Multiple Sklerose und Sport

Auswirkungen körperlicher Aktivität auf das Immunsystem

Multiple sclerosis and exercise

Effects of physical activity on the immune system

Zusammenfassung

Die Multiple Sklerose ist eine chronisch entzündliche Erkrankung des Zentralnervensystems, die häufig bereits im jungen Erwachsenenalter zu funktionellen Einschränkungen und anhaltender Behinderung führt. Aktuelle Studien belegen, dass Sport bei Multipler Sklerose nicht nur Depression und Fatigue entgegenwirken, sondern auch die Lebensqualität der Patienten verbessern und funktionelle Einschränkungen reduzieren kann. Im vorliegenden Beitrag wird der Einfluss körperlicher Aktivität auf das Immunsystem und die Freisetzung neurotropher Faktoren erläutert und ein möglicher, immunmodulierender Effekt von Sport bei Multipler Sklerose diskutiert.

Summary

Multiple sclerosis is a chronic inflammatory CNS disease which accounts for functional impairment and lasting disability in young adults. Current studies demonstrate that physical activity in patients with MS counteracts depression and fatigue and may improve quality of life. Interventional studies have described a reduction of the functional impairment in MS patients. This report presents information on the effects of physical activity on the immune system and the release of neurotrophic factors, and highlights current data on a potential immunomodulatory effect of exercise in multiple sclerosis.

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Literatur

  1. 1.

    Bayas A, Rieckmann P (2000) Multiple Sklerose und Sport. Aktuelle Neurologie 27:258–261

    Article  Google Scholar 

  2. 2.

    Berchtold Nc, Chinn G, Chou M et al (2005) Exercise primes a molecular memory for brain-derived neurotrophic factor protein induction in the rat hippocampus. Neuroscience 133:853–861

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Cattaneo D, Jonsdottir J, Zocchi M et al (2007) Effects of balance exercises on people with multiple sclerosis: a pilot study. Clin Rehabil 21:771–781

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Colcombe S, Kramer Af (2003) Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 14:125–130

    PubMed  Article  Google Scholar 

  5. 5.

    Cotman Cw, Berchtold Nc, Christie La (2007) Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends Neurosci 30:464–472

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Dalgas U, Stenager E, Ingemann-Hansen T (2008) Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training. Mult Scler 14:35–53

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Gleeson M (2007) Immune function in sport and exercise. J Appl Physiol 103:693–699

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Gold Sm, Schulz Kh, Hartmann S et al (2003) Basal serum levels and reactivity of nerve growth factor and brain-derived neurotrophic factor to standardized acute exercise in multiple sclerosis and controls. J Neuroimmunol 138:99–105

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Guthrie Tc, Nelson Da (1995) Influence of temperature changes on multiple sclerosis: critical review of mechanisms and research potential. J Neurol Sci 129:1–8

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Heesen C, Gold Sm, Hartmann S et al (2003) Endocrine and cytokine responses to standardized physical stress in multiple sclerosis. Brain Behav Immun 17:473–481

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Heesen C, Romberg A, Gold S et al (2006) Physical exercise in multiple sclerosis: supportive care or a putative disease-modifying treatment. Expert Rev Neurother 6:347–355

    PubMed  Article  Google Scholar 

  12. 12.

    Hein T, Hopfenmuller W (2000) Projection of the number of multiple sclerosis patients in Germany. Nervenarzt 71:288–294

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Henze T (2004) Symptomatic therapy of multiple sclerosis. Nervenarzt 75 [Suppl 1]:2–39

  14. 14.

    Husted C, Pham L, Hekking A et al (1999) Improving quality of life for people with chronic conditions: the example of t’ai chi and multiple sclerosis. Altern Ther Health Med 5:70–74

    PubMed  CAS  Google Scholar 

  15. 15.

    Kempermann G, Van Praag H, Gage Fh (2000) Activity-dependent regulation of neuronal plasticity and self repair. Prog Brain Res 127:35–48

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Kerschensteiner M, Gallmeier E, Behrens L et al (1999) Activated human T cells, B cells and monocytes produce brain-derived neurotrophic factor in vitro and in inflammatory brain lesions: a neuroprotective role of inflammation? J Exp Med 189:865–870

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Kramer Af, Hahn S, Cohen Nj et al (1999) Ageing, fitness and neurocognitive function. Nature 400:418–419

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Le Page C, Ferry A, Rieu M (1994) Effect of muscular exercise on chronic relapsing experimental autoimmune encephalomyelitis. J Appl Physiol 77:2341–2347

    Google Scholar 

  19. 19.

    Macallister Ws, Krupp Lb (2005) Multiple sclerosis-related fatigue. Phys Med Rehabil Clin N Am 16:483–502

    PubMed  Google Scholar 

  20. 20.

    Matthews Ce, Ockene Is, Freedson Ps et al (2002) Moderate to vigorous physical activity and risk of upper-respiratory tract infection. Med Sci Sports Exerc 34:1242–1248

    PubMed  Article  Google Scholar 

  21. 21.

    Mattson Mp, Maudsley S, Martin B (2004) BDNF and 5-HT: a dynamic duo in age-related neuronal plasticity and neurodegenerative disorders. Trends Neurosci 27:589–594

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Mccullagh R, Fitzgerald Ap, Murphy Rp et al (2008) Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study. Clin Rehabil 22:206–214

    PubMed  Article  Google Scholar 

  23. 23.

    Meyer-Heim A, Rothmaier M, Weder M et al (2007) Advanced lightweight cooling-garment technology: functional improvements in thermosensitive patients with multiple sclerosis. Mult Scler 13:232–237

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Mostert S, Kesselring J (2002) Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Mult Scler 8:161–168

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Motl Rw, Gosney Jl (2008) Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis. Mult Scler 14:129–135

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Motl Rw, Snook Em, Mcauley E et al (2006) Symptoms, self-efficacy and physical activity among individuals with multiple sclerosis. Res Nurs Health 29:597–606

    PubMed  Article  Google Scholar 

  27. 27.

    Motl Rw, Snook Em, Mcauley E et al (2006) Correlates of physical activity among individuals with multiple sclerosis. Ann Behav Med 32:154–161

    PubMed  Article  Google Scholar 

  28. 28.

    Mutluay Fk, Demir R, Ozyilmaz S et al (2007) Breathing-enhanced upper extremity exercises for patients with multiple sclerosis. Clin Rehabil 21:595–602

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Neeper Sa, Gomez-Pinilla F, Choi J et al (1995) Exercise and brain neurotrophins. Nature 373:109

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Neeper Sa, Gomez-Pinilla F, Choi J et al (1996) Physical activity increases mRNA for brain-derived neurotrophic factor and nerve growth factor in rat brain. Brain Res 726:49–56

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Ng Av, Kent-Braun Ja (1997) Quantitation of lower physical activity in persons with multiple sclerosis. Med Sci Sports Exerc 29:517–523

    PubMed  CAS  Google Scholar 

  32. 32.

    Nieman Dc (2000) Special feature for the olympics: exercise effects on systemic immunity. Immunol Cell Biol 78:496–501

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Nieman Dc, Buckley Ks, Henson Da et al (1995) Immune function in marathon runners versus sedentary controls. Med Sci Sports Exerc 27:986–992

    PubMed  Article  CAS  Google Scholar 

  34. 34.

    Nieman Dc, Johanssen Lm, Lee Jw et al (1990) Infectious episodes in runners before and after the Los Angeles marathon. J Sports Med Phys Fitness 30:316–328

    PubMed  CAS  Google Scholar 

  35. 35.

    Nieman Dc, Nehlsen-Cannarella Sl, Fagoaga Or et al (2000) Immune function in female elite rowers and non-athletes. Br J Sports Med 34:181–187

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Nieman Dc, Simandle S, Henson Da et al (1995) Lymphocyte proliferative response to 2.5 hours of running. Int J Sports Med 16:404–409

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Noseworthy Jh, Lucchinetti C, Rodriguez M et al (2000) Multiple sclerosis. N Engl J Med 343:938–952

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Petajan Jh, Gappmaier E, White At et al (1996) Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 39:432–441

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Prakash Rs, Snook Em, Erickson Ki et al (2007) Cardiorespiratory fitness: A predictor of cortical plasticity in multiple sclerosis. Neuroimage 34:1238–1244

    PubMed  Article  Google Scholar 

  40. 40.

    Rasminsky M (1973) The effects of temperature on conduction in demyelinated single nerve fibers. Arch Neurol 28:287–292

    PubMed  CAS  Google Scholar 

  41. 41.

    Rietberg Mb, Brooks D, Uitdehaag Bm et al (2005) Exercise therapy for multiple sclerosis. Cochrane Database Syst Rev:CD003980

    Google Scholar 

  42. 42.

    Romberg A, Virtanen A, Ruutiainen J (2005) Long-term exercise improves functional impairment but not quality of life in multiple sclerosis. J Neurol 252:839–845

    PubMed  Article  Google Scholar 

  43. 43.

    Schabitz Wr, Schwab S, Spranger M et al (1997) Intraventricular brain-derived neurotrophic factor reduces infarct size after focal cerebral ischemia in rats. J Cereb Blood Flow Metab 17:500–506

    PubMed  Article  CAS  Google Scholar 

  44. 44.

    Schabitz Wr, Steigleder T, Cooper-Kuhn Cm et al (2007) Intravenous brain-derived neurotrophic factor enhances poststroke sensorimotor recovery and stimulates neurogenesis. Stroke 38:2165–2172

    PubMed  Article  Google Scholar 

  45. 45.

    Schauf Cl, Davis Fa (1974) Impulse conduction in multiple sclerosis: a theoretical basis for modification by temperature and pharmacological agents. J Neurol Neurosurg Psychiatry 37:152–161

    PubMed  Article  CAS  Google Scholar 

  46. 46.

    Schwid Sr, Petrie Md, Murray R et al (2003) A randomized controlled study of the acute and chronic effects of cooling therapy for MS. Neurology 60:1955–1960

    PubMed  Google Scholar 

  47. 47.

    Shephard Rj, Shek Pn (1999) Effects of exercise and training on natural killer cell counts and cytolytic activity: a meta-analysis. Sports Med 28:177–195

    PubMed  Article  CAS  Google Scholar 

  48. 48.

    Simmons Rd, Ponsonby Al, Van Der Mei Ia et al (2004) What affects your MS? Responses to an anonymous, Internet-based epidemiological survey. Mult Scler 10:202–211

    PubMed  Article  Google Scholar 

  49. 49.

    Smith Rm, Adeney-Steel M, Fulcher G et al (2006) Symptom change with exercise is a temporary phenomenon for people with multiple sclerosis. Arch Phys Med Rehabil 87:723–727

    PubMed  Article  Google Scholar 

  50. 50.

    Somerset M, Campbell R, Sharp Dj et al (2001) What do people with MS want and expect from health-care services? Health Expect 4:29–37

    PubMed  Article  CAS  Google Scholar 

  51. 51.

    Sospedra M, Martin R (2005) Immunology of multiple sclerosis. Annu Rev Immunol 23:683–747

    PubMed  Article  CAS  Google Scholar 

  52. 52.

    Stadelmann C, Kerschensteiner M, Misgeld T et al (2002) BDNF and gp145trkB in multiple sclerosis brain lesions: neuroprotective interactions between immune and neuronal cells? Brain 125:75–85

    PubMed  Article  Google Scholar 

  53. 53.

    Steensberg A, Toft Ad, Bruunsgaard H et al (2001) Strenuous exercise decreases the percentage of type 1 T cells in the circulation. J Appl Physiol 91:1708–1712

    PubMed  CAS  Google Scholar 

  54. 54.

    Uhthoff W (1890) Untersuchungen über die bei der multiplen Herdsklerose vorkommenden Augenstörungen. Arch Psychiatr Nervenkrankh 21:305–410

    Article  Google Scholar 

  55. 55.

    Van Praag H, Christie Br, Sejnowski Tj et al (1999) Running enhances neurogenesis, learning and long-term potentiation in mice. Proc Natl Acad Sci USA 96:13427–13431

    Article  Google Scholar 

  56. 56.

    Vaynman S, Gomez-Pinilla F (2005) License to run: exercise impacts functional plasticity in the intact and injured central nervous system by using neurotrophins. Neurorehabil Neural Repair 19:283–295

    PubMed  Article  Google Scholar 

  57. 57.

    White Lj, Dressendorfer Rh (2004) Exercise and multiple sclerosis. Sports Med 34:1077–1100

    PubMed  Article  Google Scholar 

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Correspondence to PD Dr. M. Mäurer.

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Waschbisch, A., Tallner, A., Pfeifer, K. et al. Multiple Sklerose und Sport. Nervenarzt 80, 688–692 (2009). https://doi.org/10.1007/s00115-008-2639-3

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Schlüsselwörter

  • Multiple Sklerose
  • Sport
  • Körperliche Aktivität
  • Immunmodulation
  • Neurotrophe Faktoren

Keywords

  • Multiple sclerosis
  • Exercise
  • Physical activity
  • Immunomodulation
  • Neurotrophic factors