{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T08:03:27Z","timestamp":1774080207638,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007594","name":"Comenius University in Bratislava","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007594","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disease-modifying therapies (DMTs) in multiple sclerosis (MS) effectively reduce relapse activity but have limited impact on chronic progression and neurodegeneration. Non-pharmacological interventions such as structured exercise or the Wim Hof Method (WHM- which includes breathing exercises, cold exposure, and meditation), may offer complementary immunomodulatory and neuroprotective benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effects of WHM and a lifestyle intervention (LIFE; structured physical activity and nutritional counseling) on systemic inflammation and neurodegeneration biomarkers in patients with MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this randomized, prospective pilot trial, 60 MS patients (2017 McDonald criteria, EDSS 1.0\u20135.5) were allocated to WHM, LIFE, or control (CTRL) for 12 weeks. Serum cytokines (IFN-\u03b3, IL-1\u03b2, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were assessed at baseline and after 12 weeks. Mixed repeated-measures ANOVA with Bonferroni correction was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Complete datasets were obtained and analyzed for 43 participants (12 WHM, 17 LIFE, 14 CTRL; power= 0.81). Both interventions significantly reduced IL-17A and IL-18 (p&lt;0.001), indicating attenuation of Th17-related inflammation. WHM further decreased IFN-\u03b3, while LIFE lowered IL-8. No significant changes were observed for IL-1\u03b2, IL-6, IL-12p70, NfL, or GFAP. Both interventions were well tolerated, with no treatment-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both WHM and lifestyle modification demonstrated comparable short-term anti-inflammatory effects in MS, supporting their safety and feasibility as adjunctive strategies to DMT. Although neurodegeneration biomarkers remained unchanged, the consistent reduction of IL-17A and IL-18 highlights their potential to modulate smoldering inflammation. Larger, longer-term trials are warranted to determine their sustained effects on disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-08895-8","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T03:44:16Z","timestamp":1772077456000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeting low-grade inflammation in multiple sclerosis through the Wim Hof method or lifestyle intervention: a pilot comparative study"],"prefix":"10.1007","volume":"47","author":[{"given":"Darina","family":"Slez\u00e1kov\u00e1","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise M\u00e1ria","family":"Sabolov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Mar\u010dek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavol","family":"Kadlic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Hric","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Libu\u0161a","family":"Nechalov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"Bielik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"P\u00e1len\u00edk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Pastorek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Olej","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"\u017dilka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Hanes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franti\u0161ek","family":"Jur\u010daga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0812-2366","authenticated-orcid":false,"given":"Michal","family":"Min\u00e1r","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"8895_CR1","doi-asserted-by":"publisher","first-page":"175628642110667","DOI":"10.1177\/17562864211066751","volume":"15","author":"G Giovannoni","year":"2022","unstructured":"Giovannoni G et al (2022) Smouldering multiple sclerosis: the \u2018real MS\u2019. 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