Exploring Exercise and Stress Reduction in Lupus

Stress Moderation Impacting Lupus with Exercise (SMILE)

Using Tai Chi to Explore the Effects of Daily Moderate Exercise and Stress Reduction in Lupus

Click to read press releases of this project from The Ohio State Newsroom and U.S. News and World Report.

Click here to see a scientific abstract publication of the preliminary results of this work, which was presented at the American College of Rheumatology annual meeting in San Diego, CA and at the 11th International Conference of Autoimmunity in Lisbon, Portugal. 

The summary below was written by Karla Webb and Tania Masherah. It is included in the 2016 brochure for the Division of Rheumatology and Immunology at Ohio State's Wexner Medical Center.

After results in mouse models suggested that moderate exercise combined with stress reduction may be potent means to control the chronic inflammation associated with lupus, Nicholas Young, PhD, is translating his findings to the clinic.

Dr. Young is a research scientist in the laboratory of Wael Jarjour, MD, in the Division of Rheumatology and Immunology at The Ohio State University’s Wexner Medical Center. This study will enroll up to 30 patients in a Tai Chi class and track their progress over six months to determine whether inflammatory activity is suppressed. This next phase of research is funded by a pilot grant from Ohio State’s Center for Integrative Health and Wellness and an award from the Rheumatology Research Foundation.

In his previous work, Dr. Young studied the effects of exercise and social stress using mice which spontaneously develop lupus nephritis at 22-40 weeks of age. He and his team, including Saba Aqel and Jeffrey Hampton, exercised the mice daily by treadmill walking for 45 minutes at a moderate intensity starting at 18 weeks of age. They found there was a clear difference in the amount of inflammation and kidney damage compared to the mice that did not exercise.

Simultaneously, Dr. Young worked in collaboration with the laboratory of John Sheridan, PhD, to examine whether mice exposed to social stress would exhibit enhanced disease progression. Using a model of stress induction previously established by Dr. Sheridan, an aggressor mouse was placed inside a cage with other mice for two hours over the course of six days to disrupt the normal social hierarchy and kidney damage was monitored. Compared to the control pool, this repeated social stress induced significantly higher blood urea nitrogen levels and renal inflammation, as evidenced by infiltrates detected at the cellular level.

In translating these findings to people, Dr. Young says he chose Tai Chi because it is a form of moderate exercise that also incorporates stress reduction techniques including deep breathing and meditation. With the help of fellow laboratory members Giancarlo Valiente and Holly Steigelman, lupus patients who do not regularly participate in physical activity and who report an above-average stress level will be recruited from Dr. Jarjour’s lupus clinic. Patients will practice daily Tai Chi, by participating in instructor-led classes twice a week and following video-guided instruction at home the remaining five days. All Tai Chi instruction will be under the direction of Lucy Bartimole of Shift Movement Art Studio. She has been an instructor for over 15 years with certification specific to arthritis and health and specializes in working with patients that have debilitating illnesses including lupus, multiple sclerosis, rheumatoid arthritis, Parkinson’s disease, and fibromyalgia.

Dr. Young explains that after establishing baseline health and lifestyle data, he’ll use Fitbit devices to monitor patients’ heart rates and activity minutes. In addition, blood and urine samples will be collected to examine changes in molecular markers that are associated with inflammation or influenced by either exercise or stress reduction.

“This is just the beginning of research that could have far-reaching potential,” says Dr. Young. “Even though we’re starting with a small number of patients, our goal is to generate enough pilot data to be able to create a strong NIH grant submission that allows us to continue the study on a much larger scale.”

Dr. Young adds that in exploring the molecular mechanisms by which exercise and social stress are involved in suppressing the inflammatory response, including the impact on pro-inflammatory cytokine levels, it may be possible to determine precisely how and why they are effective – and allow physicians to prescribe specific exercise and/or stress management regimens for patients with autoimmune disorders to follow along with their current pharmaceutical therapy.

 “If we can characterize the anti-inflammatory effects of exercise and stress modification, our findings could eventually be applied to many other diseases,” says Dr. Young. “While some conclusions from this study may be specific to lupus, the implications extend to any disease that has an inflammatory component, ranging from other chronic autoimmune disorders to heart disease and even cancer.”

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