Research Topic

Role of The Immune System in The Processes that Regulate Rehabilitation: Restitutio ad Integrum

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Physical and Rehabilitation Medicine, or Physiatry, is the primary medical specialty responsible for the prevention, medical diagnosis, treatment and rehabilitation management of persons with debilitating health conditions and their co-morbidities. It specifically addresses their impairments and activity ...

Physical and Rehabilitation Medicine, or Physiatry, is the primary medical specialty responsible for the prevention, medical diagnosis, treatment and rehabilitation management of persons with debilitating health conditions and their co-morbidities. It specifically addresses their impairments and activity limitations in order to facilitate physical and cognitive functioning. The field of intervention of rehabilitation medicine includes cardiovascular, respiratory, musculoskeletal, neurological and pediatric diseases and cancer. Moreover, with the observed aging of population in western world, physiatrists often deal with complex patients, that present co-morbidities. Clinical evidence supports the use of various kinds of exercise training, i.e. aerobic, neuromuscular and strengthening exercises, in rehabilitation programs for patients with neurological disorders, for example those recovering from stroke. The goal of rehabilitation programs is to provide the individual with opportunities for full and effective participation and inclusion in society and this is achieved through different interventions which include pharmacological treatments, physical exercise and robot-assisted therapy.

The immune system is designed to protect the host organism from both external dangers (e.g. pathogens) and internal dangers (e.g. cancer cells). The mechanisms used by immune cells to sense danger and to respond to it, eventually eliminating the cause of the injury and terminating inflammatory responses, have been, and continue to be, deeply studied and described. During the last two decades, evidence has highlighted the relevance of the immune system in regenerative processes. In the central nervous system, despite the prevalent notion that inflammation causes tissue damage, growing evidence supports the hypothesis that immune cells can play protective roles in the CNS. Moreover, immune cells such as type 2 macrophages, have been shown to play a pivotal role in wound and tissue healing. As immune cells and mediators are virtually capable to reach every tissue and organ, they are involved, with different extents, in the pathogenesis of almost every disease.

The role of the immune system during rehabilitation programs remains poorly understood. There is strong evidence that physical exercise has beneficial effects on immune-related processes, in terms of reducing low-grade chronic inflammation and dampening immuno-senescence in the elderly. Moreover, experimental studies support the idea that physical rehabilitation induces general enhancement of immune cell functions and anti-inflammatory processes, subsequently leading to enhanced neuroprotection. For example, in women with Multiple Sclerosis, aerobic exercise has been shown to reduce circulating levels of TNF-alpha and leptin, possibly having a positive effect on fatigue and on quality of life for MS patients.

This Research Topic will provide a comprehensive overview of the role and modulation of immune cells and immune mediators during rehabilitation programs. We welcome the submission of Reviews, Mini-Reviews, Brief Research Reports, Perspective, Original Research and Clinical Trial articles covering, but not limited to, the following topics:

1. Effects of rehabilitation programs on immune cell phenotype and functions in neurological and neurodegenerative conditions (e.g. traumatic spinal cord injury, brain injury, Parkinson's disease etc.).
2. Effects of rehabilitation programs with or without the use of mobile technology (e.g. physical exercise, pharmacorehabilitation, rehabilitative/assistive technology) on immune cell phenotype and function, including lymphocytes, macrophages and granulocytes.
3. Phenotypic and functional analysis of immune cells derived from patients enrolled in multi-center clinical studies during rehabilitation programs.
4. The exploitation of immune cells and inflammatory mediators (e.g. chemokines, cytokines, growth factors, etc. ) as biomarkers of prognosis and response to rehabilitation therapies.
5. Protective or detrimental effects of immune activation during rehabilitation.


Keywords: rehabilitation, macrophages, lymphocytes, prognosis biomarkers, regenerative medicine, inflammation


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