gms | German Medical Science

Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

Artikel

Artikel empfehlen

Biomechanical stress in the context of competitive sports training triggers enthesitis

Meeting Abstract

Suche in Medline nach

  • David Simon - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Arnd Kleyer - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Sara Bayat - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Johannes Knitza - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Larissa Valor-Méndez - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Marina Schweiger - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Georg Schett - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen
  • Koray Tascilar - Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 – Rheumatology and Immunology, Erlangen; Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Deutsches Zentrum Immuntherapie, Erlangen
  • Axel Hueber - Sozialstiftung Bamberg, Section Rheumatology, Bamberg

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocSpA.32

doi: 10.3205/21dgrh156, urn:nbn:de:0183-21dgrh1565

Veröffentlicht: 14. September 2021

© 2021 Simon et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Introduction: Preclinical models have indicated that biomechanical stress can trigger entheseal inflammation [1]. Furthermore, enthesitis is a hallmark of psoriatic arthritis (PsA) and spondyloarthritis (SpA), suggesting that mechanoinflammation is an important step in their pathogenesis [2]. However, the relation between mechanical stress and enthesitis in humans is poorly investigated. Competitive badminton is a demanding stop-and-go sport that strains entheseal sites in particular and provides an opportunity to assess the impact of physical activity on the development of an instant inflammatory response in the entheses. Our aim in this study was to evaluate the influence of mechanical stress on the development of immediate enthesitis.

Methods: BEAT (Badminton Enthesitis Arthrosonography Study) is an interventional study that assessed entheses in competitive badminton players before and immediately after a 60-minute intensive training session by ultrasound. Power Doppler (PD) signal and Gray-Scale (GS) changes were evaluated at the insertions sites of both Achilles tendon, patellar tendons and lateral humeral epicondyles and quantified using a validated scoring system [3]. Preand post-training scores were compared using linear mixed-effects models. We used interaction terms to assess possible differential effects on patellar, elbow and Achilles entheses.

Results: Thirty-two badminton players (22 men, 10 women) with an average age of 31.1±13.0 years were included (Table 1 [Tab. 1]). On average, they had been playing badminton for 16.2±10.1 years. 192 entheseal sites were examined twice. The respective empirical total scores for PD examination were 0.1 (0.3) before and 0.5 (0.9) after training (Figure 1 [Fig. 1]). Mean total GS scores were 2.9 (2.5) and 3.1 (2.5) before and after training, respectively. The mean total PD score difference of 0.4 between pre- and post -training was significant with a p value of 0.0014, whereas the p value for the mean total GS score difference of 0.2 was 0.63. Overall, seven participants (22%) showed an increased empirical total PD score. A mixed-effects model showed a significant increase of PD scores after training, with a mean increase per site of 0.06 (95%CI 0.01 to 0.12, p=0.017).

Conclusion: Mechanical stress leads to rapid inflammatory responses in the entheseal structures of humans. These data support the concept of mechanoinflammation in diseases associated with enthesitis. However, while such responses may be self-contained in healthy subjects, they may be prolonged and more pronounced in certain risk groups, such as patients with PsA or SpA.

Disclosures: David Simon: NA, Arnd Kleyer: NA, Sara Bayat: NA, Johannes Knitza: NA, Larissa Valor: NA, Marina Schweiger: NA, Georg Schett: NA, Koray Tascilar: NA, Axel Hueber: Novartis Research Grant

Gliederung

References

1.
Cambré I, Gaublomme D, Burssens A, Jacques P, Schryvers N, De Muynck A, Meuris L, Lambrecht S, Carter S, de Bleser P, Saeys Y, Van Hoorebeke L, Kollias G, Mack M, Simoens P, Lories R, Callewaert N, Schett G, Elewaut D. Mechanical strain determines the site-specific localization of inflammation and tissue damage in arthritis. Nat Commun. 2018 Nov;9(1):4613. DOI: 10.1038/s41467-018-06933-4 Externer Link
2.
Schett G, Lories RJ, D’Agostino MA, Elewaut D, Kirkham B, Soriano ER, McGonagle D. Enthesitis: from pathophysiology to treatment. Nat Rev Rheumatol. 2017 Nov;13(12):731-41. DOI: 10.1038/nrrheum.2017.188 Externer Link
3.
Balint PV, Terslev L, Aegerter P, Bruyn GAW, Chary-Valckenaere I, Gandjbakhch F, Iagnocco A, Jousse-Joulin S, Möller I, Naredo E, Schmidt WA, Wakefield RJ, D’Agostino MA; OMERACT Ultrasound Task Force members. Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative. Ann Rheum Dis. 2018 Dec;77(12):1730-5. DOI: 10.1136/annrheumdis-2018-213609 Externer Link