Immune function and Multiple Sclerosis (PHDSC017)

It is now recognised that exercise is beneficial for people with MS and can lead to improvement in symptoms and a reduction in disability. The mechanism by which exercise improves function for people with MS has not been fully elucidated. Exercise training is reported to have an anti-inflammatory effect via modulation of immune parameters and could therefore affect cytokine production and circulation. For example aerobic exercise can reduce plasma levels of IL6 (a pro-inflammatory cytokine). It seems plausible therefore that exercise in MS may reduce the overall inflammatory process associated with pathogenesis and progression of the disease.
As well as reducing levels of pro-inflammatory cytokines more recent evidence has suggested that exercise and physical activity may have a role in maintaining brain health through reducing neuroinflammatory processes and increasing neurodegenerative processes. There is some evidence that the levels of neurotrophins such as Nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) can be altered with exercise although this requires further investigation.
The evidence base to support the benefits of exercise for people with MS is increasing however one of the main criticisms is that most studies exclude people with progressive forms of the disease. The pharmacological options for managing progressive MS are very limited compared to the relapsing forms of the disease and exercise may offer some benefit to this group although there no evidence to support or dispute its effectiveness.
The overall aims of this PhD studentship are to compare the physiological response to exercise in people with MS and healthy controls, to determine the exercise intensity which would provide optimal benefit for people with MS, to examine the effects of this intensity of exercise within an exercise programme and to compare the effects of exercise in people with the relapsing and progressive forms of the disease.