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Movement as medicine

Waking up in the morning with the joint pain, swelling and stiffness that accompanies lupus doesn’t exactly inspire a workout.

But research in mice and a related pilot study in humans are showing how regular activity and stress reduction could lead to better health in the long run.

Lupus, a systemic autoimmune disease, occurs when your body’s immune system attacks its own tissues and organs. The resulting inflammation can affect all different parts of your body, including joints, skin, heart and lungs.

In the Ohio State researchers’ study of lupus mice, they found that moderate exercise (45 minutes of treadmill walking per day) significantly decreased inflammatory damage to the kidneys.

And the researchers think they know why: Several biomarkers known to drive inflammation plummeted in the exercise group.

Wanting to take the study a step further, researchers analyzed those same biomarkers if they exposed the lupus mice to frequent, psychological stress.

The results? Almost exactly the opposite of the exercise findings. The inflammatory biomarkers shot up, which was not good news for mice’s kidneys.

“If we observe similar results in human studies, this could mean that stress reduction and a daily regimen of physical therapy should be considered as interventional strategies to be used alongside current medical treatment,” said Nicholas Young, a research scientist in rheumatology and immunology at Ohio State’s Wexner Medical Center and the study’s senior author.

Previous studies have supported the idea that physical activity is good for lupus patients, but hard scientific evidence explaining why has been scarce, he said.

So, to see if these results might apply to humans, Young’s research team enrolled a group of lupus patients into a daily tai chi program in a small pilot study called the Stress Moderation Impacting Lupus with Exercise (SMILE) study. The classes focused on both moderate exercise and stress reduction.

Group practicing Tai Chi, The Ohio State University

The researchers think they know why: Several biomarkers known to drive inflammation plummeted in the exercise group.

Initial results show a significant decrease in some of the same inflammatory biomarkers identified in the mouse experiments and provided enough supporting evidence that the researchers are seeking funding for a larger human trial, Young said.

“If we find consistent benefits in a large group of people with lupus and can standardize a specific regimen, you could almost imagine a prescription for exercise and stress reduction,” Young said.

The research findings prompt Young to wonder — is there potential for similar exercise-induced benefits for other inflammatory diseases that affect the joints, such as arthritis and gout?

Young said that ongoing work in his laboratory will examine these possibilities.