Exercise Alters Immune Cell Counts in Patients With MS on DMT

Immediately after exercise, people with multiple sclerosis (MS) on different disease-modifying treatments (DMT) showed increased immune cell counts that returned to baseline levels within 1 hour, similar to healthy control subjects. Researchers published their study online in Frontiers in Neurology.

“The magnitude of response seems to depend on the exercise workload,” wrote a team from University Hospital Carl Gustav Carus, Dresden University of Technology, in Germany. “Although our data are limited by a small sample size, our findings indicate that regular blood draws during DMT should be performed after resting for a minimum of 20 minutes in order to avoid invalid blood values, in particular during DMT associated with lymphocytopenia.”

The study included 16 healthy controls and 45 patients with MS. Among the patients, 15 were treated with alemtuzumab, 15 with fingolimod, and 15 with natalizumab. The study investigated the effects of exercise, specifically stair climbing and cycling, on immune cell counts and lymphocyte deformability through the analysis of blood samples collected before and after exercise.

All participants showed an increase in lymphocytes and selected immune cell subsets after exercise, according to the study. Absolute lymphocyte counts and immune cell subsets in patients with lymphopenia treated with alemtuzumab and fingolimod hit just below or within the reference range. In patients with increased lymphocyte counts on natalizumab, the exercise-induced increase was above the upper limit of the reference range.

Lymphocyte deformability was just mildly affected by the different exercise intensity levels, the study found.

“Considering the postulated effects of catecholamines and glucocorticoids on the mechanical properties of leukocytes being linked with cell softening, more pronounced effects of exercise on mechanical properties have been expected,” researchers wrote. “Further studies are needed in order to recapitulate the effect of exercise on cell deformability.”

Reference:
Proschmann U, Shalchi-Amirkhiz P, Andres P, et al. Influence of exercise on quantity and deformability of immune cells in multiple sclerosis. Front Neurol. 2023;14:1148106. doi:10.3389/fneur.2023.1148106