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Şevgin Ö, Özer S. Effect of physical exercise on inactivated COVID-19 vaccine antibody response in the elderly. Hum Antibodies 2024; 32:19-24. [PMID: 38339926 DOI: 10.3233/hab-230020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND Physical exercise has been proposed as a new alternative to chemical adjuvants. OBJECTIVE To investigate the relationship between regular exercise and post-vaccination antibody response in the elderly. METHODS The study was conducted with the elderly over the age of 65. 30 participants we randomized into 2 groups and divided into exercise and control groups. The experimental group received a 12-week exercise program. The control group was followed up without any exercise. The day on which the second dose of the vaccine was administered to all participants was considered day 0. The antibody level in the serum samples was taken 15 days and 12 weeks after the vaccination. The antibody concentration was measured after the second dose of vaccination. RESULTS The mean antibody level in the control group was 69.4 U/ml and 56.4 U/ml 15 days and 12 weeks after the second vaccination. The mean antibody level in the exercise group was 74 U/ml and 71.6 U/ml 15 days and 12 weeks after the second vaccination. CONCLUSIONS Regular exercise of light to moderate intensity may increase post-vaccination antibody response in the elderly. Therefore, exercise can be used as a behavioral adjuvant to improve the vaccine efficacy in the elderly.
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Affiliation(s)
- Ömer Şevgin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Üsküdar University, Istanbul, Turkey
| | - Songül Özer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Üsküdar University, Istanbul, Turkey
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2
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Bohn-Goldbaum E, Owen KB, Lee VYJ, Booy R, Edwards KM. Physical activity and acute exercise benefit influenza vaccination response: A systematic review with individual participant data meta-analysis. PLoS One 2022; 17:e0268625. [PMID: 35704557 PMCID: PMC9200169 DOI: 10.1371/journal.pone.0268625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 05/03/2022] [Indexed: 11/19/2022] Open
Abstract
Whether the vaccine adjuvant potential of acute exercise is uniform among different populations, e.g., inactive persons, is unknown. This meta-analysis examines influenza vaccine antibody responses and the effect of physical activity, acute exercise, and their interaction. Inclusion criteria comprised randomized controlled trials with acute exercise intervention and influenza vaccination antibody measurements at baseline and 4-6 weeks, and participant baseline physical activity measurement; there were no exclusion criteria. Searching via six databases (Medline, Embase, CINAHL, Scopus, Web of Science, and Physiotherapy Evidence) and two clinical registries (WHO and NIH), nine studies were identified and assessed with the Cochrane revised risk-of-bias tool. Data analysis comprised one-stage random-effects generalized linear mixed-effects models with random intercept. Seven of nine identified studies, all of high risk of bias, provided data for 550 included participants. Clinical measures of antibody response tended to be higher in the acute-exercised participants compared to rested controls and physically active compared to inactive. Physical activity significantly increased H1 strain seroconversion (adjusted odds ratio (aOR) 1.69, 95%CI: 1.02-2.82) among all participants and titer response (aOR 1.20, 95%CI: 1.03-1.39) among the acute exercise group. Increasing age frequently reduced immunogenic responses whereas body mass index and sex had little-to-no effect. Adjuvant effects were more pronounced with interventions exercising the same arm in which the vaccination was administered. H1 response was increased by both physical activity and the acute exercise-physical activity interaction. Given the observed modifications by age and the subset analysis suggesting the benefit is more pronounced in older populations, future attention is due for acute exercise-PA interactions to impact vaccination response in the at-risk population of older adults. Further, we identify localized exercise as the likely most-effective protocol and encourage its use to augment the available evidence.
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Affiliation(s)
- Erika Bohn-Goldbaum
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Katherine B Owen
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Vivian Y J Lee
- School of Sport, Exercise & Rehabilitation Sciences, College of Life & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, England
| | - Robert Booy
- The Children's Hospital at Westmead, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Kate M Edwards
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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3
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Domaszewska K, Boraczyński M, Tang YY, Gronek J, Wochna K, Boraczyński T, Wieliński D, Gronek P. Protective Effects of Exercise Become Especially Important for the Aging Immune System in The Covid-19 Era. Aging Dis 2022; 13:129-143. [PMID: 35111366 PMCID: PMC8782560 DOI: 10.14336/ad.2021.1219] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/01/2022] [Indexed: 12/11/2022] Open
Abstract
Aging is a complex, multietiological process and a major risk factor for most non-genetic, chronic diseases including geriatric syndromes that negatively affect healthspan and longevity. In the scenario of "healthy or good aging", especially during the COVID-19 era, the proper implementation of exercise as "adjuvant" or "polypill" to improve disease-related symptoms and comorbidities in the general population is a top priority. However, there is still a gap concerning studies analyzing influence of exercise training to immune system in older people. Therefore, the aim of this review is to provide a brief summary of well-established findings in exercise immunology and immunogerontology, but with a focus on the main exercise-induced mechanisms associated with aging of the immune system (immunosenescence). The scientific data strongly supports the notion that regular exercise as a low-cost and non-pharmacological treatment approach, when adjusted on an individual basis in elderly, induce multiple rejuvenating mechanisms: (1) affects the telomere-length dynamics (a "telo-protective" effect), (2) promote short- and long-term anti-inflammatory effects (via e.g., triggering the anti-inflammatory phenotype), 3) stimulates the adaptive immune system (e.g., helps to offset diminished adaptive responses) and in parallel inhibits the accelerated immunosenescence process, (4) increases post-vaccination immune responses, and (5) possibly extends both healthspan and lifespan.
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Affiliation(s)
- Katarzyna Domaszewska
- Department of Physiology and Biochemistry, Poznan University of Physical Education, Poland.
| | - Michał Boraczyński
- Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland.
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, USA.
| | - Joanna Gronek
- Laboratory of Genetics, Department of Dance and Gymnastics, Poznan University of Physical Education, Poland.
| | - Krystian Wochna
- Laboratory of Swimming and Water Lifesaving, Faculty of Sport Sciences, Poznan University of Physical Education, Poland.
| | | | - Dariusz Wieliński
- Department of Anthropology and Biometry, Poznan University of Physical Education, Poland.
| | - Piotr Gronek
- Laboratory of Genetics, Department of Dance and Gymnastics, Poznan University of Physical Education, Poland.
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Bohn-Goldbaum E, Pascoe A, Singh MF, Singh N, Kok J, Dwyer DE, Mathieson E, Booy R, Edwards KM. Acute exercise decreases vaccine reactions following influenza vaccination among older adults. Brain Behav Immun Health 2020; 1:100009. [PMID: 38377422 PMCID: PMC8474530 DOI: 10.1016/j.bbih.2019.100009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/13/2019] [Indexed: 11/30/2022] Open
Abstract
Although valuable and effective in decreasing disease burden, influenza vaccination has low rates of efficacy, especially in those at most risk. Studies have shown that acute exercise can improve vaccine responses, most consistently with weaker antigens. Here we examined the effect of resistance exercise on the acute and longer-term responses to influenza vaccination among healthy older adults. Forty-six participants (47.8% male, mean 73.4 ± 6.6 years) were randomised to perform one 45-min moderate-intensity resistance exercise session or sit quietly prior to the receipt of influenza vaccination. Acute exercise reduced vaccine reactions but had no effect on either antibody responses or development of influenza-like symptoms during six months of follow-up. Psychosocial and behavioural characteristics were examined for potential associations with the responses to vaccination. Participants (n = 36) vaccinated in the previous year had higher baseline antibody titres but not follow-up titres nor more frequent experience of influenza-like symptoms over 6 months compared to those unvaccinated in the previous year. These findings provide further support for the ability of acute exercise to reduce vaccine reactions and suggest risk factors for vaccine responses for future exploration.
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Affiliation(s)
- Erika Bohn-Goldbaum
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
| | - April Pascoe
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
| | - Maria Fiatarone Singh
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
- The University of Sydney, Faculty of Health Sciences, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Lidcombe, Australia
- Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nalin Singh
- The Centre for STRONG Medicine, Pymble, NSW, Australia
| | - Jen Kok
- Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital and University of Sydney, Sydney, Australia
| | - Dominic E. Dwyer
- Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital and University of Sydney, Sydney, Australia
| | | | - Robert Booy
- The University of Sydney, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - Kate M. Edwards
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
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Lee VY, Booy R, Skinner R, Edwards KM. The effect of exercise on vaccine-related pain, anxiety and fear during HPV vaccinations in adolescents. Vaccine 2018; 36:3254-3259. [PMID: 29709446 DOI: 10.1016/j.vaccine.2018.04.069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION With increased school-based vaccinations for improved coverage rates and practicality, the World Health Organization (WHO) recently endorsed research to identify possible interventions to reduce vaccine-related pain in mass clinical and school-based settings. In particular, the lack of research in adolescents indicate a particular need in this population. Acute exercise has analgesic effects and has been used as a behavioural adjuvant to vaccination. Here, we examine the effect of exercise on vaccine-related pain, anxiety and fear in adolescents, during a school-based program for HPV vaccinations. METHODS 116 students (Female: 61, Male: 55) aged 11-13 years were randomly allocated to either an Exercise (n = 60) or Control (n = 56) group. All participants completed demographic and Trait-anxiety questionnaires prior to receiving the vaccine according to usual care. The Exercise group also performed upper body exercise for 15 min prior to receiving the vaccine. Immediately after the vaccine administration, all participants reported on pain, anxiety and fear at the time of receiving the vaccine. RESULTS Female adolescents in the Exercise group reported significantly less pain (3.64; 95% CI, 2.98-4.30) than Controls (4.58; 95% CI, 3.96-5.19; p = 0.04). Further, females reported greater pain and anxiety than males in the Control group but not the Exercise group. CONCLUSION This study supports the use of exercise prior to vaccine administration, especially in female adolescents who are particularly vulnerable to negative experiences during vaccination procedures. Furthermore, the ease of application, as well as the benefit of exercise, provides support for the use of simple exercise prior to vaccination in mass vaccination settings. Clinical trial registry: ANZCTR, ACTRN12614001185651.
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Affiliation(s)
- V Y Lee
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia.
| | - R Booy
- The University of Sydney, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - R Skinner
- University of Sydney, Dept of Paediatrics & Adolescent Health, Children's Hospital at Westmead, Australia
| | - K M Edwards
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia
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Williams PT. Reduced total and cause-specific mortality from walking and running in diabetes. Med Sci Sports Exerc 2014; 46:933-9. [PMID: 24968127 DOI: 10.1249/mss.0000000000000197] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE This study aimed to assess the relationships of running and walking to mortality in diabetic subjects. METHODS We studied the mortality surveillance between January 1, 1989 and December 31, 2008, of 2160 participants of the National Walkers' and Runners' Health Studies who reported using diabetic medications at baseline. Hazard ratios (HR) and 95% confidence intervals (95% CI) were obtained from Cox proportional hazard analyses for mortality versus exercise energy expenditure (MET-hours per day, 1 MET·h ∼1-km run or a 1.5-km brisk walk). RESULTS Three hundred and thirty-one diabetic individuals died during a 9.8-yr average follow-up. Merely meeting the current exercise recommendations was not associated with lower all-cause mortality (P = 0.61), whereas exceeding the recommendations was associated with lower all-cause mortality (HR = 0.64, 95% CI = 0.49-0.82, P = 0.0005). Greater MET-hours per day ran or walked was associated with 40% lower risk for all chronic kidney disease-related deaths (HR = 0.60 per MET·h·d(-1), 95% CI = 0.35-0.91, P = 0.02), 31% lower risk for all sepsis-related deaths (HR = 0.69, 0.47-0.94, P = 0.01), and 31% lower risk for all pneumonia and influenza-related deaths (HR = 0.69, 95% CI = 0.45-0.97, P = 0.03). Running or walking ≥1.8 MET·h·d(-1) was associated with 57% reduction in cardiovascular disease (CVD) as an underlying cause of death and 46% lower risk for all CVD-related deaths versus <1.07 MET·h·d. All results remained significant: 1) adjusted for baseline BMI and 2) excluding all deaths within 3 yr of baseline. CONCLUSIONS These results suggest that 1) exercise is associated with significantly lower all-cause, CVD, chronic kidney disease, sepsis, and pneumonia, and influenza mortality in diabetic patients and 2) higher exercise standards may be warranted for diabetic patients than currently provided to the general population.
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Pascoe AR, Fiatarone Singh MA, Edwards KM. The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain Behav Immun 2014; 39:33-41. [PMID: 24126151 DOI: 10.1016/j.bbi.2013.10.003] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/03/2013] [Accepted: 10/03/2013] [Indexed: 12/15/2022] Open
Abstract
Vaccination programs, although feted for success in reducing infectious disease morbidity and mortality, are limited by vaccine efficacy, which is particularly problematic in populations with reduced immune function. Exercise has been identified as a behavioural factor that can improve immune function in some settings and cohorts, and therefore, in the setting of vaccination, it may serve as an adjuvant for immune responses. Here, we summarise the body of evidence that has investigated the effects of chronic or acute exercise interventions on vaccination responses. A systematic search of the literature was conducted including six major databases. Randomised control trials (RCTs), cross-sectional and observational studies that involved a variety of population samples and that employed any modality or intensity of acute exercise or chronic training prior to vaccine administration and measured any immune response were included. Twenty trials met the inclusion criteria for this review. Nine studies investigated the effect of acute exercise on the immune response to vaccination, whilst the remaining eleven studies investigated the effect of chronic exercise. Most of the current published literature suggests that exposure to either acute or chronic exercise significantly augments the immune response to vaccination. The clinical importance of this adjuvant action of exercise, if any, as well as variability in responsiveness across different cohorts, dose-response relationships and the optimal exercise modality to employ for this indication deserve further study.
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Affiliation(s)
- April R Pascoe
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia
| | - Maria A Fiatarone Singh
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia; Faculty of Medicine, University of Sydney, Lidcombe, Australia
| | - Kate M Edwards
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia.
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Christian LM. Optimizing benefits of influenza virus vaccination during pregnancy: potential behavioral risk factors and interventions. Vaccine 2014; 32:2958-64. [PMID: 24709586 PMCID: PMC4043397 DOI: 10.1016/j.vaccine.2014.03.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/14/2014] [Accepted: 03/25/2014] [Indexed: 12/31/2022]
Abstract
Pregnant women and infants are at high risk for complications, hospitalization, and death due to influenza. It is well-established that influenza vaccination during pregnancy reduces rates and severity of illness in women overall. Maternal vaccination also confers antibody protection to infants via both transplacental transfer and breast milk. However, as in the general population, a relatively high proportion of pregnant women and their infants do not achieve protective antibody levels against influenza virus following maternal vaccination. Behavioral factors, particularly maternal weight and stress exposure, may affect initial maternal antibody responses, maintenance of antibody levels over time (i.e., across pregnancy), as well as the efficiency of transplacental antibody transfer to the fetus. Conversely, behavioral interventions including acute exercise and stress reduction can enhance immune protection following vaccination. Such behavioral interventions are particularly appealing in pregnancy because they are safe and non-invasive. The identification of individual risk factors for poor responses to vaccines and the application of appropriate interventions represent important steps towards personalized health care.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States; Department of Psychology, The Ohio State University, Columbus, OH 43210, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
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Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine 2012; 30:6389-95. [PMID: 22921739 DOI: 10.1016/j.vaccine.2012.08.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/02/2012] [Accepted: 08/12/2012] [Indexed: 12/11/2022]
Abstract
Acute exercise at the time of vaccination can enhance subsequent immune responses. However, the potential benefit of this effect will be its efficacy in boosting poor responses, and thus protection in at-risk populations. The current study tested the effect of exercise on the response to either a full- or half-dose Pneumococcal (Pn) vaccination to elicit stronger and weaker responses. Subjects were 133 young healthy adults, randomised to one of four groups: exercise or control task, receiving a full- or half-dose Pn vaccination. Prior to vaccination, exercise groups completed a 15 min arm and shoulder exercise task, control groups rested quietly. Antibody levels to 11 Pn strains were evaluated at baseline and 1-month. Across all participants, exercise groups showed significantly greater increase in antibody levels than control groups. When doses were compared, it emerged that those who exercised had significantly larger responses than those who rested in the half-dose group, but in the full-dose groups responses were similar. This data indicates the effectiveness of exercise as a vaccine adjuvant, particularly in weaker responses. Thus, given the potential public health benefits of no-cost behavioural intervention to enhance response to vaccination, testing in at-risk populations should be pursued.
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Long JE, Ring C, Drayson M, Bosch J, Campbell JP, Bhabra J, Browne D, Dawson J, Harding S, Lau J, Burns VE. Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain Behav Immun 2012; 26:680-7. [PMID: 22386744 DOI: 10.1016/j.bbi.2012.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 01/26/2012] [Accepted: 02/10/2012] [Indexed: 11/17/2022] Open
Abstract
High intensity acute exercise at the time of vaccination has been shown to enhance the subsequent antibody response. This study examines whether an acute moderate intensity aerobic intervention prior to vaccination can enhance antibody response to pneumonia and half dose influenza vaccination. Sixty young (age (SD)=22.0 (6.1) years) and 60 older (age (SD)=57.5 (6.5) years) adults attended the laboratory on two separate occasions. At the first session, baseline antibody titres were determined, before participants completed either a brisk walk around campus at >55% of their age-predicted heart rate maximum, or a resting control condition, for 45 min. After the intervention, all participants received a full-dose pneumococcal vaccination and a half-dose influenza vaccination. Four weeks later, participants returned for a follow up blood sample. Multivariate ANOVA revealed an increase in total antibody titres against the influenza vaccine (F((12,106))=25.76, p<.001, η(2)=.75) and both the IgM (F((12,106))=17.10, p<.001, η(2)=.66) and IgG (F((12,106))=25.76, p<.001, η(2)=.75) antibody titres against the pneumococcal vaccine. However, there were no significant Time×Group interactions (p's all >.15), indicating that a 45 min brisk walk prior to vaccination did not affect antibody response to either the influenza or pneumonia vaccine. The results suggest that higher intensity exercise is necessary to augment antibody response to vaccination.
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Affiliation(s)
- Joanna E Long
- School of Sport and Exercise Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, UK.
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