UNASSIGNED:康复治疗越来越被认为是减少术后并发症的治疗选择。研究运动对细胞机制的有益影响,我们以前已经表明,一次力竭运动能有效刺激内皮祖细胞(与血管维持相关的细胞群,修复,血管生成,和新生血管形成)与较少的术后并发症相关,尽管关于这些细胞的适当细胞表面标志物谱的争论仍在继续(常见的表型定义包括CD45dim,CD133+,CD34+和/或CD31+)。为了将这些发现转化为临床应用,在适当的时间范围内实现功能和细胞益处以加快手术的可行的康复计划是必要的。
UNASSIGNED:本研究的目的是检验以下假设:为期四周的高强度间歇运动训练的康复计划是可行的,增加身体容量(主要结果)和外周血中内皮祖细胞的循环数量。
UNASSIGNED:在此非盲化中,平行组,在2014年12月1日至2016年11月30日期间进行的随机对照概念验证临床试验(德国临床试验登记号:DRKS00000527),计划在科隆大学医院进行腹部剖腹手术的15名女性成年患者被分配到一项运动(n=8,排除1名患者,分析n=7)或非运动组(n=7,排除1名患者,分析n=6)。运动组的干预包括术前四周的高强度间歇训练。在(非)训练阶段之前和之后进行伴随外周血收集的心肺运动测试。通过流式细胞术和基于簇的分析进行细胞研究。
UNASSIGNED:在运动组中,为期四周的高强度间歇训练是可行的(8名患者中有8名成功完成,没有任何伤害),显着改善患者的功能能力(无氧阈值时的摄氧量增加[干预组平均1.71±3.20mL/min/kg与对照组平均-1.83±2.14mL/min/kg;p=0.042]和峰值运动[干预组平均+1.71±1.60mL/min/kgvs.对照组平均-1.67±1.37mL/min/kg;p=0.002]),并且内皮祖细胞的循环数量显着增加(循环CD45池中的CD45dim/CD14dim/CD133/CD309/CD34/CD31亚群比例[p=0.016])。
UNASSIGNED:我们介绍了一种新的康复概念,该概念显示在术前运动的四周内有效刺激内皮祖细胞亚群,作为临床细胞介导的干预措施,旨在减少手术并发症。
未经评估:机构资助。DFG(德国研究基金会,491454339)支持物品加工费。
UNASSIGNED: Prehabilitation is increasingly recognised as a therapeutic option to reduce postoperative complications. Investigating the beneficial effects of exercise on cellular mechanisms, we have previously shown that a single episode of exhaustive exercise effectively stimulates endothelial progenitor cells (a cell population associated with vascular maintenance, repair, angiogenesis, and neovascularization) in correlation with fewer postoperative complications, despite the ongoing debate about the appropriate cell surface marker profiles of these cells (common phenotypical definitions include CD45dim, CD133+, CD34+ and/or CD31+). In order to translate these findings into clinical application, a feasible prehabilitation programme achieving both functional and cellular benefits in a suitable timeframe to expedite surgery is necessary.
UNASSIGNED: The objective of this
study was to test the hypothesis that a four-week prehabilitation programme of vigorous-intensity interval exercise training is feasible, increases physical capacity (primary outcome) and the circulatory number of endothelial progenitor cells within peripheral blood.
UNASSIGNED: In this unblinded, parallel-group, randomised controlled proof-of-concept clinical
trial (German Clinical
Trial Register number: DRKS00000527) conducted between 01st December 2014 and 30th November 2016, fifteen female adult patients scheduled for incontinence surgery with abdominal laparotomy at the University Hospital Cologne were allocated to either an exercise (n = 8, exclusion of 1 patient, analysed n = 7) or non-exercise group (n = 7, exclusion of 1 patient, analysed n = 6). The exercise group\'s intervention consisted of a vigorous-intensity interval training for four weeks preoperatively. Cardiopulmonary Exercise Testing accompanied by peripheral blood collection was performed before and after the (non-)training phase. Cellular investigations were conducted by flow cytometry and cluster-based analyses.
UNASSIGNED: Vigorous-intensity interval training over four weeks was feasible in the exercise group (successful completion by 8 out of 8 patients without any harms), with significant improvements in patients\' functional capacity (increased oxygen uptake at anaerobic threshold [intervention group mean + 1.71 ± 3.20 mL/min/kg vs. control group mean -1.83 ± 2.14 mL/min/kg; p = 0.042] and peak exercise [intervention group mean + 1.71 ± 1.60 mL/min/kg vs. control group mean -1.67 ± 1.37 mL/min/kg; p = 0.002]) and a significant increase in the circulatory number of endothelial progenitor cells (proportionate CD45dim/CD14dim/CD133+/CD309+/CD34+/CD31 + subpopulation within the circulating CD45-pool [p = 0.016]).
UNASSIGNED: We introduce a novel prehabilitation concept that shows effective stimulation of an endothelial progenitor cell subpopulation within four weeks of preoperative exercise, serving as a clinical cell-mediated intervention with the aim to reduce surgical complications.
UNASSIGNED: Institutional funding. DFG (German Research Foundation, 491454339) support for the Article Processing Charge.