Inflammatory biomarkers in axial spondyloarthritis and the effect of moderate and high-intensity interval training – a narrative review

Abstract

Rheumatic and musculoskeletal diseases pose a significant and increasing global burden, where axial spondyloarthritis (axSpA) shows a prevalence ranging between 0.2% and 1.6% worldwide. Alongside pharmacological treatments, non-pharmacological exercise interventions are a well-established option for axSpA, offering benefits such as improved disease activity, pain, mobility, and overall quality of life. Moderate-intensity training (MIT) is linked to anti-inflammatory effects, while high-intensity interval training (HIIT) shows promising results for cardiovascular health and to reduce systemic inflammation. Current research emphasizes the need to investigate the effects of MIT and HIIT on inflammation, bone remodeling, and tissue repair. Exercise influences inflammatory biomarkers like C-reactive Protein (CRP), Tumor Necrosis Factor-α (TNF-α), Interleukin-6 (IL-6), and calprotectin, though responses vary by intensity, duration, and disease stage. Further studies are crucial to optimize exercise regimens for axSpA patients by comparing moderate- and high-intensity training concerning their effects on selected blood biomarkers. The aim of this review is to summarize results from studies on specific biomarkers after exercise interventions in individuals with axSpA.