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Effect of Exercise on β-Endorphin and Its Receptors in Myasthenia Gravis Patients

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Abstract

This is a prospective observational study evaluating the change in β-endorphin (BE) and its receptors following exercise in patients with myasthenia gravis (MG) and their association with clinical improvement. Fifteen patients with mild to moderate MG, aged 16–70 years, who were able to do 6-Minute Walk Test (6-MWT) and had MG Quality of Life-15 (MGQoL-15) ≤ 45 without any contraindication for exercise were included. The patients walked 30 min daily for 3 months. The primary outcome at 3 months was > 50% improvement in MGQoL-15 from the baseline, and the secondary outcomes were MG Activities of Daily Living (MGADL), Hospital Anxiety and Depression Scale (HADS), number of steps, and distance covered on 6-MWT and adverse events. Plasma BE level, μ-opioid receptor (MOR), and δ-opioid receptor (DOR) were measured on admission and at 1 and 3 months. Twelve age- and gender-matched healthy controls who were not on regular exercise were included for comparison of BE, MOR, and DOR levels. Plasma BE level (P = 0.007) and DOR expression (P = 0.001) were lower in MG patients compared to the healthy controls. After 3 months of exercise, 6 patients improved. Plasma BE, MOR, and DOR levels increased in the first and decreased in the third month. MGQoL-15 (P < 0.001), HADS (P < 0.0001), number of steps (P < 0.007), distance (P = 0.030), and MGADL (P < 0.001) significantly improved compared to baseline. At 3 months, MGQoL-15 was associated with HADS score (P = 0.001), reduced depression (P = 0.013), MGADL (P = 0.035), and distance travelled on the 6-WMW test (P = 0.050). The improvement in depression was associated with higher BE level.

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Data Availability

The data will be available on the reasonable request by the corresponding author.

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Acknowledgements

The authors gratefully acknowledge the help of Prof. Prabhakar Mishra of the Department of Biostatistics Sanjay Gandhi PGI, Lucknow, and Mr. Aditya Pande MA for the help in statistical analysis and Mr Shakti Kumar for secretarial help.

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Author notes

  1. Usha K. Misra

    Present address: Director of Neuroscience Department, Apollo Medics Superspeciality Hospital, Lucknow, 226012, Uttar Pradesh, India

  2. Usha K. Misra

    Present address: Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, 226007, Uttar Pradesh, India

  3. Gyanesh M. Tripathi, Usha K. Misra, Jayantee Kalita, Varun K. Singh and Abhilasha Tripathi contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India

    Gyanesh M. Tripathi, Jayantee Kalita & Abhilasha Tripathi

  2. Ex-HOD, Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India

    Usha K. Misra

  3. Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India

    Varun K. Singh

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Contributions

All authors contributed to the study conception and design (Usha K Misra). Material preparation (Varun K Singh), data collection, and analysis were performed by Gyanesh M Tripathi and Abhilasha Tripathi. The first draft of the manuscript was written by Usha K Misra and Jayantee Kalita and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Usha K. Misra.

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Ethics Approval

This study was approved by the Institutional Ethics committee (PGI/BE/632/2018), SGPGIMS, Lucknow.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Patients signed an informed consent regarding publishing their data and photographs.

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The authors declare no competing interests.

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Tripathi, G.M., Misra, U.K., Kalita, J. et al. Effect of Exercise on β-Endorphin and Its Receptors in Myasthenia Gravis Patients. Mol Neurobiol 60, 3010–3019 (2023). https://doi.org/10.1007/s12035-023-03247-5

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