Impactos do exercício físico contra resistido de salto em meio aquático em modelo experimental de artrite reumatoide associada à periodontite

Abstract

Introduction: Rheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases that share similar immune-inflammatory mechanisms. The bidirectional relationship between these diseases involves genetic, environmental, and immune inflammatory factors, contributing to systemic exacerbation. Furthermore, not all alterations associated with RA are reversed by pharmacological treatment, and in periodontitis, physical exercise has shown potential as a complementary strategy. In this context, resistance exercise in an aquatic environment emerges as a promising approach due to its potential immunomodulatory effects. Objective: To analyze the impacts of an aquatic resisted jumping exercise protocol as a complementary strategy for minimizing inflammatory, tissue, and functional damage caused by the simultaneous presence of experimentally induced rheumatoid arthritis and periodontitis in Wistar rats. Methodology: Forty-six male Wistar rats were distributed into six groups: control group (CG, n=7), exercise group (EXG, n=8), periodontitis group (PG, n=8), rheumatoid arthritis group (RAG, n=8), periodontitis + rheumatoid arthritis group (PRAG, n=7), periodontitis + rheumatoid arthritis + exercise group (PRAEXG, n=8). RA was induced by inoculation of Freund’s Complete Adjuvant, and periodontitis was induced by ligature placement. Eight assessments of nociceptive threshold and joint diameter were performed. After 22 days, the animals were euthanized, and synovial fluid from the right knee was collected for analysis of total leukocyte count and IL-17. The left hemimandibles and right knee joints were collected and processed for histomorphometric analysis. Results: The RA-induced groups showed an increase in joint diameter, confirming the onset of the disease. However, PRAEXG showed a significant reduction in diameter as early as EV4, whereas the PRAG showed a reduction only starting at EV5. Regarding leukocyte migration, althought there was no statistically significant difference, the PRAG presented a higher number of leukocytes compared to PRAEXG, however, no difference was observed in IL-17 expression. The nociceptive threshold decreased in the RA groups; however, the PRAEXG showed an increase at EV5, whereas the PRAG did not show a significant increase throughout the evaluation period. In the synovial membrane score analysis, the RA groups presented higher scores; however, morphologically, the PRAG showed clusters of inflammatory cells, a feature that was absent in the exercise group. In the histometric of the hemimandibles, the groups with periodontitis showed alveolar bone resorption; however, the PRAEXG presented the lowest value for the distance between the alveolar bone crest and the cementoenemal junction, as well as a lower number of osteoclasts compared to the PRAG group. Conclusion: Although some variables did not show a statistically significant difference, aquatic resisted jumping exercise had positive impacts, particularly in reducing edema and increasing the nociceptive threshold, suggesting its potential as a complementary strategy in the management of these chronic inflammatory conditions.