اثر 12 هفته تمرین هوازی با شدت متوسط بر تعادل Th1/Th2 در سه ماه دوم بارداری

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد فیزیولوژی ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شهید مدنی آذربایجان، تبریز، ایران.

2 دانشیار فیزیولوژی ورزشی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه شهید مدنی آذربایجان، تبریز، ایران.

3 استادیار علوم تغذیه، مرکز تحقیقات طب فیزیکی و توانبخشی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: اختلال ایمونولوژیکی و عدم تعادل سلول‌های Th1و Th2 در زنان باردار می‌تواند منجر به پیامدهای مضر بارداری گردد. اثر تمرین ورزشی در تغییر تعادل سلول‌های ایمنی در دوران بارداری نامشخص است، لذا مطالعه حاضر با هدف بررسی اثر 12 هفته تمرین هوازی شدت متوسط بر تعادل (IL-4/ IFN-γ) Th1/Th2 در سه ماه دوم بارداری انجام شد.
روشکار: این مطالعه نیمه تجربی در سال 1401 بر روی 30 زن باردار 35-20 ساله، با مدت بارداری 15-12 هفته در شهر تبریز انجام شد. افراد به‌صورت تصادفی در دو گروه تمرین و کنترل قرار گرفتند. تمرین هوازی طبق توصیه‌های کالج آمریکایی زنان و زایمان با شدت متوسط (14-12 امتیاز بورگ) به‌مدت 12 هفته، 3 جلسه در هفته و هر جلسه 45 دقیقه اجرا شد. متغیرهای وزن، فشارخون، ضربان قلب و سطوح سرمیIL-4 ، IFN-γ قبل و بعد از پروتکل تمرینی ارزیابی شدند. تجزیه و تحلیل داده­ ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) و آزمون‌ آنکوا انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: بر اساس نتایج، افزایش وزن گروه تمرین در مقایسه با گروه کنترل به‌طور معناداری کمتر بود (027/0=p). متوسط فشارخون شریانی (019/0=p) و IFN-γ (025/0=p) در گروه تمرین در مقایسه با گروه کنترل کاهش معناداری یافتند، ولی IL-4 و نسبت Th1/Th2 تفاوت معناداری نشان ندادند (05/0<p).
نتیجه­ گیری: در مجموع تمرین هوازی با شدت متوسط ممکن است روشی مفید در ارتقای سلامتی مادران در دوره دوم بارداری باشد، ولی با توجه به مطالعات محدود و نتایج متناقض، به‌نظر می­ رسد که اثر تمرین ورزشی بر تعادل Th1/Th2 در سه دوره مختلف بارداری نیاز به بررسی­ های بیشتری داشته باشد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effect of 12 Weeks Moderate Intensity Aerobic Exercise Training on Th1/Th2 Balance in the Second Trimester of Pregnancy

نویسندگان [English]

  • mahsa zohouri 1
  • Azam Zarneshan 2
  • Azizeh Farshbaf Khalili 3
1 M.Sc. student of Sport Physiology, School of Educational Sciences and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran.
2 Associate Professor, Department of Sport Physiology, School of Educational Sciences and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran.
3 Assistant Professor, Department of Nutritional Sciences, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Immunological dysfunctions and imbalance of Th1 and Th2 cells in pregnant women can lead to adverse pregnancy outcomes. The effect of exercise training in changing immune-cell distribution during pregnancy is unclear. Therefore, this study was performed with aim to investigate the effect of 12 weeks moderate-intensity aerobic exercise training (AET) on Th1/Th2 (IFN-γ/IL-4) balance in the second trimester of pregnancy.
Methods: This semi-experimental study was conducted in 2022 on 30 pregnant women aged 20 to 35 years, with gestational age 12 to 15 weeks in Tabriz city. The subjects were randomly divided into two exercise and control groups. AET were performed according to the recommendations of the American College of Obstetricians and Gynecologists with moderate intensity (12-14 Borg RPE) for 12 weeks, 3 sessions per week and each session 45 min. The variables of weight, blood pressure, heart rate and serum levels of IL-4, IFN-γ were evaluated before and after the exercise protocol. The data were evaluated by SPSS software (version 25) and ANCOVA test. P<0.05 was considered statistically significant.
Results: According to the results, the weight gain of the exercise group was significantly lower compared to the control group (P=0.027). Mean arterial blood pressure (P=0.019) and IFN-γ (P=0.025) were significantly decreased in the exercise group compared to the control group, but IL-4 and Th1/Th2 ratio did not show any significant difference (P>0.05).
Conclusion: In general, moderate intensity AET may be a safe way to improve the health of mothers in the second trimester of pregnancy, but considering limited studies and conflicting results, it seems that the effect of exercise training on Th1/Th2 balance in three different periods of pregnancy needs more investigations.

کلیدواژه‌ها [English]

  • Aerobic Exercise
  • IFN-γ
  • IL-4
  • Th1-Th2 balance
  • Pregnancy
  1. Morelli SS, Mandal M, Goldsmith LT, Kashani BN, Ponzio NM. The maternal immune system during pregnancy and its influence on fetal development. Research and Reports in Biology 2015: 171-89.
  2. Wang W, Sung N, Gilman-Sachs A, Kwak-Kim J. T helper (Th) cell profiles in pregnancy and recurrent pregnancy losses: Th1/Th2/Th9/Th17/Th22/Tfh cells. Frontiers in immunology 2020; 11:2025.
  3. Kuroda K, Nakagawa K, Horikawa T, Moriyama A, Ojiro Y, Takamizawa S, et al. Increasing number of implantation failures and pregnancy losses associated with elevated Th1/Th2 cell ratio. American Journal of Reproductive Immunology 2021; 86(3):e13429.
  4. Meng S, Zhang T, Li C, Zhang X, Shen H. Immunoregulatory therapy improves reproductive outcomes in elevated Th1/Th2 women with embryo transfer failure. BioMed Research International 2022; 2022.
  5. Reinhard G, Noll A, Schlebusch H, Mallmann P, Ruecker AV. Shifts in the TH1/TH2 balance during human pregnancy correlate with apoptotic changes. Biochemical and biophysical research communications 1998; 245(3):933-8.
  6. Casey S, Carter M, Looney AM, Livingstone V, Moloney G, O’Keeffe GW, et al. Maternal mid-gestation cytokine dysregulation in mothers of children with autism spectrum disorder. Journal of Autism and Developmental Disorders 2021: 1-14.
  7. Goines PE, Croen LA, Braunschweig D, Yoshida CK, Grether J, Hansen R, et al. Increased midgestational IFN-γ, IL-4 and IL-5 in women bearing a child with autism: a case-control study. Molecular autism 2011; 2:1-11.
  8. Carter M, Casey S, O’Keeffe GW, Gibson L, Murray DM. Mid-gestation cytokine profiles in mothers of children affected by autism spectrum disorder: a case–control study. Scientific Reports 2021; 11(1):22315.
  9. Chatterjee P, Chiasson VL, Bounds KR, Mitchell BM. Regulation of the anti-inflammatory cytokines interleukin-4 and interleukin-10 during pregnancy. Frontiers in immunology 2014; 5:253.
  10. Szukiewicz D. Cytokines in placental physiology and disease. Mediators of inflammation. 2012; 2012.
  11. Qian Y, Pei Y, Jiang W, Zheng C. Astilbin improves pregnancy outcome in rats with recurrent spontaneous abortion by regulating Th1/Th2 balance. Immunopharmacology and Immunotoxicology 2022; 44(5):663-70.
  12. Sykes L, MacIntyre DA, Yap XJ, Ponnampalam S, Teoh TG, Bennett PR. Changes in the Th1: Th2 Cytokine Bias in Pregnancy and the Effects of the Anti-Inflammatory Cyclopentenone Prostaglandin 15-Deoxy--Prostaglandin. Mediators of inflammation 2012; 2012.
  13. Birsner ML, Gyamfi-Bannerman C. Physical activity and exercise during pregnancy and the postpartum period ACOG committee opinion summary, number 804. Obstetrics and gynecology 2020; 135(4):E178-88.
  14. Zarneshan A, Salehzadeh K, Ghorbanian B, Sharabiani S, Shirpour S. The Role of Exercise Indices on Menstrual Dysfunctions inFemale College Athletes. The Iranian Journal of Obstetrics, Gynecology and Infertility 2013; 16(46):20-7.
  15. Zarneshan A, Gholamnejad M. Moderate aerobic exercise enhances the th1/th2 ratio in women with asthma. Tanaffos 2019; 18(3):230.
  16. Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Liu RT, et al. Regular Tai Chi Chuan exercise improves T cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production. British journal of sports medicine 2009; 43(11):845-50.
  17. Supriya R, Gao Y, Gu Y, Baker JS. Role of exercise intensity on Th1/Th2 immune modulations during the COVID-19 pandemic. Frontiers in immunology 2021; 12:761382.
  18. Xiang L, Rehm KE, Marshall Jr GD. Effects of strenuous exercise on Th1/Th2 gene expression from human peripheral blood mononuclear cells of marathon participants. Molecular immunology 2014; 60(2):129-34.
  19. Mohammady M, Janani L. Randomization in randomized clinical trials: From theory to practice. Hayat 2016; 22(2):102-14.
  20. Wang R, Liu J, Chen P, Yu D. Regular Tai Chi exercise decreases the percentage of type 2 cytokine–producing cells in postsurgical non–small cell lung cancer survivors. Cancer nursing 2013; 36(4):E27-34.
  21. Ziaei S, Kazemnejad A. Relationship between body mass index and preterm delivery before and during pregnancy. Zahedan Journal of Research in Medical Sciences 2011; 12(5).
  22. Seo WH, Choi BM, Lee H, Yoo Y, Choung JT, Han Y. Effect of the prenatal maternal environments and diets on cord blood interleukin-4 and interferon-gamma: a pilot study. Asian Pacific Journal of Allergy and Immunology 2017; 35(1).
  23. Nasiri Âmiri F, Âqajani Delavar M, Mohamadpour RA. The midtrimester mean arterial pressure in the prediction of pre-eclampcia. Journal of Mazandaran University of Medical Sciences 2004; 14(45):67-73.
  24. Zarneshan A, Zolfaghari M, Gholamnejad M, Yousefi M. Effect of Regular Aerobic Exercise on Serum Levels of IL-4 and IgE in Overweight and Obese Asthmatic Women. Journal of Arak University of Medical Sciences 2017; 20(8):73-82.
  25. Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The physical activity guidelines for Americans. Jama 2018; 320(19):2020-8.
  26. SH N. Effect of period of high intensity interval training on serum IL-4 in schizophrenic male. Journal of Torbat Heydariyeh University of Medical Sciences 2022; 9(3):13-21.
  27. Shakoor E, Salesi M, Jahromi MK, Sadeghi H, Karimi MH, Yusof A. The effect of exercise on interferon gamma, body fat and bmi of kidney transplant patients. Revista Brasileira de Medicina do Esporte 2018; 24:333-7.
  28. Zhao G, Zhou S, Davie A, Su Q. Effects of moderate and high intensity exercise on T1/T2 balance. Exercise immunology review 2012; 18.
  29. Babazadeh B. Effects of morning exercise training in fasted vs carbohydrate intake on serum levels of cortisol, testosterone and some cardiovascular risk factors. Journal of Applied Health Studies in Sport Physiology 2021; 8(2):10-7.
  30. Corazza DI, Sebastião É, Pedroso RV, Andreatto CA, de Melo Coelho FG, Gobbi S, et al. Influence of chronic exercise on serum cortisol levels in older adults. European Review of Aging and Physical Activity 2014; 11(1):25-34.
  31. Alghadir AH, Gabr SA, Aly FA. The effects of four weeks aerobic training on saliva cortisol and testosterone in young healthy persons. Journal of physical therapy science 2015; 27(7):2029-33.
  32. Kargarfard M, Afrasyabi S. The effects of 12-weeks aerobic exercise on catecholamine’s levels, and cardiorespiratory fitness in children with attention deficit hyperactivity disorder. Sport Physiology 2015; 7(26):113-26.
  33. Yousefi B, Baradaran R, Mokhtari T, Semnani V, Sameni H. Maternal aerobic running during mid or late gestation improves the quality of oogenesis and folliculogenesis in the ovary of neonatal rats: An experimental study. International Journal of Reproductive BioMedicine 2021; 19(9):811.
  34. Shahidi RM, ASKARI R, Hosseini KS. The Effect of 8 Weeks of Resistance Training on Changes in IL4, IL17 and Muscle Strength in Women with Multiple Sclerosis; 2020: 365-77.
  35. Conroy SM, Courneya KS, Brenner DR, Shaw E, O'Reilly R, Yasui Y, et al. Impact of aerobic exercise on levels of IL‐4 and IL‐10: results from two randomized intervention trials. Cancer medicine 2016; 5(9):2385-97.
  36. Acosta-Manzano P, Coll-Risco I, Van Poppel MN, Segura-Jiménez V, Femia P, Romero-Gallardo L, et al. Influence of a concurrent exercise training intervention during pregnancy on maternal and arterial and venous cord serum cytokines: The GESTAFIT project. Journal of Clinical Medicine 2019; 8(11):1862.
  37. Zar A, Ebrahim K, Hovanloo F, Amani D. Effects of an 8-week endurance training course on changes in interferon gamma and leukocyte subsets. Journal of Isfahan Medical School 2012; 30(185).
  38. Jahromi AS, Zar A, Ahmadi F, Krustrup P, Ebrahim K, Hovanloo F, et al. Effects of endurance training on the serum levels of tumour necrosis factor-α and interferon-γ in sedentary men. Immune network 2014; 14(5):255-9.
  39. Jijon H, Ueno A, Sharifi N, Leung Y, Ghosh S, Seow CH. Elevated interferon-gamma levels during pregnancy are associated with adverse maternofetal outcomes in IBD. Gut 2020; 69(10):1895-7.
  40. Halonen M, Lohman IC, Stern DA, Spangenberg A, Anderson D, Mobley S, et al. Th1/Th2 patterns and balance in cytokine production in the parents and infants of a large birth cohort. The Journal of Immunology 2009; 182(5):3285-93.
  41. Sasayama D, Kurahashi K, Oda K, Yasaki T, Yamada Y, Sugiyama N, et al. Negative correlation between serum cytokine levels and cognitive abilities in children with autism spectrum disorder. Journal of Intelligence 2017; 5(2):19.
  42. Jones KL, Croen LA, Yoshida CK, Heuer L, Hansen R, Zerbo O, et al. Autism with intellectual disability is associated with increased levels of maternal cytokines and chemokines during gestation. Molecular psychiatry 2017; 22(2):273-9.
  43. Dozmorov MG, Bilbo SD, Kollins SH, Zucker N, Do EK, Schechter JC, et al. Associations between maternal cytokine levels during gestation and measures of child cognitive abilities and executive functioning. Brain, behavior, and immunity 2018; 70:390-7.
  44. Djuardi Y, Supali T, Wibowo H, Heijmans BT, Deelen J, Slagboom EP, et al. Maternal and child cytokine relationship in early life is not altered by cytokine gene polymorphisms. Genes & Immunity 2016; 17(7):380-5.
  45. Hansen-Pupp I, Harling S, Berg AC, Cilio C, Hellström-Westas L, Ley D. Circulating interferon-gamma and white matter brain damage in preterm infants. Pediatric research 2005; 58(5):946-52.
  46. Langer-Gould A, Gupta R, Huang S, Hagan A, Atkuri K, Leimpeter AD, et al. Interferon-γ–producing t cells, pregnancy, and postpartum relapses of multiple sclerosis. Archives of neurology 2010; 67(1):51-7.
  47. Huang LY, Chiu CJ, Hsing CH, Hsu YH. Interferon family cytokines in obesity and insulin sensitivity. Cells 2022; 11(24):4041.
  48. Mahalehi SJ, Ziaei S, Kazemnejad A. Relations between the Mother’s Body Mass Index and the Trend of Mother’s Weight Gain with IUGR. Avicenna Journal of Nursing and Midwifery Care 2009; 17(12):67-77.