Balneotherapy as a potential immunomodulator in inflammaging

This study aimed to investigate the association between the senescence-associated secretory phenotype (SASP) and balneotherapy (BT) in the elderly.

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.

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).

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.