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Impaired Aerobic Capacity in Systemic Lupus Erythematosus Patients: What are the Physiological Mechanisms

Prado DM, Silva AG and Rocco DFM

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown origin affecting virtually all organ systems. In addition, SLE patients can present limitations in exercise capacity and reduced quality of life due to various clinical conditions such as fatigue, cardiorespiratory disease and muscle involvement. For instance, impaired tissue O2 transport due to altered convective O2 transport (product of arterial O2 content and blood flow) to the working locomotor muscles or O2 diffusive transport from muscle capillaries to mitochondria is the major determinant of reduced aerobic capacity in patients with SLE. In this respect, scientific evidences suggest that during exercise SLE patients show an attenuated increase in heart rate and systolic volume, reduced ventilatory efficiency and oxidative metabolism impairment. Importantly, recent investigations suggest that aerobic exercise training has direct effects on improving both aerobic capacity and exercise tolerance in SLE patients. Within this context, previous studies suggest that either central or peripheral components are involved in improved aerobic capacity after exercise training program. In this light, the present review sought to clarify the physiological mechanisms associated with reduced aerobic capacity in SLE patients. Secondly, special focus was given to the role of physical training in improving aerobic capacity in these patients as well as to the underlying mechanisms.