MD Other ways to protect against oxidative stress Exercise is a very effective way to increase our antioxidant defenses. However, in order to obtain this benefit, one has to first use exercise to increase levels of oxidative stress. The body then responds by boosting its antioxidant defenses. While the oxidative stress produced in exercise is vital, the exact effect this may have on FSHD is not fully understood. The type, intensity, and duration of the exercise all may influence the outcome. Bankolé and colleagues (Bankolé et al., 2016) have shown that a combined strength and interval cycling exercise-training program significantly improved fitness and skeletal muscle function without negatively impacting muscle damage. While this study did not investigate the antioxidant levels of participants, it does highlight that certain types of exercise can be beneficial for people with FSHD regardless of the increases in oxidative stress induced by exercise. In conclusion… Research to date has shown some positive results, but important questions remain. First, oxidative stress has a strong link with FSHD cells in the test tube, but the relevance of oxidative stress in FSHD patients is unknown. Also, while antioxidant therapies have shown modest benefits, these results came from relatively small clinical trials. We need to conduct larger trials to understand if antioxidant therapies can protect muscles in people with FSHD. Editor ’s note: Adam Denny earned his PhD in the Department of Physiology at the University of Otago in New Zealand. Article available at: https://www.fshsociety.org/<strong>2018</strong>/10/the-use-of-antioxidants-in-fshd/ References Bankolé, L.C., Millet, G.Y., Temesi, J., Bachasson, D., Ravelojaona, M., Wuyam, B., Verges, S., Ponsot, E., Antoine, J.C., Kadi, F. & Féasson, L. 2016. “Safety and efficacy of a 6-month home-based exercise program in patients with facioscapulohumeral muscular dystrophy: A randomized controlled trial”, Medicine, 95(31): e4497. doi: 10.1097/MD.0000000000004497. Dias Wilson, V., Thomas, C., Passerieux, E., Hugon, G., Pillard, F., Andrade, A.G., Bommart, S., Pincemail, J., Mercier, J., Arbogast, S. & Laoudj-Chenivesse, D. <strong>2018</strong>. “Impaired oxygen demand during exercise is related to oxidative stress and muscle function in FSHD”, JCSM (Journal of Cachexia, Sarcopenia and Muscle) Rapid Communications, 1(1). https://jcsmrapid-communications.info/index.php/jcsm-rc/article/view/29. Passerieux, E., Hayot, M., Jaussent, A., Carnac, G., Gouzi, F., Pillard, F., Picot, M-C., Böcker, K., Hugon, G., Pincemail, J., Defraigne, J.O., Verrips, T., Mercier, J. & Laoudj-Chenivesse, D. 2015. “Effects of vitamin C, vitamin E, zinc gluconate, and selenomethionine supplementation on muscle function and oxidative stress biomarkers in patients with facioscapulohumeral dystrophy: A double-blind randomized controlled clinical trial”, Free Radical Biology and Medicine, 81: 158-169. Sasaki-Honda, M., Jonouchi, T., Arai, M., Hotta, A., Mitsuhashi, S., Nishino, I., Matsuda, R. & Sakurai, H. <strong>2018</strong>. “A patientderived iPSC model revealed oxidative stress increases facioscapulohumeral muscular dystrophy-causative DUX4”, Human Molecular Genetics, September 12. DOI: 10.1093/hmg/ddy293. Van der Kooi, E.L., De Greef, No effect of folic acid and methionine supplementation on D4Z4 methylation in patients with facioscapulohumeral muscular dystrophy”, Neuromuscular Disorders, 16(11): 766-769. DOI: 10.1016/j.nmd.2006.08.005. 12
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