IMROVEMENT OF OXIDATIVE DEFENSIVE PATHWAYS AND INFLAMMATION IN PERIPHERAL ARTERY DISEASE AFTER SUPERVISED TRAINING

Recent evidences suggest that exercise training may improve oxidative stress in patients with peripheral arterial disease (PAD) and reduce inflammation. Few data are available on mechanisms involved. Nuclear related factor 2 (Nrf2), regulates the expression of antioxidant enzymes and proteins through the antioxidant response ; Nrf2 is also involved in protection against oxidative stress during the processes of ischemia-reperfusion injury , phenomenon that is elicited during claudication pain. Also monocytes (CD16+) are recognized as an important actor in aterosclerosis expecially for progression of plaques and inflammatory damage. We aimed to evaluate in PAD the effects of controlled exercise training on oxidative stress, Nrf2 gene expression and monocyte subsets.Our study shows that training in PAD patients improves walking time, furthermore it reduces oxidative stress (decrease of MDA) and increases anti-oxidative defensive system enhancing Nrf2-gene expression. The training elicited multiple episodes of ischemia-reperfusion every day and, since Nrf2 is involved in protecting from ischemia-reperfusion injury we can infer that somehow we "trained" also Nrf2 system. The shift of monocytes subtype from an inflammatory to a classic subtype suggests a deep change in inflammation profile of these patients with training.