Re: Cryogenic Chamber Therapy
Just imagine the results if people would be on the paleo diet...
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Scand J Clin Lab Invest. 2011 Sep;71(5):419-25. Epub 2011 May 16.
The effect of prolonged whole-body cryostimulation treatment with different amounts of sessions on chosen pro- and anti-inflammatory cytokines levels in healthy men.
Lubkowska A, Szyguła Z, Chlubek D, Banfi G.
One of the advantages of whole-body cryostimulation in medicine, rehabilitation, sport and biological renewal is the provocation of systemic physiological responses that lead to a reduction in inflammatory reaction [1]. However, reports on the effects of cryogenic temperatures are often contradictory, mainly due to the differing number of treatments applied during the tests, differing durations of a single treatment, participation of people with various diseases in the study, and the lack of information about changes induced by cryogenic temperature in healthy patients [2–4].
Usually cryostimulations are performed at temperatures from −110°C to −160°C, depending on the available cryochamber. The most frequently used temperature is −130°C, relatively well tolerated by patients; the stimulation may then take from 2.5–3 minutes without complications, e.g. frostbite. Cryostimulation is usually performed once a day for 10 following days, but there is no sufficient information and research showing that this number is the most advantageous. In our previous studies, the most beneficial effects on the lipid profile induced by cryostimulation were observed after the application of 20 daily 3-min treatments [5]. Numerous studies confirm that short-term whole-body cold exposure induces an oxidative stress but does not decrease the antioxidant capacity [6–10]. Additionally it is known that hypothermia inhibits the expression of inflammatory mediators and induces expression of anti-inflammatory cytokines [11–13].
Cold is known to affect leukocyte mobilization, and it is suggested that cold exposure initiates changes in cytokine expression associated with a nonspecific acute phase reaction that could be the affect of multiple interactions between the cytokines and neuroendocrine hormones [14]. Despite a recently growing interest in cryostimulation, relatively little is known about the physiological modulation of the immune system, cytokine expression and their serum concentration by cryogenic temperatures, both as cryostimulation and as a cryotherapy. It seems important to know the influence of repeated exposure to the stress induced by cryogenic temperatures affecting the whole-body of healthy people in order to use this knowledge efficiently in clinical practice. Therefore, the aim of this study was to observe changes in the levels of cytokines under the influence of repeated systemic cryostimulation in young healthy men. In addition, it was examined whether there were differences in response to cryostimulation, depending on the daily number of applied treatments.
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Discussion
Whole-body cryotherapy (WBC) is recommended for patients suffering from arthritis, osteoarthritis, fibromyalgia, acute injury, trauma, chronic pain, and muscle spasms [1,2,15] and is widespread in the biological regeneration and rehabilitation of athletes to improve recovery from muscle injuries [4,16]. Recently we have observed a growing interest in cryostimulation as a method of prevention and treatment of obesity. Most of the aforementioned disorders are accompanied by acute or chronic, clinical or subclinical inflammation. At the same time still very little is known about the modulation of the human immune system, inflammatory mediator response, and cytokine expression and its serum or plasma levels by cryogenic temperatures.
The inflammatory reaction involves cells (migration, adhesion, diapedesis, chemotaxis) and humoral and immune responses associated with the release of C-reactive protein, complement proteins, interleukins, interferon and the synthesis of antibodies [17]. Cytokines, small-molecule proteins with autocrine, paracrine and endocrine action, are involved in the regulation of cell migration, inflammation, proliferation, hematopoiesis, lipolysis, and glucose homeostasis [18–21]. A dynamic balance exists between the proinflammatory cytokines and the anti-inflammatory components of the human immune system, and additionally almost all the anti-inflammatory cytokines, with the exception of a receptor (IL-1ra), have at least some proinflammatory properties [22]. Production of various pro-and and anti-inflammatory cytokines is upregulated rapidly in response to different forms of stress, e.g. exercise [23–27]. In this paper we analysed changes in the level of pro-inflammatory and anti-inflammatory cytokines: IL-1α, IL-1β, TNF-α IL-12, IL-10 and the most important in immunological and cell regulation IL-6, which, although initially considered a pro-inflammatory mediator, is currently recognized mainly as an anti-inflammatory agent [28,29]. In this study it was found that stress induced by exposure to extremely low temperatures causes changes in the level of cytokines in healthy individuals. Particularly interesting is the fact that the increased levels of cytokines involved all the anti-inflammatory ones, most significantly IL-6.
This increase occurs even after the application of only five daily 3-min-long cryostimulations. In our previous studies, we observed increased levels of white blood cells in response to a series of 10 treatments and at the same time we showed that even a single, 3-min-long whole body exposure to cryogenic temperature (−130°C) leads to increased levels of interleukin-6 [30]. This is confirmed in this study. Because during cryostimulations an increase in circulating IL-6 is accompanied only by an increase in anti-inflammatory interleukin IL-10, without an increase in classical pro-inflammatory cytokines (IL-1α, IL-1β and TNF α) the role of IL-6 in this case could be deemed anti-inflammatory. These dependencies resemble those induced by physical effort. It has been noticed that the anti-inflammatory effect of acute exercise displays as an increase in the level of circulating IL-6 with following IL-1ra and IL-10 rise [29]. It indicates that the activation of cytokine cascade after exposure to cryogenic temperatures, for example, during exercise is caused by a mechanism different to that during infection.
The accompanying reduction in the level of a proinflammatory interleukin IL-1α confirms the positive effect of this form of physical treatment and shows advantages of repeated exposure of the human body to low-level stress.
The observed increase in IL-10 may be a consequence of the increased secretion of IL-6. In vivo studies show that the administration recombinant interleukin-6 increases plasma IL-10, which in turn inhibits the release of both proinflammatory cytokines IL-1α, IL-1β, TNFα [31] and chemokines, including IL-8 and macrophage inflammatory protein α (MIP α) from lipopolysaccharides (LPS)-activated human monocytes [32]. Additionally, anti-inflammatory effects of IL-6 are demonstrated by the stimulation of the production of IL-1ra (IL-1 receptor antagonist), the release of soluble TNFα receptors, and down-regulation of the synthesis of IL-1 and TNFα [22,26,30]. Our research confirms earlier reports about no changes in pro-inflammatory interleukins IL-1β and TNFα after cryostimulation [3,15].
Our observations of immunostimulation and the protective action of cryostimulation are consistent with other reports. Banfi et al. [13] shows that whole body cryotherapy leads to an increase in anti-inflammatory interleukin-10 and a decrease in pro-inflammatory interleukin-2 and IL-8. Additionally, this author observed a decrease in sICAM-1 (intercellular adhesion molecule 1) and prostaglandin E2 which intensify the anti-inflammatory response after cryostimulation [16]. It is also known that inflammation leads to an increase in the level of pro- and anti-inflammatory cytokines. A question arises if such low temperatures as a stressogenic factor exacerbate inflammation in the body. It seems that this hypothesis can be rejected, as in such a case the increase would be chronic and significantly higher (2–3 times) [18,26].
IL-6 is produced by monocytes and macrophages, fibroblasts, T and B cells, endothelial cells, adipocytes and in the contracting skeletal muscle. A number of studies demonstrated that following exercise, the basal plasma IL-6 concentration may increase considerably, and the response is sensitive to exercise intensity and the muscle mass involved in the contractile activity [18,24,33]. Initially it was thought that an exercise-induced increase in IL-6 was a consequence of an immune response to local damage in the working muscles but nowadays it is clear that the contracting skeletal muscle per se is the main source of the IL-6 in the circulation in response to physical effort [25,26], and therefore IL-6 can be classified as a myokine [34,35].
Sudden exposure to cold induces physiological responses of the sympathetic nervous system, leading to minimized heat loss and the simultaneous increase in heat production (peripheral vascular spasm, and shivering and non-shivering thermogenesis) [36]. It can therefore be assumed that one of the possible causes of the increase in the aforementioned myokine during cryostimulation is the shivering thermogenesis during cryostimulation, based on involuntary repetitive rhythmic contractions of skeletal muscles. Shivering thermogenesis is activated in the first minutes of exposure to cold, initially in the muscles of the torso and limbs, and is assisted by the secretion of catecholamines [37]. The skeletal muscles do not have to be the only source of elevated IL-6. The adipose tissue may also contribute markedly to IL-6 increase in the circulation even during rest [2]. Additionally IL-6 mRNA levels increase in adipose tissue during exercise [38].
Some reports suggest that approximately 30% of circulating IL-6 comes from adipose tissue and that visceral adipose tissue secretes more IL-6 than subcutaneous adipose tissue [39]. It is recognized that obesity results in the secretion of TNFα, IL-1β and IL-6, and these cytokines are secreted both from adipocytes and macrophages within the adipose tissue bed [2].
There have been some reports about the relationship between BMI and the level of C-reactive proteins (CRP), and between BMI and IL-6 [32,40,41]. In our study, we checked if there were relationships between body weight, BMI and the level of the examined cytokines. The results were very interesting. When examining the initial values and after the series of five treatments, there were no such correlations, but the series of 10 and 20 cryostimulations resulted in the emergence of significant and positive correlations between the levels of IL-6 and IL-12 and BMI. The correlation coefficients between IL-6 and BMI were respectively: r = 0.8 after 10 treatments and r = 0.6 after 20 sessions, correlation between IL-12 and BMI: r = 0.68 and r = 0.64 after 20 stimulations (Table III). This may indicate the role of adipose tissue in the synthesis of these cytokines during exposure to cold. Our earlier studies on the effects of whole-body cryostimulation on lipid profile in healthy subjects have shown that the use of only 10 and most preferably 20 treatments produces beneficial changes in lipid fractions, which were not observed after five treatments [5]. Il-6 is identified as a modulator of fat metabolisms in humans, increasing lypolysis and fat oxidation without causing hypertriacylglycerolemia [42]. As observed in this study, the beneficial effect of cryostimulation – the increased levels of anti-inflammatory cytokines – continued only during the series of cryostimulations, but was not visible 2 weeks after the series of treatments, regardless of their number. The effect of reduced proinflammatory IL-1α, observed during the series of 5, 10 or 20 treatments, was only observed after the end of the series of 20 treatments.
In order to observe the probable delayed effect of cryostimulation, in group A (five treatments) blood was taken after a period of 5 weeks, and in group B (10 treatments) after 4 weeks from the last treatment. At the same time blood was taken 2 weeks after the end of 20 treatments in Group C. Cytokine levels observed in groups A and B nullified assumptions about the long-term delayed effect of cryostimulation. Therefore in accordance with earlier observations, it seems that the series of 20 daily 3-min-long cryostimulations is more advantageous than the routinely used series of 10 treatments.
