Regular Tai Chi Chuan exercise improves T cell helper function of type 2 DM patients with an increase in T-bet transcription factor and IL-12 production

Shu-Hui Yeh ¹, Hau Chuang ², Li-Wei Lin ³, Chiu-Yueh Hsiao ⁴, Pei-Wen Wang ⁵, Rue-Tsuan Liu ⁵ and Kuender D Yang ^2*

¹ Chang Gung Institute of Technology, Taiwan
² Dept. Medical Research, Chang Gung Memorial Hospital at Kaohsiung, Taiwan
³ College of Nursing, Deakin University, Burwood 3125, Australia, Australia
⁴ School of Nursing, Tzu-Hui Institute of Technology, Ping-Tung 926, Taiwan, Taiwan
⁵ Division of Endocrinology & Metabolism, Chang Gung Memorial Hospital at Kaohsiung, Taiwan

^* To whom correspondence should be addressed. E-mail: yangkd.yeh{at}hotmail.com.

Accepted 22 January 2008

Abstract

BACKGROUND-- Exercise has been shown to be beneficial in treatment of type 2 diabetes mellitus (DM); its benefit to immune function, however, remains to be determined.

OBJECTIVE-- This study investigated the effect of a 12-week course of Tai Chi Chuan (TCC) exercise on T cell helper (Th) reaction in type 2 DM patients.

DESIGH AND METHODS -- This study was a case-control design. Thirty pairs of type 2 DM patients and normal age-matched adults completed this study. Fasting blood glucose, HbA1c, mediators (IL-12, IL-4 and TGFÒ) and transcription factors (T-bet, GATA-3 and FoxP3) of Th1/Th2/T regulatory (Treg) reaction were measured before and after a 12-week TCC exercise program. RESULTS -- Fasting glucose and HbA1c levels in the participating type 2 DM patients were significantly higher than age-matched controls before exercise. After the TCC exercise, HbA1c levels in type 2 DM patients significantly decreased (7.59 ¡&Oacute 0.32 vs. 7.16 ¡&Oacute 0.22 %; P= 0.047), along with a significant increase of blood IL-12 levels (5.96 ¡&Oacute 1.10 vs. 12.96 ¡&Oacute 3.07; P = 0.035). To probe molecular Th1/Th2/Treg reaction, we found that type 2 DM patients had lower T-bet, but not GATA-3 or FoxP3 expression than normal controls before TCC exercise. After the 12-week TCC exercise, T-bet expression significantly increased in type 2 DM patients.

CONCLUSIONS -- A 12-week TCC exercise program decreases HbA1c levels, along with increase of the Th1 reaction. A combination of TCC with medication may provide even better in both metabolism and immunity of type 2 DM patients.