A lack of physical activity is linked to the development of many chronic diseases through a chronic
low-grade inflammation state. It is now well accepted that the immune system plays a central role in the development
of several chronic diseases, including insulin resistance, type 2 diabetes, atherosclerosis, heart failure and
certain types of cancer. Exercise elicits a strong anti-inflammatory response independently of weight loss and can
be a useful non-pharmacologic strategy to counteract the low-grade inflammation. The CD4+CD25+CD127-
FoxP3+ Regulatory T (Treg) cells are a unique subset of helper T-cells, which regulate immune response and
establish self-tolerance through the secretion of immunoregulatory cytokines, such as IL-10 and TGF-β, and the
suppression of the function and activity of many immune effector cells (including monocytes/macrophages, dendritic
cells, CD4+ and CD8+ T cells, and Natural Killers). The metabolic phenotype of Tregs are regulated by the
transcription factor Foxp3, providing flexibility in fuel choice, but a preference for higher fatty acid oxidation. In
this review, we focus on the mechanisms by which exercise - both acute and chronic - exerts its antiinflammatory
effects through Treg cells mobilization. Furthermore, we discuss the implications of immunometabolic
changes during exercise for the modulation of Treg phenotype and its immunosuppressive function. This
narrative review focuses on the current knowledge regarding the role of Treg cells in the context of acute and
chronic exercise using data from observational and experimental studies. Emerging evidence suggests that the
immunomodulatory effects of exercise are mediated by the ability of exercise to adjust and improve Tregs number
and function.