P-017 Impact of yoga intervention on immunosenescence, fertility potential and quality of life in men with Rheumatoid arthritis. (30th June 2022) - Gautam, S
Abstract: Study question: Can a yoga intervention bring about alterations in immune aging, fertility potential and quality of life in men with Rheumatoid arthritis? Summary answer: Yoga not only reduces disease severity, minimizes usage of drugs but also reduces the rate of immune aging and cellular aging. What is known already: The complex mechanism of Rheumatoid arthritis with infertility in men involves interactions between endocrine, immune, and reproductive systems. Association of autoimmunity with dysregulated androgen (hypogonadism) levels may cause transient infertility in men. Furthermore, usage of disease-modifying antirheumatic drugs (DMARDs) like cyclophosphamide, methotrexate, sulphasalazine etc. may result into decreased quantity and quality of sperm, mitochondrial dysfunctions, reduced fertility potential and ultimately permanent infertility. These drugs can cross blood-testis-barrier and induce changes in sperm impairing spermatogenesis. Complementary and alternative medicine like yoga reduces seminal oxidative stress and its consequences like DNA fragmentation in sperm nuclear/mitochondrial genome. Study design, size, duration: Fifty males with RA were enrolled in this 12-week prospective, open-label, single-arm exploratory study, designed to explore the impact of yoga intervention on immunosenescence, fertility potential and quality of life (QoL). Participants/materials, setting, methods: The participants were evaluated for pre (day 0) and post (12 th week) levels of inflammatory markers: IL-6, IL-17A, TGF-β and TNF-α. T cell sub-set populations along with their aged T cell profiles for immunosenescence as well as telomere length and telomerase activity for cellular aging were studied. Seminal reactive oxygen species (ROS), DNA fragmentation index (DFI) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels were estimated as per WHO 2010 guidelines. QoL was measured by WHOQOL-BREF Scale. Main results and the role of chance: There was significant reduction in mean levels of TNF-α, IL-6, IL-17A and elevation in TGF-β after 12 weeks. A significant reduction was seen in seminal ROS levels, 8-OHdG and DFI as well. There was a significant decline in aged T cell populations after yoga. There was no change seen in the telomere length but there was an improvement in the telomerase activity. The participants showed significant improvements in QoL after 12 weeks. Limitations, reasons for caution: Compliance of patients for Yoga intervention was poor, hence we enrolled large number of patients to achieve the desirable sample size. Wider implications of the findings: Adoption of yoga intervention holds the key to maintaining immune homeostasis, reduction of inflammation, reduction in the rate of cellular aging, improved overall QoL, and its associated consequences associated with physical, mental, and reproductive health. Trial registration number: N/A