Background Systemic lupus erythematosus (SLE) is an autoimmune disease associated with chronic inflammation. Pro-opiomelanocortin (POMC) axis activation leads to the production of several bioactive hormones, such as adrenocorticotropic hormone (ACTH) and the neuropeptide α-melanocyte stimulating hormone (α-MSH). Both hormones are closely related to the inflammatory process with pro- or anti-inflammatory effects. Although physical exercise has been described as a promoter of alterations in the neuroendocrine profile, no studies have addressed the participation of melanocortins in SLE patients in response to acute aerobic exercise.
Objectives To evaluate α-MSH production in SLE patients under acute aerobic exercise.
Methods Ten active SLE patients [age: 29.9±4.2yrs; body mass index (BMI): 26.0±4.8 kg/m2; SLEDAI: 5.9±2.1; glucocorticoid: 16.0±6.0 mg] and 10 age- and BMI-matched healthy controls performed 30 minutes of aerobic exercise (∼70% of VO2 peak) in a treadmill. The a-MSH and ACTH serum levels were assessed at baseline and immediately after exercise session by a multiplex system (HNP-35K kit, Millipore, Billerica, MA, USA).
Results Similar levels of a-MSH were observed at baseline between active SLE patients and healthy controls (P=0.69). However, after exercise, a distinct pattern of response was noted (Fig. 1). The serum levels of a-MSH was not altered in healthy controls, but a significant increase in mean levels was observed in active SLE patients after exercise (92.39±16.12 vs. 146.23±25.01 pg/mL, P=0.04). ACTH levels did not differ between groups at baseline and after exercise (P>0.05).
Conclusions The present study provides novel evidence that acute aerobic exercise induces a hypothalamic-pituitary-adrenal axis response with an increase in the levels of neuropeptide α-MSH in active SLE patients. We speculate that this is an exacerbated adaptive response to exercise stress to avoid further stimulation of proinflammatory cytokines in these patients.
Disclosure of Interest : None declared