RESUMO
Functionally limiting health conditions have a high rate of prevalence worldwide and incur a significant amount of economic burden. Physical activity (PA) can prevent the onset of these conditions and alleviate economic burden by reducing symptoms, but a large portion of these individuals do not engage in health enhancing PA. Consumer wearable physical activity monitors (WPAM) are tools that have become increasingly popular within the past few years and could provide a means to improve PA levels for individuals with health conditions that cause functional limitations. This review reports on the validity of PA outcomes, feasibility and utility, and intervention/promotion effectiveness for consumer WPAM in functionally limited clinical populations. 2250 records from January 2018 to July 2021 were retrieved from PubMed, Web of Science, SPORTDiscus and CINAHL with 656 records being duplicates and 23 records passing a full-text article review. Studies included within the review looked at individuals with osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, multiple sclerosis, Parkinson's disease, ischemic stroke and peripheral arterial disease. The most popular brand of consumer WPAM was Fitbit. Validation studies for consumer WPAM were primarily focused on step counts showing overestimations for daily step counts and over- and under-estimations occurring within shorter time durations depending on step cadence. Wrist worn WPAM are the most feasible for functionally limited clinical populations with widespread utilization for associating clinically relevant outcomes with PA levels but they have limited validation to confirm their accuracy and precision in measurement. Interventions included used a mixture of a WPAM and other behavior change techniques to improve PA levels for clinical populations and show promising effectiveness. Future work is warranted on determining the validity of PA outcomes from WPAM determined to be feasible in select clinical populations and creating interventions looking at which features of a consumer WPAM intervention promote PA.
RESUMO
Innate immune cells are integral to the pathogenesis of several diseases of the central nervous system (CNS), including multiple sclerosis (MS). Dendritic cells (DCs) are potent CD11c+ antigen-presenting cells that are critical regulators of adaptive immune responses, particularly in autoimmune diseases such as MS. The regulation of DC function in both the periphery and CNS compartment has not been fully elucidated. One limitation to studying the role of CD11c+ DCs in the CNS is that microglia can upregulate CD11c during inflammation, making it challenging to distinguish bone marrow-derived DCs (BMDCs) from microglia. Selective expression of microRNAs (miRNAs) has been shown to distinguish populations of innate cells and regulate their function within the CNS during neuro-inflammation. Using the experimental autoimmune encephalomyelitis (EAE) murine model of MS, we characterized the expression of miRNAs in CD11c+ cells using a non-biased murine array. Several miRNAs, including miR-31, were enriched in CD11c+ cells within the CNS during EAE, but not LysM+ microglia. Moreover, to distinguish CD11c+ DCs from microglia that upregulate CD11c, we generated bone marrow chimeras and found that miR-31 expression was specific to BMDCs. Interestingly, miR-31-binding sites were enriched in mRNAs downregulated in BMDCs that migrated into the CNS, and a subset was confirmed to be regulated by miR-31. Finally, miR-31 was elevated in DCs migrating through an in vitro blood-brain barrier. Our findings suggest miRNAs, including miR-31, may regulate entry of DCs into the CNS during EAE, and could potentially represent therapeutic targets for CNS autoimmune diseases such as MS.
