Exercise and the Regulation of Immune Functions

Can exercise as a complementary technique manage inflammatory markers in women with breast cancer who are overweight and obese? A systematic review and meta-analysis

BACKGROUND

Inflammation can result in the development of breast cancer in women with overweight and obese, and also affects the outcome and prognosis of breast cancer patients, thereby decreasing the cure and survival rates of breast cancer patients. Exercise may benefit breast cancer patients as a supplement to conventional treatments. However, research on the effects of exercise on inflammatory markers in women with breast cancer who are overweight and obese remains incomplete.

OBJECTIVE

A systematic review and meta-analysis were used to study the effects of exercise on inflammatory markers in women with breast cancer who are overweight and obese.

METHOD

Literature up to May 2024 was searched from databases such as Cochrane, Embase, Pubmed, Web of Science, and EBSCO, and English-language randomized controlled trials (RCTs) that met the inclusion criteria were screened. The screening criteria were as follows (A) written in English; (B) RCT; (C) studied in women with overweight obese and breast cancer; (D) outcome measures: inflammatory markers; (E) the duration of the exercise intervention was unlimited.

RESULTS

A total of 14 articles and 1064 participants were included. Exercise significantly reduced C-reactive protein (CRP) (MD: -0.52, 95 % CI: -0.94 to -0.11; p = 0.01; heterogeneity p < 0.1), interleukin-6 (IL-6) (MD: -0.87, 95 % CI: -1.62 to -0.11; p = 0.02; heterogeneity p < 0.1), and leptin (MD: -0.92, 95 % CI: -1.71 to -0.13; p = 0.02; heterogeneity p < 0.1) levels and exercise significantly increased adiponectin levels (MD: 0.89, 95 % CI: 0.03-1.75, p = 0.04; heterogeneity p < 0.1) but had no effect on tumor necrosis factor-α (TNF-α) (MD: -0.26, 95 % CI: -0.82-0.29; p = 0.35; heterogeneity p < 0.1) and IL-10 (MD: 0.14, 95 % CI: -0.17-0.45; p = 0.37; heterogeneity p = 0.45) were not significant. In addition, subgroup analyses suggest that combination training (CE) may be the most recommended type of exercise to decrease pro-inflammatory markers, and increase anti-inflammatory markers in women with overweight obesity, and have breast cancer.

CONCLUSION

Exercise significantly reduced CRP, IL-6, and leptin levels and overall increased adiponectin levels in women with overweight obese, and breast cancer. However, the effects on TNF-α and IL-10 levels were not significant. CE may be the most recommended type of exercise for reducing pro-inflammatory factors and increasing anti-inflammatory factors. Therefore, this study considers exercise as an effective complementary approach to managing inflammatory markers in women with breast cancer who are overweight and obese. Future researchers may consider exploring the combined effects of exercise and dietary control, weight loss, and other factors, and formulate a comprehensive treatment plan accordingly.

Unveiling the role of exercise in modulating plasma heat shock protein 27 levels: insights for exercise immunology and cardiovascular health

Cardiovascular disease is one of the leading causes of mortality worldwide, primarily driven by atherosclerosis, a chronic inflammatory condition contributing significantly to fatalities. Various biological determinants affecting cardiovascular health across different age and sex groups have been identified. In this context, recent attention has focused on the potential therapeutic and preventive role of increasing circulating levels of heat shock protein 27 (plasma HSP27) in combating atherosclerosis. Plasma HSP27 is recognized for its protective function in inflammatory atherogenesis, offering promising avenues for intervention and management strategies against this prevalent cardiovascular ailment. Exercise has emerged as a pivotal strategy in preventing and managing cardiovascular disease, with literature indicating an increase in plasma HSP27 levels post-exercise. However, there is limited understanding of the impact of exercise on the release of HSP27 into circulation. Clarifying these aspects is crucial for understanding the role of exercise in modulating plasma HSP27 levels and its potential implications for cardiovascular health across diverse populations. Therefore, this review aims to establish a more comprehensive understanding of the relationship between plasma HSP27 and exercise.

Development and validation of the systemic nutrition/inflammation index for improving perioperative management of non-small cell lung cancer

BACKGROUND

Systemic nutrition and inflammation status is recognized for its influence on cancer survival, yet its role in perioperative outcomes remains poorly defined. This study aimed to refine the assessment of systemic nutrition and inflammation status in non-small cell lung cancer (NSCLC) patients and to elucidate its impact on perioperative outcomes.

METHODS

All patients underwent video-assisted thoracoscopic lobectomy, with their nutrition and inflammation status assessed based on preoperative blood tests. The development cohort, comprising 1497 NSCLC patients from two centers, evaluated the predictive value of systemic nutrition/inflammation indicators for perioperative endpoints and formulated the systemic nutrition-inflammation index (SNII). The tertiles of SNII were used to classify the nutrition/inflammation risk as high (< 15.6), moderate (15.6-23.1), and low (> 23.1). An external validation cohort of 505 NSCLC patients was utilized to confirm the effectiveness of SNII in guiding perioperative management.

RESULTS

In the development cohort, the SNII tool, calculated as the product of total cholesterol and total lymphocytes divided by total monocytes, demonstrated a stronger correlation with perioperative outcomes compared to 11 existing nutrition/inflammation indicators. A low SNII score, indicative of high nutrition/inflammation risk, was independently predictive of increased complication incidence and severity, as well as prolonged chest tube duration and hospital stay. These findings were corroborated in the validation cohort. Upon combining the development and validation cohorts, the superiority of the SNII in predicting perioperative outcomes was further confirmed over the existing nutrition/inflammation indicators. Additionally, comprehensive subgroup analyses revealed the moderately variable efficacy of SNII across different patient populations.

CONCLUSIONS

This study developed and validated the SNII as a tool for identifying systemic nutrition and inflammation risk, which can enhance perioperative managements in NSCLC patients. Patients identified with high risk may benefit from prehabilitation and intensive treatments, highlighting the need for further research.

An aerobe exercise intervention for optimizing metabolic, cardiovascular and immune status: protocol of an intervention study with a multi-systemic approach for women with unexplained recurrent pregnancy loss

Women confronted with recurrent pregnancy loss (RPL) are often desperately searching for a possible explanation and hoping they will someday fulfill a healthy pregnancy. Unfortunately, in more than 50% of these women no cause for their losses can be identified after clinical investigations and therefore clinicians have no treatment options to help these women. Although adaptations in several systems such as the metabolic, the cardiovascular, and the immune system are highly important to support early pregnancy, especially the contribution of a specific subset of immune cells in the uterus known as CD56bright Natural Killer (NK) cells has gained a lot of interest, investigating separate RPL associated factors might not be the way forward. Moreover, a readily available and non-invasive exercise intervention might optimize all systems simultaneously, reducing metabolic, cardiovascular and immunological risk factors contributing to RPL. Therefore, we propose an aerobe exercise intervention and study the influence on the cardiovascular, the metabolic, and the immune system, with a particular focus on endometrial CD56bright NK cells, in women with unexplained RPL. In this exercise intervention study, women with unexplained RPL will receive two questionnaires to assess baseline characteristics. Moreover, they will receive (1) an immunological assessment (by sampling menstrual blood, peripheral blood and a vaginal swab) (2) an assessment of the cardiovascular system (by transvaginal ultrasound to assess uterine artery perfusion, by measuring hemodynamic and autonomic nerve system responses during a tilt test and by maximum stress test on a cycle ergometer) and (3) a metabolic assessment (by sampling peripheral blood, urine and by measuring body characteristics) before and after intervention. The intervention consists of 12-weeks moderate exercise training based on 50-65% of heart rate reserve. One year after the end of the intervention women will receive a final questionnaire regarding possible subsequent pregnancy outcome. This clinical trial with a multi-systemic approach can not only provide new insights by studying contribution and associations of the immune system, the cardiovascular system and the metabolic system in women with unexplained RPL, it also can support shared decision-making between clinicians and patients by evaluating the importance of a ready available exercise intervention strategy.

Effects of Exercise Training on the Bone Marrow Immune Microenvironment and Minimal Residual Disease in Multiple Myeloma Patients Following First-Line Treatment

The purpose of the study was to investigate the effects of exercise training on the bone marrow immune microenvironment and on minimal residual disease of multiple myeloma patients who completed first-line induction treatment. Eight multiple myeloma patients underwent 5 months of exercise training along with standard medical treatment. Eight age- and sex-matched patients who received medical treatment only, served as controls. Before and after the intervention, white blood cells, red blood cells, and platelets, as well as the percentages of neutrophils, lymphocytes, monocytes, eosinophils, and basophils, were measured in the peripheral blood. Abnormal plasma cells, normal plasma cells, B cells, T cells, NK/NKT cells, monocytes, neutrophils, eosinophils, basophils, mast cells, myeloid progenitors, erythroid progenitors, and erythroblasts were assessed in the bone marrow. Exercise training increased the percentage of blood monocytes (mean difference 3.5% ± 2.6%; p = 0.006), while no change was detected in the control group. In the bone marrow, the CD27+ T cell subset increased (mean difference 18.2% ± 21.9%; p = 0.043) and the ratio of CD27-/CD27+ T lymphocytes decreased (pre: 1.06 ± 0.59; post: 0.76 ± 0.47; p = 0.049) in the exercise group, but remained unaltered in the control group. In conclusion, the study provides evidence that 5 months of exercise training can induce an increase in the percentage of activated T lymphocytes, as shown by the higher expression of the costimulatory CD27 marker. It also suggests that exercise-induced changes in the bone marrow microenvironment may be beneficial in the control of clonal cell proliferation.

Unraveling the transcriptomic effects of leucine supplementation on muscle growth and performance in basketball athletes

Leucine has gained recognition as an athletic dietary supplement in recent years due to its various benefits; however, the underlying molecular mechanisms remain unclear. In this study, 20 basketball players were recruited and randomly assigned to two groups. Baseline exercise performance-assessed through a 282-foot sprint, free throws, three-point field goals, and self-rated practice assessments-was measured prior to leucine supplementation. Participants were then given a functional drink containing either leucine (50 mg/kg body weight) or a placebo for 28 days. After supplementation, the same exercise performance metrics were reassessed. Following leucine supplementation, biceps brachii muscle tissue from both groups was collected for transcriptome sequencing and qPCR verification. Our results suggested that leucine supplementation significantly improved 282-foot sprint performance, reducing times from 17.4 ± 0.9 to 16.2 ± 0.9 seconds in the leucine group, compared to minimal changes in the control group (from 17.3 ± 0.9 to 17.1 ± 0.8 seconds; P = 0.034). For other exercise performance metrics, no significant differences were observed (P > 0.05); however, trends toward improvement were noted. Transcriptomic analysis revealed 3,658 differentially expressed genes (DEGs) between the two groups. These DEGs were enriched in pathways related to immune response (P < 0.0001), positive regulation of cytokine production (P < 0.0001), and neutrophil extracellular trap formation (P < 0.0001), among others. Weighted Gene Co-expression Network Analysis (WGCNA) identified a module (turquoise) strongly associated with muscle growth, with DEGs in this module enriched in cytoskeletal pathways in muscle cells. Gene expression changes (α-tubulin, β-tubulin, CK18, CK8, vimentin, cofilin, gelsolin, profilin, MAP1, MAP2, MAP4, E-cadherin, and N-cadherin) were verified by qPCR. In summary, leucine supplementation improved exercise performance, particularly by significantly reducing sprint times and showing trends of improvement in other performance metrics, including three-point field goals, free throws, and self-rated well-being. Identified DEGs enriched in pathways related to immune response, cytokine production, and cell adhesion. WGCNA highlighted a key module associated with muscle growth, enriched in cytoskeletal pathways. qPCR validation confirmed the upregulation of cytoskeleton-related genes, supporting the transcriptomic findings. These results suggest that leucine enhances muscle adaptation by regulating cytoskeletal dynamics, providing molecular insights into its role in improving athletic performance.

Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above

Background

Regular participation in physical activity (PA) reduces all-cause mortality (ACM) in the general population. However, the effects of PA on depressed patients and potential gender-specific responses have not been fully elucidated. In this study, we aimed to investigate the role of PA on new-onset depression and ACM in Chinese adults aged 45 year and older, with particular emphasis on gender differences.

Methods

This was a longitudinal cohort study that took place over a nine-year period and featured 2,264 participants drawn from the China Health and Retirement Longitudinal Study (CHARLS). PA levels were categorized into quartiles using metabolic equivalents (MET; minutes/week), and depression was evaluated according to the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) scale. Specific relationships between PA, depression, and mortality were then investigated by applying multivariate logistic regression and Cox proportional hazards models.

Results

Highest quantile levels of PA were correlated with a 37% increase in the risk of new-onset depression in middle-aged (45-59 years) and older adults (>60 years). This association was predominantly influenced by a significant increase in the risk of mild depression (a score of 10-14 on the CESD-10) (odds ratio [OR]: 1.76; 95% confidence interval [CI]: 1.29-2.42, p < 0.001), with a more pronounced effect observed in women (OR: 1.83; 95% CI: 1.26-2.66, p = 0.002). A critical threshold for PA was identified at 4536 MET-minutes/week, beyond which the risk of depression increased significantly (p < 0.05). Conversely, higher levels of PA were linked to a 90% reduction in ACM (HR: 0.10; 95% CI: 0.02-0.44, p = 0.002), with the effect being more pronounced in men.

Conclusion

While PA reduces mortality, excessive activity may increase the risk of mild depression, particularly in women. These findings highlight the need for gender-specific PA guidelines that balance physical and mental health outcomes.

Immune inflammation markers and physical fitness during a congested match play period in elite male soccer players

BACKGROUND/OBJECTIVE

Cellular immune markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) are frequently used in patient care. The adoption of these markers to elite sports, e.g. soccer could be beneficial when monitoring training and aiming to maximize physical fitness. This study investigated cellular immune inflammation markers and physical fitness in elite male soccer players in relation to changes in training and match exposure during a congested match play period.

METHODS

Fifteen elite male soccer players were evaluated three times (T1, T2, and T3) over 12 weeks (T1-T2: six weeks uncongested period of match play and T2-T3: six weeks congested period of match play). Players performed vertical jump tests (squat jumps [SJ], countermovement jumps [CMJ]), the 20-meter sprint test, and the Yo-Yo intermittent recovery test (YYIRL1) at T1, T2 and T3. Measurements included counts of leucocytes and its subtypes, as well as platelets. Cellular immune inflammation markers (NLR, PLR and SII) were calculatedat T1, T2, and T3. Training session rating of perceived exertion was also recorded on a daily basis.

RESULTS

Significant increases in leucocyte, neutrophil, eosinophil, basophil and monocyte counts occurred at T3 compared with T2 (0.002 < p < 0.04, -0.56 < ES < -0.40) and T1 (-0.78 < ES < -0.49). Lymphocyte counts were lower at T3 as compared to T2 and T1 (p = 0.038, -0.48 < ES <-0.25), while NLR, PLR and SII were greater at T3 compared to T2 (0.001 < p < 0.015, -1.01 < ES < -0.44) and T1 (-0.99 < ES < -0.21). There was a negative correlation between YYIRL1 performance with NLR (r= -0.56; p = 0.02), PLR (r=-0,44, p = 0.015), and SII (r= -0.63; p = 0.01) after the congested period of match play (i.e., T3). Values for maximal oxygen uptake (VO2max), estimated from the YYIRL1 test, negatively correlated with NLR (r= -0.56; p = 0.02), PLR (r=-0,44, p = 0.015), and SII (p = 0.01; r= -0.63). There was a positive correlation between NLR, and SII with workload parameters. In addition, a clear positive correlation was observed between NLR and SII with competitive loadinstead (r= [0.59-0.64; p˂ 0.001), training load (TL) (r= [0.65-0.68]; p˂ 0.001), session rating of perceived exertion (S-RPE) (r= [0.65-0.68]; p = 0.001), and training volume (r= [0.60-0.61; p = 0.001).

CONCLUSION

An intensive period of congested match play significantly alterated immune cell counts and cellular markers of inflammation (NLR, PLR and SII). Changes in NLR and SII were related to workload parameters, suggesting the usefulness of these markers in regulating training intensity and competitive load. An association between physical fitness (YYIRL1, VO2max) and NLR, PLR and SII suggests that these biomarkers are promising tools to monitor aerobic physical fitness of elite soccer players during congested periods of match play.

Emerging Mechanisms of Physical Exercise Benefits in Adjuvant and Neoadjuvant Cancer Immunotherapy

The primary factors that can be modified in one's lifestyle are the most influential determinants and significant preventable causes of various types of cancer. Exercise has demonstrated numerous advantages in preventing cancer and aiding in its treatment. However, the precise mechanisms behind these effects are still not fully understood. To contribute to our comprehension of exercise's impact on cancer immunotherapy and provide recommendations for future research in exercise oncology, we will examine the roles and underlying mechanisms of exercise on immune cells. In addition to reducing the likelihood of developing cancer, exercise can also improve the effectiveness of certain approved anticancer treatments, such as targeted therapy, immunotherapy, and radiotherapy. Exercise is a pivotal modulator of the immune response, and thus, it can play an emerging important role in new immunotherapies. The mechanisms responsible for these effects involve the regulation of intra-tumoral angiogenesis, myokines, adipokines, their associated pathways, cancer metabolism, and anticancer immunity. Our review assesses the potential of physical exercise as an adjuvant/neoadjuvant tool, reducing the burden of cancer relapse, and analyzes emerging molecular mechanisms predicting favorable adjuvanticity effects.

Exploring the association between lifestyle and cardiovascular health metrics and HPV infection risk: insights from the National Health and Nutrition Examination Survey 2005-2016 data

BACKGROUND

Human Papillomavirus (HPV) infection has garnered significant attention due to its high prevalence and association with various cancers and other health conditions. Composite lifestyle factors may influence the risk of HPV infection, yet their cumulative impact remains insufficiently explored. This study aims to explore the association between the Life's Essential 8 (LE8) Score and HPV infection status, highlighting the potential role of lifestyle and health behaviors in HPV infection prevention.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2016, we analyzed the health and nutritional statuses of 6,773 participants after excluding those with missing HPV infection status, inability to calculate the LE8 Score, and missing covariate data. The LE8 Score was computed based on eight cardiovascular health metrics, encompassing both health factors (BMI, non-HDL cholesterol, blood pressure, and blood glucose) and health behaviors (physical activity, diet, sleep duration, and nicotine exposure). HPV infection status was determined through vaginal swab specimens analyzed using various Roche assays. Multivariate logistic regression, the restricted cubic splines (RCS) analysis and weighted quantile sum (WQS) regression were employed to assess the association between LE8 Score and HPV infection risk.

RESULTS

Our findings indicate a significant inverse association between the LE8 Score and HPV infection risk. Participants with medium and high LE8 Scores exhibited a 21% and 31% lower risk of HPV infection, respectively, compared to those with low LE8 Scores in multivariate logistic regression models. The analysis also revealed that lifestyle factors, particularly nicotine exposure and blood pressure, significantly contributed to the observed association.

CONCLUSION

The study underscores the importance of healthy lifestyle behaviors in reducing the risk of HPV infection. Public health strategies promoting such behaviors could complement existing HPV prevention measures, potentially lowering the burden of HPV-related diseases. Future research should further investigate the mechanisms underlying this association and the effectiveness of lifestyle interventions in diverse populations.

Combined proteomics and metabolomics analysis reveal the effect of a training course on the immune function of Chinese elite short-track speed skaters

INTRODUCTION

The aim of this study was to combine proteomics and metabolomics to evaluate the immune system of short-track speed skaters (STSS) before and after a training course. Our research focused on changes in urinary proteins and metabolites that have the potential to serve as indicators for training load.

METHODS

Urine samples were collected from 21 elite STSS (13 male and 8 female) of the China National Team before and immediately after one training course. First-beat sports sensor was used to monitor the training load. Proteomic detection was performed using a Thermo UltiMate 3000 ultra high performence chromatography nano liquid chromatograph and an Orbitrap Exploris 480 mass spectrometer. MSstats (R package) was used for the statistical evaluation of significant differences in proteins from the samples. Two filtration criteria (fold change [FC] > 2 and p < 0.05) were used to identify the differential expressed proteins. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis for differential proteins was performed to identify the pathways involved. Nontargeted metabolomic detection was performed using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS_) with an ACQUITY 2D UPLC plus Q Exactive (QE) hybrid Quadrupole-Orbitrap mass spectrometer. Differential metabolites were identified using non-parametric statistical methods (Wilcox's rank test). Two filtration criteria (FC > 1.2 and p < 0.05) were used to identify differential metabolites. Combined analysis of proteomic and metabolomics were performed on the "Wu Kong" platform. Correlation analysis was performed using Spearman's rank correlation coefficient.

RESULTS

(1) The most upregulated proteins were immune-related proteins, including complement proteins (C9, C4-B, and C9) and immunoglobulins (IgA, IgM, and IgG). The most downregulated proteins were osteopontin (OPN) and CD44 in urine. The correlation analysis showed that the content of OPN and CD44 (the receptor for OPN) in urine were significantly negatively correlated with the upregulated immune-related proteins. The content of OPN and CD44 is sex-dependent and negatively correlated with the training load. (2) The most upregulated metabolites included lactate, cortisol, inosine, glutamine, argininosuccinate (the precursor for arginine synthesis), 3-methyl-2-oxobutyrate (the catabolite of valine), 3-methyl-2-oxovalerate (the catabolite of isoleucine), and 4-methyl-2-oxopentanoate (the catabolite of leucine), which is sex-dependent and negatively correlated with OPN and CD44. (3) The joint analysis revealed five main related pathways, including the immune and innate immune systems. The enriched immune-related proteins included complements, immunoglobulins, and protein catabolism-related proteins. The enriched immune-related metabolites included cAMP, N-acetylgalactosamine, and glutamate. (4) There is a significant negative correlation between the content of OPN and CD44 in urine and the training load.

CONCLUSION

One training course can lead to the activation of the immune system and a sex-dependent decrease in the content of OPN and CD44. Training load has a significant and negative correlation with the content of OPN and CD44, suggesting that OPN and CD44 could be potential indicators for training load.

Effects of circuit weight training by intensity on stress hormones and antioxidant capacity in high-school wrestlers

We aimed to investigate the effects of 8-week circuit weight training by intensity on blood stress hormones and antioxidant capacity in high-school wrestlers. This study involved 27 male wrestlers with >2 years of wrestling experience who were randomly assigned to either a low intensity (n=13) or a high-intensity circuit weight training group (n=14). The participants performed circuit weight training for 60 min per session, 3 times per week for 8 weeks. The low- and high-intensity circuit weight training exercises were performed at 50%-60% and 70%-80% of one-repetition maximum for 10 stations, respectively, and 8-15 repeated sessions per station were performed in order. No changes were observed in adrenocorticotropic hormone (ACTH), cortisol, epinephrine, and norepinephrine levels between the two training groups. When compared to levels before the training, ACTH and epinephrine levels decreased, whereas cortisol levels increased. However, no difference was observed in norepinephrine levels. Further, no differences were observed in malondialdehyde (MDA) and glutathione peroxidase (GPX) levels between the two groups. However, MDA and GPX levels were increased from those before training. Changes in superoxide dismutase levels were observed between the two groups, but the change was significant only in the high-intensity circuit weight training group. Long-term training did not increase lipid peroxidation, but increased the activity of antioxidant enzymes that defend against oxidative stress. The antioxidant defense system in tissues can be regulated by exercise intensity as well as physical training status.

Kinetics of Immune Cell Mobilization during Acute Aerobic Exercise in Healthy Adults

While pre-post differences in immune cell mobilization after acute aerobic exercise are well investigated, less is known about when and to what extent immune cells are mobilized during acute aerobic exercise. This experimental trial aimed to investigate the detailed kinetics of circulating immune cells in twelve healthy adults (n=6 females) who completed a 40-min aerobic exercise bout at 60% of the participants' V̇O2peak on a bicycle ergometer. Cellular inflammation markers and sex-dependent differences in circulating immune cells were analyzed. Blood samples were taken immediately before, after warm-up, during exercise after 5 min, 10 min, 15 min, 30 min, 40 min (cessation), and 60 min post exercise. Significant increases in leukocytes (p<0.001), lymphocytes (p<0.001), neutrophils (p=0.003) and platelets (p=0.047) can be observed after 5 min of exercise. The cellular inflammation markers show significant alterations only post exercise. Significant sex differences were observed for neutrophils (p=0.049) and neutrophil-to-lymphocyte ratio (p=0.007) one hour post exercise. These results indicate that i) leukocytes are already mobilized after 5 min of moderate-to-vigorous aerobic exercise, ii) the magnitude of exercise induced leukocyte mobilization is dependent on exercise duration, iii) integrative cellular inflammation markers are only altered after exercise cessation, and iv) the observed effects might be sex-dependent.

Effect of physical activity on risk reduction of infective endocarditis among patients with diabetes: a nationwide cohort study

Patients with diabetes mellitus (DM) are at a higher risk of infectious diseases, and exercise is an important treatment modality for DM. Despite their susceptibility to infection in diabetic patients, the association between the amount of physical activity and the incidence of infective endocarditis (IE) is unclear. We attempted to demonstrate risk reduction by physical activity in diabetic patients with IE. From the National Health Insurance database, patients with DM were verified, and the incidence of IE was investigated. The level of physical activity was categorized into < 500, 500-999, 1,000-1,499, and ≥ 1,500 metabolic equivalent task (METs) minutes/week. Cox proportional hazard models were used to analyze the relationship between incident IE and physical activity. A total of 2,603,012 patients were included in this study. The incidence rate of IE was 10.06, 9.45, 7.78, and 8.84 in < 500, 500-999, 1,000-1,499, and ≥ 1,500 METs-minutes/week groups, respectively (100,000 person/year). A significant risk reduction of incident IE was observed in the 1,000-1499 and ≥ 1,500 METs-min/week groups compared to the < 500 METs-min/week group (Hazard ratio = 0.82, 95% confidence interval [0.690-0.976], HR = 0.831, 95% CI [0.704-0.981]). An analysis of a large national cohort database demonstrated that physical exercise reduced the risk of IE in patients with DM.

Duration of Breastfeeding and Risk Reduction of Breast Cancer among Mothers Who Have Ever Breastfed: A Case-Control Study Conducted in Bahir Dar, Ethiopia

Introduction

Breast cancer is currently the most frequently detected cancer in women and the primary cause of cancer-related deaths globally. The incidence of breast cancer has significantly increased in countries across sub-Saharan Africa, counting Ethiopia. There are multiple determinants of breast cancer, a few of these can be changeable whereas others are not. Evidence suggests that breastfeeding, which is a changeable determinant, reduces breast cancer risk. However, there is a lack of evidence specifically linking the duration of breastfeeding to breast cancer risk. To date, no study has been conducted on the association between the duration of breastfeeding and the likelihood of breast cancer among Ethiopian women.

Objective

The aim of this study was to evaluate the relationship between breastfeeding duration and breast cancer risk in Ethiopian mothers who had breastfed, taking into account other significant determinants.

Methods

A hospital-based case-control study was carried out in Bahir Dar, Ethiopia, involving 203 women (70 cases and 133 controls). Face-to-face interviews were performed using a standardized, validated questionnaire that assessed various sociodemographic, reproductive, lifestyle, and dietary characteristics. Differences between cases and controls were evaluated using the chi-square test. The associations among factors were examined through bivariate and multivariable binary logistic regression, with results presented as odds ratios and 95% confidence intervals.

Results

The multivariable investigation revealed that an inverse relationship between breastfeeding duration and breast cancer risk. Mothers who breastfed for a longer period had a 93% lower risk of breast cancer (AOR = 0.07; 95% CI: 0.021-0.21) compared to those who breastfed for a shorter duration. Younger mothers had a 95% lower likelihood of developing breast cancer (AOR = 0.05; 95% CI: 0.003-0.91) than older mothers. Additionally, mothers with sedentary behaviour were 10.53 times more likely to develop breast cancer (AOR = 10.53; 95% CI: 5.21-21.36) than those who were moderately or highly active. Mothers who experienced chest therapy were 6.43 times more likely to develop breast cancer (AOR = 6.43; 95% CI: 3.20-13.90) compared to those who had not.

Conclusions

Interventions such as breastfeeding counselling and promoting the recommended duration of breastfeeding are crucial in minimizing the risk of breast cancer. Enhancing physical activity should also be viewed as a vital approach for lowering breast cancer risk. Additionally, healthcare professionals need to limit exposure to chest radiation therapy to reduce the likelihood of breast cancer.

Prediction of white blood cell count during exercise: a comparison between standalone and hybrid intelligent algorithms

Decades of research in exercise immunology have demonstrated the profound impact of exercise on the immune response, influencing an individual's disease susceptibility. Accurate prediction of white blood cells (WBCs) count during exercise can help to design effective training programs to maintain optimal the immune system function and prevent its suppression. In this regard, this study aimed to develop an easy-to-use and efficient modelling tool for predicting WBCs count during exercise. To achieve this goal, the predictive power of a range of machine-learning algorithms, including six standalone models (M5 prime (M5P), random forest (RF), alternating model trees (AMT), reduced error pruning tree (REPT), locally weighted learning (LWL), and support vector regression (SVR)) were assessed along with six types of hybrid models trained with a bagging (BA) algorithm (BA-M5P, BA-RF, BA-AMT, BA-REPT, BA-LWL, and BA- SVR). A comprehensive database was constructed from 200 eligible people. The models employed post-exercise training WBCs counts as the output parameter and seven WBCs-influencing factors, including intensity and duration of exercise, pre-exercise training WBCs counts, age, body fat percentage, maximal aerobic capacity, and muscle mass as input parameters. Comparing the prediction results of the models to the observed WBCs using standard statistics indicated that the BA-M5P model had the greatest potential to produce a robust prediction of the number of lymphocytes, neutrophils, monocytes, and WBC compared to other models. Moreover, pre-exercise training WBCs counts, intensity and duration of exercise and body fat percentage were the most important features in predicting WBCs counts. These findings hold significant implications for the advancement of exercise immunology and the promotion of public health.

Effect of aging and exercise on hTERT expression in thymus tissue of hTERT transgenic bacterial artificial chromosome mice

Telomere shortening occurs with aging in immune cells and may be related to immunosenescence. Exercise can upregulate telomerase activity and attenuate telomere shortening in immune cells, but it is unknown if exercise impacts other immune tissues such as the thymus. This study aimed to examine human telomerase reverse transcriptase (hTERT) alternative splicing (AS) in response to aging and exercise in thymus tissue. Transgenic mice with a human TERT bacterial artificial chromosome integrated into its genome (hTERT-BAC) were utilized in two different exercise models. Mice of different ages were assigned to an exercise cage (running wheel) or not for 3 weeks prior to thymus tissue excision. Middle-aged mice (16 months) were exposed or not to treadmill running (30 min at 60% maximum speed) prior to thymus collection. hTERT transcript variants were measured by RT-PCR. hTERT transcripts decreased with aging (r =  - 0.7511, p < 0.0001) and 3 weeks of wheel running did not counteract this reduction. The ratio of exons 7/8 containing hTERT to total hTERT transcripts increased with aging (r = 0.3669, p = 0.0423) but 3 weeks of voluntary wheel running attenuated this aging-driven effect (r = 0.2013, p = 0.4719). Aging increased the expression of senescence marker p16 with no impact of wheel running. Thymus regeneration transcription factor, Foxn1, went down with age with no impact of wheel running exercise. Acute treadmill exercise did not induce any significant changes in thymus hTERT expression or AS variant ratio (p > 0.05). In summary, thymic hTERT expression is reduced with aging. Exercise counteracted a shift in hTERT AS ratio with age. Our data demonstrate that aging impacts telomerase expression and that exercise impacts dysregulated splicing that occurs with aging.

Infections in long-duration space missions

As government space agencies and private companies announce plans for deep space exploration and colonisation, prioritisation of medical preparedness is becoming crucial. Among all medical conditions, infections pose one of the biggest threats to astronaut health and mission success. To gain a comprehensive understanding of these risks, we review the measured and estimated incidence of infections in space, effect of space environment on the human immune system and microbial behaviour, current preventive and management strategies for infections, and future perspectives for diagnosis and treatment. This information will enable space agencies to enhance their comprehension of the risk of infection in space, highlight gaps in knowledge, aid better crew preparation, and potentially contribute to sepsis management in terrestrial settings, including not only isolated or austere environments but also conventional clinical settings.

Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis

OBJECTIVE

Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19.

METHODS

The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis.

RESULTS

Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, p < 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, p = 0.016; OR = 2.18, p = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, p = 0.009) and SMQL (OR = 0.972, p = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic.

CONCLUSIONS

This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42023395476.

Causal effect of lifestyle and metabolic indicator with herpes zoster: a two-sample Mendelian randomization study

Background

Previous observational studies have reported certain causal relationships between factors such as smoking, alcohol consumption, obesity, physical activity, metabolic disorders, and the incidence of herpes zoster (HZ). However, there is controversy regarding the observed results across different studies. Our objective was to investigate the causal effects of these risk factors on the risk of herpes zoster through a Mendelian randomization analysis using two-sample bidirectional approaches.

Methods

We conducted two-sample bidirectional Mendelian randomization analyses to explore the causal relationships between different lifestyles, obesity assessment indices, metabolic indicators, and the risk of herpes zoster. All exposure and outcome data were sourced from publicly available data from genome-wide association studies.

Results

In the inverse-variance weighted (IVW) analysis, body mass index (BMI) (OR: 1.160, 95% CI: 1.030-1.307, p = 0.014), Body fat percentage (BFP) (OR: 1.241, 95% CI: 1.050-1.467, p = 0.011), and whole body fat mass (WBFM) (OR: 1.199, 95% CI: 1.057-1.362, p = 0.005) exhibited positive associations with the risk of HZ. However, usual walking pace (UWP) (OR: 0.498, 95% CI: 0.254-0.976, p = 0.042) demonstrated a significant negative correlation with HZ risk. Other factors including alcohol intake frequency, smoking initiation, smoking status, insomnia, and sleep duration did not show significant causal relationships with HZ.

Conclusion

Mendelian randomization studies revealed that BMI, BFP, and WBFM are risk factors for HZ. UWP showed a protective effect against HZ. These findings provide a straightforward method for evaluating future clinical practices aiming to develop personalized management strategies and assess high-risk populations for HZ.

Pro- and anti-inflammatory cytokines are the game-changers in childhood obesity-associated metabolic disorders (diabetes and non-alcoholic fatty liver diseases)

Childhood obesity is a chronic inflammatory epidemic that affects children worldwide. Obesity affects approximately 1 in 5 children worldwide. Obesity in children can worsen weight gain and raise the risk of obesity-related comorbidities like diabetes and non-alcoholic fatty liver disease (NAFLD). It can also negatively impact the quality of life for these children. Obesity disrupts immune system function, influencing cytokine (interleukins) balance and expression levels, adipokines, and innate and adaptive immune cells. The altered expression of immune system mediators, including interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-17 (IL-17), interleukin-18 (IL-18), transforming growth factor (TGF), tumor necrosis factor (TNF), and others, caused inflammation, progression, and the development of pediatric obesity and linked illnesses such as diabetes and NAFLD. Furthermore, anti-inflammatory cytokines, including interleukin-2 (IL-2), have been shown to have anti-diabetes and IL-1 receptor antagonist (IL-1Ra) anti-diabetic and pro-NAFLFD properties, and interleukin-10 (IL-10) has been shown to have a dual role in managing diabetes and anti-NAFLD. In light of the substantial increase in childhood obesity-associated disorders such as diabetes and NAFLD and the absence of an effective pharmaceutical intervention to inhibit immune modulation factors, it is critical to consider the alteration of immune system components as a preventive and therapeutic approach. Thus, the current review focuses on the most recent information regarding the influence of pro- and anti-inflammatory cytokines (interleukins) and their molecular mechanisms on pediatric obesity-associated disorders (diabetes and NAFLD). Furthermore, we discussed the current therapeutic clinical trials in childhood obesity-associated diseases, diabetes, and NAFLD.

Brief cycling intervals incrementally increase the number of hematopoietic stem and progenitor cells in human peripheral blood

Introduction

Peripheral blood stem cell (PBSC) donation is the primary procedure used to collect hematopoietic stem and progenitor cells (HSPCs) for hematopoietic stem cell transplantation. Single bouts of exercise transiently enrich peripheral blood with HSPCs and cytolytic natural killer cells (CD56dim), which are important in preventing post-transplant complications. To provide a rationale to investigate the utility of exercise in a PBSC donation setting (≈3 h), this study aimed to establish whether interval cycling increased peripheral blood HSPC and CD56dim concentrations to a greater degree than continuous cycling.

Methods

In a randomised crossover study design, eleven males (mean ± SD: age 25 ± 7 years) undertook bouts of moderate intensity continuous exercise [MICE, 30 min, 65%-70% maximum heart rate (HRmax)], high-volume high intensity interval exercise (HV-HIIE, 4 × 4 min, 80%-85% HRmax) and low-volume HIIE (LV-HIIE, 4 × 2 min, 90%-95% HRmax). The cumulative impact of each interval on circulating HSPC (CD34+CD45dimSSClow) and CD56dim concentrations (cells/µL), and the bone marrow homing potential of HSPCs (expression of CXCR-4 and VLA-4) were determined.

Results

There was an increase in HSPC concentration after two intervals of LV-HIIE (Rest: 1.84 ± 1.55 vs. Interval 2: 2.94 ± 1.34, P = 0.01) and three intervals of HV-HIIE only (Rest: 2.05 ± 0.86 vs. Interval 3: 2.51 ± 1.05, P = 0.04). The concentration of all leukocyte subsets increased after each trial, with this greatest for CD56dim NK cells, and in HIIE vs. MICE (LV-HIIE: 4.77 ± 2.82, HV-HIIE: 4.65 ± 2.06, MICE: 2.44 ± 0.77, P < 0.0001). These patterns were observed for concentration, not frequency of CXCR-4+ and VLA-4+ HSPCs, which was unaltered. There was a marginal decrease in VLA-4, but not CXCR-4 expression on exercise-mobilised HSPCs after all trials (P < 0.0001).

Discussion

The results of the present study indicate that HIIE caused a more marked increase in HSPC and CD56dim NK cell concentrations than MICE, with mobilised HSPCs maintaining their bone marrow homing phenotype. LV-HIIE evoked an increase in HSPC concentration after just 2 × 2-minute intervals. The feasibility and clinical utility of interval cycling in a PBSC donation context should therefore be evaluated.

Saturation effects of the relationship between physical exercise and systemic immune inflammation index in the short-sleep population: a cross-sectional study

BACKGROUND

Short sleep can lead to an increase in inflammation and regular exercise has been shown to have a mitigation effect. However, the association between physical exercise (PE) and inflammation in the short sleep population is an unknown and intriguing issue.

METHODS

NHANES dataset spanning the years 2007 to 2018 were analyzed. To investigate the relationship mentioned above, we carried out multivariate linear regression models controlling for sociodemographic and lifestyles factors. The systemic immune inflammation index (SII) served as a reflection of inflammatory potential, calculated as the product of platelet count, neutrophil count, and divided by the lymphocyte count. Self-reported questionnaires were used to collect sleep and exercise information.

RESULTS

A total of 14,664 participants were included for final analysis. Across the three models, PE showed significant negative associations with SII as a continuous variable [Crude Model, β (95% CI): -1.261(-1.600, -0.922), p < 0.001; Model 1, β (95% CI): -1.005(-1.344, -0.666), p < 0.001; Model 2, β (95% CI): -0.470(-0.827, -0.112), p = 0.011]. The consistent nature of the findings persisted when investigating physical exercise (PE) as a categorized variable. By two-piecewise linear regression model, we calculated a saturation effect of PE with the inflection point as 2400 MET-minutes/week.

CONCLUSION

This study suggested that performing no more than 2400 MET-minutes/week of PE was associated with lower SII levels in the short sleep population, while more PE might not bring additional benefits.

Circulating immune cell populations at rest and in response to acute endurance exercise in young adults with cerebral palsy

AIM

The aim of this observational study was to determine the immune status and function in young adults with cerebral palsy (CP) in comparison to typically developing individuals.

METHOD

Blood samples from 12 individuals with CP (five males, seven females; mean age: 25 years 1 month (5 years 9 months); age range: 19-38 years) and 17 typically developing individuals (eight males, nine females; mean age: 31 years 4 months (6 years 2 months); age range: 20-40 years) were collected before, immediately after, and 1 hour after 45 minutes of frame running or running respectively. Independent t-tests were used to compare heart rate, level of exertion, and baseline cell proportions between groups. Mixed model analysis of variance was utilized to investigate immune cell responses to exercise across groups.

RESULTS

Baseline levels of gamma delta (TCRγδ+) T-cells were significantly higher (absolute percentage: +2.65, p = 0.028) in the individuals with CP. Several cell populations showed similar significant changes after exercise in both CP and typically developing groups. Cytotoxic (CD8+) T-cells were only significantly elevated immediately after exercise in the typically developing participants (p < 0.01). Individuals with CP exhibited significantly lower heart rates (-11.1%, p < 0.01), despite similar ratings of perceived exertion.

INTERPRETATION

Elevated baseline TCRγδ+ T-cells may indicate low-grade inflammation in adults with CP. Although most of the cell populations showed typical responses to endurance exercise, the absence of response in CD8+ T-cells in individuals with CP may indicate the need for higher intensity during exercise.

WHAT THIS PAPER ADDS

TCRγδ+ T-cell baseline levels are elevated in adults with cerebral palsy (CP). The CD8+ T-cell response to exercise was blunted in adults with CP. Exercise intensity is decisive for CD8+ T-cell responses in individuals with CP.

Effect of exercise-induced Neutrophil maturation on skeletal muscle repair in vitro

Neutrophils as first line defender initiate a cascade of healing process immediately after muscle injury. At muscle injury site, neutrophils remove damaged muscle fibers and recruit other immune cells and these functions show in mature neutrophils. In the previous study, physical exercise can mediate neutrophils' functional changes such as phagocytosis and chemotaxis, though there is no research on how exercise-induced neutrophils contribute the muscle regeneration. In this present study, we investigated the maturation of neutrophils after 4 weeks of mouse treadmill exercise and assessed wound healing assay to evaluate whether treatment with exercise-activated neutrophils is effective for skeletal muscle repair in vitro. In the exercise group, significantly higher mRNA levels of maturation markers compared to the sedentary group and exercise-activated neutrophils improved wound healing of mouse muscle cells. To confirm at the human cell level, based on the well-known fact that exercise increases circulating cortisol levels, neutrophil-like cells were treated with dexamethasone (dHL60 + dex) as exercise mimetics. dHL60 + dex had significantly higher mRNA levels of neutrophil maturation marker and improved wound healing of human skeletal muscle cells compared to the control. These findings suggest that exercise affects neutrophil maturation and that exercise-induced neutrophils contribute to skeletal muscle repair in vitro.

Whole-blood transcriptome analysis reveals distinct gene expression signatures in paediatric patients with sickle cell anaemia before and after exercise

Sickle cell anaemia (SCA) patients display elevated levels of circulating pro-inflammatory cytokines and endothelial activation markers compared to healthy peers. The impact of exercise on the pro-inflammatory state in SCA remains unclear. This study aimed to characterize the whole-blood transcriptome profile in response to an acute bout of exercise in paediatric SCA patients. Twenty-three SCA participants (13 ± 3 years, 52% girls) and 17 healthy controls (14 ± 3 years, 29% girls) performed eight 2-min bouts of cycle ergometry interspersed with 1-min rest intervals. Whole-blood transcriptome profile (RNA-seq) was performed before and after exercise. At baseline, gene pathways associated with gas transport in erythrocytes were up-regulated in SCA patients compared to controls. Following exercise, gene pathways associated with innate immunity were altered in both groups. Interaction analyses revealed 160 annotated genes (101 up- and 59 down-regulated) that differentially altered by exercise in SCA patients. Moreover, genes that exhibited a blunted response to exercise in SCA patients were enriched in the IL-17 signalling pathway, suggesting an impaired innate immune response to exercise. This data will contribute to the development of evidence-based exercise prescription guidelines for this patient population.

Sports and Immunity, from the recreational to the elite athlete

The pivotal role of the immune system in physical activity is well-established. While interactions are complex, they tend to constitute discrete immune responses. Moderate intensity exercise causes leukocytosis with a mild anti-inflammatory cytokine profile and immunoenhancement. Above a threshold of intensity, lactate-mediated IL-6 release causes a proinflammatory state followed by a depressed inflammatory state, which stimulates immune adaptation and longer term cardiometabolic enhancement. Exercise-related immune responses are modulated by sex, age and immunonutrition. At all ability levels, these factors collectively affect the immune balance between enhancement or overload and dysfunction. Excessive training, mental stress or insufficient recovery risks immune cell exhaustion and hypothalamic pituitary axis (HPA) stress responses causing immunodepression with negative impacts on performance or general health. Participation in sport provides additional immune benefits in terms of ensuring regularity, social inclusion, mental well-being and healthier life choices in terms of diet and reduced smoking and alcohol, thereby consolidating healthy lifestyles and longer term health. Significant differences exist between recreational and professional athletes in terms of inherent characteristics, training resilience and additional stresses arising from competition schedules, travel-related infections and stress. Exercise immunology examines the central role of immunity in exercise physiology and straddles multiple disciplines ranging from neuroendocrinology to nutrition and genetics, with the aim of guiding athletes to train optimally and safely. This review provides a brief outline of the main interactions of immunity and exercise, some influencing factors, and current guidance on maintaining immune health.

Direct assessment of leukocyte signalling and cytokine secretion reveals exercise intensity-dependent reductions in anti-inflammatory cytokine action

Circulating interleukin (IL)-6 and IL-10 concentrations are widely used to evaluate the anti-inflammatory effects of exercise but do not capture cytokine action at the cellular level. Whether and how acute exercise impacts anti-inflammatory cytokine action in humans is unknown. To determine how exercise intensity and pattern impact IL-6 and IL-10 action in blood leukocytes, 16 active adults (eight males/eight females; age: 30 ± 3 years; body mass index: 22.8 ± 2.3 kg/m2;V ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ : 51 ± 6 mL/kg/min) completed a no-exercise control condition (CTL) or isocaloric bouts of cycling performed below (moderate continuous exercise; MCE) or above (heavy continuous or heavy intermittent exercise; HCE or HIE, respectively) lactate threshold. Venous blood (before, after, 30 min after and 90 min after exercise) was analysed for immune cell subpopulations, plasma cytokine concentrations, anti-inflammatory cytokine action and monocyte phenotype. Exercise induced rapid leukocytosis (P < 0.001) and increased plasma IL-6 (P < 0.001), IL-10 (P = 0.0145) and tumour necrosis factor-⍺ (TNF-⍺) (P = 0.0338) concentrations in an intensity-dependent manner (HCE and/or HIE vs. CTL). These systemic changes coincided with a diminished ability of IL-10/6 to phosphorylate STAT3 (P < 0.001) and inhibit TNF-⍺ secretion (P = 0.0238) in blood leukocytes following HCE and HIE. Monocyte polarization experiments revealed lower CD80 [MCE (P = 0.0933) and HIE (P = 0.0187) vs. CTL] and a tendency for higher CD163 expression (HCE vs. CTL, P = 0.0985), suggesting that hyporesponsiveness to anti-inflammatory cytokine action does not impede the ability of exercise to promote an anti-inflammatory monocyte phenotype. These findings provide novel insights into the immunomodulatory effects of exercise in humans and highlight the importance of directly measuring cellular cytokine action when evaluating the anti-inflammatory effects of exercise. KEY POINTS: Circulating cytokine concentrations are frequently used to evaluate the anti-inflammatory effects of exercise but may not capture changes in cytokine action occurring at the cellular level. We directly assessed anti-inflammatory cytokine action - measured using a combination of intracellular signalling and cytokine secretion ex vivo - in distinct immune cell subpopulations after acute calorie-matched exercise bouts differing in intensity and pattern. Anti-inflammatory cytokine action was blunted following higher intensity exercise despite corresponding increases in circulating cytokine concentrations and immune cell counts. Changes in cytokine action were not explained by changes in cytokine receptor expression on circulating immune cells. Our findings provide new insights into the immunomodulatory effects of exercise in humans and highlight the importance of directly measuring cellular cytokine action when evaluating the anti-inflammatory effects of exercise.

Recovery during Successive 120-min Football Games: Results from the 120-min Placebo/Carbohydrate Randomized Controlled Trial

PURPOSE

This study aimed to examine the recovery kinetics (i.e., time-dependent changes) of performance-related variables between two 120-min male football games performed 3 d apart with and without carbohydrate supplementation.

METHODS

Twenty male players (20 ± 1 yr; body fat, 14.9% ± 5.1%; maximal oxygen consumption, 59.4 ± 3.7 mL·kg -1 ·min -1 ) participated in two 120-min football games (G1, G2) according to a randomized, two-trial, repeated-measures, crossover, double-blind design. Participants received carbohydrate/placebo supplements during recovery between games. Field activity was monitored during the games. Performance testing and blood sampling were performed before and at 90 and 120 min of each game. Muscle biopsies were collected at baseline and at 90 and 120 min of G1 and pre-G2.

RESULTS

Compared with G1, G2 was associated with reduced total distance (10,870 vs 10,685 m during 90 min and 3327 vs 3089 m during extra 30 min; P = 0.007-0.038), average (6.7 vs 6.2 km/h during extra 30-min game-play; P = 0.007) and maximal speed (32.2 vs 30.2 km/h during 90 min and 29.0 vs 27.9 km/h during extra 30 min; P < 0.05), accelerations/decelerations ( P < 0.05), and mean heart rate ( P < 0.05). Repeated sprint ability ( P < 0.001), jumping ( P < 0.05), and strength ( P < 0.001) performance were compromised before and during G2. Muscle glycogen was not restored at G2 baseline ( P = 0.005). Extended game-play reduced lymphocyte, erythrocyte counts, hematocrit, hemoglobin, reduced glutathione ( P < 0.05) and increased delayed onset of muscle soreness, creatine kinase activity, blood glycerol, ammonia, and protein carbonyls ( P < 0.05) before and during G2. Pax7 + ( P = 0.004) and MyoD + cells ( P = 0.019) increased at baseline G2. Carbohydrate supplementation restored performance and glycogen, reduced glycerol and delayed onset of muscle soreness responses, and increased leukocyte counts and Pax7 + and MyoD + cells.

CONCLUSIONS

Results suggest that extended football games induce a prolonged recovery of performance, which may be facilitated by carbohydrate supplementation during a congested game fixture.

Exercise-induced β2-adrenergic Receptor Activation Enhances the Antileukemic Activity of Expanded γδ T-Cells via DNAM-1 Upregulation and PVR/Nectin-2 Recognition

Exercise mobilizes cytotoxic lymphocytes to blood which may allow superior cell products to be harvested and manufactured for cancer therapy. Gamma-Delta (γδ) T-cells have shown promise for treating solid tumors, but there is a need to increase their potency against hematologic malignancies. Here, we show that human γδ T-cells mobilized to blood in response to just 20 minutes of graded exercise have surface phenotypes and transcriptomic profiles associated with cytotoxicity, adhesion, migration, and cytokine signaling. Following 14 days ex vivo expansion with zoledronic acid and IL2, exercise mobilized γδ T-cells had surface phenotypes and transcriptomic profiles associated with enhanced effector functions and demonstrated superior cytotoxic activity against multiple hematologic tumors in vitro and in vivo in leukemia-bearing xenogeneic mice. Infusing humans with the β1+β2-agonist isoproterenol and administering β1 or β1+β2 antagonists prior to exercise revealed these effects to be β2-adrenergic receptor (AR) dependent. Antibody blocking of DNAM-1 on expanded γδ T-cells, as well as the DNAM-1 ligands PVR and Nectin-2 on leukemic targets, abolished the enhanced antileukemic effects of exercise. These findings provide a mechanistic link between exercise, β2-AR activation, and the manufacture of superior γδ T-cell products for adoptive cell therapy against hematologic malignancies.

SIGNIFICANCE

Exercise mobilizes effector γδ T-cells to blood via β2-adrenergic signaling which allows for generation of a potent expanded γδ T-cell product that is highly cytotoxic against hematologic malignancies.

The Impact of Exercise on Interleukin-6 to Counteract Immunosenescence: Methodological Quality and Overview of Systematic Reviews

OBJECTIVE

This study evaluated the methodological quality of published systematic reviews on randomized and non-randomized clinical trials to synthesize evidence on the association between IL-6, immunosenescence, and aerobic and/or resistance exercise.

METHOD

The Preferred Reporting Items for Overviews of Systematic Reviews (PRIO-harms) guideline was used, with registration number CRD42022346142-PROSPERO. Relevant databases such as Cochrane Library, PubMed, Web of Science, Scopus, and Google Scholar were searched using English Medical Subject Headings terms. Inclusion criteria were systematic reviews analyzing aerobic exercise, resistance exercise, or a combination of both and assessing IL-6 as a biomarker of cellular immunosenescence in humans. The Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was employed.

RESULTS

Out of 742 identified articles, 18 were eligible, and 13 were selected for analysis. Sample sizes ranged from 249 to 1421 participants, mostly female, with ages ranging from 17 to 95 years. Aerobic exercise was the most studied type (46.15%), followed by combined exercise (38.46%) and resistance exercise (15.38%). Aerobic exercise showed a statistically significant reduction in IL-6, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels. Among the 13 reviews analyzed using AMSTAR-2, 8 were rated as critically low quality, and 5 were classified as low quality.

CONCLUSION

Aerobic exercise has anti-inflammatory properties and the potential to modulate IL-6, CRP, and TNF-α levels in immunosenescence. However, the limited methodological quality of the analyzed systematic reviews highlights the urgent need for robust, high-quality studies to improve access to information and facilitate evidence-based decision-making in healthcare.

A single bout of vigorous intensity exercise enhances the efficacy of rituximab against human chronic lymphocytic leukaemia B-cells ex vivo

Chronic lymphocytic leukaemia (CLL) is characterised by the clonal proliferation and accumulation of mature B-cells and is often treated with rituximab, an anti-CD20 monoclonal antibody immunotherapy. Rituximab often fails to induce stringent disease eradication, due in part to failure of antibody-dependent cellular cytotoxicity (ADCC) which relies on natural killer (NK)-cells binding to rituximab-bound CD20 on B-cells. CLL cells are diffusely spread across lymphoid and other bodily tissues, and ADCC resistance in survival niches may be due to several factors including low NK-cell frequency and a suppressive stromal environment that promotes CLL cell survival. It is well established that exercise bouts induce a transient relocation of NK-cells and B-cells into peripheral blood, which could be harnessed to enhance the efficacy of rituximab in CLL by relocating both target and effector cells together with rituximab in blood. In this pilot study, n = 20 patients with treatment-naïve CLL completed a bout of cycling 15 % above anaerobic threshold for ∼ 30-minutes, with blood samples collected pre-, immediately post-, and 1-hour post-exercise. Flow cytometry revealed that exercise evoked a 254 % increase in effector (CD3-CD56+CD16+) NK-cells in blood, and a 67 % increase in CD5+CD19+CD20+ CLL cells in blood (all p < 0.005). NK-cells were isolated from blood samples pre-, and immediately post-exercise and incubated with primary isolated CLL cells with or without the presence of rituximab to determine specific lysis using a calcein-release assay. Rituximab-mediated cell lysis increased by 129 % following exercise (p < 0.001). Direct NK-cell lysis of CLL cells - independent of rituximab - was unchanged following exercise (p = 0.25). We conclude that exercise improved the efficacy of rituximab-mediated ADCC against autologous CLL cells ex vivo and propose that exercise should be explored as a means of enhancing clinical responses in patients receiving anti-CD20 immunotherapy.

The athlete gut microbiota: state of the art and practical guidance

The gut microbiota has been proposed to grant the athlete a metabolic advantage that might be key when optimising performance. While a taxonomic core set of microorganisms characterising the athlete's gut microbiota has not been delineated, some compositional features might be associated with improved metabolic efficiency, which appears to be driven by the production of bacterial metabolites, such as short-chain fatty acids. Not only long-term exercise but also dietary patterns associated with high-level sports practice contribute to this microbial environment, yet isolating the impact of individual dietary components is challenging. The present review synthetises the available evidence on the compositional aspects of the athlete's gut microbiota, discusses mechanisms involved in the bidirectional association between exercise and the gut environment, and evaluates the role of athletes' diet in this interplay. Additionally, a practical approach to indicators commonly reported in metagenomic and metabolomic analyses is provided to explore how these insights can translate to support dietary protocols.

Exercise and osteoimmunology in bone remodeling

Bones can form the scaffolding of the body, support the organism, coordinate somatic movements, and control mineral homeostasis and hematopoiesis. The immune system plays immune supervisory, defensive, and regulatory roles in the organism, which mainly consists of immune organs (spleen, bone marrow, tonsils, lymph nodes, etc.), immune cells (granulocytes, platelets, lymphocytes, etc.), and immune molecules (immune factors, interferons, interleukins, tumor necrosis factors, etc.). Bone and the immune system have long been considered two distinct fields of study, and the bone marrow, as a shared microenvironment between the bone and the immune system, closely links the two. Osteoimmunology organically combines bone and the immune system, elucidates the role of the immune system in bone, and creatively emphasizes its interdisciplinary characteristics and the function of immune cells and factors in maintaining bone homeostasis, providing new perspectives for skeletal-related field research. In recent years, bone immunology has gradually become a hot spot in the study of bone-related diseases. As a new branch of immunology, bone immunology emphasizes that the immune system can directly or indirectly affect bones through the RANKL/RANK/OPG signaling pathway, IL family, TNF-α, TGF-β, and IFN-γ. These effects are of great significance for understanding inflammatory bone loss caused by various autoimmune or infectious diseases. In addition, as an external environment that plays an important role in immunity and bone, this study pays attention to the role of exercise-mediated bone immunity in bone reconstruction.

Immunoactivation by Cutaneous Blue Light Irradiation Inhibits Remote Tumor Growth and Metastasis

An improved innate immunity will respond quickly to pathogens and initiate efficient adaptive immune responses. However, up to now, there have been limited clinical ways for effective and rapid consolidation of innate immunity. Here, we report that cutaneous irradiation with blue light of 450 nm rapidly stimulates the innate immunity through cell endogenous reactive oxygen species (ROS) regulation in a noninvasive way. The iron porphyrin-containing proteins, mitochondrial cytochrome c (Cyt-c), and cytochrome p450 (CYP450) can be mobilized by blue light, which boosts electron transport and ROS production in epidermal and dermal tissues. As a messenger of innate immune activation, the increased level of ROS activates the NF-κB signaling pathway and promotes the secretion of immunomodulatory cytokines in skin. Initiated from skin, a regulatory network composed of cytokines and immune cells is established through the circulation system for innate immune activation. The innate immunity activated by whole-body blue light irradiation inhibits tumor growth and metastasis by increasing the infiltration of antitumor neutrophils and tumor-associated macrophages. Our results elucidate the remote immune modulation mechanism of blue light and provide a clinically applicable way for innate immunity activation.

The effect of physical exercise on anticancer immunity

Regular physical activity is associated with lower cancer incidence and mortality, as well as with a lower rate of tumour recurrence. The epidemiological evidence is supported by preclinical studies in animal models showing that regular exercise delays the progression of cancer, including highly aggressive malignancies. Although the mechanisms underlying the antitumorigenic effects of exercise remain to be defined, an improvement in cancer immunosurveillance is likely important, with different immune cell subtypes stimulated by exercise to infiltrate tumours. There is also evidence that immune cells from blood collected after an exercise bout could be used as adoptive cell therapy for cancer. In this Perspective, we address the importance of muscular activity for maintaining a healthy immune system and discuss the effects of a single bout of exercise (that is, 'acute' exercise) and those of 'regular' exercise (that is, repeated bouts) on anticancer immunity, including tumour infiltrates. We also address the postulated mechanisms and the clinical implications of this emerging area of research.

Impact of Melatonin Supplementation on Sports Performance and Circulating Biomarkers in Highly Trained Athletes: A Systematic Review of Randomized Controlled Trials

Melatonin (N-acetyl-5 methoxytryptamine) is an indolic neurohormone that modulates a variety of physiological functions due to its antioxidant, anti-inflammatory, and immunoregulatory properties. Therefore, the purpose of this study was to critically review the effects of melatonin supplementation in sports performance and circulating biomarkers related to the health status of highly trained athletes. Data were obtained by performing searches in the following three bibliography databases: Web of Science, PubMed, and Scopus. The terms used were "Highly Trained Athletes", "Melatonin", and "Sports Performance", "Health Biomarkers" using "Humans" as a filter. The search update was carried out in February 2024 from original articles published with a controlled trial design. The PRISMA rules, the modified McMaster critical review form for quantitative studies, the PEDro scale, and the Cochrane risk of bias were applied. According to the inclusion and exclusion criteria, 21 articles were selected out of 294 references. The dose of melatonin supplemented in the trials ranged between 5 mg to 100 mg administered before or after exercise. The outcomes showed improvements in antioxidant status and inflammatory response and reversed liver damage and muscle damage. Moderate effects on modulating glycemia, total cholesterol, triglycerides, and creatinine were reported. Promising data were found regarding the potential benefits of melatonin in hematological biomarkers, hormonal responses, and sports performance. Therefore, the true efficiency of melatonin to directly improve sports performance remains to be assessed. Nevertheless, an indirect effect of melatonin supplementation in sports performance could be evaluated through improvements in health biomarkers.

Impact of exercise training and diet therapy on the physical fitness, quality of life, and immune response of people living with HIV/AIDS: a randomized controlled trial

BACKGROUND

Exercise and dietary nutrition are considered crucial in human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) treatment protocols and people living with HIV/AIDS (PLWHA) rehabilitation care. However, there is no well-studied research evaluating the effects of combined interventions on the fitness and immune systems of PLWHA. Therefore, this study aimed to analyze the effects of exercise and dietary intervention on physical fitness, quality of life and immune response in PLWHA.

METHODS

This was an experimental study, with a sample of 25 male PLWHA divided into two groups: the intervention group (IG: 12 participants) and the control group (CG: 13 participants). All participants have not had any exercise habits and nutritional supplements in the past six months. The participants in the IG completed 45 min of exercise (60-80% HRmax) 4 times per week for 4 weeks. The exercise was in the form of brisk walking or running. They were also given a nutritional dietary supplement 3 times a day for 4 weeks. The 13 individuals in the CG continued their normal daily life (physical activity and diet). The following parameters were evaluated before and after the intervention: body composition, physical fitness, immune response, quality of life (QoL), stress, dietary behavior, dietary habits, exercise motivation, and physical self-efficacy.

RESULTS

The significant changes were observed in burnout of stress variables and physical efficiency index (PEI) of physical fitness in the IG (p =.023). Moreover, in the saliva samples, sal-T levels significantly increased only after the intervention in the IG (p =.012). Additionally, regarding the analysis of the interaction (group × time), there was a significant improvement in the reaction speed (p =.001) and grip strength (left: p =.002, right: p =.030) and a significant difference in physical satisfaction in QoL (p =.001), stress burnout (p =.043), self-confidence in physical efficacy (p =.045), external display (p =.008), and fulfillment (p =.047) in exercise motivation. Moreover, the significant effect of the intervention on emotional eating in dietary behavior was shown in the comparison of the IG before and after intervention (p =.001) and in the comparison of the IG group with the CG after the experiment (p =.013). However, there was no significant effect of time or interaction between the condition and time on body composition.

CONCLUSIONS

In conclusion, exercise training and diet therapy caused changes in physical fitness and Sal-T levels, which had positive effects on the health promotion of PLWHA.

Exercise Inhibits Doxorubicin-Induced Cardiotoxicity via Regulating B Cells

BACKGROUND

Doxorubicin is an effective chemotherapeutic agent, but its use is limited by acute and chronic cardiotoxicity. Exercise training has been shown to protect against doxorubicin-induced cardiotoxicity, but the involvement of immune cells remains unclear. This study aimed to investigate the role of exercise-derived B cells in protecting against doxorubicin-induced cardiotoxicity and to further determine whether B cell activation and antibody secretion play a role in this protection.

METHODS

Mice that were administered with doxorubicin (5 mg/kg per week, 20 mg/kg cumulative dose) received treadmill running exercise. The adoptive transfer of exercise-derived splenic B cells to μMT-/- (B cell-deficient) mice was performed to elucidate the mechanism of B cell regulation that mediated the effect of exercise.

RESULTS

Doxorubicin-administered mice that had undergone exercise training showed improved cardiac function, and low levels of cardiac apoptosis, atrophy, and fibrosis, and had reduced cardiac antibody deposition and proinflammatory responses. Similarly, B cell pharmacological and genetic depletion alleviated doxorubicin-induced cardiotoxicity, which phenocopied the protection of exercise. In vitro performed coculture experiments confirmed that exercise-derived B cells reduced cardiomyocyte apoptosis and fibroblast activation compared with control B cells. Importantly, the protective effect of exercise on B cells was confirmed by the adoptive transfer of splenic B cells from exercised donor mice to μMT-/- recipient mice. However, blockage of Fc gamma receptor IIB function using B cell transplants from exercised Fc gamma receptor IIB-/- mice abolished the protection of exercise-derived B cells against doxorubicin-induced cardiotoxicity. Mechanistically, we found that Fc gamma receptor IIB, an important B cell inhibitory receptor, responded to exercise and increased B cell activation threshold, which participated in exercise-induced protection against doxorubicin-induced cardiotoxicity.

CONCLUSIONS

Our results demonstrate that exercise training protects against doxorubicin-induced cardiotoxicity by upregulating Fc gamma receptor IIB expression in B cells, which plays an important anti-inflammatory role and participates in the protective effect of exercise against doxorubicin-induced cardiotoxicity.

HIIT Induces Stronger Shifts within the Peripheral T Cell Compartment Independent of Sex

Acute exercise induces changes within the T-cell compartment, especially in cytotoxic CD8+ memory subsets, depending on exercise intensity and duration. It is unclear whether exercise-induced changes in major T-cell subsets differ in response to acute high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) and whether sex-specific effects exist. Twenty-four recreationally active runners (females: n=12, 27.8±4.1years, 54.4±4.6 ml*kg-1*min-1; males: n=12, 31.6±3.8years, 58.9±7.7 ml*kg-1*min-1) participated in this randomized controlled crossover study, and conducted an energy- and duration-matched HIIT and MICT session. Blood was sampled before (T1), immediately (T2) and 1 h after exercise (T3). Flow cytometry was used to identify T-cell populations. HIIT decreased the proportion of CD8+ T-cells more pronounced at T3 compared to MICT (p=0.007), induced a significantly stronger increase in the CD8+ effector memory (TEM) cell proportion at T2 (p=0.032), and decreased CD4+ central memory proportion more pronounced at T2 (p=0.029). A decrease below baseline CD8+ TEM proportion at T3 was observed only after HIIT (p<0.001). No interaction effects between sexes were revealed. Taken together, HIIT represents a more potent stimulus to induce shifts mainly within the cytotoxic CD8+ T-cell compartment, thereby giving implications to investigate the role of HIIT on the cell´s effector phenotype and function in more detail.

Acute exercise-induced release of innate immune proteins via small extracellular vesicles changes with aerobic fitness and age

AIM

Physical exercise triggers the secretion of small extracellular vesicles (sEVs) into the circulation in humans, enabling signalling crosstalk between tissues. Exercise-derived EVs and their cargo have been proposed to mediate adaptations to exercise; however, our understanding of how exercise-derived EV protein cargo is modulated by factors such as aerobic fitness and age of an individual is currently unknown. Here, we examined the circulating sEV proteome following aerobic exercise in healthy males of different ages and aerobic fitness to understand exercise-induced EV response during the aging process.

METHODS

Twenty-eight healthy men completed a bout of 20-min cycling exercise at 70% estimated VO2peak . Small EVs were isolated from blood samples collected before and immediately after exercise, and then quantified using particle analysis and Western blotting. Small EV proteome was examined using quantitative proteomic analysis.

RESULTS

We identified a significant increase in 13 proteins in small plasma EVs following moderate-to-vigorous intensity exercise. We observed distinct changes in sEV proteome after exercise in young, mature, unfit, and fit individuals, highlighting the impact of aerobic fitness and age on sEV protein secretion. Functional enrichment and pathway analysis identified that the majority of the significantly altered sEV proteins are associated with the innate immune system, including proteins known to be damage-associated molecular patterns (DAMPs).

CONCLUSION

Together, our findings suggest that exercise-evoked acute stress can positively challenge the innate immune system through the release of signalling molecules such as DAMPs in sEVs, proposing a novel EV-based mechanism for moderate-to-vigorous intensity exercise in immune surveillance pathways.

Neuropsychiatric Systemic Lupus Erythematosus: Molecules Involved in Its Imunopathogenesis, Clinical Features, and Treatment

Systemic lupus erythematosus (SLE) is an idiopathic chronic autoimmune disease that can affect any organ in the body, including the neurological system. Multiple factors, such as environmental (infections), genetic (many HLA alleles including DR2 and DR3, and genes including C4), and immunological influences on self-antigens, such as nuclear antigens, lead to the formation of multiple autoantibodies that cause deleterious damage to bodily tissues and organs. The production of autoantibodies, such as anti-dsDNA, anti-SS(A), anti-SS(B), anti-Smith, and anti-neuronal DNA are characteristic features of this disease. This autoimmune disease results from a failure of the mechanisms responsible for maintaining self-tolerance in T cells, B cells, or both. Immune complexes, circulating antibodies, cytokines, and autoreactive T lymphocytes are responsible for tissue injury in this autoimmune disease. The diagnosis of SLE is a rheumatological challenge despite the availability of clinical criteria. NPSLE was previously referred to as lupus cerebritis or lupus sclerosis. However, these terms are no longer recommended because there is no definitive pathological cause for the neuropsychiatric manifestations of SLE. Currently, the treatment options are primarily based on symptomatic presentations. These include the use of antipsychotics, antidepressants, and anxiolytic medications for the treatment of psychiatric and mood disorders. Antiepileptic drugs to treat seizures, and immunosuppressants (e.g., corticosteroids, azathioprine, and mycophenolate mofetil), are directed against inflammatory responses along with non-pharmacological interventions.

The acute effects of pre- and mid-exercise carbohydrate ingestion on the immunoregulatory stress hormone release in experienced endurance athletes-a systematic review

Background

In times of physical stress, the body orchestrates a multisystemic regulatory response. The hormones epinephrine and norepinephrine play a role in the immediate regulation chain, while cortisol is involved in delayed regulation. The release of those stress hormones in response to exercise has previously been reported to elicit diverse immune reactions.

Objective

The aim of this systematic review was to examine and present the acute effects of immediate pre- and mid-exercise carbohydrate ingestion on cortisol, epinephrine and norepinephrine levels in experienced endurance athletes.

Methods

A systematic literature search was conducted using PubMed, Cochrane Library and Web of Science in accordance with PRISMA guidelines up to February 2023. Randomized controlled trials in English or German language were included if baseline and at least two follow-up measures of blood plasma or serum of chosen stress hormones (cortisol, epinephrine, norepinephrine) were collected in response to prolonged continuous endurance activity. Eligibility furthermore required an acute carbohydrate ingestion of at least 30 g of carbohydrates per hour no more than 30 min before start of the exercise, as well as a placebo-controlled study design.

Results

Eleven studies of moderate to high quality were included in this review. Carbohydrate ingestion of at least 30 g per hour was able to attenuate rises in cortisol concentration in majority of the included studies. Epinephrine levels were considerably lower with ingestion of carbohydrates compared to placebo in all studies. Norepinephrine concentrations were largely unaffected by acute carbohydrate feeding.

Conclusion

Pre- and mid-exercise ingestion of carbohydrates seems an effective dietary strategy to attenuate rises in cortisol and epinephrine levels and, thus, an effective countermeasure for endurance exercise-induced increases in stress hormone levels.

The Influence of Mobility Training on the Myofascial Structures of the Back and Extremities

BACKGROUND

The subject of the study was the effect of a multicomponent program (Mobility Routine) on muscular and fascial stiffness, flexibility, subjective well-being, and body perception.

METHODS

The assumption was that high physical stress affects myofascial structures and joint range of motion. The assessment of myofascial stiffness employed a Shear Wave Elastography. The joint flexibility, pressure pain threshold, and subjective experiences with regard to tension, pain, and general discomfort were documented.

RESULTS

In the CT group, a greater increase in stiffness was measured in fewer measurement areas compared to the MR group. MR demonstrated superior gains in flexibility compared to CT. Both groups experienced significant reductions in pain, tension, and discomfort. In conclusion, repetitive motion patterns akin to CT lead to increased myofascial stiffness, whereas MR yields more balanced stiffness development, compensates for asymmetries, and improves body awareness.

CONCLUSIONS

Hence, this study highlights the advantages of mobility training over Crosstrainer exercises and provides valuable insights for the recommendation of training regimens aiming at the enhancement of musculoskeletal functionality and overall well-being.

Effects of Physical Exercise and Motor Activity on Depression and Anxiety in Post-Mastectomy Pain Syndrome

BACKGROUND

Chronic post-surgical pain is a condition persisting for not less than 3 months after surgical intervention. It is evaluated that 25-60% of women who underwent breast cancer excision suffer from post-mastectomy pain syndrome, and anxiety, depression, sleep disturbance, and catastrophizing. Physical activity can reduce the risk of chronic diseases and has a good impact on mood and cognitive function. The aim of this study was to estimate the influence of physical activity on the intensity of pain, depression, and anxiety in women who underwent mastectomy for breast cancer removal.

METHODS

A prospective observational unicentric cohort study was performed. Patients were females who underwent unilateral or bilateral mastectomy. The Numerical Rating Scale (NRS) was used to measure pain intensity, Beck's Depression Inventory (BDI) for depression, and Generalized Anxiety Disorders-7 (GAD-7) for anxiety evaluation. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). Interleukin (IL)-17, IL-1β, cortisol, adrenocorticotropic hormone (ACTH), and brain-derived neurotrophic factor (BDNF) were also evaluated in the blood of patients. All evaluations were assessed 3 and 6 months after the surgery.

RESULTS

Adequate physical activity reduced the intensity of pain, depression, and anxiety symptoms in women affected by post-mastectomy pain syndrome. Moreover, adequately active women showed a reduction in biomarkers of inflammation, cortisol, ACTH, and an increase of BDNF.

CONCLUSIONS

Our results suggest that physical activity can improve the quality of life, reduce the intensity of pain and inflammatory markers, and be useful in the reduction of associated anxiety and depression.

Intensity-effects of strengthening exercise on thigh muscle volume, pro- or anti-inflammatory cytokines, and immunocytes in the older adults: A randomized controlled trial

BACKGROUND

This study investigated the intensity-effects of strength training on thigh muscle mass, cytokines, and immunocytes in the older adults.

MATERIALS AND METHODS

A total of 81 participated in this study. Participants were assigned randomly to four groups: control group (CON), low- (LSE), moderate- (MSE), and high-intensity strength exercise (HSE) groups. Three exercise groups worked out for 50 min/day, 3 days/week for 12 weeks.

RESULTS

In the thigh volume analyzed by computed tomography, the exercise groups showed a significant increase in the muscle mass, with a clear pattern of change observed in the groups who exercised with moderate to high intensity. The lowest levels of interleukin (IL)-6 in the MSE group (-20.94%) and tumor necrosis factor-α in the HSE group (-28.75%) were observed. Notably, IL-10 showed a significant increase (35.72%) only in the MSE group. In the CON group, natural killer (NK) cells showed a decrease, while in the exercise groups, their levels increased. The highest levels of NK cells were observed in the HSE group. Similar patterns of change were observed in CD4 T cells and CD19 B cells. CD3 and CD8 T cells exhibited significant increases in the MSE and HSE groups.

CONCLUSIONS

This study presents evidence that engaging in moderate to high-intensity exercise may have a positive impact on cytokines and immunocytes by increasing muscle mass in older adults who may have sarcopenia.

SIMPLE SUMMARY

Engaging in strength training exercises is considered crucial for maintaining the health of older individuals who are susceptible to sarcopenia. When resistance exercises are performed at a moderate to strenuous intensity, it is anticipated that positive changes can occur in cytokines and immunocytes. These changes can be observed through improvements in thigh muscle volumes as measured by computed tomography.

COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history

BACKGROUND

The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific T-cells and neutralizing antibodies (nAbs) during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019 (COVID-19). We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb titers.

METHODS

Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 vaccine. All major leukocyte subtypes were enumerated before, during, and after exercise by flow cytometry, and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays, T-cell receptor (TCR)-β sequencing, and SARS-CoV-2 nAb serology.

RESULTS

COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded exercise. However, non-infected participants had a significantly reduced mobilization of CD4+ and CD8+ naive T-cells, as well as CD4+ central memory T-cells, after vaccination (synthetic immunity group); this was not seen after vaccination in those with prior SARS-CoV-2 infection (hybrid immunity group). Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent manner. Both groups mobilized T-cells that reacted to spike protein; however, only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid antigens. nAbs increased significantly during exercise only in the hybrid immunity group.

CONCLUSION

These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.

Nasal Injuries and Issues in Athletes

ABSTRACT

Nasal injuries and issues are widespread in athletic populations and can adversely affect training, performance, and overall well-being. Causes can typically be understood as cellular (allergic, nonallergic, and infectious rhinitis) or structural (static vs dynamic obstruction, trauma), and diagnosis and management differ accordingly. Upper respiratory tract infections, a subtype of infectious rhinitis, remain the most common illnesses among athletes. Here, the authors review the research surrounding the complex relationship between exercise, immunology, and susceptibility to infection. Furthermore, the authors provide an updated understanding of the current literature surrounding rhinitis and nasal trauma management and synthesize practical treatment considerations for providers caring for athletes at all levels.

Effect of intensive training on immune system cells in elite female weightlifters

OBJECTIVE

This study aimed to investigate the effects of intense weightlifting training on lymphocyte and natural killer cell subgroups, which are the major cells of the immune system, in elite female weightlifters.

METHODS

A total of 20 elite female weightlifters were evaluated using flow cytometry before training (pre-T), immediately after training (post-T), and after a 120-min rest period (rest-T).

RESULTS

Post-T and rest-T showed significant decreases in helper T (Th) and cytotoxic T compared with pre-T (p=0.045, p<0.001 and p=0.05, p<0.001, respectively). B and natural killer cells were higher in post-T and rest-T than in pre-T. The increase in B cells was significant in pre-T/rest-T (p<0.001) but not in pre-T/post-T (p=0.122). Intense training significantly increased natural killer cells in both post-T and rest-T (p<0.001). CD56bright and CD56dim natural killer cell subgroups were significantly lower in post-T and rest-T than in pre-T (p=0.005, p=0.006 and p<0.001, p=0.004, respectively).

CONCLUSION

This study shows that intense weightlifting alters peripheral lymphocyte and natural killer subgroup ratios, being the first investigation in this field.

Voluntary wheel running from early adolescence reduces disease progression, and anxiety- and depression-related symptoms in an adult male mouse model of rheumatoid arthritis

Rheumatoid arthritis (RA) is a multifactorial autoimmune disease that progressively destroys synovial joints and leads to chronic systemic inflammation. This autoimmune disorder is associated with increased anxiety- and depression-related symptoms, which reduces quality of life. Clinical and experimental evidence suggests that higher physical activity from early adolescence may prevent chronic diseases and reduce the risk of mental health problems in adulthood. This study aimed to assess whether voluntary wheel running from early adolescence can decrease clinical symptoms, anxiety- and depression-related behaviors in adult mice with rheumatoid arthritis. Adolescent male mice were exposed to voluntary wheel running until adulthood and got collagen-induced arthritis. We measured body weight, the thickness of the hind paw and knee joint (clinical signs), anxiety- and depression-related behaviors, serum testosterone, and cytokines (IFN-γ IL-1β, IL-6, TNF-α, IL-10). The findings showed that collagen-induced arthritis resulted in anxious-like behavior, increased anhedonia, elevated IL-6, IL-1β, TNF-α, and IFN-γ, and decreased testosterone levels in the serum of mice. However, no change was observed in behavioral despair. We found that higher physical activity from early adolescence significantly reduced the severity of clinical signs, anxiety- and anhedonia-like behaviors, and decreased behavioral despair in RA-induced mice. In addition, the running wheel exposure normalized RA-induced abnormalities in testosterone and inflammatory cytokines in mice. Altogether, this study suggests that higher physical activity from early adolescence may make mice less vulnerable or resistant to RA-induced clinical symptoms and anxiety- and depression-related behaviors by changing testosterone and inflammatory cytokines productions in adulthood.