Exercise-induced modulation of kynurenine pathway metabolite patterns in multiple sclerosis: a targeted metabolomics analysis across four randomized controlled trials.
Marie Kupjetz, Martin Langeskov-Christensen, Morten Riemenschneider et al.
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In 30 seconds
This pooled analysis of four randomized controlled trials examined acute and chronic exercise-related changes in serum kynurenine patterns among 273 people with multiple sclerosis. The researchers used targeted metabolomics and linear mixed-effects models to assess neurotoxic (NeuroTox) and neuroprotective (NeuroPro) patterns. A single session of combined strength-focused exercise increased NeuroPro (0.421, 95% CI [0.216, 0.626], p < 0.001), while 24-week endurance exercise decreased NeuroTox (-0.432, 95% CI [-0.786, -0.080], p = 0.019). The patterns showed similar factor loadings across subcohorts.
Key findings
- A single session of combined strength-focused exercise increased NeuroPro (0.421, 95% CI [0.216, 0.626], p < 0.001).
- Twenty-four-week endurance exercise decreased NeuroTox (-0.432, 95% CI [-0.786, -0.080], p = 0.019).
- Repeated exploratory factor analyses found similar kynurenine factor loadings across the four subcohorts.
Why it matters
The findings suggest that exercise modalities may have distinct acute or longer-term associations with serum kynurenine patterns in multiple sclerosis. These patterns are proposed to reflect neuroprotective and neurotoxic profiles, but the study does not establish whether the observed changes translate into clinical benefit. Clarifying their determinants and clinical relevance is therefore important before interpreting them as meaningful disease outcomes.
What to keep in mind
The reported outcomes are serum metabolite patterns; their clinical relevance remains undetermined.