Tai-Chi-Chuan on Differentiation and Maturation of Dendritic Cells
Condition: Immunity
Study type: Observational

Summary: 
      Tai-Chi-Chuan (TCC), a branch of traditional Chinese martial arts, has been widely practiced
      since the 17th century. Recent studies have shown that TCC can improve cardiorespiratory
      function, muscle strength, humoral and cellular immunity, metabolic response and mental
      control.

      Cultured monocytes from blood or bone marrow can be triggered to differentiate to myeloid
      dendritic cells (DC). DCs are specialized leukocytes for presenting antigens to quiescent,
      naive, and memory T cells, and they play pivotal roles in the induction of cell-mediated as
      well as humoral immune responses in vivo. Mature DCs have a capacity for initiating immunity
      or tolerance, which depends on their activation state.

      In this study we will investigate the effect of TCC on DC differentiation in the peripheral
      blood obtained from the healthy donors who take part with and without TCC exercise. The
      distribution of various DC sub-populations (myeloid DC and plasmacytoid cell) will be
      analyzed by detecting surface marker expression.
    

Detailed description: 
      Introduction

      Tai-Chi-Chuan (TCC), a branch of traditional Chinese martial arts, has been widely practiced
      since the 17th century. TCC gradually evolved into many styles, the Chen style is the oldest
      and the Yang style is the most popular. The practice of TCC was originally related to
      concerns about physical fitness and the capacity for self defense. Over the centuries, it has
      become far more focused on the homoeostasis of the body's internal environment. The
      interaction between mind and body has long been seen as more important than the development
      of any martial arts skills. Classical TCC consists of many complex postures, and performing a
      complete set takes 20 to 30 minutes. A simplified form of TCC was developed to facilitate
      promotion in 1956 (1), however, simplified TCC have lesser training benefits owing to
      reduction of exercise intensity and duration. TCC has been considered as a practice of
      medico-athletics, which can improvement of physical condition and treatment of certain
      chronic diseases. Exercise has definite effects on the health of human, but appropriate forms
      are scarce. Recent studies have shown that TCC can improve cardiorespiratory function (2-4),
      muscle strength (5), humoral and cellular immunity (6-8), metabolic response (9), and mental
      control (10). Studies used TCC postures for training showed that the exercise intensity of
      TCC training is moderate (2). A well designed study for TCC on human health, especially
      whether TCC improve immune response or not, will be processed in this project.

      Dendritic cells (DCs) are specialized leukocytes for presenting antigens to quiescent, naive,
      and memory T cells, and they play pivotal roles in the induction of cell-mediated as well as
      humoral immune responses in vivo (11). The exceptional ability of DCs to stimulate T cells in
      vitro and in vivo is attributed, at least in part, to their ability to capture antigen, to
      migrate into lymphoid organs, and to express high levels of immunostimulatory molecules, such
      as major histocompatibility complex (MHC) class II, B7-1, B7-2, and IL-12 (11,12). Immature
      DCs, such as Langerhans cells of the skin, capture and process antigens very efficiently
      (13). Upon exposure to various microbial and inflammatory products (eg, lipopolysaccharide
      [LPS], IL-1, TNF-alpha), DCs mature and migrate into lymphoid tissues to interact with T and
      B cells (14-17).

      In this study we will investigate the effect of Tai-Chi-Chuan (TCC) on DC differentiation in
      the peripheral blood obtained from the healthy donor who take part with and without TCC
      exercise. Subjects who practice with or without Yang TCC will be assessed their distribution
      of various DC sub-populations (myeloid DC and plasmacytoid cell) and their activation state
      will be analyzed by detecting surface marker expression.

      The potential of this study is to demonstrate the immunomodulatory activity of TCC, a novel
      sport in Chinese for thousand years.

      Materials and methods

        1. Subjects and study design. Yang TCC practitioner who keep practicing at least 3 times a
           week for more than 3 years will be recruited.

        2. Cardiopulmonary fitness measurement during TCC practice. To determine the exercise
           intensity and cardiopulmonary fitness of the classical form of Yang TCC, HP responses
           and VO2max will be measured during TCC exercise. Lactate response before and immediately
           after TCC practice will be measured. The Cosmed K4 system (Cosmed s.r.l., Rome, Italy)
           consists of a photoelectric turbine flowmeter will be used to calculate the minute
           ventilation, and measure the number of expiratory cycles per minute. Cardiorespiratory
           parameters including heart rate, minute ventilation (VE), oxygen uptake, carbon dioxide
           production (VCO2), will be also measured.

        3. Cell preparation. The mononuclaer cells of blood will be isolated by using
           centrifugation on a density gradient (Ficoll-Hypaque, 1.077 gm/ml, Pharmacia Fine
           Chemicals). DCs will be isolated by using CD11c-conjugated MACS magnetic beads.

        4. Assess the distribution of various DC sub-populations. Myeloid DC (CD11c+) and
           plasmacytoid cells (CD123+), which are excluded by lineage markers
           (CD3，CD14，CD16，CD19，CD20，CD56) will be analyzed by detecting surface marker expression
           with flow cytometer.

      References:

        1. China Sports. Simplified "Taijiquan". 1983:1-5. Bejing, China Publications Center.

        2. Lan C, Chen SY, Lai JS, Wong MK. Heart rate responses and oxygen consumption during Tai
           Chi Chuan practice. Am J Chin Med 2001;29:403.

        3. Lai JS, Lan C, Wong MK, Teng SH. Two-year trends in cardiorespiratory function among
           older Tai Chi Chuan practitioners and sedentary subjects. J Am Geriatr Soc 1995;43:1222.

        4. Gong L, Qian J, Zhang J, et al. Changes in heart rate and electrocardiogram during
           Taijiquan exercise. Chin Med J 1981;94:589.

        5. Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults:
           intervention gains and Tai Chi maintenance. J Am Geriatr Soc 1996;44:498.

        6. Sun X, Xu Y, Zhu R. Detection of ZC resette-forming lymphocytes in the healthy aged with
           TaichiQuan (88 style) exercise. J Sports Med Physic Fit 1990;30:401.

        7. Zhang GD. The impacts of 48-form Tai Chi Chuan and Yi Qi Yang Fei Gong on the serum
           levels of IgG, IgM, IgA and Ig E in human. Journal of Beijing Institute of Physical
           Education 1990;4:12.

        8. Sun X, Xu Y, Xia Y. Determination of E-resette-forming lymphocytes in aged subjects with
           Taichiquan exercise. Int J Sports Med 1989;10:217.

        9. Zhou D, Shephard RJ, Plyley MJ, et al. Cardiorespiratory and metabolic responses during
           Tai Chi Chuan exercise. Can J Appl Sport Sci 1984;9:7.

       10. Xu S, Fan Z. Physiological studies of Tai Ji Quan in Cina. In: Qu M, Yu C, eds. China's
           sports medicine. Basel, New York: Karger 1988:70.

       11. Banchereau J, Steinman RM. Dendritic cells and the control of immunity. Nature
           1998;392:245.

       12. Hart DN. Dendritic cells: unique leukocyte populations which control the primary immune
           response. Blood 1997;90:3245.

       13. Albert ML, Pearce SF, Francisco LM, et al. Immature dendritic cells phagocytose
           apoptotic cells via avb5 and CD36, and cross-present antigens to cytotoxic T
           lymphocytes. J Exp Med 1998;188:1359.

       14. Jonuleit H, Kuhn U, Muller G, et al. Pro-inflammatory cytokines and prostaglandins
           induce maturation of potent immunostimulatory dendritic cells under fetal calf
           serum-free conditions. Eur J Immunol. 1997;27:3135.

       15. Kato T, Yamane H, Nariuchi H. Differential effects of LPS and CD40 ligand stimulations
           on the induction of IL-12 production by dendritic cells and macrophages. Cell Immunol
           1997;181:59.

       16. Cella M, Scheidegger D, Palmer-Lehmann K, Lane P, Lanzavecchia A, Alber G. Ligation of
           CD40 on dendritic cells triggers production of high levels of interleukin-12 and
           enhances T cell stimulatory capacity: T-T help via APC activation. J Exp Med
           1996;184:747.

       17. Labeur MS, Roters B, Pers B, et al. Generation of tumor immunity by bone marrow-derived
           dendritic cells correlates with dendritic cell maturation stage. J Immunol 1999;162:168.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        TCC practitioner and Healthy subjects as controls
      
Keywords: dendritic cells; Tai-Chi-Chuan