Journal of Atherosclerosis and Thrombosis
Online ISSN : 1880-3873
Print ISSN : 1340-3478
ISSN-L : 1340-3478
Original Articles
Physical Exercise Reduces Cytotoxicity and Up-Regulates Nrf2 and UPR Expression in Circulating Cells of Peripheral Artery Disease Patients: An Hypoxic Adaptation?
Anna Maria Fratta PasiniChiara StranieriAnna Maria RigoniSergio De MarchiDenise PesericoChiara MozziniLuciano CominaciniUlisse Garbin
キーワード: Nrf2, UPR, PAD, Oxidative stress
ジャーナル フリー

2018 年 25 巻 9 号 p. 808-820


Aim: Ischemia-reperfusion (I-R) produces reactive oxygen species (ROS) that damage cells and favour cytotoxicity and apoptosis in peripheral artery disease (PAD) patients. Since brief episodes of I-R (ischemic conditioning) protect cells against ischemic harms, we evaluated whether a short-course of supervised treadmill training, characterized by repeated episodes of I-R, makes peripheral blood mononuclear cells (PBMCs) from PAD patients with intermittent claudication more resistant to I-R injuries by reducing oxidative stress and by inducing an adaptative response of unfolded protein response (UPR) and nuclear factor-E2-related factor (Nrf2) pathway expression.

Methods: 24 PAD patients underwent 21 sessions of treadmill training and a treadmill test as indicator of acute response to I-R.

Results: Maximal and pain free walking distance improved (p<0.01), whereas LDH leakage and apoptosis of PBMCs decreased (p<0.01); plasma malondialdehyde and ROS generation in PBMCs declined, while plasma glutathione augmented (p<0.01). Moreover we demonstrated an up-regulation of UPR and Nrf2 expression in PBMCs (p<0.01). To understand whether treadmill training may act as a trigger of ischemic conditioning, we examined the effect of repeated episodes of I-R on adaptative response in PBMCs derived from the patients. We showed an up-regulation of UPR and Nrf2 gene expression (p<0.01), while oxidative stress and cytotoxicity, after an initial increase, declined (p<0.01). This positive effect on cytotoxicity was reduced after inhibition of UPR and Nrf2 pathways.

Conclusions: Treadmill training in PAD patients through UPR and Nrf2 up-regulation may trigger hypoxic adaptation similar to conditioning, thus modifying cell survival.


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