Influence of an Exergaming Training Program on Reducing the Expression of IL-10 and TGF-β in Cancer Patients

Ricardo da Silva Alves, Douglas Reis Abdalla, Denise Hollanda Iunes, Karina Oliveira Prado Mariano, Juliana Bassalobre Carvalho Borges, Eddie Fernando Cândido Murta, Márcia Antoniazi Michelin, Leonardo César Carvalho, Ricardo da Silva Alves, Douglas Reis Abdalla, Denise Hollanda Iunes, Karina Oliveira Prado Mariano, Juliana Bassalobre Carvalho Borges, Eddie Fernando Cândido Murta, Márcia Antoniazi Michelin, Leonardo César Carvalho

Abstract

Objective: To evaluate the effect of exergaming in the plasma levels of adipokines (interleukin [IL]-1β, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]), Th1 (IL-2, IL-12, and interferon gamma [IFN-γ]), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and regulatory T (Treg) (IL-10 and transforming growth factor-beta [TGF-β]) in cancer patients undergoing treatment. Materials and Methods: We conducted a quasi-experimental control clinical trial using exergaming in all groups through the Xbox 360 Kinect™. The game used in this study was called Your Shape Fitness Evolved 2012. The volunteer participants played the game two to three times per week, for a total of 20 sessions. Forty-five volunteer participants were divided into 3 groups: cancer patients undergoing chemotherapy and/or radiotherapy treatment (chemotherapy and/or radiotherapy group CRG; n = 15); cancer patients who finished chemotherapy and/or radiotherapy treatment (cancer accompaniment group CAG; n = 15); and the control group (volunteers without a cancer diagnosis CG; n = 15). In the pre- and post-training period, all volunteers submitted to blood collection procedures using the enzyme-linked immunosorbent assay (ELISA). This test was used to obtain the levels of adipokines expression (IL-1β, IL-6, IL-8, and TNF-α) and the cytokine profiles Th1 (IL-2, IL-12, and IFN-γ), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and Treg (IL-10 and TGF-β). Results: After exergaming, the CRG showed significant reductions in proinflammatory cytokines (IL-6: P < 0.05; IL-10: P = 0.038; TGF-β: P = 0.049) and for CAG (IL-10: P = 0.034), as well as a reduction in the expression of cytokines related to the action of T lymphocytes. Conclusion: Exergaming promoted changes in the expression of cytokine profiles IL-6, IL-10, and TGF-β, which correlated with the action profiles of CD4+ T lymphocytes.

Keywords: Adipokines; Cancer; Cytokines; Exergaming; Rehabilitation.

Figures

FIG. 1.
FIG. 1.
Representation of the values expressed as mean and SEM of inflammatory cytokines in peripheral blood, IL-1β (A); IL-6 (B); IL-8 (C), and TNF-α (D). *P < 0.05 versus CRG pre-training. CAG, cancer accompaniment group; CG, control group; CRG, chemotherapy and/or radiotherapy group; IL, interleukin; SEM, standard error of the mean; TNF-α, tumor necrosis factor-alpha.
FIG. 2.
FIG. 2.
Representation of the values of mean and SEM of Treg profile cytokine concentrations before and after the training protocol with exergames. (A) IL-10 concentrations in the different experimental groups. (B) TGF-β concentrations. *P < 0.05 versus CRG post-training; **P < 0.01 versus CAG post-training. TGF-β, transforming growth factor-beta; Treg, regulatory T.
FIG. 3
FIG. 3
Left: Representation of concentration mean values on a logarithmic scale of the behavior of cytokine concentrations in the response profiles of CD4 T lymphocytes, comparing the moments before and after training protocol with exergaming. (A) CG; (B) CRG; (C) CAG. Right: Heat map representation of the behavior of cytokines related to the performance profiles of CD4 T lymphocytes. Evidence of alteration in the intensity pattern of the concentration averages after the training protocol with exergaming, highlighting a balance between the Th1 and Treg profiles.

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