Mucosal microbiota and gene expression are associated with long-term remission after discontinuation of adalimumab in ulcerative colitis.

Given that sustained remission is the ultimate treatment goal in the management of patients with ulcerative colitis (UC), the decision to stop anti-tumor necrosis factor (anti-TNF) treatment in UC patients is difficult. The aim of this study was to evaluate mucosal microbiota and gene expression profiles associated with long-term remission after discontinuation of anti-TNF therapy. In nine UC patients who received anti-TNF therapy for 6 months, microbiota isolated from uninflamed mucosae and gene expression in inflamed and uninflamed mucosae were investigated at week 0 and at week 24. At treatment initiation, Fusobacterium sp. and Veillonella dispar were over-represented in the relapse group compared with the non-relapse group. After treatment, Dorea sp. and Lachnospira sp. were over-represented in the non-relapse group. In the relapse group only, a significant shift in gut bacterial community composition was found between week 0 and week 24. Gene expression of ALIX (PDCD6IP) and SLC9A3 was significantly higher in the non-relapse group than in the relapse group. Lastly, we used machine learning methods to identify relevant gene signatures associated with sustained remission. Statistical analyses of microbiota and expression profiles revealed differences between UC patients who did or did not keep remission after the discontinuation of TNF inhibitors.Trial registration: UMIN000020785: Evaluation of adalimumab therapy in mesalazine-resistant or -intolerant ulcerative colitis; an observational study (EARLY study).

Effects of hydraulic-resistance exercise on strength and power in untrained healthy older adults.

The purpose of this study was to determine the efficacy of hydraulic-resistance exercise (HDRE) in improving strength and power in healthy older adults. Thirty-nine older adults (68.6 ± 4.9 years; 15 men, 24 women) were divided into a training group or control group (CON). Hydraulic-resistance exercise consisted of a 12-week supervised program, 50 min · d(-1), 3 d · wk(-1). Hydraulic-resistance exercise was used for 10 exercises: Chest press and pull, shoulder press and pull, low back flexion and extension squat, leg adduction/abduction, leg press, and elbow extension/flexion. The number of the sets and the hydraulic-resistance dial setting (D) were gradually increased in 3 stages during the 12-week program. Strength, rating of perceived exertion, and relative intensity during exercise increased significantly from stage to stage whereas repetition velocity decreased. Total work was higher in the second stage compared with the first but lower in the final stage because of reduced repetitions. Peak torque at D2 and D11 increased (p < 0.05) for knee extension (58 and 9%) and flexion (94 and 21%), chest press (35 and 12%) and pull (29 and 14%), shoulder press (14 and 18%) and pull (75 and 18%), and low back flexion (59 and 46%) and extension (84 and 34%). Peak power at D2 and D11 also increased (p < 0.05) for knee extension (140 and 26%) and flexion (96 and 36%), chest press (54 and 28%) and pull (62 and 23%), shoulder press (55 and 31%) and pull (159 and 30%), and low back flexion (177 and 127%) and extension (104 and 66%). There were no significant changes in the CON. Hydraulic-resistance exercise elicits significant improvements in strength and power in older adults. Therefore, HDRE is an effective form of resistance training that provides benefits using low and moderate intensity of training for older adults.

Effects of the muscle pump and body posture on cardiovascular responses during recovery from cycle exercise.

The purpose of the study was to characterize the effects of muscular contractions (the muscle pump) and body posture on cardiovascular responses during recovery from moderate exercise in the upright-sitting or supine positions. Heart rate (HR), stroke volume (SV), and cardiac output (CO) were measured in seven young male subjects at rest and during 10-min of cycle exercise at 60% of peak oxygen uptake (VO2peak). This was followed by either complete rest for 5 min (inactive recovery) or cycling at VO2peak for 5 min (active recovery) in the upright or supine positions. In the upright position, an initial rapid decrease in HR was followed by a gradual decrease in HR, and this response was similar when comparing inactive and active recoveries. Upright SV during inactive recovery decreased gradually to the pre-exercise resting level, whereas upright SV during active recovery remained significantly elevated. In contrast, in the supine position, the HR during active recovery decreased, but remained significantly higher than that during inactive recovery. Changes in supine SV were similar when comparing inactive and active recovery. Thus, maintenance of SV and HR resulted in significantly greater CO during active recovery than during inactive recovery, regardless of body position. HR was greater during supine active-recovery than during supine inactive-recovery, and there was no difference in SV. These data suggest that the muscle pump is less important in facilitating venous return and vagal resumption in the supine position as compared to the upright position.

Effect of concurrent aerobic and resistance circuit exercise training on fitness in older adults.

The purpose of this study was to determine the physiological effects of a programmed accommodating circuit exercise (PACE) program consisting of aerobic exercise and hydraulic-resistance exercise (HRE) on fitness in older adults. Thirty-five volunteers were randomly divided into two groups [PACE group (PG) 8 men and 10 women, 68.3 (4.9) years, and non-exercise control group (CG) 7 men and 10 women, 68.0 (3.4) years). The PG participated in a 12-week, 3 days per week supervised program consisting of 10 min warm-up and 30 min of PACE (moderate intensity HRE and aerobic movements at 70% of peak heart rate) followed by 10 min cool-down exercise. PACE increased ( P<0.05) oxygen uptake ( V(.)O(2)) at lactate threshold [PG, pre 0.79 (0.20) l min(-1), post 1.02 (0.22) l min(-1), 29%; CG, pre 0.87 (0.14) l min(-1), post 0.85 (0.15) l min(-1), -2%] and at peak V(.)O(2) [PG, pre 1.36 (0.24) l min(-1), post 1.56 (0.28) l min(-1), 15%; CG, pre 1.32 (0.29) l min(-1), post 1.37 (0.37) l min(-1), 4%] in PG measured using an incremental cycle ergometer. Muscular strength evaluated by a HRE machine increased at low to high resistance dial settings for knee extension (9-52%), knee flexion (14-76%), back extension (18-92%) and flexion (50-70%), chest pull (6-28%) and press (3-17%), shoulder press (18-31%) and pull (26-85%), and leg press (21%). Body fat (sum of three skinfolds) decreased (16%), and high-density lipoprotein cholesterol (HDLC) increased (10.9 mg dl(-1)) for PG. There were no changes in any variables for CG. These results indicate that PACE training incorporating aerobic exercise and HRE elicits significant improvements in cardiorespiratory fitness, muscular strength, body composition, and HDLC for older adults. Therefore, PACE training is an effective well-rounded exercise program that can be utilized as a means to improve health-related components of fitness in older adults.

Water-based exercise improves health-related aspects of fitness in older women.

PURPOSE: The purpose of this study was to determine the physiological responses of elderly women to a well-rounded exercise program performed in water (WEX). METHODS: The participants (60-75 yr of age) were randomly divided into a training (TR) group (N = 15) and a control group (N = 15). The TR group participated in a 12-wk supervised WEX program, 70 min x day(-1), 3 d x wk(-1). The WEX consisted of 20 min of warm-up and stretching exercise, 10 min of resistance exercise, 30 min of endurance-type exercise (walking and dancing), and 10 min of cool-down exercise. RESULTS: The WEX led to an increase (P < 0.05) in peak VO2 (12%) and VO2 at lactate threshold (20%). Muscular strength evaluated by a hydraulic resistance machine increased significantly at resistance dial setting 8 (slow) for knee extension (8%), knee flexion (13%), chest press (7%) and pull (11%), shoulder press (4%) and pull (6%), and back extension (6%). Vertical jump (9%), side-stepping agility (22%), trunk extension (11%), and FEV1.0 (7%) also increased significantly. There was a significant decrease in skin-fold thickness (-8%), low-density lipoprotein (LDL) cholesterol (-17%), and total cholesterol (-11%). There were no significant changes in these variables in the control group. CONCLUSION: These results indicate that WEX elicits significant improvements in cardiorespiratory fitness, muscular strength, body fat, and total cholesterol in older adult women. Water-based exercise appears to be a very safe and beneficial mode of exercise that can be performed as part of a well-rounded exercise program.

Influence of cool-down exercise on autonomic control of heart rate during recovery from dynamic exercise.

The recovery of post-exercise heart rate (HR) is enhanced by a procedure of cooling down; however, the mechanism of this facilitated reduction is unknown. To determine whether more cardiac vagal reactivation is associated with a decrease in HR following cool-down exercise, we examined high-frequency R-R interval variability (HF, 0.15-0.40 Hz), an index of cardiac vagal tone, in six young healthy male subjects with a comparison between sitting rest after 6 minutes of cool-down cycling at 20% peak oxygen uptake (VO2peak) and sitting complete rest, following 5 min of upright cycle exercise at 70% VO2peak. During the last minute of exercise, there was no difference in HR between the two exercise tests before performing or not performing cool-down exercise (mean +/- SE, 148.7 +/- 6.9 versus 149.7 +/- 7.0 beats/min, respectively, by a Wilcoxon signed-ranks test). After exercise, a similar initial rapid decrease in HR and subsequent decline was observed during the first 6 min of recovery, regardless of cool-down exercise. However, the resting HR average following cool-down exercise was significantly lower than the corresponding HR without cool-down exercise (92.1 +/- 3.0 versus 100.8 +/- 3.6 beats/min, P < 0.05). The corresponding HF amplitude was slightly, but significantly greater with than without cool-down exercise (10.6 +/- 2.2 versus 9.0 +/- 1.9, P < 0.05). Thus the increase in HF amplitude corresponded to a decrease in resting HR following cool-down exercise, as compared to complete rest without cool-down exercise. Therefore, we conclude that after moderate exercise, the decrease in resting HR following cool-down exercise is associated with an increase in cardiac vagal tone.