Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review

Abstract

Background: Exercise leads to a robust inflammatory response mainly characterized by the mobilization of leukocytes and an increase in circulating inflammatory mediators produced by immune cells and directly from the active muscle tissue. Both positive and negative effects on immune function and susceptibility to minor illness have been observed following different training protocols. While engaging in moderate activity may enhance immune function above sedentary levels, excessive amounts of prolonged, high-intensity exercise may impair immune function. Thus, the aim of the present review was to clarify the inflammatory effects in response to different exercise intensities. Methods: Search was performed on PubMed and was completed on July 31st, 2017. The studies were eligible if they met the predefined inclusion criteria: a) observational or interventional studies, b) conducted in healthy adults (18-65 years), c) written in Portuguese, English or Spanish, d) including moderate and/or intense exercise. Eighteen articles were included. The specific components that were examined included circulating blood levels of cytokines, leukocytes, creatine kinase (CK) and C-reactive protein (CRP). The methodological quality of the included studies was assessed. Results: Most of the intervention studies showed changes in the assessed biomarkers, although these changes were not consistent. White blood cells (WBC) had an increase immediately after intensive exercise (> 64% VO 2max), without alteration after moderate exercise (46-64% VO 2max). The results suggested an elevation of the pro-inflammatory cytokines, namely IL-6, followed by an elevation of IL-10 that were more evident after intense exercise bouts. CRP increased both after intense and moderate exercise, with peak increases up to 28 h. CK increased only after intensive and long exercising. Conclusion: In summary, intense long exercise can lead, in general, to higher levels of inflammatory mediators, and thus might increase the risk of injury and chronic inflammation. In contrast, moderate exercise or vigorous exercise with appropriate resting periods can achieve maximum benefit.

Biochemical markers after the Norseman Extreme Triathlon

“…Norseman (8 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] mg/L, p < 0.001) with a clinically significant increase the following day (39 mg/L, p < 0.001 compared to baseline, < 0.001 compared to finish line). AST had increased at the finish line (99 [74-136] U/L, p < 0.001) but it increased to even higher values the day after the race (142 [99-191] U/L, p < 0.001 compared to baseline, p < 0.05 compared to finish line).…”

“…Occasionally, competition athletes need medical assistance and hospitalisation due to fatigue, illness or accidents [3]. Prolonged exercise is known to cause changes in common biomarkers [4][5][6]. There are major changes in serval biomarkers after Ironman distance triathlons [7][8][9].…”

“…We examined Creatinine Kinase (CK), N-terminal pro Brain Natriuretic Peptide (NT-proBNP), Creatinine, C-reactive protein (CRP), White blood cells (WBC), Thrombocytes, Hemoglobin (Hb), Sodium (Na + ), Potassium (K + ), Calcium (Ca 2+ ), Magnesium (Mg 2+ ), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Triiodothyronine (T3), Thyroxine (T4) and Thyroid Stimulating Hormone (TSH), covering heart function, inflammation markers, markers of cell injury, electrolytes and thyroid function [4][5][6][7][8][9][14][15][16][17][18][19][20]. For comparison of the impact of different types of triathlons we have also examined the same biomarkers after an Olympic triathlon.…”

SARS-CoV-2 and mitochondrial health: implications of lifestyle and ageing

“…A retrospective study following the Hong Kong influenza outbreak in 2008 found that physical activity was protective and displayed a “U” shaped dose-response curve [ 165 ]. High aerobic fitness is associated with reduced morbidity and mortality [ 166 , 167 ] and physical activity, if not overdone, is generally anti-inflammatory in the longer term [ 15 , 168 ] and results in an enhanced anti-oxidant status [ 169 ]. Equally, calorie restriction, which is associated with improved lifespan, is also anti-inflammatory [ 170 , 171 ], as is a diet high in polyphenols and probiotics [ 172 ].…”

Antioxidants in Sport Sarcopenia

“…During this kind of training, it is necessary to have a long-term preparation, sufficient nutrition, and balance between multiple stressful factors, such as thermal stress, muscle damage, central fatigue, and limited endogenous muscle glycogen content [56]. The main acute effects of ultra-endurance exercise are increased concentrations of interleukin 6 (IL-6) and white blood cells (WBCs), which are proportional to type, intensity, and time of exercise [57]. Anthropometric aspects (i.e., body mass, body fat, fat-free mass), training characteristics (i.e., intensity, frequency, and duration of training), and physiological variables (i.e., maximum oxygen uptake) are important predictor elements for competition performance.…”