Effect of aerobic exercise on immunoglobulins and anemia after chemotherapy in breast cancer patients

Impact of exercise on markers of B cell-related immunity: A systematic review

BACKGROUND

B cells represent a crucial component of adaptive immunity that ensures long-term protection from infection by generating pathogen-specific immunoglobulins. Exercise alters B cell counts and immunoglobulin levels, but evidence-based conclusions on potential benefits for adaptive immunity are lacking. This systematic review assessed current literatures on the impact of acute exercise and exercise training on B cells, immunoglobulins, and markers of secretory immunity in human biofluids.

METHODS

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, MEDLINE, Web of Science, and Embase were searched on March 8, 2023. Non-randomized controlled trials and crossover trials investigating the impact of acute exercise or exercise training on B cell counts and proportions, immunoglobulin levels, salivary flow rate, or secretory immunoglobulin A secretion rate were included. Quality and reporting of exercise training studies were assessed using the Tool for the Assessment of Study Quality and reporting in Exercise. Study characteristics, outcome measures, and statistically significant changes were summarized tabularly.

RESULTS

Of the 67 eligible studies, 22 applied acute exercise and 45 applied exercise training. All included outcomes revealed significant alterations over time in acute exercise and exercise training context, but only a few investigations showed significant differences compared to control conditions. Secretory and plasma immunoglobulin A levels were most consistently increased in response to exercise training.

CONCLUSION

B cell-related outcomes are altered by acute exercise and exercise training, but evidence-based conclusions cannot be drawn with high confidence due to the large heterogeneity in populations and exercise modalities. Well-designed trials with large sample sizes are needed to clarify how exercise shapes B cell-related immunity.

Exercise and anemia in cancer patients: could make the difference?

INTRODUCTION

Anemia is one of the most common hematological manifestations occurring in cancer patients, related to a poorer prognosis. Among supportive care in cancer, exercise is emerging as a crucial tool demonstrating to reduce mortality risk, as well as to counteract several diseases and treatment-related adverse events. Nevertheless, the effect of exercise on anemia in cancer is still a relatively unexplored area.

AREA COVERED

Six studies investigated the impact of exercise on anemia trajectory in cancer patients, with intriguing results. The potential mechanisms by which exercise may modulate the blood system are heterogenous, including bone marrow stimulation, improvements in the hematopoietic microenvironment, and control of both inflammation and hormones levels. Although training and/or living at high altitudes is a recognized method to increase erythropoiesis, the effect of a hypoxic external environment on tumor progression should be clarified before considering this strategy in cancer patients.

EXPERT OPINION

Although the available investigations about exercise in anemic patients with cancer are few, exercise emerges as an important supportive oncological care capable of assisting patients maintain their autonomy. Our special report offers several suggestions to address future research in this field and determine the real contribution of an active lifestyle on this condition.