Compelling evidence supports the health benefits of physical exercise on the immune system, possibly through the molecules secreted by the skeletal muscles known as myokines. Herein, we assessed the impact of exercise interventions on plasma Heat shock protein 90 (Hsp90) levels in 27 patients with idiopathic inflammatory myopathies (IIM) compared with 23 IIM patients treated with standard-of-care immunosuppressive therapy only, and in 18 healthy subjects undergoing strenuous eccentric exercise, and their associations with the traditional serum markers of muscle damage and inflammation. In contrast to IIM patients treated with pharmacotherapy only, in whom we demonstrated a significant decrease in Hsp90 over 24 weeks, the 24-week exercise program resulted in a stabilization of Hsp90 levels. These changes in Hsp90 levels were associated with changes in several inflammatory cytokines/chemokines involved in the pathogenesis of IIM or muscle regeneration in general. Strenuous eccentric exercise in healthy volunteers induced a brief increase in Hsp90 levels with a subsequent return to baseline levels at 14 days after the exercise, with less pronounced correlations to systemic inflammation. In this study, we identified Hsp90 as a potential myokine and mediator for exercise-induced immune response and as a potential biomarker predicting improvement after physiotherapy in muscle endurance in IIM.

1st Faculty of Medicine Charles University 121 08 Prague Czech Republic

Department of Human Movement Laboratory Faculty of Physical Education and Sport Charles University 162 52 Prague Czech Republic

Department of Methodology Faculty of Physical Education and Sport Charles University 162 52 Prague Czech Republic

Department of Pathology and Molecular Medicine 2nd Faculty of Medicine Charles University University Hospital Motol 150 06 Prague Czech Republic

Department of Physiotherapy Faculty of Physical Education and Sport Charles University 162 52 Prague Czech Republic

Department of Rehabilitation and Sports Medicine 2nd Faculty of Medicine Charles University University Hospital Motol 150 06 Prague Czech Republic

Department of Rheumatology 1st Faculty of Medicine Charles University 128 50 Prague Czech Republic

Institute of Rheumatology 128 00 Prague Czech Republic

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