopulmonary exercise test and monitored by frequency meter.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * female systemic lupus erythematosus patients * 18 to 45 years of age * Fulfilled at least four criteria classification for lupus (ACR criteria, 1997) - Signed the consent form approved by the ethics committee of the institution Exclusion Criteria: * Hemoglobin \< 10 mg/dL * Neuropsychiatric, pulmonary, articular or vascular damage that would prevent the practice of exercise * Coronary disease or heart failure, functional class ≥ II * Pulmonary hypertension * Uncontrolled hypertension * Creatinine ≥ 1.4 mg/dL * Body mass index (BMI) ≥ 35 kg/m2 * Diabetes mellitus * Uncontrolled hypothyroidism * Smoking in the last 12 months * Pregnancy * Menopause * Use of statins in the last three months * Practice of physical exercise in past three months * Overlap with other autoimmune rheumatic diseases, except antiphospholipid syndrome.

Locations (1)

Federal University of Sao Paulo

São Paulo, São Paulo, Brazil

Outcomes

Primary Outcomes

Endothelial function and endothelial progenitor cells (EPCs) number

Patients were evaluated at baseline and after 16 weeks by high-resolution ultrasound of brachial artery in resting conditions, after reactive hyperaemia (flow-mediated dilation-FMD) and after oral glyceryl trinitrate to assess endothelial function; EPCs were evaluated by flow cytometry using anti-CD34 (cluster of differentiation 34) (FITC), anti-CD133 (PE) and anti-kinase domain receptor (KDR) (APC)

Time frame: 16 weeks

Secondary Outcomes

Quality of life

Short Form-36

Time frame: 16 weeks

Vascular endothelial growth factor (VEGF)

ELISA

Time frame: 16 weeks

Disease activity

Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)

Time frame: 16 weeks

perceived exertion

Borg scale

Time frame: 16 weeks

Fatigue

Severity fatigue scale

Time frame: 16 weeks

Ergospirometric variables

Cardiopulmonary exercise test

Time frame: 16 weeks

Data from ClinicalTrials.gov

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