Exercise Immunology Review
type: channel
description: Exercise Immunology Review, an official publication of the International Society of Exercise and Immunology and of the German Society of Sports Medicine and Prevention, is committed to developing and enriching knowledge in all aspects of immunology that relate to sport, exercise, and regular physical activity. In recognition of the broad range of disciplines that contribute to the understanding of immune function, the journal has adopted an interdisciplinary focus. This allows dissemination of research findings from such disciplines as exercise science, medicine, immunology, physiology, behavioral science, endocrinology, pharmacology, and psychology. Exercise Immunology Review publishes review articles that explore: (a) fundamental aspects of immune function and regulation during exercise. (b) interactions of exercise and immunology in the optimization of health and protection against acute infections. (c) deterioration of immune function resulting from competitive stress and overtraining. (d) prevention or modulation of the effects of aging or disease (including HIV infection; cancer; autoimmune, metabolic or transplantation associated disorders) through exercise. (e) instrumental use of exercise or related stress models for basic or applied research in any field of physiology, pathophysiology or medicine with relations to immune function.
publisher: International Society of Exercise and Immunology (ISEI)
language: en
publication name: Exercise Immunology Review
issn: 1077-5552
items: Immunometabolic profiling of T cells in response to prolonged moderate intensity cycling in humans
items: Exercise-Induced Metabolic Reprogramming and Immune Modulation: A Novel Strategy for Cancer Therapy
items: Less Inflammatory Debris, Improved Immunity from Immune Detox: A New Perspective on the Benefits of Exercise in Chronic Disease
items: Occurrence of acute respiratory illnesses in athletes: a systematic review and meta-analysis
items: Is stretching an appropriate control for studies on exercise immunology in older adults? A systematic review
items: Unleashing anti-tumour immunity: dietary restriction and exercise interventions adjunct to chemotherapy for cancer patients
items: Involvement of neutrophils and macrophages in exhaustive exercise-induced liver, kidney, heart, and lung injuries
items: Immune Response to COVID-19 Vaccination in Elite Athletes
items: Investigating the impact of exercise on T and NK cells in skin cancer: a systematic review
items: Higher risk of upper respiratory tract infection post marathon running: when physical exercise becomes a threat to the immune system
items: Combined exercise intervention in a mouse model of high-risk neuroblastoma: effects on physical, immune, tumor and clinical outcomes.
items: Respiratory viral infections - impact on sport and exercise medicine
items: The anti-inflammatory and bioregulatory effects of habitual exercise in high-fat diet-induced obesity involve crown-like structures and MCP-1 in white adipose tissue.
items: A Scoping Review on the Effects of Physical Exercise and Fitness on Peripheral Leukocyte Energy Metabolism in Humans
items: Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis.
items: Exercise effect on symptom severity, morbidity and mortality in viral infections: a systematic review and meta-analysis.
items: Effect of high intensity interval training and moderate intensity continuous training on lymphoid, myeloid and inflammatory cells in kidney transplant recipients
items: Exercise, inflammation and acute cardiovascular events.
items: The effects of exercise on complement system proteins in humans: a systematic scoping review
items: Traumatic Brain Injury Rehabilitation: An Exercise Immunology Perspective
items: Immunometabolism-fit: How exercise and training can modify T cell and macro- phage metabolism in health and disease
items: Acute effects of heavy resistance exercise on biomarkers of neuroendocrine- immune regulation in healthy adults: a systematic review
items: The effect of exercise on regulatory T cells: A systematic review of human and animal studies with future perspectives and methodological recommendations
items: Exercise training effects on natural killer cells: a preliminary proteomics and systems biology approach
items: A systematic literature review on the effects of exercise on human Toll-like receptor expression
items: Improvement in the anti-inflammatory profile with lifelong physical exercise is related to clock genes expression in effector-memory CD4+T cells in master athletes.
items: Higher levels of physical activity are associated with reduced tethering and migration of pro-inflammatory monocytes in males with central obesity
items: Regular physical exercise mediates the immune response in atherosclerosis
items: Physical Exercise: A Versatile Anti-Inflammatory Tool Involved in the Control of Hypothalamic Satiety Signaling
items: Effect of exercise-conditioned human serum on the viability of human cancer cell cultures: A systematic review and meta-analysis

Immunometabolic profiling of T cells in response to prolonged moderate intensity cycling in humans
type: item
description: Background: Emerging data indicates that enrichment of peripheral blood with T lymphocytes during exercise and their associated changes in function are underpinned by modulation of cellular bioenergetics. However, there is a dearth of literature examining these responses using metabolic thresholds to prescribe exercise intensity or providing single cell resolution on immunometabolic outcome measures. Objectives: The current study was designed to examine the metabolic phenotypes and real-time bioenergetic responses to activation of enriched naive helper (CD4(+)) and cytotoxic (CD8(+)) T cells and peripheral blood mononuclear cells (PBMCs) in response to prolonged cycling. Methods: Ten aerobically trained males and females (mean +/- SD: age 21 +/- 1 years; maximal oxygen consumption: 53.9 +/- 9.8 ml . kg(-1) . min(-1)) undertook a 2-hour bout of continuous cycling at a power output eliciting 95% lactate threshold-1. Blood samples were collected at rest, immediately (post), and 2 hours after cycling cessation (recovery). Using injection sequences of cell respiration modulators and a CD3/CD28 activator, bioenergetic profiles of PBMCs and enriched naive CD4(+) and CD8(+) T cells were determined using extracellular flux analysis. Mitochondrial membrane potential (Delta Psi m) was examined using flow cytometry. Results: Despite cycling evoking significant fluctuations in peripheral blood T cell numbers, there were no changes in absolute or relative measures of mitochondrial respiration, glycolytic flux and ATP synthesis rate post and recovery vs rest. Contribution of mitochondrial respiration to ATP production was greater than glycolysis in naive T cells across all timepoints, but not PBMCs in recovery. This was despite absolute and relative changes in Delta Psi m of memory T cells being greater in recovery vs. rest. Bioenergetic responses to ex vivo T cell activation were not different between cell types or timepoints. Conclusion: These data indicate that the metabolic ph…
subject: Articles
  topic: section
subject: OXYGEN-UPTAKE
  topic: keywords
subject: EXERCISE
  topic: keywords
subject: LYMPHOCYTES
  topic: keywords
subject: GLYCOLYSIS
  topic: keywords
creator: Fendi Pradana
creator: Jonathan P. Barlow
creator: Jack Shayler
creator: Sarah K. Dimeloe
creator: Nancy Gudgeon
creator: Tim Podlogar
creator: Gareth A. Wallis
creator: Alex J. Wadley
rights: Copyright (c) 2025 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 67
ending page: 84
doi: 10.22029/eir.2025.1768

Exercise-Induced Metabolic Reprogramming and Immune Modulation: A Novel Strategy for Cancer Therapy
type: item
description: Exercise represents a non-pharmacological strategy capable of concurrently modulating tumor metabolism and immunity. Regular physical activity reprograms systemic and tumor-localized metabolic networks, including glucose, lactate, amino acid, and lipid pathways, while enhancing innate and adaptive immune responses. Exercise-induced myokines (e.g., IL-6, IL-15, irisin, SPARC) and improved vascularization contribute to reshaping the tumor microenvironment (TME), mitigating immunosuppressive metabolite accumulation, and promoting T cell and NK cell infiltration. Mechanistically, exercise activates integrated signaling networks including AMPK-mTOR-HIF1 alpha, PGC-1 alpha-ERR alpha, and IL-6/STAT3 axes, supporting metabolic flexibility and anti-tumor immunity. Translational and clinical studies suggest exercise can enhance chemotherapy and immunotherapy efficacy, while precision exercise prescriptions based on FITT principles, biomarkers, and patient-specific tolerance may maximize therapeutic benefits. This review summarizes the molecular and systemic mechanisms of exercise-induced metabolic-immune reprogramming and outlines strategies for clinical translation in oncology.
subject: Articles
  topic: section
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: BREAST-CANCER
  topic: keywords
subject: AEROBIC EXERCISE
  topic: keywords
subject: CELL METABOLISM
  topic: keywords
subject: TUMOR-GROWTH
  topic: keywords
subject: MOLECULAR-MECHANISMS
  topic: keywords
subject: GLUCOSE-METABOLISM
  topic: keywords
subject: LACTIC-ACID
  topic: keywords
subject: INTENSITY
  topic: keywords
subject: MICROENVIRONMENT
  topic: keywords
creator: Anqui He
creator: Sha Wang
creator: Tianjiee Bao
creator: Shunzi Rong
creator: Chong Li
creator: Min Luo
creator: CQ He
creator: Yonghong Yang
creator: Yong Xia
rights: Copyright (c) 2025 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 43
ending page: 66
doi: 10.22029/eir.2025.1767

Less Inflammatory Debris, Improved Immunity from Immune Detox: A New Perspective on the Benefits of Exercise in Chronic Disease
type: item
description: The immunological benefits of exercise are commonly attributed to its immune-boosting effects such as the release of exercise-induced factors (e.g., exerkines) and activation of anti-inflammatory molecules. However, this may not fully explain its benefits in chronic inflammatory conditions. We propose a complementary view whereby exercise potentially functions as a biological detoxifier by removing harmful immunological debris such as damage-associated molecular patterns (DAMPs), senescent cells, dysfunctional mitochondria and pro-inflammatory extracellular vesicles (EVs) that drive chronic immune activation. We highlight key mechanisms by which exercise may reduce or remove these harmful signals, including autophagy and mitophagy activation, enhanced efferocytosis, reduced senescence burden, and modulation of EV cargo. This ""immune detox"" model may help explain the clinical benefits of exercise in conditions where the immune system is overactivated, not deficient. It shifts the narrative from immune boosting to restoring immune balance, and could have potentially important implications for biomarker discovery and personalized exercise prescriptions in chronic disease.
subject: Articles
  topic: section
subject: APOPTOTIC CELL CLEARANCE
  topic: keywords
subject: MITOCHONDRIAL-DNA
  topic: keywords
subject: EXTRACELLULAR VESICLES
  topic: keywords
subject: SECRETORY PHENOTYPE
  topic: keywords
subject: SENESCENCE
  topic: keywords
subject: EFFEROCYTOSIS
  topic: keywords
subject: PATHOGENESIS
  topic: keywords
subject: DAMPS
  topic: keywords
subject: RECOGNITION
  topic: keywords
subject: NEUTROPHILS
  topic: keywords
creator: Asghar Abbasi
creator: William Stringer
rights: Copyright (c) 2025 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 35
ending page: 42
doi: 10.22029/eir.2025.1766

Occurrence of acute respiratory illnesses in athletes: a systematic review and meta-analysis
type: item
description: Background: Estimating the occurrence of acute respiratory illness (ARI) in athletes is crucial for understanding the need for preventive measures. This study aimed to estimate the occurrence of ARIs in athletes compared to non-athlete controls. We evaluated which of the published studies on the occurrence of ARI in athletes were eligible, giving due consideration to the epidemic nature of viral ARIs. Methods: We performed a systematic search of PubMed, EBSCOhost, and Web of Science databases from January 1990 to May 2023. Only studies reporting the occurrence of ARIs in athletes, with a duration of at least 12 months and simultaneously employing non-athlete controls, were included. The random effects model was used to calculate the incidence rate ratio (IRR) of ARI in athletes compared to non-athlete controls, with 95% confidence intervals. Results: Our search yielded 218 results, of which 6 studies met the essential criteria for viral ARIs and were included in our metaanalysis. Since the exact number of ARIs was not reported in many studies, we had to estimate the total number of ARIs for both athletes and non-athlete controls. The occurrence of ARIs was 1.87 times higher in athletes compared to non-athlete controls (3.2 vs 1.7, pooled IRR 1.87, 95% CI 1.08 to 3.26). Publication bias analysis or a funnel plot was not evaluated because the primary objective of none of the studies was to determine the occurrence of ARI in athletes. Most of the studies on the occurrence of ARIs in athletes had a duration of less than 12 months and did not include a concurrent control group, making them ineligible considering the seasonal and contagious nature of ARIs. Conclusion: Our meta-analysis suggests that athletes suffer from significantly more ARIs than non-athletic subjects. Our observations highlighted the lack of high-quality long-term studies on the occurrence of ARIs in athletes.
subject: Articles
  topic: section
subject: SECRETORY IMMUNOGLOBULIN-A
  topic: keywords
subject: OLYMPIC SUMMER GAMES
  topic: keywords
subject: SPORTS INJURIES
  topic: keywords
subject: MUCOSAL IMMUNITY
  topic: keywords
subject: PROSPECTIVE COHORT
  topic: keywords
subject: TRACT INFECTIONS
  topic: keywords
subject: TRAINING LOAD
  topic: keywords
subject: ULTRAMARATHON RUNNERS
  topic: keywords
subject: UNIVERSITY-STUDENTS
  topic: keywords
subject: BASKETBALL PLAYERS
  topic: keywords
creator: Wilma Gronroos
creator: Matti Uhari
creator: Olli Ruuskanen
rights: Copyright (c) 2025 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 6
ending page: 18
doi: 10.22029/eir.2025.1764

Is stretching an appropriate control for studies on exercise immunology in older adults? A systematic review
type: item
description: Objective: Active muscle contraction is assumed to be essential in the anti-inflammatory effect of physical exercise, also in older adults. Although stretching does not involve active muscle contractions, its (anti)inflammatory effects remain unclear. This systematic review aims to determine whether stretching affects the inflammatory profile of older adults and if it can be considered as an appropriate control intervention for exercise immunology studies. Methods: This systematic review was registered in PROSPERO (CRD42023388920) and conducted in accordance with PRISMA guidelines. PubMed and Web of Science were systematically screened for articles describing the effect of muscle stretching on the inflammatory profile (immune cell proportions, cytokines, oxidative markers, and inflammatory gene expression in muscle/immune cells) in older adults. A methodological quality assessment was performed using the ROB2 tool and effect sizes (ES) were calculated. Results: Nine randomized controlled trials were included, all showing sufficient methodological quality and reporting effects on basal levels of inflammation. Muscle stretching had no effect on the number of na & iuml;ve, memory, and senescence-prone T-cells or circulating inflammatory markers CRP and IL-6 neither on most studied oxidative stress markers (SOD, NO, VCAM, ICAM, PTX3, OX-LDL, MDA, HNE, nitrotyrosine, ox-LDL, and protein carbonyls). However, the oxidative stress marker LPO increased (ES=0.76) while CAT, ROS, fibrinogen, andMDA-LDL decreased (ES between-0.50 and-0.63) after stretching in older persons with chronic diseases. Contradictory results were found for TNF-alpha and gene expression levels. One study observed no changes in circulating TNF-alpha after stretching in healthy women, while another study showed an increase in muscle gene expression of TNF-alpha (ES=1.60) as well as circulating TNF-alpha (ES=0.64) in men with peripheral arterial disease. Regarding gene expression changes in pro/anti-inflam…
subject: Articles
  topic: section
subject: PERIPHERAL ARTERIAL-DISEASE
  topic: keywords
subject: ADHESION MOLECULES
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: IMMUNOSENESCENCE
  topic: keywords
subject: MARKERS
  topic: keywords
subject: SERUM
  topic: keywords
creator: Emelyn Mathot
creator: Lene Salimans
creator: Arno Goens
creator: Rose Njemini
creator: Jan Gutermuth
creator: Inge Kortekaas Krohn
creator: Ivan Bautmans
rights: Copyright (c) 2025 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 19
ending page: 34
doi: 10.22029/eir.2025.1765

Unleashing anti-tumour immunity: dietary restriction and exercise interventions adjunct to chemotherapy for cancer patients
type: item
description: Conventional chemotherapies can stimulate the immune system by increasing tumour antigenicity (e.g., neoantigen exposure to immune cells) and altering adjuvanticity in the tumour (e.g., danger associated molecular patterns and cytokines). These molecules promote the recruitment, activation, and maturation of dendritic cells, which in turn, prime and activate cytotoxic T cells against tumour cells. However, several factors can decrease the immunostimulatory efficacy of chemotherapeutic agents. These include reduced tumour cell antigenicity and adjuvanticity and compromised immune function at a local and systemic level. Findings from preclinical studies show that dietary restriction and exercise promote systemic changes that may help to restore immune system function through several mechanisms, including an enhanced infiltration and function of antitumoral immune cells and a decrease in immunosuppressive cells, leading to a reduction in tumour volume. In addition, dietary restriction and exercise training in mice have been shown to enhance the efficacy of chemotherapy. In human studies there is also emerging evidence that dietary restriction and exercise can impact the immune system towards a more antitumoral profile. In this review, we discuss the immunostimulatory effects of dietary restriction (caloric restriction and fasting) and exercise training in preclinical cancer models, and potential synergies with chemotherapy. We then review clinical studies assessing the effects of these interventions on immune-related endpoints and tumour responses. Finally, we propose that combining dietary restriction with exercise could be a promising strategy to increase chemotherapy efficacy.
subject: Articles
  topic: section
subject: SUPPRESSES TUMOR-GROWTH
  topic: keywords
subject: FASTING-MIMICKING DIET
  topic: keywords
subject: CD8(+) T-CELLS
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: GUT MICROBIOME
  topic: keywords
subject: AKKERMANSIA-MUCINIPHILA
  topic: keywords
subject: MOLECULAR-MECHANISMS
  topic: keywords
subject: NUTRIENT RESTRICTION
  topic: keywords
subject: CALORIE RESTRICTION
  topic: keywords
subject: DENDRITIC CELLS
  topic: keywords
creator: Cristina Crespo-Garcia
creator: John P. Campbel
creator: Dennis R. Taaffe
creator: Carolyn J. Peddle-McIntyre
creator: Emily Jeffery
creator: Daniel A. Galvao
creator: Andrew D. Redfern
creator: Robert U. Newton
rights: Copyright (c) 2024 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2024-12-31
publication date: 2024-12-31
starting page: 31
ending page: 58
doi: 10.22029/eir.2024.1763

Involvement of neutrophils and macrophages in exhaustive exercise-induced liver, kidney, heart, and lung injuries
type: item
description: Moderate exercise is effective for maintaining or improving overall health. However, excessive exercise that exhausts the adaptive reserve of the body or its ability to positively respond to training stimuli can induce tissue damage and dysfunction of multiple organs and systems. Tissue injury, inflammation, and oxidative stress are reportedly induced the skeletal muscles, liver, and kidneys after exercise. However, the precise mechanisms underlying acute tissue injury after intense exercise have not yet been fully elucidated. Studies using various experimental models of acute tissue injury, other than intense exercise, have demonstrated infiltration of inflammatory cells, including neutrophils and macrophages. These cells infiltrate injured tissues and induce inflammatory and oxidative stress responses by producing inflammatory cytokines and reactive oxygen species, thereby exacerbating tissue injury. In addition to the activation of blood neutrophils and increase in their levels during and/or after prolonged or intense exercise, chemokines that contribute to leukocyte migration are released, facilitating the migration of neutrophils and monocytes into tissues. Therefore, neutrophils and macrophages, activated by exhaustive exercise, may infiltrate tissues and contribute exhaustive exercise-induced tissue injury. Recently, the contributions of neutrophils and macrophages to various tissue injuries caused by exhaustive exercise have been reported. In this review, we summarize the involvement of neutrophils and monocytes/macrophages in exhaustive exercise-induced non-skeletal muscle tissue injury. In addition, we present novel data demonstrating the contribution of neutrophils and macrophages to exhaustive exercise-induced cardiac and pulmonary injuries. Our study findings and the evidence presented in this review suggest that neutrophils and macrophages may play pivotal roles in exhaustive exercise-induced tissue injuries.
subject: Articles
  topic: section
subject: ISCHEMIA-REPERFUSION INJURY
  topic: keywords
subject: ACUTE-RENAL-FAILURE
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: ENDURANCE EXERCISE
  topic: keywords
subject: RAT-LIVER
  topic: keywords
subject: STRENUOUS EXERCISE
  topic: keywords
subject: RECEPTOR
  topic: keywords
subject: DAMAGE
  topic: keywords
subject: INFLAMMATION
  topic: keywords
subject: MARATHON
  topic: keywords
creator: Tsubasa Mizokami
creator: Katsuhiko Suzuki
rights: Copyright (c) 2024 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2024-12-31
publication date: 2024-12-31
starting page: 59
ending page: 72
doi: 10.22029/eir.2024.1761

Immune Response to COVID-19 Vaccination in Elite Athletes
type: item
description: Purpose: This study analyses the immune response of elite athletes after COVID-19 vaccination with double-dose mRNA and a single-dose vector vaccine. Methods: Immunoglobulin G (IgG) antibody titers, neutralizing activity, CD4 and CD8 T-cells were examined in blood samples from 72 athletes before and after vaccination against COVID-19 (56 mRNA (BNT162b2 / mRNA-1273), 16 vector (Ad26.COV.2) vaccines). Side effects and training time loss was also recorded. Results: Induction of IgG antibodies (mRNA: 5702 BAU/ml; 4343 BAU/ml (hereafter: median), vector: 61 BAU/ml; 52 BAU/ ml, p<0.01), their neutralizing activity (99.7%; 10.6%, p<0.01), and SARS-CoV-2 spike-specific CD4 T-cells (0.13%; 0.05%; p<0.01) after mRNA double-dose vaccines was significantly more pronounced than after a single-dose vector vaccine. SARS-CoV-2 spike-specific CD8 T-cell levels after a vector vaccine (0.15%) were significantly higher than after mRNA vaccines (0.02%; p<0.01). When athletes who had initially received the vector vaccine were boostered with an mRNA vaccine, IgG antibodies (to 3456 BAU/ml; p<0.01), neutralizing activity (to 100%; p<0.01), CD4 (to 0.13%; p<0.01) and CD8 T-cells (to 0.43%; p<0.01) significantly increased. When compared with dual-dose mRNA regimen, IgG antibody response was lower (p<0.01), the neutralizing activity (p<0.01) and CD8 T-cell (p<0.01) response higher and no significant difference in CD4 T-cell response (p=0.54) between the two regimens. Cumulative training loss (3 days) did not significantly differ between vaccination regimens (p=0.46). Conclusion: mRNA and vector vaccines against SARS-CoV-2 appear to induce different patterns of immune response in athletes. Lower immune induction after a single-shot vector vaccine was clearly optimized by a heterologous booster. Vaccine reactions were mild and short-lived.
subject: Articles
  topic: section
creator: Lea Halmans
creator: Andreas Venhorst
creator: Verena Klemis
creator: Tina Schmidt
creator: Franziska Greiß
creator: Urban Sester
creator: Barbara C. Gärtner
creator: Martina Sester
creator: Tim Meyer
rights: Copyright (c) 2024 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2024-12-31
publication date: 2024-12-31
starting page: 73
ending page: 80
doi: 10.22029/eir.2024.1762

Investigating the impact of exercise on T and NK cells in skin cancer: a systematic review
type: item
description: Skin cancer has the highest incidence of all cancers, and their incidence are increasing in both melanoma and non-melanoma skin cancers. Alternative adjuvant treatment strategies appropriate for their management are needed. Modifiable lifestyle factors influence disease outcomes, either improving or worsening outcomes. Exercise is an example of a modifiable lifestyle factor, and can be prescribed as an adjuvant therapy in other cancer types to improve immune function and overall clinical outcomes. The initial aim of the review was to investigate the T-cell specific mechanisms of exercise which affect clinical/disease outcomes in skin cancer. Study quality was assessed by a modified Covidence quality assessment template with animal-model study specific criteria. A total of 10 articles were included; all articles were murine model studies investigating melanoma. Eight studies (n=8) employed a randomised controlled trial design, with two bio-informatics studies, and one study using human data which could solidify a link to human health. While the review focussed initially on T-cells, many studies reported significant changes in NK cells, and as they share the same haematopoietic lineage/ common lymphoid progenitor as T cells, the data was included in the analyses. Most studies indicated that exercise reduced melanoma tumour burden. Exercising prior to melanoma inoculation was most effective for delaying carcinogenesis and reducing tumour burden. Synergism was a topic identified in studies; PD-1/PD-L1 treatment, and exercise were not synergistic. Conversely, exercise and mental stimulation were synergistic, and the temperature at which exercise was conducted significantly reduced tumour burden. Several murine studies reported that exercise improved clinical outcomes in melanoma, and that long-term exercise was more effective in reducing tumour burden. Further studies are required to investigate this relationship in humans, and in other types of skin cancer.
subject: Articles
  topic: section
subject: BREAST-CANCER
  topic: keywords
subject: BURDEN
  topic: keywords
subject: MULTIPLICITY
  topic: keywords
subject: LYMPHEDEMA
  topic: keywords
subject: EXPRESSION
  topic: keywords
creator: Heidi F. Bochenek
creator: David B. Pyne
creator: Andrew J. McKune
creator: Rachel E. Neale
creator: Rachael M. Anforth
creator: Chloé D. Goldsmith
rights: Copyright (c) 2024 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2024-12-31
publication date: 2024-12-31
starting page: 14
ending page: 30
doi: 10.22029/eir.2024.1760

Higher risk of upper respiratory tract infection post marathon running: when physical exercise becomes a threat to the immune system
type: item
description: Background: Several studies have reported that marathon runners have a higher risk of upper respiratory tract infections (URTI) post marathon than non-exercising controls. However, other studies did notfind a higher risk of URTI in the same participants before and after a marathon, precluding a conclusive consensus. Besides the between-subjects effects, another important confounding factor in these results is the different pre and post follow-up time to track URTI. Objectives: Identify by meta-analysis whether a marathon running increases the risk of URTI, adjusting the follow-up time to track URTI. Data sources: We searched for articles using MEDLINE (PubMed), Embase, Scopus, Web of Science, the Cochrane Library, andEBSCOhost, combining the marathon and respiratory infection descriptor synonyms, on 1st December 2022. Eligibility criteria: The PICOS framework included human population, comparison between pre and post marathon running, of URTI symptoms (assessed from one to 4 weeks), in non-controlled intervention studies. Data Synthesis: Because follow-up was longer before the marathon in many studies, we adjusted the number of subjects with infections before marathon to the equivalent post-marathon follow-up duration. There was 18% higher incidence of URTI post-marathon (OR 1.18 95%CI [1.05-1.33], p= 0.005) in a very consistent meta-analysis (I2 = 0%, p = 0.69), with no risk of publication bias (Egger test p-value = 0.82) for the 7 studies included. The main issues in the quality of the studies were bias in measuring the outcome, bias in classification of intervention (participation in the marathon) and time-varying confounding (corrected for analysis), and therefore the quality of evidence was moderate (GRADE approach = 3). Limitations: The need for follow-up time adjustment is a limitation, since the number of URTI recorded could be different if the original studies had used the same follow-up time pre and post marathon. The subjectivity of the URTI self-assessme…
subject: Articles
  topic: section
subject: CARBOHYDRATE INGESTION
  topic: keywords
subject: CONSENSUS STATEMENT
  topic: keywords
subject: SUSCEPTIBILITY
  topic: keywords
subject: RESPONSES
  topic: keywords
subject: SYMPTOMS
  topic: keywords
subject: CYTOKINE
  topic: keywords
subject: EPISODES
  topic: keywords
subject: IMPACT
  topic: keywords
subject: RACE
  topic: keywords
creator: Amanda Veiga Sardeli
creator: Rafaela Bertini de Araujo
creator: Jeffery A. Woods
creator: Janet M. Lord
creator: Mara Patrícia Traina Chacon-Mikahil
rights: Copyright (c) 2024 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2024-12-31
publication date: 2024-12-31
starting page: 6
ending page: 13
doi: 10.22029/eir.2024.1759

Combined exercise intervention in a mouse model of high-risk neuroblastoma: effects on physical, immune, tumor and clinical outcomes.
type: item
description: Background: Exercise might exert anti-tumoral effects in adult cancers but this question remains open in pediatric tumors, which frequently show a different biology compared to adult malignancies. We studied the effects of an exercise intervention on physical function, immune variables and tumoral response in a preclinical model of a highly aggressive pediatric cancer, high-risk neuroblastoma (HR-NB). Methods: 6-8-week-old male mice with orthotopically-induced HR-NB were assigned to a control (N=13) or exercise (5-week combined [aerobic+resistance]) group (N=17). Outcomes included physical function (cardiorespiratory fitness [CRF] and muscle strength), as well as related muscle molecular indicators, blood and tumor immune cell and molecular variables, tumor progression, clinical severity, and survival. Results: Exercise attenuated CRF decline (p=0.029 for the group-by-time interaction effect), which was accompanied by higher muscle levels of oxidative capacity (citrate synthase and respiratory chain complexes III, IV and V) and an indicator of antioxidant defense (glutathione reductase) in the intervention arm (all p <= 0.001), as well as by higher levels of apoptosis (caspase-3, p=0.029) and angiogenesis (vascular endothelial growth factor receptor-2, p=0.012). The proportion of 'hot-like' (i.e., with viable immune infiltrates in flow cytometry analyses) tumors tended to be higher (p=0.0789) in the exercise group (76.9%, vs. 33.3% in control mice). Exercise also promoted greater total immune (p=0.045) and myeloid cell (p=0.049) infiltration within the 'hot' tumors, with a higher proportion of two myeloid cell subsets (CD11C+ [dendritic] cells [p=0.049] and M2-like tumor-associated macrophages [p=0.028]), yet with no significant changes in lymphoid infiltrates or in circulating immune cells or chemokines/cytokines. No training effect was found either for muscle strength or anabolic status, cancer progression (tumor weight and metastasis, tumor microenvironment), cli…
subject: Articles
  topic: section
subject: CANCER-PATIENTS
  topic: keywords
subject: CARDIORESPIRATORY FITNESS
  topic: keywords
subject: CHILDHOOD-CANCER
  topic: keywords
subject: T-CELL
  topic: keywords
subject: BENEFITS
  topic: keywords
subject: GROWTH
  topic: keywords
subject: EXPRESSION
  topic: keywords
subject: LANDSCAPE
  topic: keywords
subject: SURVIVORS
  topic: keywords
subject: MORTALITY
  topic: keywords
creator: Asuncion Martin-Ruiz
creator: Ana L. Luis Huertas
creator: Sandra Zazo
creator: Maria Moran
creator: Alejandro Santos-Lozano
creator: SJ Fleck
creator: M Ramírez
creator: Federico Rojo
creator: Alejandro Lucia
creator: A González-Murillo
creator: Carmen Fiuza-Luces
rights: Copyright (c) 2023 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 91
ending page: 115
doi: 10.22029/eir.2023.1758

Respiratory viral infections - impact on sport and exercise medicine
type: item
description: Respiratory viruses are the most frequent causative agents of disease in humans and thus also in elite athletes. The COVID-19 pandemic has recently emphasized the entire spectrum of respiratory tract infections worldwide. Understanding the basic elements of respiratory viral infections is a fundamental requirement from the perspective of etiological diagnostics, treatment, and prevention strategy planning, as well as resource allocation.
subject: Articles
  topic: section
subject: POINT-OF-CARE
  topic: keywords
subject: SYNCYTIAL VIRUS
  topic: keywords
subject: COMMON COLD
  topic: keywords
subject: NATURAL-HISTORY
  topic: keywords
subject: CLINICAL IMPACT
  topic: keywords
subject: ELITE SWIMMERS
  topic: keywords
subject: INFLUENZA-A
  topic: keywords
subject: OPEN-LABEL
  topic: keywords
subject: TRANSMISSION
  topic: keywords
subject: ILLNESS
  topic: keywords
creator: Raakel Luoto
creator: Matti Waris
creator: Maarit Valtonen
creator: Olli Ruuskanen
rights: Copyright (c) 2023 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 7
ending page: 21
doi: 10.22029/eir.2023.1757

The anti-inflammatory and bioregulatory effects of habitual exercise in high-fat diet-induced obesity involve crown-like structures and MCP-1 in white adipose tissue.
type: item
description: "Macrophage accumulation in the adipose tissue and changes in their inflammatory phenotype is a hallmark of obesity-induced inflammation, notably forming inflammatory structures known as ""crown-like structures (CLS)"". Exercise can be a key strategy to improve inflammation-related complications, but it is crucial to consider that, although exercise generally exerts systemic and local anti-inflammatory effects, this depends on the basal inflammatory status and exercise modality. In this context, the ""bioregulatory effect of exercise"" implies to achieve the reduction or prevention of an excessive inflammatory response and also the preservation or stimulation of the innate response. In the present work, our aim was to evaluate the effect of regular exercise on adipose tissue inflammation in high-fat diet-induced obesity in mice, as reflected by macrophage infiltration and phenotype, and CLS formation, together with a potential role for the chemokine MCP-1 in this process. Results showed that obesity is associated with greater MCP-1 expression (p<0.05), macrophage accumulation (p<0.05), and CLS presence (p<0.001). Regular exercise reduced macrophage accumulation (p<0.05), MCP-1 expression (p<0.01), and CLS presence (p<0.05) in obese mice; while it increased macrophage and CLS presence (p<0.01), MCP-1 expression (p<0.05), and M2 polarization (p<0.05) in lean mice. MCP-1 was associated with the proliferation of CLS, showing the first image demonstrating a potential role of this chemokine in the development of these structures. Altogether, these results confirm, for the first time, the ""bioregulatory effect of exercise"" in the adipose tissue: reducing inflammation in individuals with an elevated inflammatory set point, but stimulating this response of the immune system in healthy individuals."
subject: Articles
  topic: section
subject: MACROPHAGE INFILTRATION
  topic: keywords
subject: LOCAL PROLIFERATION
  topic: keywords
subject: INSULIN-RESISTANCE
  topic: keywords
subject: ADIPOCYTE DEATH
  topic: keywords
subject: CRUCIAL ROLE
  topic: keywords
subject: INFLAMMATION
  topic: keywords
subject: CONTRIBUTES
  topic: keywords
subject: ACTIVATION
  topic: keywords
subject: PHENOTYPE
  topic: keywords
subject: PLAYS
  topic: keywords
creator: Isabel Galvez
creator: Leticia Martin-Cordero
creator: Gerry Graham
creator: Javier Francisco-Morcillo
creator: Eduardo Ortega
rights: Copyright (c) 2023 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 116
ending page: 125
doi: 10.22029/eir.2023.1756

A Scoping Review on the Effects of Physical Exercise and Fitness on Peripheral Leukocyte Energy Metabolism in Humans
type: item
description: Background: Both acute and chronic exercise have profound effects on systemic metabolism and the immune system. While acute exercise transiently disturbs energy homeostasis and elicits acute inflammation, exercise training improves systemic metabolic capacity, lowers basal inflammation, and reduces infection risk. Accordingly, accumulating evidence indicates links between systemic and immune cell metabolism and suggests that cellular metabolism may be an important way exercise influences immune function. Yet, no reviews have systematically surveyed the literature in this area. Aims: The aims of this scoping review were to collect, summarize, and provide descriptive analysis of literature on the effects of acute exercise, chronic exercise, and physical fitness on peripheral leukocyte energy metabolism of human adults. Methods: Reports were retrieved from the databases Pubmed, Scopus, and Embase and hierarchically filtered for eligibility. Eligible reports were those that implemented acute or chronic exercise interventions, or assessed physical fitness, in relation to the regulation or function of leukocyte energy metabolism in human adults. Data were charted from eligible reports by two independent reviewers, confirmed by conference, and organized for reporting. Results & Conclusion: Results suggest acute exercise can influence the regulation and function of leukocyte metabolism, with some similarities to what has been previously documented in skeletal muscle. Data also evidence that exercise training and/ or physical fitness alters cellular metabolic regulation and function. Improvements in markers of cell respiratory function or mitochondrial regulation were frequently observed following training or with greater fitness. However, notable gaps in the literature remain. These gaps include: the effects of acute exercise and exercise training on leukocyte glycolysis, the effects of resistance and concurrent exercise, and potential differences in the effects of exercise…
subject: Articles
  topic: section
subject: BLOOD MONONUCLEAR-CELLS
  topic: keywords
subject: MITOCHONDRIAL DYSFUNCTION
  topic: keywords
subject: PPAR-GAMMA
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: FAT OXIDATION
  topic: keywords
subject: T-CELL
  topic: keywords
subject: RESPIRATION
  topic: keywords
subject: IMMUNOMETABOLISM
  topic: keywords
subject: ADAPTATIONS
  topic: keywords
subject: EXPRESSION
  topic: keywords
creator: CF Hodgman
creator: RM Hunt
creator: JC Crane
creator: Mahmoud Elzayat
creator: EC LaVoy
rights: Copyright (c) 2023 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 54
ending page: 90
doi: 10.22029/eir.2023.1755

Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis.
type: item
description: Background: In the pathogenesis of knee osteoarthritis (KOA), inflammatory mediators play an important role. However, the precise underlying mechanism by which regular exercise therapy (ET) exert effects on the immune system in KOA patients is unknown. Objectives: The aim of this systematic review was to investigate the basal and acute effects of ET on inflammatory biomarkers and brain derived neurotrophic factor (BDNF) in KOA patients. Methods: PubMed, Web Of Science and PEDro were systematically searched for appropriate studies. If possible, a meta-analysis was performed or an approximation of the effect size (ES) was calculated. Risk of bias was scored using the Cochrane ROB 2.0 or ROBINS-I tools. Results: Twenty-one studies involving 1374 participants were included. Fifteen articles focused on basal exercise effects, four on acute effects, and two on both. Biomarker analysis (n=18) was performed in synovial fluid (n=4) or serum/plasma (n=17). A meta-analysis demonstrated that basal CRP was reduced in KOA patients 6-18 weeks weeks after ET (MD: -0.17;95%CI[-0.31;-0.03]), while IL-6 (MD: 0.21;95%CI[-0.44;0.85]), and TNF-alpha (MD:-0.57;95%CI[-1.47;0.32]), levels did not significantly change. Also, sTNFR1/2 did not change significantly after ET. For other biomarkers, insufficient data were available to perform a meta-analysis. Nevertheless, a low degree evidence was found for a decrease in IL-6 (ES:-0.596 &-0.259 &-0.513), an increase in sTNFR1 (ES:2.325), a decrease sTNFR2 (ES:-0.997) and an increase in BDNF (ES:1.412). Locally, intra-articular IL-10 (ES:9.163) increased, and IL-1 beta (ES:-6.199) and TNF-alpha decreased (ES:-2.322) after ET. An acute exercise session elicited a myokine response (ES IL-6:0.314), and an increase in BDNF (no ES-data). No inflammatory effect (ES CRP:0.052; ES TNF-alpha:-0.019 0.081) following an acute bout of training was found. However, a single bout of exercise elicited a decrease in intra-articular IL-10 (no ES-data). Conclusion: …
subject: Articles
  topic: section
subject: NEUROBLASTOMA RISK GROUP
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: CANCER
  topic: keywords
subject: BENEFITS
  topic: keywords
subject: CHILDREN
  topic: keywords
creator: Sofi Puts
creator: Keliane Liberman
creator: Laurence Leysen
creator: Louis Forti
creator: Eveline Muyldermans
creator: Peter Vaes
creator: Jo Nijs
creator: David Beckwee
creator: Ivan Bautmans
rights: Copyright (c) 2023 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 22
ending page: 53
doi: 10.22029/eir.2023.1754

Exercise effect on symptom severity, morbidity and mortality in viral infections: a systematic review and meta-analysis.
type: item
description: There is a knowledge gap regarding the consequences of exercise during acute infections in humans and contradictory findings in animal studies, compromising public health advice on the poten-tial benefits of physical activity for immunity. Here, we carried out a meta-analysis of studies of the effects of moderate exercise (ME) and exercise until fatigue (EF) on symptom severity, morbidity and mortality during viral infection in animal models. The sys-tematic review on PubMed, Scopus, Embase, Web of Science, Co-chrane and EBSCOhost (CINAHL and SPORT Discus) identified 8 controlled studies, with 15 subgroups within them. The studies exposed the animals (mice [7 studies] and monkeys [1 study]) to exercise immediately before or after viral inoculation (HSV-1, H1N1 influenza and B.K. virus) with follow-up for 21 days. ME significantly reduced morbidity (OR 0.43 [0.19; 0.98], P = 0.04) with no change for symptom severity (SMD-3.37 [-9.01; 2.28], P = 0.24) or mortality (OR 0.48 [0.08;3.03], P = 0.43). In con-trast, EF gave a trend towards increased symptom severity (SMD 0.96 [-0.06; 1.98], P = 0.07) and mortality (OR 1.47 [0.96;2.28], P =0.08) with no change in morbidity (OR 1.22 [0.60;2.5], P = 0.58). We conclude that in animals moderate exercise during in-fection is advantageous, whilst exercise until fatigue should be avoided. Further research is required to determine if moderate exercise may also be beneficial in humans during infection.
subject: Articles
  topic: section
subject: IMMUNE FUNCTION
  topic: keywords
subject: MODERATE EXERCISE
  topic: keywords
subject: CELL MOBILIZATION
  topic: keywords
subject: SUSCEPTIBILITY
  topic: keywords
subject: INFECTION
  topic: keywords
subject: STRESS
  topic: keywords
subject: REDISTRIBUTION
  topic: keywords
subject: LYMPHOCYTES
  topic: keywords
subject: SUBSETS
  topic: keywords
subject: MICE
  topic: keywords
creator: Rafaela Bertini de Araujo
creator: Mara Patricia Traina Chacon-Mikahil
creator: Janet M. Lord
creator: Amanda Veiga Sardelia
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 131
ending page: 138
doi: 10.22029/eir.2022.1753

Effect of high intensity interval training and moderate intensity continuous training on lymphoid, myeloid and inflammatory cells in kidney transplant recipients
type: item
description: Kidney transplantations are seen to be a double-edge sword. Transplantations help to partially restore renal function, however there are a number of health-related co-morbidities associated with transplantation. Cardiovascular disease (CVD), malignancy and infections all limit patient and graft survival. Immunosuppressive medications alter innate and adaptive immunity and can result in immune dysfunction. Over suppression of the immune system can result in infections whereas under suppression can result in graft rejection. Exercise is a known therapeutic intervention with many physiological benefits. Its effects on immune function are not well characterised and may include both positive and negative influences depending on the type, intensity, and duration of the exercise bout. High intensity interval training (HIIT) has become more popular due to it resulting in improvements to traditional and inflammatory markers of cardiovascular (CV) risk in clinical and non-clinical populations. Though these improvements are similar to those seen with moderate intensity exercise, HIIT requires a shorter overall time commitment, whilst improvements can also be seen even with a reduced exercise volume. The purpose of this study was to explore the physiological and immunological impact of 8-weeks of HIIT and moderate intensity continuous training (MICT) in kidney transplant recipients (KTRs). In addition, the natural variations of immune and inflammatory cells in KTRs and Non-chronic kidney disease (non-CKD) controls over a longitudinal period are explored. Newly developed multi-colour flow cytometry methods were devised to identify and characterise immune cell populations. Twenty-six KTRs were randomised into one of two HIIT protocols or MICT: HIIT A (n=8; 4-, 2-, and 1-min intervals; 80-90% (V)over dotO(2peak)), HIIT B (n=8, 4x4 min intervals; 80-90% (V)over dotO(2peak)) or MICT (n=8, similar to 40 min; 50-60% (V)over dotO(2peak)) for 24 supervised sessions on a stationary bike …
subject: Articles
  topic: section
subject: REGULATORY T-CELLS
  topic: keywords
subject: QUALITY-OF-LIFE
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: METABOLIC SYNDROME
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: MYCOPHENOLATE-MOFETIL
  topic: keywords
subject: RENAL-TRANSPLANTATION
  topic: keywords
subject: HEMODIALYSIS-PATIENTS
  topic: keywords
subject: PRACTICE GUIDELINES
  topic: keywords
subject: EXERCISE INTENSITY
  topic: keywords
creator: Ganisha M. Hutchinson
creator: AM Cooper
creator: RE Billany
creator: DGD Nixon
creator: NC Bishop
creator: AC Smith
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 103
ending page: 130
doi: 10.22029/eir.2022.1752

Exercise, inflammation and acute cardiovascular events.
type: item
description: Individuals who participate in regular exercise over time have a markedly reduced risk of cardiovascular disease. Paradoxically, in susceptible individuals with underlying, often undiagnosed, disease states, exercise may acutely increase an individual's risk of cardiovascular events during and immediately following physical exertion. Exercise is thought to evoke conditions that trigger atheromatous plaque rupture or trigger life threatening arrhythmias in individuals with pre-existing, vulnerable coronary artery and inherited cardiovascular disease respectively. This transient increased risk may be driven by the inflammatory trigger provided by physical exertion where exercise is associated with an upregulation of inflammatory mediators in the acute phase. Conversely, habitual exercise can lead to a modulation of the inflammatory response over time. This review explores: exercise related inflammation; acute cardiovascular events related to exercise and strategies to mitigate these risks.
subject: Articles
  topic: section
subject: ACUTE MYOCARDIAL-INFARCTION
  topic: keywords
subject: SUDDEN CARDIAC-ARREST
  topic: keywords
subject: MUSCLE-DERIVED INTERLEUKIN-6
  topic: keywords
subject: AMERICAN-HEART-ASSOCIATION
  topic: keywords
subject: ACUTE CORONARY SYNDROMES
  topic: keywords
subject: NECROSIS-FACTOR-ALPHA
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: HYPERTROPHIC CARDIOMYOPATHY
  topic: keywords
subject: SCIENTIFIC STATEMENT
  topic: keywords
subject: EUROPEAN ASSOCIATION
  topic: keywords
creator: Susil Pallikadavath
creator: GM Walters
creator: TA Kite
creator: MPM Graham-Brown
creator: Andrew Ladwiniec
creator: Michael Papadakis
creator: Gerry McCann
creator: Anvesha Singh
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 92
ending page: 102
doi: 10.22029/eir.2022.1751

The effects of exercise on complement system proteins in humans: a systematic scoping review
type: item
description: Background: The complement system is comprised of the classical, lectin and alternative pathways that result in the formation of: pro-inflammatory anaphylatoxins; opsonins that label cells for phagocytic removal; and, a membrane attack complex that directly lyses target cells. Complement-dependent cytotoxicity (CDC) - cell lysis triggered by complement protein C1q binding to the Fc region of antibodies bound to target cells - is another effector function of complement and a key mechanism-of-action of several monoclonal antibody therapies. At present, it is not well established how exercise affects complement system proteins in humans. Methods: A systematic search was conducted to identify studies that included original data and investigated the association between soluble complement proteins in the blood of healthy humans, and: 1) an acute bout of exercise; 2) exercise training interventions; or, 3) measurements of habitual physical activity and fitness. Results: 77 studies were eligible for inclusion in this review, which included a total of 10,236 participants, and 40 complement proteins and constituent fragments. Higher levels of exercise training and cardiorespiratory fitness were commonly associated with reduced C3 in blood. Additionally, muscle strength was negatively associated with C1q. Elevated C3a-des-Arg, C4a-desArg and C5a, lower C1-inhibitor, and unchanged C3 and C4 were reported immediately post-laboratory based exercise, compared to baseline. Whereas, ultra-endurance running and resistance training increased markers of the alternative (factor B and H), classical (C1s), and leptin (mannose binding lectin) pathways, as well as C3 and C6 family proteins, up to 72-h following exercise. Heterogeneity among studies may be due to discrepancies in blood sampling/handling procedures, analytical techniques, exercise interventions/measurements and fitness of included populations. Conclusions: Increased anaphylatoxins were observed immediately following an acute …
subject: Articles
  topic: section
subject: OXYGEN SPECIES PRODUCTION
  topic: keywords
subject: LOW-GRADE INFLAMMATION
  topic: keywords
subject: SERUM OPSONIC ACTIVITY
  topic: keywords
subject: FRESH-FROZEN PLASMA
  topic: keywords
subject: IN-VITRO ACTIVATION
  topic: keywords
subject: C-REACTIVE PROTEIN
  topic: keywords
subject: BODY-FAT MASS
  topic: keywords
subject: ALTERNATIVE PATHWAY
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
creator: Daniela Rothschild-Rodriguez
creator: John P. Campbell
creator: FF Brown
creator: HD Collier-Bain
creator: Sally Moore
creator: James Murray
creator: JE Turner
creator: JP Campbell
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 57
ending page: 91
doi: 10.22029/eir.2022.1750

Traumatic Brain Injury Rehabilitation: An Exercise Immunology Perspective
type: item
description: Traumatic brain injury (TBI) is the largest cause of death and disability globally. The physical and psychosocial consequences after TBI can persist for prolonged periods, and lead to increased health care and economic burden. Exercise has shown promise over recent years as a mode of rehabilitation that alleviates multiple TBI symptoms; but there is a lack of controlled large-scale studies and limited research into the underlying mechanisms. This critical review draws from animal and human studies on exercise immunology to speculate on possible mechanisms that could underlie beneficial outcomes of exercise after TBI. The anti-inflammatory role of exercise, protective role offered by pre-injury exercise, and the need for more objective studies on biomarker analysis are expected to be useful considerations to develop optimal post-TBI exercise rehabilitation programs. Future studies can consider investigating the specific immunological processes induced by exercise in consideration of individual differences and non-aerobic exercise modalities.
subject: Articles
  topic: section
subject: TREADMILL EXERCISE
  topic: keywords
subject: AEROBIC EXERCISE
  topic: keywords
subject: POSTCONCUSSION SYNDROME
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: ACTIVE REHABILITATION
  topic: keywords
subject: NEUROTROPHIC FACTOR
  topic: keywords
subject: CELL-PROLIFERATION
  topic: keywords
subject: DENTATE GYRUS
  topic: keywords
subject: ANIMAL-MODELS
  topic: keywords
subject: UP-REGULATION
  topic: keywords
creator: Kannan Singaravelu Jaganathan
creator: Karen A. Sullivan
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 46
ending page: 56
doi: 10.22029/eir.2022.1749

Immunometabolism-fit: How exercise and training can modify T cell and macro- phage metabolism in health and disease
type: item
description: Background: The term immunometabolism describes cellular and molecular metabolic processes that control the immune system and the associated immune responses. Acute exercise and regular physical activity have a substantial influence on the metabolism and the immune system, so that both processes are closely associated and influence each other bidirectionally.Scope of review: We limit the review here to focus on metabolic phenotypes and metabolic plasticity of T cells and macrophages to describe the complex role of acute exercise stress and regular physical activity on these cell types. The metabolic and immunological consequences of the social problem of inactivity and how, conversely, an active lifestyle can break this vicious circle, are then described. Finally, these aspects are evaluated against the background of an aging society.Major conclusions: T cells and macrophages show high sensitivity to changes in their metabolic environment, which indirectly or directly affects their central functions. Physical activity and sedentary behaviour have an important influence on metabolic status, thereby modifying immune cell phenotypes and influencing immunological plasticity. A detailed understanding of the interactions between acute and chronic physical activity, sedentary behaviour, and the metabolic status of immune cells, can help to target the dysregulated immune system of people who live in a much too inactive society.
subject: Articles
  topic: section
subject: ENDOPLASMIC-RETICULUM STRESS
  topic: keywords
subject: HYPOXIA-INDUCIBLE FACTORS
  topic: keywords
subject: FREE FATTY-ACIDS
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: ADIPOSE-TISSUE
  topic: keywords
subject: SITTING TIME
  topic: keywords
subject: PPAR-GAMMA
  topic: keywords
subject: INSULIN SENSITIVITY
  topic: keywords
subject: SEDENTARY BEHAVIORS
  topic: keywords
creator: Jose Cesar Rosa-Neto
creator: Fabio Santo Lira
creator: Jonathan Peter Little
creator: Graham Landells
creator: Hashim Islam
creator: Benedicte Chazaud
creator: David B Pyne
creator: Ana Maria Teixeira
creator: Helena Batatinha
creator: Barbara Moura Antunes
creator: Luciele Guerra Minuzzi
creator: Jana Palmowksi
creator: Richard J Simpson
creator: Karsten Krüger
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 28
ending page: 45
doi: 10.22029/eir.2022.1748

Acute effects of heavy resistance exercise on biomarkers of neuroendocrine- immune regulation in healthy adults: a systematic review
type: item
description: Background: The nervous system integrates the immune system in the systemic effort to maintain or restore the organism's homeostasis. Acute bouts of exercise may alter the activity of specific pathways associated with neuroendocrine regulation of the immune system. Objective: To examine the acute effects of heavy resistance exercise on biomarkers of neuroendocrine-immune regulation in healthy adults.Methods: A systematic literature search was conducted using PubMed, Cochrane Controlled Trials Register, Web of Science and SportDiscus with no date restrictions up to March 2021. Clinical trials in English or German were included if they measured the blood plasma or serum concentrations of specific biomarkers of neuroendocrine-immune regulation (adrenaline, noradrenaline, acetylcholine, vasoactive intestinal peptide (VIP), cortisol, growth hormone, calcitonin gene -related peptide (CGRP), substance p, serotonin, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) or glia-derived neurotrophic factor (GDNF)) in a resting state prior to and no later than 60 minutes after an acute bout of heavy resistance exercise in healthy adults.Results: 7801 records were identified through literature search, of which 36 studies, with a total of 58 intervention groups, met the inclusion criteria. Evidence was found that an acute bout of heavy resistance exercise increased the levels of adrenaline (median: 185%), noradrenaline (median: 113%) and GH (median: 265%) immediately after the exercise. Mixed results were found for cortisol (median: 0%), suggesting that its response might be more sensitive to the configuration of the exercise scheme. The limited evidence regarding the effects on BDNF and ACTH allows no firm conclusions to be drawn about their response to heavy resistance exercise. The vast majority of the included studies reported a return of the biomarker concentrations to their baseline value within one hour after the termination of the exercise bout. No studies …
subject: Articles
  topic: section
subject: ACUTE HORMONAL RESPONSES
  topic: keywords
subject: GROWTH-FACTOR RESPONSES
  topic: keywords
subject: SHORT REST PERIODS
  topic: keywords
subject: NEUROTROPHIC FACTOR
  topic: keywords
subject: HIGH-INTENSITY
  topic: keywords
subject: RECOVERY RESPONSES
  topic: keywords
subject: MONONUCLEAR-CELLS
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: SINGLE BOUT
  topic: keywords
subject: BRAIN
  topic: keywords
creator: Simon Haunhorst
creator: Wilhelm Bloch
creator: Miriam Ringleb
creator: Lena Fennen
creator: Heiko Wagner
creator: HHW Gabriel
creator: Christian Puta
rights: Copyright (c) 2022 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 6
ending page: 27
doi: 10.22029/eir.2022.1747

The effect of exercise on regulatory T cells: A systematic review of human and animal studies with future perspectives and methodological recommendations
type: item
description: Many of the exercise-related health-promoting effects are attributed to beneficial immunomodulation. The restoration of immune homeostasis is context-dependent, meaning either to increase anti-inflammatory signaling to counteract disease progression of non-communicable (auto)inflammatory diseases or to enhance (local) activity of proinflammatory immune cells to slow down or inhibit cancer progression. Regulatory CD4+ T cells (T regs) represent the main regulatory component of the adaptive immune system that fine-tunes inflammatory responses, keeps them in check and prevents long-lasting autoimmunity. Because often dysregulated in the context of various diseases, emerging treatment approaches aim to modulate their number or inherent anti-inflammatory and immunosuppressive function in a highly disease-specific way. Exercise represents a non-pharmacologic strategy in disease prevention and rehabilitation and may be an effective treatment with few to no side effects to counteract dysregulation of T regs. To date, several studies have evaluated the effect of exercise on T reg-related outcomes. This review aims at providing a comprehensive overview on alterations of blood- or tissue-derived T reg counts, proportion and functionality following acute and chronic exercise in humans and animal models. From the 60 reviewed studies, an overall disease-specific beneficial effect of chronic exercise on T reg levels in animal models can be stated, while both acute and chronic effects in human studies are less definite. However, T reg phenotyping is less sufficient in the animal studies compared to human studies. Only a limited number of studies investigated T reg functionality. There is a large heterogeneity concerning study design, human population or animal model, exercise protocol, and T reg outcome measure specification which makes it difficult to compare results and draw clear conclusions. Study results are discussed in the context of current concepts in exercise immunology. …
subject: Articles
  topic: section
subject: EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS
  topic: keywords
subject: CYCLIC ADENOSINE-MONOPHOSPHATE
  topic: keywords
subject: ARYL-HYDROCARBON RECEPTOR
  topic: keywords
subject: PHYSICAL-ACTIVITY
  topic: keywords
subject: AEROBIC EXERCISE
  topic: keywords
subject: OXIDATIVE STRESS
  topic: keywords
subject: IMMUNE-RESPONSE
  topic: keywords
subject: INDOLEAMINE 2,3-DIOXYGENASE
  topic: keywords
subject: SUPPRESSIVE FUNCTION
  topic: keywords
subject: ANTITUMOR IMMUNITY
  topic: keywords
creator: Sebastian Proschinger
creator: Matteo Winker
creator: Niklas Joisten
creator: Wilhelm Bloch
creator: Jana Palmowski
creator: Philipp Zimmer
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 142
ending page: 167
doi: 10.22029/eir.2021.1746

Exercise training effects on natural killer cells: a preliminary proteomics and systems biology approach
type: item
description: Background: Regular exercise, particularly moderate-intensity continuous training (MICT), can improve immune function. Natural killer (NK) cells, a subset of lymphocytes that react to infections, are the most responsive innate immune cells to exercise, but the mechanisms underlying this are poorly understood. A type of exercise training that is gaining popularity in recent years is high-intensity interval training (HIIT), but how it affects NK cells is largely unknown. In fact, intense exercise has been traditionally viewed as a potential stressor to immune homeostasis. The purpose of this study was to determine in healthy, previously untrained adults (N=8 [3 male; 40 +/- 6 years]) the effects of an intervention consisting of 4-week MICT followed by 4-week HIIT on NK cells as compared with a pre-training (baseline) state. Methods: Participants were studied at three time points: baseline, mid-intervention (after MICT), and post-intervention (after HIIT). Main assessments included cytotoxicity assays, flow-cytometry analysis of NK cell surface markers, and interrogation of the cellular proteome using a systems biology approach. Results: A significant time effect was found for NK cell cytotoxicity (p<0.001), which was increased similar to 10-fold at both midand post-intervention versus baseline. No significant intervention effect was found for NK surface receptor expression, except for CXCR3 determined as mean fluorescence intensity (p=0.044, although with no significant differences in post hoc pairwise comparisons). The proteins showing a higher differential expression (Log2 fold-change>10 and false discovery rate [FDR] q-value<0.001) were COP9 signalosome subunit 3 (COPS3), DnaJ heat shock protein family member B11 (DNAJB11), histidyl-TRNA synthetase 1 (HARS), NIMA related kinase 9 (NEK9), nucleoporin 88 (NUP88), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), regulator of chromosome condensation 2 (RCC2), TAO kinase 3 (TAOK3), transducin beta like 2 (TBL2),…
subject: Articles
  topic: section
subject: IMMUNE FUNCTION
  topic: keywords
subject: BREAST-CANCER
  topic: keywords
subject: HIGH-INTENSITY
  topic: keywords
subject: NK CELLS
  topic: keywords
subject: CYTOTOXIC ACTIVITY
  topic: keywords
subject: PERIPHERAL-BLOOD
  topic: keywords
subject: TRANSCRIPTOME
  topic: keywords
subject: EXPRESSION
  topic: keywords
subject: REGULATOR
  topic: keywords
subject: RESPONSES
  topic: keywords
creator: Francisco Llavero
creator: Adrian Castillo-Garcia
creator: Carmen Fiuza-Luces
creator: Alejandro Lopez Soto
creator: Jose L. Zugaza
creator: JS Morales
creator: D Fernández
creator: IP Aldazabal
creator: M Ramírez
creator: Alejandro Santos-Lozano
creator: JL Zugaza
creator: Alejandro Lucia
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 125
ending page: 141
doi: 10.22029/eir.2021.1745

A systematic literature review on the effects of exercise on human Toll-like receptor expression
type: item
description: Background Toll-like receptors (TLRs) are a family of transmembrane pattern recognition receptors that are mainly expressed on immune cells. Recognition of various exogenous and endogenous molecular patterns activates the TLR signalling cascade, which orchestrates an inflammatory immune response. Dysfunctional immune responses, including aberrant TLR signalling, are increasingly implicated in the associations between sedentarism, chronic low-grade systemic inflammation and various non-communicable diseases. Conversely, exercise exerts anti-inflammatory effects, which could be conferred through its immunomodulatory properties, potentially affecting TLRs. This study aims to systematically review the effects of exercise on human TLR expression. Method A systematic literature search of Pubmed, Embase, The Cochrane Library and SPORTDiscus for articles addressing the impact of exercise (as isolated intervention) on TLRs in humans was conducted, ending in February 2020. Results A total of 66 articles were included. The publications were categorised according to exercise modality and duration: acute resistance exercise (4 studies), acute aerobic exercise (26 studies), resistance training program (9 studies), aerobic training program (16 studies), combined (i.e. resistance and aerobic) training program (8 studies) and chronic exercise not otherwise classifiable (9 studies). Five articles investigated more than one of the aforementioned exercise categories. Several trends could be discerned with regard to the TLR response in the different exercise categories. Acute resistance exercise seemed to elicit TLR upregulation, whereas acute aerobic exercise had less activating potential with the majority of responses being neutral or, especially in healthy participants, downregulatory. Chronic resistance and combined exercise programs predominantly resulted in unaltered or decreased TLR levels. In the chronic aerobic exercise category, mixed effects were observed, but the majority of…
subject: Articles
  topic: section
subject: NF-KAPPA-B
  topic: keywords
subject: INFLAMMATORY GENE-EXPRESSION
  topic: keywords
subject: MESSENGER-RNA EXPRESSION
  topic: keywords
subject: ANTIGEN-PRESENTING CELLS
  topic: keywords
subject: LOW-DENSITY-LIPOPROTEIN
  topic: keywords
subject: HIGH-INTENSITY INTERVAL
  topic: keywords
subject: SIGNALING PATHWAY
  topic: keywords
subject: EXHAUSTIVE EXERCISE
  topic: keywords
subject: CYTOKINE PRODUCTION
  topic: keywords
subject: IMMUNE-RESPONSE
  topic: keywords
creator: Kasper Favere
creator: Matthias Bosman
creator: PL Delputte
creator: HW Favoreel
creator: Emeline M. Van Craenenbroeck
creator: Johan De Sutter
creator: Isabel Witvrouwen
creator: GRY De Meyer
creator: Hein Heidbuchel
creator: PJDF Guns
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 84
ending page: 124
doi: 10.22029/eir.2021.1744

Improvement in the anti-inflammatory profile with lifelong physical exercise is related to clock genes expression in effector-memory CD4+T cells in master athletes.
type: item
description: Purpose: Ageing is associated with alterations in the immune system as well as with alterations of the circadian rhythm. Immune cells show rhythmicity in execution of their tasks. Chronic inflammation (inflammaging), which is observed in the elderly, is mitigated by lifelong exercise. The aimed this study was to determine the acute effect of a maximal exercise test on clock genes, regulatory proteins and cytokine expression, and evaluate the effect of lifelong exercise on the expression of clock genes in subpopulations of effector-memory (EM) CD4+ and CD8+T cells and the association of these processes with the inflammatory profile. Therefore, this study aimed to investigate the expression of clock genes in subpopulations of effector memory (EM) CD4+ and CD8+ T cells in master athletes and healthy controls and further associate them with systemic inflammatory responses to acute exercise. Methods: The study population comprised national and international master athletes (n = 18) involved in three sports (athletics, swimming and judo). The control group (n = 8) comprised untrained healthy volunteers who had not participated in any regular and competitive physical exercise in the past 20 years. Anthropometric measurements and blood samples were taken before (Pre), 10 min after (Post) and 1 h after (1 h Post) a maximal cycle ergometer test for the determination of maximum oxygen consumption (VO 2 max). The subpopulations of EM CD4+ and CD8+ T cells were purified using fluorescenceactivated cell sorting. RNA extraction of clock genes (CLOCK, BMAL1, PER1, PER2, CRY1, CRY2, REV-ERBa, REV-ERB ss, RORa, RORb and RORc) in EM CD4+ and EM CD8+ T cells as well as regulatory proteins (IL-4, IFN-., Tbx21, PD-1, Ki67, NF-kB, p53 and p21) in EM CD4+ T cells was performed. The serum concentration of cytokines (IL-8, IL-10, IL-12p70 and IL-17A) was measured. Results: The master athletes showed better physiological parameters than the untrained healthy controls (P<0.05). The levels of c…
subject: Articles
  topic: section
creator: AAD Teixeira
creator: LG Minuzzi
creator: FS Lira
creator: ASVP Gonçalves
creator: Antonio Martinho
creator: JCR Neto
creator: AM Teixeira
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 67
ending page: 83
doi: 10.22029/eir.2021.1743

Higher levels of physical activity are associated with reduced tethering and migration of pro-inflammatory monocytes in males with central obesity
type: item
description: Despite evidence that monocyte migration is accentuated by central adiposity, the impact of physical activity (PA) and exercise, particularly in the post-prandial state, on limiting migration are not established. We hypothesised that PA and a single bout of walking exercise would be associated with reduced ex vivo monocyte tethering and migration in middleaged males with central obesity (CO). Objective levels of PA were measured for 7 days in lean males (LE, N=12, mean (SD) age 39 (10) years, waist circumference 81.0 (6.3) cm) and males with CO (N=12, mean (SD) age 40 (9) years, waist circumference 115.3 (13.9) cm), followed by donation of a fasted blood sample. On the same day, CO undertook a bout of walking exercise, before donation of a second fasted blood sample. An ex vivo assay, coupled to flow cytometry, determined tethering and migration of classical, intermediate, and non-classical monocytes. C-C and CXC chemokine receptor (CCR2, CCR5 and CX3CR1) expression were also determined on total and classical monocytes. Monocyte subsets (total, classical, intermediate and CCR2+ monocytes), metabolic (glucose and lipids) and inflammatory (C-reactive protein) markers were greater in CO vs. LE (lower highdensity lipoprotein); however, adjustments for PA mitigated group differences for glucose, lipids, and monocyte subsets. Ex vivo tethering and migration (absolute and relative) of most monocyte subsets was greater in CO vs LE. Relative monocyte tethering and migration was largely not influenced by PA; however, higher PA was associated with reduced absolute migration and tethering of CD16 expressing monocytes in CO. Prior walking had no impact on these variables. These results highlight that regular PA, not single exercise bouts may limit the migration of pro-inflammatory monocytes in CO. These changes may relate to physiological parameters in blood (i.e. number of cells and their adhesion), rather than differences in chemokine receptor expression.
subject: Articles
  topic: section
creator: AJ Wadley
creator: MJ Roberts
creator: Jade Creighton
creator: AE Thackray
creator: DJ Stensel
creator: NC Bishop
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 54
ending page: 66
doi: 10.22029/eir.2021.1742

Regular physical exercise mediates the immune response in atherosclerosis
type: item
description: Atherosclerosis is a chronic inflammatory cardiovascular disease, which results from lipid accumulation in the blood vessel wall, forming a plaque, and ultimately restricting blood flow. The immune system plays a vital role in progression to plaque rupture. While recent evidence clearly indicates the anti-inflammatory function of regular exercise, the mechanisms by which regular exercise can modulate its pathophysiology is not well understood. In this review, we discuss how regular exercise can lower systemic inflammation directly via modulation of the immune system or indirectly via altered myokine concentrations and metabolites. We describe the exercise-induced responses of various myokines (such as IL-6, adiponectin, and FGF21), and how cell function in the innate immune system can be modulated via regular exercise, with the aim to modulate plaque formation in atherosclerosis.
subject: Articles
  topic: section
subject: APOLIPOPROTEIN-E POLYMORPHISM
  topic: keywords
subject: LOW-DENSITY LIPOPROTEINS
  topic: keywords
subject: NITRIC-OXIDE PRODUCTION
  topic: keywords
subject: SMOOTH-MUSCLE-CELLS
  topic: keywords
subject: GROWTH-FACTOR 21
  topic: keywords
subject: BLOOD MONOCYTES
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
subject: T-CELLS
  topic: keywords
subject: THERAPEUTIC ANGIOGENESIS
  topic: keywords
subject: CORONARY ATHEROSCLEROSIS
  topic: keywords
creator: AFD Valente
creator: RT Jaspers
creator: RCI Wüst
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 42
ending page: 53
doi: 10.22029/eir.2021.1741

Physical Exercise: A Versatile Anti-Inflammatory Tool Involved in the Control of Hypothalamic Satiety Signaling
type: item
description: "The hypothalamus plays a critical role in the control of food consumption and energy expenditure. Fatty diets can elicit an inflammatory response in specific hypothalamic cells, including astrocytes, tanycytes, and microglia, disrupting anorexigenic signals in region-specific hypothalamic neurons, contributing to overeating and body weight gain. In this study, we present an update regarding the knowledge of the effects of physical exercise on inflammatory signaling and circuits to control hunger in the hypothalamus in obesity conditions. To try to understand changes in the hypothalamus, we review the use of magnetic resonance/anorexigenic hormone analysis in humans, as well as in animal models to explore the physiological and molecular mechanism by which exercise modulates satiety signals, such as the central antiinflammatory response, myokine delivery from skeletal muscle, and others. The accumulation of scientific evidence in recent years allows us to understand that exercise contributes to weight control, and it is managed by mechanisms that go far beyond ""burning calories."""
subject: Articles
  topic: section
subject: PLASMA ENDOCANNABINOID LEVELS
  topic: keywords
subject: APPETITE-RELATED HORMONES
  topic: keywords
subject: CENTRAL-NERVOUS-SYSTEM
  topic: keywords
subject: DIET-INDUCED OBESITY
  topic: keywords
subject: INDUCED WEIGHT-LOSS
  topic: keywords
subject: CHAIN FATTY-ACIDS
  topic: keywords
subject: BETA/NF-KAPPA-B
  topic: keywords
subject: ENERGY-INTAKE
  topic: keywords
subject: AEROBIC EXERCISE
  topic: keywords
subject: SKELETAL-MUSCLE
  topic: keywords
creator: Adelino Sanchez Ramos da Silva
creator: Dennys Esper Cintra
creator: Ana Maria Teixeira
creator: AM Teixeira
creator: JR Pauli
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 7
ending page: 23
doi: 10.22029/eir.2021.1739

Effect of exercise-conditioned human serum on the viability of human cancer cell cultures: A systematic review and meta-analysis
type: item
description: Numerous epidemiological studies have shown the existence of a relationship between exercise and a reduced risk of different types of cancer. In vitro studies have identified a direct effect of exercise-conditioned human serum on cancer cell lines of the lung, breast, prostate, and colon. The aim of this systematic review with meta-analysis (SRM) was to estimate the magnitude of the effect that exercise-conditioned human serum produced on the viability of human cancer cell cultures. The design followed the PRISMA guidelines and the TREND statement to assess the quality of information (QoI) in each study. Nine in vitro studies were included in the SRM, involving a total of nine cancer cell lines and serum from 244 individuals from different countries, including namely healthy sedentary individuals, at risk of prostate cancer individuals and cancer patients, with ages ranging from 18 to 73 years. The impact of acute exercise-conditioned human serum on the viability of cancer cell cultures was analysed by a variety of assays, using pre-exercise human serum for comparison purposes. Globally, cultures of cancer cell lines exposed to human serum conditioned by acute exercise of various intensities exhibited a reduced viability, when compared with control cultures, with an overall effect size (ES) of -1.126 (95% CI; -1.300 to -0.952; p < 0.001). When the analysis only included human serum conditioned by acute high-intensity exercise, the effect became more pronounced (ES -1.350; -1.522 to -1.179 (95% CI); p < 0.001). These results are in line with the hypothesis that changes in human serum induced by exercise might play a role in the beneficial effects of physical activity in cancer prevention and management and that these effects depend on exercise intensity.
subject: Articles
  topic: section
subject: TIME PHYSICAL-ACTIVITY
  topic: keywords
subject: PROSTATE TUMOR-CELLS
  topic: keywords
subject: AXIS IN-VIVO
  topic: keywords
subject: PUBLICATION BIAS
  topic: keywords
subject: LOW-FAT
  topic: keywords
subject: PREVENTION
  topic: keywords
subject: GROWTH
  topic: keywords
subject: DIET
  topic: keywords
subject: MECHANISMS
  topic: keywords
subject: HALLMARKS
  topic: keywords
creator: Carlos M. Soares
creator: Meirielly Furmann
creator: Hugo Sarmento
creator: FM Silva
creator: MC Rusenhack
creator: PR Nobre
creator: MA Fachada
creator: AM Urbano
creator: JP Ferreira
rights: Copyright (c) 2021 Exercise Immunology Review https://rightsstatements.org/page/InC/1.0/
date: 2026-07-15
publication date: 2026-07-15
starting page: 24
ending page: 41
doi: 10.22029/eir.2021.1740