Physical exercise, immune response, and susceptibility to infections-current knowledge and growing research areas.

Department of Immunology and Allergy, Medical University of Łódź, Łódź, Poland. Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. National Heart and Lung Institute (NHLI), Imperial College London, London, UK. Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy. Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal. Serviço de Imunoalergologia, Centro Hospitalar de São João E.P.E, Porto, Portugal. Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden. Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic. Epidemiology Research Unit- Instituto de Saúde Pública, University of Porto, Porto, Portugal. Allergy & Immunology Centre, Tbilisi, Georgia. Teaching University Geomedi LLC, Tbilisi, Georgia. Allergy Unit, Hospital CUF Descobertas, Lisbon, Portugal.

Allergy. 2022;(9):2653-2664

Abstract

This review presents state-of-the-art knowledge and identifies knowledge gaps for future research in the area of exercise-associated modifications of infection susceptibility. Regular moderate-intensity exercise is believed to have beneficial effects on immune health through lowering inflammation intensity and reducing susceptibility to respiratory infections. However, strenuous exercise, as performed by professional athletes, may promote infection: in about half of athletes presenting respiratory symptoms, no causative pathogen can be identified. Acute bouts of exercise enhance the release of pro-inflammatory mediators, which may induce infection-like respiratory symptoms. Relatively few studies have assessed the influence of regularly repeated exercise on the immune response and systemic inflammation compared to the effects of acute exercise. Additionally, ambient and environmental conditions may modify the systemic inflammatory response and infection susceptibility, particularly in outdoor athletes. Both acute and chronic regular exercise influence humoral and cellular immune response mechanisms, resulting in decreased specific and non-specific response in competitive athletes. The most promising areas of further research in exercise immunology include detailed immunological characterization of infection-prone and infection-resistant athletes, examining the efficacy of nutritional and pharmaceutical interventions as countermeasures to infection symptoms, and determining the influence of various exercise loads on susceptibility to infections with respiratory viruses, including SARS-CoV-2. By establishing a uniform definition of an "elite athlete," it will be possible to make a comparable and straightforward interpretation of data from different studies and settings.

Methodological quality

Publication Type : Review

Metadata