Balneotherapy as a potential immunomodulator in inflammaging

Abstract

Objective: This study aimed to investigate the association between the senescence-associated secretory phenotype (SASP) and balneotherapy (BT) in the elderly. Materials and methods: Patients over the age of 65 with simple osteoarthritis were screened for their demographic characteristics, and those prone to inflammaging were included. Individuals were divided into two groups: the BT group (n = 20) and the control group (n = 20). Patients in both groups performed home-based relaxation and active range of motion (ROM) exercises three times a week. SASP levels were evaluated in both groups before and after 2 weeks of intervention. Results: In the BT group, interleukin-8 (IL-8) (p = 0.044), laminin (LN) (p < 0.001), fibroblast growth factor-2 (p < 0.001), membrane cofactor protein (MCP-2) (p = 0.002), interleukin-1β (p = 0.002), metalloproteinase-3 (MMP-3) (p = 0.028), and tumor necrosis factor-α (TNF-α) (p = 0.044) increased following treatment, while MMP-1 (p = 0.019) decreased. In the control group, LN (p < 0.001), MMP-3 (p = 0.044), and MCP-2 (p < 0.001) increased, whereas TNF-α (p < 0.001) decreased. Intergroup comparisons showed significant changes in LN (p = 0.001), TNF-α (p < 0.001), and MMP-10 (p = 0.003). TNF-α and LN levels increased in favor of the BT group. A significant positive correlation was observed between TNF-α and the markers IL-8 (r = 0.344, p = 0.030), plasminogen activator inhibitor (r = 0.313, p = 0.050), LN (r = 0.328, p = 0.039), and glutathione (r = 0.374, p = 0.018). Conclusions: Our findings support the hypothesis that BT, through heat and chemical stressors, triggers a controlled inflammatory response that facilitates tissue regeneration while also mitigating oxidative stress to prevent excessive damage in aged individuals with potential inflammaging.