Acute response of peripheral CCr5 chemoreceptor and NK cells in individuals submitted to a single session of low-intensity strength exercise with blood flow restriction

Comparison of enjoyment and energy expenditure of exergame with and without blood flow restriction in men and women

This study compared the effects of blood flow restriction (BFR) on intensity and perceived enjoyment during an exergame. Fourteen healthy young participants engaged in a boxing exergame for 20 min, with or without BFR, across two sessions. Perceived enjoyment levels were assessed using the Physical Activity Enjoyment Scale. Heart rate was monitored, and energy expenditure (EE) during exercise was calculated. A mixed model analysis of variance with repeated measures was used to evaluate differences in EE and enjoyment between exergame conditions (with and without BFR) as well as the interaction effects of these protocols with gender. Although not statistically significant, perceived enjoyment decreased with BFR inclusion for both genders. No significant differences were observed between men and women for both protocols. Regarding EE, there was no significant difference between the two groups (with and without BFR). However, a significant main effect of gender was found, with men exhibiting higher EE values in both protocols compared to women. In conclusion, exergames incorporating BFR impact perceptual responses, particularly perceived enjoyment. Furthermore, significant gender differences in EE were found, with men displaying higher values.

Prevention of Chemotherapy-Induced Peripheral Neuropathy With PRESIONA, a Therapeutic Exercise and Blood Flow Restriction Program: A Randomized Controlled Study Protocol

OBJECTIVE

This trial will analyze the acute and cumulative effects of a tailored program called PRESIONA that combines therapeutic exercise and blood flow restriction to prevent chemotherapy-induced peripheral neuropathy (CIPN) in individuals with early breast cancer undergoing neoadjuvant chemotherapy.

METHODS

PRESIONA will be a physical therapist-led multimodal exercise program that uses blood flow restriction during low-load aerobic and strength exercises. For the acute study, only 1 session will be performed 1 day before the first taxane cycle, in which 72 women will be assessed before intervention and 24 hours post intervention. For the cumulative study, PRESIONA will consist of 24 to 36 sessions for 12 weeks following an undulatory prescription. At least 80 women will be randomized to the experimental group or control group. Feasibility will be quantified based on the participant recruitment to acceptance ratio; dropout, retention, and adherence rates; participant satisfaction; tolerance; and program security. In the efficacy study, the main outcomes will be CIPN symptoms assessed with a participant-reported questionnaire (EORTC QLQ-CIPN20). In addition, to determine the impact on other participant-reported health and sensorimotor and physical outcomes, the proportion of completed scheduled chemotherapy sessions will be examined at baseline (t0), after anthracycline completion (t1), after intervention (t2), and at the 2-month (t3) and 1-year follow-ups (t4).

CONCLUSION

The proposed innovative approach of this study could have a far-reaching impact on therapeutic options, and the physical therapist role could be essential in the oncology unit to improve quality of life in individuals with cancer and reduce side effects of cancer and its treatments.

IMPACT

Physical therapists in the health care system could be essential to achieve the planned doses of chemotherapy to improve survival and decrease the side effects of individuals with breast cancer. The prevention of CIPN would have an impact on the quality of life in these individuals, and this protocol potentially could provide an action guide that could be implemented in any health care system.

Systematic review on the effects of physical exercise on cellular immunosenescence-related markers - An update

Immunosenescence is a remodeling of the immune system occurring with aging that leads to an increased susceptibility to auto-immunity, infections and reduced vaccination response. A growing consensus supports the view that physical exercise may counteract immunosenescence and improve the immune response. Unfortunately, evidence regarding the effects of exercise on markers of cellular immunosenescence lacked uniformity at the time of an extensive literature review in 2016. Moreover, exercise-induced effects in older adults were underrepresented compared to young adults or completely lacking, such as for senescent T-cells and apoptosis of T-lymphocytes. The aim of this systematic literature study was to collect and appraise newly available data regarding exercise-induced changes on immunosenescence-related markers of immune cells and compare this against data that was already available in 2016. Systematic reviewing of newly available data in the field of exercise immunology provides additional evidence for the effect of exercise on immunosenescence-related cellular markers. Importantly, this review provides evidence for the effect of long-term exercise on senescent T-lymphocytes in older adults. Additionally, newly retrieved evidence shows an acute exercise-induced mobilization of naïve and memory cells in older adults. In general, data regarding long-term exercise-induced effects in older adults remain scarce. Noteworthy was the high number of articles describing exercise-induced effects on regulatory T-cells. However exercise-induced effects on this cell type are still inconclusive as some articles reported an exercise-induced up- or downregulation, while others reported no effects at all. Numerous studies on Natural Killer cell counts did not provide uniformity among data that was already available. Recent data regarding dendritic cells mostly described an increase after exercise. Overall, our literature update highlights the major influence of the type and intensity of exercise on immunosenescence-related markers, especially in older adults.

Effect of resistance training with blood flow restriction on muscle damage markers in adults: A systematic review

Background

The purpose of this review was to systematically analyze the evidence regarding the occurrence of muscle damage (changes in muscle damage markers) after resistance training with blood flow restriction sessions.

Materials and methods

This systematic review was conducted in accordance with the PRISMA recommendations. Two researchers independently and blindly searched the following electronic databases: PubMed, Scopus, Web of Science, CINAHL, LILACS and SPORTdicus. Randomized and non-randomized clinical trials which analyzed the effect of resistance training with blood flow restriction on muscle damage markers in humans were included. The risk of bias assessment was performed by two blinded and independent researchers using the RoB2 tool.

Results

A total of 21 studies involving 352 healthy participants (men, n = 301; women, n = 51) were eligible for this review. The samples in 66.6% of the studies (n = 14) were composed of untrained individuals. All included studies analyzed muscle damage using indirect markers. Most studies had more than one muscle damage marker and Delayed Onset Muscle Soreness was the measure most frequently used. The results for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions were contrasting, and the use of a pre-defined repetition scheme versus muscle failure seems to be the determining point for this divergence, mainly in untrained individuals.

Conclusions

In summary, the use of sets until failure is seen to be determinant for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions, especially in individuals not used to resistance exercise.

Trial registration

Register number: PROSPERO number: CRD42020177119.

The impact of intradialytic exercise on immune cells expressing CCR5+ in patients with chronic kidney disease: A cross-over trial

The C-C chemokine receptor type 5 (CCR5) plays a role in the immunopathogenesis of chronic kidney disease (CKD). Exercise has anti-inflammatory properties that may contribute to the rehabilitation of CKD patients. To date, the impact of the intradialytic exercise on CCR5 expression in monocytes and lymphocytes of CKD patients is unknown. We aimed to evaluate the effects of an acute intradialytic moderate-intensity exercise on CD4+CCR5+ T-cells and CD14+CCR5+ monocytes of elderly individuals with Chronic Kidney Disease (CKD). Eight CKD elderly patients performed a single bout of 20 min intradialytic exercise and a control hemodialysis (HD) session. Blood samples were collected at baseline, during and immediately after the trials. HD therapy increased the peripheral frequency of CD4+CCR5+ T-cells. The systemic CCL5 levels and the peripheral CD14+CCR5+ proportions increased during and after HD therapy. No significant alterations in CD4+CCR5+ and CD14+CCR5+ proportions or CCL5 levels were identified in CKD patients during and after intradialytic exercise. A negative correlation between the peripheral frequency of CD14+CCR5+ and the creatinine levels was identified in the intradialytic exercise session. A single moderate-intensity intradialytic exercise imposes an immunomodulatory impact in CKD elderly patients, preventing an excessive inflammatory response induced by hemodialysis.

The immune system in sporadic inclusion body myositis patients is not compromised by blood-flow restricted exercise training

BACKGROUND

Sporadic inclusion body myositis (sIBM) is clinically characterised by progressive proximal and distal muscle weakness and impaired physical function while skeletal muscle tissue displays abnormal cellular infiltration of T cells, macrophages, and dendritic cells. Only limited knowledge exists about the effects of low-load blood flow restriction exercise in sIBM patients, and its effect on the immunological responses at the myocellular level remains unknown. The present study is the first to investigate the longitudinal effects of low-load blood flow restriction exercise on innate and adaptive immune markers in skeletal muscle from sIBM patients.

METHODS

Twenty-two biopsy-validated sIBM patients were randomised into either 12 weeks of low-load blood flow restriction exercise (BFRE) or no exercise (CON). Five patients from the control group completed 12 weeks of BFRE immediately following participation in the 12-week control period leading to an intervention group of 16 patients. Muscle biopsies were obtained from either the m. tibialis anterior or the m. vastus lateralis for evaluation of CD3-, CD8-, CD68-, CD206-, CD244- and FOXP3-positive cells by three-colour immunofluorescence microscopy and Visiopharm-based image analysis quantification. A linear mixed model was used for the statistical analysis.

RESULTS

Myocellular infiltration of CD3^-/CD8⁺ expressing natural killer cells increased following BFRE (P < 0.05) with no changes in CON. No changes were observed for CD3⁺/CD8^- or CD3⁺/CD8⁺ T cells in BFRE or CON. CD3⁺/CD244⁺ T cells decreased in CON, while no changes were observed in BFRE. Pronounced infiltration of M1 pro-inflammatory (CD68⁺/CD206^-) and M2 anti-inflammatory (CD68⁺/CD206⁺) macrophages were observed at baseline; however, no longitudinal changes in macrophage content were observed for both groups.

CONCLUSIONS

Low-load blood flow restriction exercise elicited an upregulation in CD3^-/CD8⁺ expressing natural killer cell content, which suggests that 12 weeks of BFRE training evokes an amplified immune response in sIBM muscle. However, the observation of no changes in macrophage or T cell infiltration in the BFRE-trained patients indicates that patients with sIBM may engage in this type of exercise with no risk of intensified inflammatory activity.

Blood flow restriction impairs the inflammatory adaptations of strength training in overweight men: a clinical randomized trial

The aim of this study was to evaluate the impact of high-intensity strength training (ST) or low-intensity strength training with blood flow restriction (ST-BFR) on monocyte subsets, the expression of C-C chemokine receptor 5 (CCR5), and CD16 on monocytes, and tumor necrosis factor alpha (TNF-α) production of overweight men. Thirty overweight men were randomly assigned to conventional ST or ST-BFR. Both groups performed exercises of knee extension and biceps curl with equal volume (3 sessions/week) over 8 weeks, and the peripheral frequency of monocytes (CD14+CD16-, classical monocytes; CD14+CD16+, intermediate monocytes; CD14-CD16+, nonclassical monocytes), the mean fluorescence intensity (MFI) of CCR5 and CD16 on CD14+ monocytes; and the production of TNF-α by lipopolysaccharide (LPS)-stimulated cells were quantified. Eight weeks of ST increased the frequency of CD14+CD16- monocytes (p = 0.04) and reduced the percentage of CD14-CD16+ (p = 0.02) and the production of TNF-α by LPS-stimulated cells (p = 0.03). The MFI of CD16 on CD14+ monocytes decreased after the ST intervention (p = 0.02). No difference in monocyte subsets, CCR5 or CD16 expression, and TNF-α production were identified after ST-BFR intervention (p > 0.05). The adoption of ST promotes anti-inflammatory effects on monocyte subsets of overweight men, but this effect was lost when BFR was adopted. Novelty High-intensity strength training reduces the production of TNF-α and the peripheral frequency of CD16+ monocytes in overweight men. Blood flow restriction method blunts the strength training adaptations on monocyte subsets and pro-inflammatory TNF-α production in overweight men.

Exercise Increases Mucosal-associated Invariant T Cell Cytokine Expression but Not Activation or Homing Markers

Mucosal-associated invariant T (MAIT) cells have properties of both the innate and adaptive immune systems but are an understudied population within exercise immunology. These lymphocytes aggregate at the mucous membranes, but it is unknown if submaximal exercise alters their circulating numbers or function.

PURPOSE

To determine the MAIT cell response to submaximal exercise on activation and homing marker expression and stimulated cytokine production.

METHODS

Twenty healthy, young, recreationally active males cycled for 40 min at 86% of VT after an overnight fast. Peripheral blood mononuclear cells were isolated and labeled to identify specific MAIT cell populations using flow cytometry. Cytokine production after stimulation was also determined.

RESULTS

Mucosal-associated invariant T cells were 2.9% of T cells and increased to 3.9% after exercise and with recovery whereas cell numbers significantly increased by 91.5% after exercise before returning to resting levels. Chemokine and activation marker absolute cell number significantly increased while expression levels remained constant but the high levels of CCR5 may help direct MAIT cells to sites of inflammation. After stimulation, TNFα expression significantly increased after exercise before returning to baseline with a similar trend for IFNγ.

CONCLUSIONS

The MAIT cell numbers undergo a partial biphasic response after submaximal exercise and appear to be preferentially mobilized within T cells; however, the magnitude of the submaximal response was attenuated relative to maximal exercise. Stimulated MAIT cells increase TNFα expression, indicating greater responsiveness to pathogens after acute exercise.

Effects of Physical Exercise on Markers of Cellular Immunosenescence: A Systematic Review

Aging affects negatively the immune system, defined as immunosenescence, which increases the susceptibility of elderly persons to infection, autoimmune disease, and cancer. There are strong indications that physical exercise in elderly persons may prevent the age-related decline in immune response without significant side effects. Consequently, exercise is being considered as a safe mode of intervention to reduce immunosenescence. The aim of this review was to appraise the existing evidence regarding the impact of exercise on surface markers of cellular immunosenescence in either young and old humans or animals. PubMed and Web of Science were systematically screened, and 28 relevant articles in humans or animals were retrieved. Most of the intervention studies demonstrated that an acute bout of exercise induced increases in senescent, naïve, memory CD4⁺ and CD8⁺ T-lymphocytes and significantly elevated apoptotic lymphocytes in peripheral blood. As regards long-term effects, exercise induced increased levels of T-lymphocytes expressing CD28⁺ in both young and elderly subjects. Few studies found an increase in natural killer cell activity following a period of training. We can conclude that exercise has considerable effects on markers of cellular aspects of the immune system. However, very few studies have been conducted so far to investigate the effects of exercise on markers of cellular immunosenescence in elderly persons. Implications for immunosenescence need further investigation.