sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20250406sibmed-2336Research ArticleОБЗОРЫREVIEWSОсобенности цитокинового статуса в патогенезе детского церебрального паралича и возможности физической реабилитацииFeatures of cytokine status in the pathogenesis of cerebral palsy and possibilities of physical rehabilitationhttps://orcid.org/0000-0003-3786-3195ЩербининаТ. Н.ShcherbininaТ. N.

Щербинина Татьяна Николаевна

297412, г. Евпатория, ул. Маяковского, 6

Tatiana N. Shcherbinina

297412, Yevpatoria, Mayakovskogo st., 6

tn9512@mail.ruНИИ детской курортологии, физиотерапии и медицинской реабилитацииРоссияResearch Institute of Children’s Balneology, Physiotherapy, and Medical RehabilitationRussian Federation2025050920254545864Copyright © Щербинина Т.Н., 20252025Щербинина Т.Н.Shcherbinina Т.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2336

Детский церебральный паралич (ДЦП) является одной из ведущих причин инвалидизации в детском возрасте. В ряде случаев данная патология существенно снижает качество жизни пациентов и требует комплексного междисциплинарного подхода к лечению, поэтому крайне актуальны задачи ранней диагностики, профилактики и коррекции ее осложнений. Для разработки эффективных стратегий лечения необходимо понимать не только этиологические факторы, но и патогенетические механизмы, лежащие в основе заболевания. Последнее время особая роль уделяется проблеме персистирующего воспаления в результате активации микроглии у пациентов с ДЦП после органического повреждения мозга. Все больше данных свидетельствует о том, что дисбаланс прои противовоспалительных цитокинов в головном мозге усугубляет нейрональное повреждение и ухудшает реабилитационный прогноз. Дальнейшие исследования нейровоспаления необходимы для выявления ключевых мишеней и разработки новых подходов физической реабилитации пациентов с ДЦП. Цель данного обзора – представить современные данные по проблеме нейровоспаления у пациентов с ДЦП и возможные точки воздействия методами физической реабилитации.

Cerebral palsy (CP) is one of the leading causes of disability in childhood. In many cases, this condition significantly reduces patients’ quality of life and requires a comprehensive interdisciplinary treatment approach, therefore, early diagnosis, prevention, and correction of its complications are of great importance. Developing effective treatment strategies requires an understanding not only of the etiological factors but also of the pathogenetic mechanisms underlying the disease. In recent years, persistent inflammation due to microglial activation following organic brain damage has been recognized as a key factor in CP pathogenesis. Growing evidence suggests that an imbalance between proand anti-inflammatory cytokines in the brain exacerbates neuronal damage and worsens rehabilitation outcomes. Further research on neuroinflammation is essential for identifying key therapeutic targets and developing new approaches to the physical rehabilitation of patients with CP. This review aims to present current data on the problem of neuroinflammation in CP patients and potential intervention points for physical rehabilitation methods.

детский церебральный параличцитокиныбиомаркерыреабилитацияcerebral palsycytokinesbiomarkersrehabilitationReferencesGraham H.K., Rosenbaum P., Paneth N., Dan B., Lin J.P., Damiano D.L., Becher J.G., GaeblerSpira D., Colver A., Reddihough D.S., Crompton K.E., Lieber R.L. Cerebral palsy. Nat. Rev. Dis. Primers. 2016;2(1):15082. doi: 10.1038/nrdp.2015.82Graham H.K., Rosenbaum P., Paneth N., Dan B., Lin J.P., Damiano D.L., Becher J.G., GaeblerSpira D., Colver A., Reddihough D.S., Crompton K.E., Lieber R.L. Cerebral palsy. Nat. Rev. Dis. Primers. 2016;2(1):15082. doi: 10.1038/nrdp.2015.82Sadowska M., Sarecka-Hujar B., Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr. Dis. Treat. 2020;16:1505–1518. doi: 10.2147/NDT.S235165Sadowska M., Sarecka-Hujar B., Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr. Dis. Treat. 2020;16:1505–1518. doi: 10.2147/NDT.S235165Novak I., Morgan C., Adde L., Blackman J., Boyd R.N., Brunstrom-Hernandez J., Cioni G., Damiano D., Darrah J., Eliasson A.C., … Badawi N. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatrics. 2017;171(9):897–907. doi: 10.1001/jamapediatrics.2017.1689Novak I., Morgan C., Adde L., Blackman J., Boyd R.N., Brunstrom-Hernandez J., Cioni G., Damiano D., Darrah J., Eliasson A.C., … Badawi N. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatrics. 2017;171(9):897–907. doi: 10.1001/jamapediatrics.2017.1689Kołtuniuk A., Rozensztrauch A., Budzińska P., Rosińczuk J. The quality of life of Polish children with cerebral palsy and the impact of the disease on the family functioning. J. Pediatr. Nurs. 2019;47:75–82. doi: 10.1016/j.pedn.2019.05.011Kołtuniuk A., Rozensztrauch A., Budzińska P., Rosińczuk J. The quality of life of Polish children with cerebral palsy and the impact of the disease on the family functioning. J. Pediatr. Nurs. 2019;47:75–82. doi: 10.1016/j.pedn.2019.05.011Vitrikas K., Dalton H., Breish D. Cerebral palsy: an overview. Am. Fam. Physician. 2020;101(4):213–220.Vitrikas K., Dalton H., Breish D. Cerebral palsy: an overview. Am. Fam. Physician. 2020;101(4):213–220.Paton M.C., Finch-Edmondson M., Dale R.C., Fahey M.C., Nold-Petry C.A., Nold M.F., Griffin A.R., Novak I. Persistent inflammation in cerebral palsy: pathogenic mediator or comorbidity? A scoping review. J. Clin. Med. 2022;11(24):7368. doi: 10.3390/jcm11247368Paton M.C., Finch-Edmondson M., Dale R.C., Fahey M.C., Nold-Petry C.A., Nold M.F., Griffin A.R., Novak I. Persistent inflammation in cerebral palsy: pathogenic mediator or comorbidity? A scoping review. J. Clin. Med. 2022;11(24):7368. doi: 10.3390/jcm11247368Than U.T., Nguyen L.T., Nguyen P.H., Nguyen X.H., Trinh D.P., Hoang D.H., Nguyen P.A., Dang V.D. Inflammatory mediators drive neuroinflammation in autism spectrum disorder and cerebral palsy. Sci. Rep. 2023;13(1):22587. doi: 10.1038/s41598-023-49902-8Than U.T., Nguyen L.T., Nguyen P.H., Nguyen X.H., Trinh D.P., Hoang D.H., Nguyen P.A., Dang V.D. Inflammatory mediators drive neuroinflammation in autism spectrum disorder and cerebral palsy. Sci. Rep. 2023;13(1):22587. doi: 10.1038/s41598-023-49902-8Schleiss M.R. Altered cytokine responses in children with cerebral palsy: pathogenesis and novel therapies. Dev. Med. Child. Neurol. 2021;63(4):365–366. doi: 10.1111/dmcn.14821Schleiss M.R. Altered cytokine responses in children with cerebral palsy: pathogenesis and novel therapies. Dev. Med. Child. Neurol. 2021;63(4):365–366. doi: 10.1111/dmcn.14821Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., … Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71. doi: 10.1136/bmj.n71Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., … Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71. doi: 10.1136/bmj.n71Yi M., Li T., Niu M., Zhang H., Wu Y., Wu K., Dai Z. Targeting cytokine and chemokine signaling pathways for cancer therapy. Signal Transduct. Target. Ther. 2024;9(1):176. doi: 10.1038/s41392-024-01868-3Yi M., Li T., Niu M., Zhang H., Wu Y., Wu K., Dai Z. Targeting cytokine and chemokine signaling pathways for cancer therapy. Signal Transduct. Target. Ther. 2024;9(1):176. doi: 10.1038/s41392-024-01868-3Sochocka M., Diniz B.S., Leszek J. Inflammatory response in the CNS: friend or foe? Mol. Neurobiol. 2017;54(10):8071–8089. doi: 10.1007/s12035-016-0297-1Sochocka M., Diniz B.S., Leszek J. Inflammatory response in the CNS: friend or foe? Mol. Neurobiol. 2017;54(10):8071–8089. doi: 10.1007/s12035-016-0297-1Mallah K., Couch C., Borucki D.M., Toutonji A., Alshareef M., Tomlinson S. Anti-inflammatory and neuroprotective agents in clinical trials for CNS disease and injury: where do we go from here? Front. Immunol. 2020;11:2021. doi: 10.3389/fimmu.2020.02021Mallah K., Couch C., Borucki D.M., Toutonji A., Alshareef M., Tomlinson S. Anti-inflammatory and neuroprotective agents in clinical trials for CNS disease and injury: where do we go from here? Front. Immunol. 2020;11:2021. doi: 10.3389/fimmu.2020.02021Bourgognon J.M., Cavanagh J. The role of cytokines in modulating learning and memory and brain plasticity. Brain Neurosci. Adv. 2020;4:2398212820979802. doi: 10.1177/2398212820979802Bourgognon J.M., Cavanagh J. The role of cytokines in modulating learning and memory and brain plasticity. Brain Neurosci. Adv. 2020;4:2398212820979802. doi: 10.1177/2398212820979802Kummer K.K., Zeidler M., Kalpachidou T., Kress M. Role of IL-6 in the regulation of neuronal development, survival and function. Cytokine. 2021;144:155582. doi: 10.1016/j.cyto.2021.155582Kummer K.K., Zeidler M., Kalpachidou T., Kress M. Role of IL-6 in the regulation of neuronal development, survival and function. Cytokine. 2021;144:155582. doi: 10.1016/j.cyto.2021.155582Kerkis I., da Silva Á.P., Araldi R.P. The impact of interleukin-6 (IL-6) and mesenchymal stem cell-derived IL-6 on neurological conditions. Front. Immunol. 2024;15:1400533. doi: 10.3389/fimmu.2024.1400533Kerkis I., da Silva Á.P., Araldi R.P. The impact of interleukin-6 (IL-6) and mesenchymal stem cell-derived IL-6 on neurological conditions. Front. Immunol. 2024;15:1400533. doi: 10.3389/fimmu.2024.1400533Belizário J.E., Fontes-Oliveira C.C., Borges J.P., Kashiabara J.A., Vannier E. Skeletal muscle wasting and renewal: a pivotal role of myokine IL-6. Springerplus. 2016;5:619. doi: 10.1186/s40064-016-2197-2Belizário J.E., Fontes-Oliveira C.C., Borges J.P., Kashiabara J.A., Vannier E. Skeletal muscle wasting and renewal: a pivotal role of myokine IL-6. Springerplus. 2016;5:619. doi: 10.1186/s40064-016-2197-2Ramesh G., MacLean A.G., Philipp M.T. Cytokines and chemokines at the crossroads of neuroinflammation, neurodegeneration, and neuropathic pain. Mediators Inflamm. 2013;2013:480739. doi: 10.1155/2013/480739Ramesh G., MacLean A.G., Philipp M.T. Cytokines and chemokines at the crossroads of neuroinflammation, neurodegeneration, and neuropathic pain. Mediators Inflamm. 2013;2013:480739. doi: 10.1155/2013/480739Wu J., Li X. Plasma tumor necrosis factor-alpha (TNF-α) levels correlate with disease severity in spastic diplegia, triplegia, and quadriplegia in children with cerebral palsy. Med. Sci. Monit. 2015;21:3868–3874. doi: 10.12659/msm.895400Wu J., Li X. Plasma tumor necrosis factor-alpha (TNF-α) levels correlate with disease severity in spastic diplegia, triplegia, and quadriplegia in children with cerebral palsy. Med. Sci. Monit. 2015;21:3868–3874. doi: 10.12659/msm.895400Bi D., Chen M., Zhang X., Wang H., Xia L., Shang Q., Li T., Zhu D., Blomgren K., He L., … Zhu C. The association between sex-related interleukin-6 gene polymorphisms and the risk for cerebral palsy. J. Neuroinflammation. 2014;11:100. doi: 10.1186/1742-2094-11-100Bi D., Chen M., Zhang X., Wang H., Xia L., Shang Q., Li T., Zhu D., Blomgren K., He L., … Zhu C. The association between sex-related interleukin-6 gene polymorphisms and the risk for cerebral palsy. J. Neuroinflammation. 2014;11:100. doi: 10.1186/1742-2094-11-100Pingel J., Barber L., Andersen I.T., Walden F.V., Wong C., Døssing S., Nielsen J.B. Systemic inflammatory markers in individuals with cerebral palsy. European Journal of Inflammation. 2019;17:205873921882347. doi: 10.1177/2058739218823474Pingel J., Barber L., Andersen I.T., Walden F.V., Wong C., Døssing S., Nielsen J.B. Systemic inflammatory markers in individuals with cerebral palsy. European Journal of Inflammation. 2019;17:205873921882347. doi: 10.1177/2058739218823474Hu M., Bai C., Zhao H., Wu J., Luan X. Research progress on the role of the interleukin family in the pathogenesis of cerebral palsy in children. J. Integr. Neurosci. 2024;23(12):213. doi: 10.31083/j.jin2312213Hu M., Bai C., Zhao H., Wu J., Luan X. Research progress on the role of the interleukin family in the pathogenesis of cerebral palsy in children. J. Integr. Neurosci. 2024;23(12):213. doi: 10.31083/j.jin2312213Mallick R., Basak S., Chowdhury P., Bhowmik P., Das R.K., Banerjee A., Paul S., Pathak S., Duttaroy A.K. Targeting cytokine-mediated inflammation in brain disorders: developing new treatment strategies. Pharmaceuticals (Basel). 2025;18(1):104. doi: 10.3390/ph18010104Mallick R., Basak S., Chowdhury P., Bhowmik P., Das R.K., Banerjee A., Paul S., Pathak S., Duttaroy A.K. Targeting cytokine-mediated inflammation in brain disorders: developing new treatment strategies. Pharmaceuticals (Basel). 2025;18(1):104. doi: 10.3390/ph18010104Bessis A., Béchade C., Bernard D., Roumier A. Microglial control of neuronal death and synaptic properties. Glia. 2007;55(3):233–238. doi: 10.1002/glia.20459Bessis A., Béchade C., Bernard D., Roumier A. Microglial control of neuronal death and synaptic properties. Glia. 2007;55(3):233–238. doi: 10.1002/glia.20459Teo E.J., Chand K.K., Miller S.M., Wixey J.A., Colditz P.B., Bjorkman S.T. Early evolution of glial morphology and inflammatory cytokines following hypoxic-ischemic injury in the newborn piglet brain. Sci. Rep. 2023;13(1):282. doi: 10.1038/s41598-022-27034-9Teo E.J., Chand K.K., Miller S.M., Wixey J.A., Colditz P.B., Bjorkman S.T. Early evolution of glial morphology and inflammatory cytokines following hypoxic-ischemic injury in the newborn piglet brain. Sci. Rep. 2023;13(1):282. doi: 10.1038/s41598-022-27034-9Zheng Y., Zhu T., Chen B., Fang Y., Wu Y., Feng X., Pang M., Wang H., Zhu J., Lin Z. Diallyl disulfide attenuates pyroptosis via NLRP3/Caspase-1/ IL-1β signaling pathway to exert a protective effect on hypoxic-ischemic brain damage in neonatal rats. Int. Immunopharmacol. 2023;124(Pt B):111030. doi: 10.1016/j.intimp.2023.111030Zheng Y., Zhu T., Chen B., Fang Y., Wu Y., Feng X., Pang M., Wang H., Zhu J., Lin Z. Diallyl disulfide attenuates pyroptosis via NLRP3/Caspase-1/ IL-1β signaling pathway to exert a protective effect on hypoxic-ischemic brain damage in neonatal rats. Int. Immunopharmacol. 2023;124(Pt B):111030. doi: 10.1016/j.intimp.2023.111030Schafer D.P., Stevens B. Microglia function in central nervous system development and plasticity. Cold Spring Harb. Perspect. Biol. 2015;7(10):a020545. doi: 10.1101/cshperspect.a020545Schafer D.P., Stevens B. Microglia function in central nervous system development and plasticity. Cold Spring Harb. Perspect. Biol. 2015;7(10):a020545. doi: 10.1101/cshperspect.a020545Liu G., Li M., Qian S., Yu L., Qian L., Feng X. Interleukin-35 exhibits protective effects in a rat model of hypoxic-ischemic encephalopathy through the inhibition of microglia-mediated inflammation. Transl. Pediatr. 2022;11(5):651–662. doi: 10.21037/tp-22-100Liu G., Li M., Qian S., Yu L., Qian L., Feng X. Interleukin-35 exhibits protective effects in a rat model of hypoxic-ischemic encephalopathy through the inhibition of microglia-mediated inflammation. Transl. Pediatr. 2022;11(5):651–662. doi: 10.21037/tp-22-100Tan Z., Yang G., Qiu J., Yan W., Liu Y., Ma Z., Li J., Liu J., Shan N. Quercetin alleviates demyelination through regulating microglial phenotype transformation to mitigate neuropsychiatric symptoms in mice with vascular dementia. Mol. Neurobiol. 2022;59(5):3140– 3158. doi: 10.1007/s12035-021-02712-3Tan Z., Yang G., Qiu J., Yan W., Liu Y., Ma Z., Li J., Liu J., Shan N. Quercetin alleviates demyelination through regulating microglial phenotype transformation to mitigate neuropsychiatric symptoms in mice with vascular dementia. Mol. Neurobiol. 2022;59(5):3140– 3158. doi: 10.1007/s12035-021-02712-3Gilles F.H., Leviton A. Neonatal white matter damage and the fetal inflammatory response. Semin. Fetal. Neonatal. Med. 2020;25(4):101111. doi: 10.1016/j.siny.2020.101111Gilles F.H., Leviton A. Neonatal white matter damage and the fetal inflammatory response. Semin. Fetal. Neonatal. Med. 2020;25(4):101111. doi: 10.1016/j.siny.2020.101111Jearjaroen P., Thangwong P., Tocharus C., Chaichompoo W., Suksamrarn A., Tocharus J. Hexahydrocurcumin attenuated demyelination and improved cognitive impairment in chronic cerebral hypoperfusion rats. Inflammopharmacology. 2024;32(2):1531–1544. doi: 10.1007/s10787-023-01406-7Jearjaroen P., Thangwong P., Tocharus C., Chaichompoo W., Suksamrarn A., Tocharus J. Hexahydrocurcumin attenuated demyelination and improved cognitive impairment in chronic cerebral hypoperfusion rats. Inflammopharmacology. 2024;32(2):1531–1544. doi: 10.1007/s10787-023-01406-7Clark I.A., Vissel B. Autocrine positive feedback of tumor necrosis factor from activated microglia proposed to be of widespread relevance in chronic neurological disease. Pharmacol. Res. Perspect. 2023;11(5):e01136. doi: 10.1002/prp2.1136Clark I.A., Vissel B. Autocrine positive feedback of tumor necrosis factor from activated microglia proposed to be of widespread relevance in chronic neurological disease. Pharmacol. Res. Perspect. 2023;11(5):e01136. doi: 10.1002/prp2.1136Sedel F., Béchade C., Vyas S., Triller A. Macrophage-derived tumor necrosis factor alpha, an early developmental signal for motoneuron death. J. Neurosci. 2004;24(9):2236–2246. doi: 10.1523/JNEUROSCI.4464-03.2004Sedel F., Béchade C., Vyas S., Triller A. Macrophage-derived tumor necrosis factor alpha, an early developmental signal for motoneuron death. J. Neurosci. 2004;24(9):2236–2246. doi: 10.1523/JNEUROSCI.4464-03.2004Franki I., Desloovere K., de Cat J., Feys H., Molenaers G., Calders P., Vanderstraeten G., Himpens E., van Broeck C. The evidence-base for basic physical therapy techniques targeting lower limb function in children with cerebral palsy: a systematic review using the International Classification of Functioning, Disability and Health as a conceptual framework. J. Rehabil. Med. 2012;44(5):385–395. doi: 10.2340/16501977-0983Franki I., Desloovere K., de Cat J., Feys H., Molenaers G., Calders P., Vanderstraeten G., Himpens E., van Broeck C. The evidence-base for basic physical therapy techniques targeting lower limb function in children with cerebral palsy: a systematic review using the International Classification of Functioning, Disability and Health as a conceptual framework. J. Rehabil. Med. 2012;44(5):385–395. doi: 10.2340/16501977-0983Solanki R., Karande A., Ranganathan P. Emerging role of gut microbiota dysbiosis in neuroinflammation and neurodegeneration. Front. Neurol. 2023;14:1149618. doi: 10.3389/fneur.2023.1149618Solanki R., Karande A., Ranganathan P. Emerging role of gut microbiota dysbiosis in neuroinflammation and neurodegeneration. Front. Neurol. 2023;14:1149618. doi: 10.3389/fneur.2023.1149618Vieira C.P., Lelis C.A., Ochioni A.C., Rosário D.K.A., Rosario I.L.S., Vieira I.R.S., Carvalho A.P.A., Janeiro J.M., da Costa M.P., Lima F.R.S., … Junior C.A.C. Estimating the therapeutic potential of NSAIDs and linoleic acid-isomers supplementation against neuroinflammation. Biomed. Pharmacother. 2024;177:116884. doi: 10.1016/j.biopha.2024.116884Vieira C.P., Lelis C.A., Ochioni A.C., Rosário D.K.A., Rosario I.L.S., Vieira I.R.S., Carvalho A.P.A., Janeiro J.M., da Costa M.P., Lima F.R.S., … Junior C.A.C. Estimating the therapeutic potential of NSAIDs and linoleic acid-isomers supplementation against neuroinflammation. Biomed. Pharmacother. 2024;177:116884. doi: 10.1016/j.biopha.2024.116884Kumari S., Dhapola R., Sharma P., Singh S.K., Reddy D.H. Implicative role of cytokines in neuroinflammation-mediated AD and associated signaling pathways: current progress in molecular signaling and therapeutics. Ageing Res. Rev. 2023;102098. doi: 10.1016/j.arr.2023.102098Kumari S., Dhapola R., Sharma P., Singh S.K., Reddy D.H. Implicative role of cytokines in neuroinflammation-mediated AD and associated signaling pathways: current progress in molecular signaling and therapeutics. Ageing Res. Rev. 2023;102098. doi: 10.1016/j.arr.2023.102098Ramesh G., MacLean A.G., Philipp M.T. Cytokines and chemokines at the crossroads of neuroinflammation, neurodegeneration, and neuropathic pain. Mediators Inflamm. 2013;2013:480739. doi: 10.1155/2013/480739Ramesh G., MacLean A.G., Philipp M.T. Cytokines and chemokines at the crossroads of neuroinflammation, neurodegeneration, and neuropathic pain. Mediators Inflamm. 2013;2013:480739. doi: 10.1155/2013/480739Guha A., Husain M.A., Si Y., Nabors L.B., Filippova N., Promer G., Smith R., King P.H. RNA regulation of inflammatory responses in glia and its potential as a therapeutic target in central nervous system disorders. Glia. 2023;71(3):485–508. doi: 10.1002/glia.24288Guha A., Husain M.A., Si Y., Nabors L.B., Filippova N., Promer G., Smith R., King P.H. RNA regulation of inflammatory responses in glia and its potential as a therapeutic target in central nervous system disorders. Glia. 2023;71(3):485–508. doi: 10.1002/glia.24288Sharma S., Bhonde R. Mesenchymal stromal cells are genetically stable under a hostile in vivo-like scenario as revealed by in vitro micronucleus test. Cytotherapy. 2015;17(10):1384–1395. doi: 10.1016/j.jcyt.2015.07.004Sharma S., Bhonde R. Mesenchymal stromal cells are genetically stable under a hostile in vivo-like scenario as revealed by in vitro micronucleus test. Cytotherapy. 2015;17(10):1384–1395. doi: 10.1016/j.jcyt.2015.07.004Mińko A., Turoń-Skrzypińska A., Rył A., Mańkowska K., Cymbaluk-Płoska A., Rotter I. The importance of the concentration of selected cytokines (IL-6, IL-10, IL-12, IL-15, TNF-α) and inflammatory markers (CRP, NLR, PLR, LMR, SII) in predicting the course of rehabilitation for patients after COVID-19 infection. Biomedicines. 2024;12(9):2055. doi: 10.3390/biomedicines12092055Mińko A., Turoń-Skrzypińska A., Rył A., Mańkowska K., Cymbaluk-Płoska A., Rotter I. The importance of the concentration of selected cytokines (IL-6, IL-10, IL-12, IL-15, TNF-α) and inflammatory markers (CRP, NLR, PLR, LMR, SII) in predicting the course of rehabilitation for patients after COVID-19 infection. Biomedicines. 2024;12(9):2055. doi: 10.3390/biomedicines12092055Magalhães R.C., Filha R.D.S., Vieira É.L.M., Teixeira A.L., Moreira J.M., Simões E Silva A.C. Rehabilitation intervention is associated with improved neurodevelopment and modulation of inflammatory molecules in children with cerebral palsy. J. Child Neurol. 2024;39(9-10):324–333. doi: 10.1177/08830738241273436Magalhães R.C., Filha R.D.S., Vieira É.L.M., Teixeira A.L., Moreira J.M., Simões E Silva A.C. Rehabilitation intervention is associated with improved neurodevelopment and modulation of inflammatory molecules in children with cerebral palsy. J. Child Neurol. 2024;39(9-10):324–333. doi: 10.1177/08830738241273436Nash D., Hughes M.G., Butcher L., Aicheler R., Smith P., Cullen T., Webb R. IL-6 signaling in acute exercise and chronic training: Potential consequences for health and athletic performance. Scand. J. Med. Sci. Sports. 2023;33(1):4–19. doi: 10.1111/sms.14241Nash D., Hughes M.G., Butcher L., Aicheler R., Smith P., Cullen T., Webb R. IL-6 signaling in acute exercise and chronic training: Potential consequences for health and athletic performance. Scand. J. Med. Sci. Sports. 2023;33(1):4–19. doi: 10.1111/sms.14241Vella C.A., Allison M.A., Cushman M., Jenny N.S., Miles M.P., Larsen B., Lakoski S.G., Michos E.D., Blaha M.J. Physical activity and adiposity-related inflammation: the MESA. Med. Sci. Sports. Exerc. 2017;49(5):915–921. doi: 10.1249/MSS.0000000000001179Vella C.A., Allison M.A., Cushman M., Jenny N.S., Miles M.P., Larsen B., Lakoski S.G., Michos E.D., Blaha M.J. Physical activity and adiposity-related inflammation: the MESA. Med. Sci. Sports. Exerc. 2017;49(5):915–921. doi: 10.1249/MSS.0000000000001179Hamer M., Sabia S., Batty G.D., Shipley M.J., Tabák A.G., Singh-Manoux A., Kivimaki M. Physical activity and inflammatory markers over 10 years: follow-up in men and women from the Whitehall II cohort study. Circulation. 2012;126(8):928–933. doi: 10.1161/CIRCULATIONAHA.112.103879Hamer M., Sabia S., Batty G.D., Shipley M.J., Tabák A.G., Singh-Manoux A., Kivimaki M. Physical activity and inflammatory markers over 10 years: follow-up in men and women from the Whitehall II cohort study. Circulation. 2012;126(8):928–933. doi: 10.1161/CIRCULATIONAHA.112.103879Libardi C.A., de Souza G.V., Cavaglieri C.R., Madruga V.A., Chacon-Mikahil M.P. Effect of resistance, endurance, and concurrent training on TNF-α, IL-6, and CRP. Med. Sci. Sports. Exerc. 2012;44(1):50– 56. doi: 10.1249/MSS.0b013e318229d2e9Libardi C.A., de Souza G.V., Cavaglieri C.R., Madruga V.A., Chacon-Mikahil M.P. Effect of resistance, endurance, and concurrent training on TNF-α, IL-6, and CRP. Med. Sci. Sports. Exerc. 2012;44(1):50– 56. doi: 10.1249/MSS.0b013e318229d2e9Park S.S., Park S.H., Jeong H.T., Shin M.S., Kim M.K., Kim B.K., Yoon H.S., Kim S.H., Kim T.W. The effect of treadmill exercise on memory function and gut microbiota composition in old rats. J. Exerc. Rehabil. 2024;20(6):205–212. doi:10.12965/jer.2448692.346Park S.S., Park S.H., Jeong H.T., Shin M.S., Kim M.K., Kim B.K., Yoon H.S., Kim S.H., Kim T.W. The effect of treadmill exercise on memory function and gut microbiota composition in old rats. J. Exerc. Rehabil. 2024;20(6):205–212. doi:10.12965/jer.2448692.346Feng H., Qi Y., Wang X., Chen F., Li X. Treadmill exercise decreases inflammation via modulating IL-6 expression in the rat model of middle cerebral artery occlusion. Neurocrit. Care. 2023;38(2):279–287. doi: 10.1007/s12028-022-01575-3Feng H., Qi Y., Wang X., Chen F., Li X. Treadmill exercise decreases inflammation via modulating IL-6 expression in the rat model of middle cerebral artery occlusion. Neurocrit. Care. 2023;38(2):279–287. doi: 10.1007/s12028-022-01575-3Zheng G., Qiu P., Xia R., Lin H., Ye B., Tao J., Chen L. Effect of aerobic exercise on inflammatory markers in healthy middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials. Front. Aging Neurosci. 2019;11:98. doi: 10.3389/fnagi.2019.00098Zheng G., Qiu P., Xia R., Lin H., Ye B., Tao J., Chen L. Effect of aerobic exercise on inflammatory markers in healthy middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials. Front. Aging Neurosci. 2019;11:98. doi: 10.3389/fnagi.2019.00098da Cunha M.J., Pires Dorneles G., Peres A., Maurer S., Horn K., Souza Pagnussat A. tDCS does not add effect to foot drop stimulator and gait training in improving clinical parameters and neuroplasticity biomarkers in chronic post-stroke: randomized controlled trial. Int. J. Neurosci. 2024;134(12):1518–1527. doi: 10.1080/00207454.2023.2272041da Cunha M.J., Pires Dorneles G., Peres A., Maurer S., Horn K., Souza Pagnussat A. tDCS does not add effect to foot drop stimulator and gait training in improving clinical parameters and neuroplasticity biomarkers in chronic post-stroke: randomized controlled trial. Int. J. Neurosci. 2024;134(12):1518–1527. doi: 10.1080/00207454.2023.2272041Reid L.B., Rose S.E., Boyd R.N. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy. Nat. Rev. Neurol. 2015;11(7):390–400. doi: 10.1038/nrneurol.2015.97Reid L.B., Rose S.E., Boyd R.N. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy. Nat. Rev. Neurol. 2015;11(7):390–400. doi: 10.1038/nrneurol.2015.97Reid S., Hamer P., Alderson J., Lloyd D. Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy. Dev. Med. Child Neurol. 2010;52(4):358–363. doi: 10.1111/j.1469-8749.2009.03409.xReid S., Hamer P., Alderson J., Lloyd D. Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy. Dev. Med. Child Neurol. 2010;52(4):358–363. doi: 10.1111/j.1469-8749.2009.03409.xHou S., Wu G., Liang J., Cheng H., Chen C. Hyperbaric oxygen on rehabilitation of brain tumors after surgery and effects on TNF-α and IL-6 levels. Oncol. Lett. 2019;17(3):3277–3282. doi: 10.3892/ol.2019.10000Hou S., Wu G., Liang J., Cheng H., Chen C. Hyperbaric oxygen on rehabilitation of brain tumors after surgery and effects on TNF-α and IL-6 levels. Oncol. Lett. 2019;17(3):3277–3282. doi: 10.3892/ol.2019.10000Sharova O., Smiyan O., Borén T. Immunological effects of cerebral palsy and rehabilitation exercises in children. Brain Behav. Immun. Health. 2021;18:100365. doi: 10.1016/j.bbih.2021.100365Sharova O., Smiyan O., Borén T. Immunological effects of cerebral palsy and rehabilitation exercises in children. Brain Behav. Immun. Health. 2021;18:100365. doi: 10.1016/j.bbih.2021.100365

The authors declare that there are no conflicts of interest present.