No Effect of Acute Eccentric Resistance Exercise on Immune Responses to Influenza Vaccination in Older Adults: A Randomized Control Trial

Abstract

IntroductionOlder adults are at elevated risk for morbidity and mortality caused by influenza. Vaccination is the primary means of prophylaxis, but protection is often compromised in older adults. As resistance exercise mobilizes immune cells into muscle, it may enhance vaccination response.PurposeCompare antibody and cell mediated immune responses to influenza vaccination in older adults who performed eccentric resistance exercise immediately prior to vaccination to those who did not exercise.MethodsTwenty nine resistance training-naive older adults (20 women, 73.9 ± 5.3 years) were randomized to 1 of 3 groups: vaccination in the same arm that exercised (Ex-S), vaccination in the opposite arm that exercised (Ex-Op), and seated rest (No-Ex). Exercise consisted of 10 sets of 5 eccentric unilateral repetitions at 80% of the pre-determined concentric one repetition maximum. Lateral raises were alternated with bicep curls. No-Ex sat quietly for 25 min. Following exercise or rest, all received the 2018 quadrivalent influenza vaccine (Seqirus Afluria) in the non-dominant deltoid. Antibody titers against each influenza vaccine strain were determined by hemagglutinin inhibition assays at baseline, 6-, and 24-weeks post-vaccination. Influenza-specific T cells were quantified after stimulation with the vaccine by intracellular cytokine staining.ResultsNo significant group x time effects were found in antibody responses to any strain (interaction for A/H1N1: p = 0.682; A/H3N2: p = 0.644; B/Colorado/06/2017: p = 0.262; B/Phuket/3073/2013: p = 0.851). Groups did not differ in fold-increase of antibody titers 6- and 24-weeks post-vaccination. Influenza-specific T-cells did not differ between groups at any time (comparison at baseline: p = 0.985; 6-weeks: p = 0.889; 24 weeks: p = 0.857). One subject (Ex-S) reported flu-like symptoms 18 weeks post-vaccination.ConclusionAcute arm eccentric exercise did not influence antibody titers or cell mediated immune responses to the influenza vaccine delivered post-exercise in older adults. More strenuous exercise may be required for exercise to act as an adjuvant. ClinicalTrials.gov Identifier: NCT03736759.

Effects of Exercise and Physical Activity Levels on Vaccination Efficacy: A Systematic Review and Meta-Analysis

“…Seventeen studies were RCTs, five were CTs, and 16 were CSS. Four RCTs [ 31 , 34 , 35 , 59 ] and one CT [ 45 ] examined the effects of acute aerobic exercise, while seven RCTs [ 28 , 30 , 38 , 49 , 50 , 60 , 61 ] studied acute resistance exercise. Four RCTs [ 47 , 48 , 62 , 63 ] examined the effects of chronic aerobic exercise, and one RCT [ 64 ] investigated chronic physical activity levels.…”

“…Most studies ( n = 29) [ 23 , 24 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 41 , 47 , 48 , 49 , 61 , 62 , 63 , 65 , 66 , 67 , 68 , 69 , 70 , 72 ] utilized influenza vaccines, six studies [ 34 , 40 , 45 , 50 , 51 , 64 ] pneumococcal, two SARS-CoV-2 [ 71 , 73 ], two tetanus [ 32 , 45 ], one human papillomavirus [ 60 ], one diphtheria [ 45 ], and one meningococcal vaccines [ 59 ]. The risk of bias assessment outcomes are shown in the Supplementary Materials (Table S2 and Figure S2) .…”

“…All the eligible studies that examined the effects of acute exercise on vaccination efficacy, reported that the vaccinations were administered after the exercise session. Furthermore, 10 eligible studies [ 28 , 30 , 31 , 34 , 35 , 38 , 45 , 49 , 59 , 60 ] that examined the effects of acute exercise on vaccination efficacy reported no data, while two studies reported no severe immediate symptomatic responses due to the administration of vaccines [ 61 , 72 ]. Three studies [ 31 , 35 , 50 ] reported that interleukin 6 (IL-6) did not affect vaccination efficacy.…”

“…For 17 eligible studies [ 23 , 24 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], the means and SD s were depicted only in figures, as we were unable to retrieve data on the leading authors. Therefore, we used the WebPlotDigitizer 4.5, 2021, software (Rohatgi, USA) [ 42 ] to extract numerical data for our meta-analyses.…”

Physical activity and acute exercise benefit influenza vaccination response: A systematic review with individual participant data meta-analysis

“…The acute exercise bout comprised 15–50 minutes resistance (n = 359; studies 1, 2, 3, 5, 6 and 7 [ 16 , 19 , 21 , 22 , 24 , 25 ]) or aerobic exercise (n = 20; study 4 [ 23 ]). Most exercise bouts were conducted immediately prior vaccination but for two exercise groups this occurred six or 48 hours prior (n = 39 for each group; study 1 [ 21 ]) and for one test group this occurred directly following vaccination (n = 16; study 6 [ 19 ]).…”