ScopeScope
• host immune response
• acute exercise & IR
• chronic exercise & IR
• neuro-endocrine &immunity
• clinical implication
Confrontation with infectious agent, do I get ill or not?
Confrontation with infectious agent, do I get ill or not?
non-spimmunity
non-spimmunity
adaptive immunity
adaptive immunity
illness recovery
2 Types of Host Defense
2 Types of Host Defense
Natural (non-specific)
innate IR
Acquired(specific)
• active• passive
Non-specific immune response
(Innate immunity)
Non-specific immune response
(Innate immunity)
barrier : skin, mucosa
monocytes / macrophages
PMN
cytokines
complements
The first lines of defense: body surfaceThe first lines of defense: body surface
lysozymein saliva
acid
mucus
cilia mucus
no
rmal
gu
t fl
ora
lysozymewashingaction
Fat
ty a
cid
sN
orm
al b
acte
rial
skin
flo
ra
washingaction ofurine
Cellular innate IR Cellular innate IR
• neutrophil
• macrophage• monocyte• NK cells
adhearance, chemotaxis, phagocytosis, oxidative burst, degranulation, IC killing
2 Types of Specific IR
2 Types of Specific IR
HIR (B-cell)
CMIR
(T-cell)
Ab production • T-cells• B-cells
ScopeScope
• host immune response
• acute exercise & IR
• chronic exercise & IR
• neuro-endocrine &immunity
• clinical implication
less cold during 5 yr.
catch cold immediately
following a race
study 1
enhancein general
impairafter excercise
Common cold in marathonCommon cold in marathon
9/10
7/10
study 2
heavy trainingathletes
participatedin competition
plan, but not participate in competition
Common cold in marathonCommon cold in marathon
2x
6ximpair
coldfreq.
study 3Animal trailsAnimal trails
moderate exercise intense exercise
Protected Susceptibility
infectioninfection
enhance impair
study 4
45 min walk, 5 days a week15 weeks
days with colddays with cold
enhance
5.1+1.2
36 women
10.8 + 2.3
study 5
enhance
8
% who took a cold
during 12 weeks
21
50
very active& fit
mod. active& fit
inactiveless fit
Immune changes after acute exerciseImmune changes after acute exercise
variable results intensity & duration
transient effects
Cross sectional study (case control)
Immune changes after chronic exerciseImmune changes after chronic exercise
• many confounding factors influence immunity
• difficult to study during actual resting period
Longitudinal study study (RCT)
• inadequate duration of chronic exercise
Factors influence immune functionFactors influence immune function
ImmunityImmunity
Sleep
Social burdens
Environmental factors
Psychological loads
Malnutrition
Physical stress
Age
Inherited factors
CD16,56 (NK cell)
CD19 (B cell)
(CD4/CD8)CD8 (T suppressor)
CD4 (T helper)
Lymphocyte count
Monocyte count
Neutrophil count
afterduringNumber of immune cells
Effect of strenuous exercise on the immune system
• most CD4, CD8 are memory cells (contain CD45RO)
• overall, NK cells increase more than other lymphocyte subpopulation
non-specific
specific
Effect of short strenuous exercise on the number of WBC
Effect of short strenuous exercise on the number of WBC
120600 5 15 30 Minutes
% change
0
100
50
resting value
stopexercise
7 3 2 2 3 3
number of studies performed
• increases by 50%
• recovers within 2 hours
• shift from central pool.
• increases by 50%
• recovers within 2 hours
• shift from central pool.
% change from resting
5
20
220
120
090
Minutes after exercise stopped
6040
80100
140160180200
6 h
Effect of prolonged exercise (3h)on the number of WBC
Effect of prolonged exercise (3h)on the number of WBC
• increase are more advance• continue after run• take more time to recover• shift from the central pool
• increase are more advance• continue after run• take more time to recover• shift from the central pool
most = neutrophilia
effect of cortisol
most = neutrophilia
effect of cortisol
Effect of short strenuous exercise on number of lymphocytes
Effect of short strenuous exercise on number of lymphocytes
% change
0
200
60
120600 5 15 30 Minutes
- 80
120
10 3 2 3 5 5number of studies performed
• increase by 100%
• recover quickly
• shift from cells sitting at rest on blood vessels wall
• increase by 100%
• recover quickly
• shift from cells sitting at rest on blood vessels wall
Effect of prolonged exercise on # lymphocytes Effect of prolonged exercise on # lymphocytes
Marathon race (42.6 km)
0
1
2
3
4
2days before Run (arrival) 2days after
Giga/l
Change isnot significant
Change isnot significant
Effect of prolonged exercise on # T-cellsEffect of prolonged exercise on # T-cells
Change isnot significant
Change isnot significantMarathon race (42.6 km)
0
1
2
3
2days before Run (arrival) 2days after
Giga/l
Effect of strenuous exercise on the immune system
Killer cell activity (lymphokine activated)
NK cell activity *
Delayed type hypersensitivity
Salivary IgA
Ab response in vitro
Proliferative response
Lymphocyte apoptosis
after exercise
during exercise
Function of immune cells
• NK cells activity intensity > duration of exercise,
• mod. exercise NK cell activity, while intense exercise NK cell activity.
number L.
Ab production
L. activity
Effect of prolonged exercise on T-cell activationEffect of prolonged exercise on T-cell activation
0
1
2
2days before Run (arrival) 2days after
Marathon race (42.6 km)change is
significant
change is
significant
ConA test
Effect of prolonged exercise on IgGEffect of prolonged exercise on IgG
21 km run (workout intensity) : total IgG
00
5 10 15 20 25 30 35 days
4
8
12
16g/l
no significant changesno significant changes
Effect of strenuous exercise on the immune system
MIP-1
IL-10
TNF-R
IL-8
IL-1ra
IL-6
IL-1
TNF
Neopterin
C-reactive protein
after exercise
during exercise
acute phase protein and cytokines
proinflammatory cytokines
anti-inflammatory cytokines
acute phase protein
infection disease recovery
days
acute phase protein (unit)
100
10
1
2 4 6 8 10 12 14
acute phase protein CRP, proteasepart of HIbind with bacteria & fungiwork with complement
acute phase protein CRP, proteasepart of HIbind with bacteria & fungiwork with complement
InflammationInflammation
Acute phase protein & cytokine levelAcute phase protein & cytokine level
Before AfterDuring
3hr. run to exhaustion
1h 3h 24h 48h
pla
sma
con
cen
trat
ion
Elastase
-1 antitrypsine
Neopterin
TNF
ScopeScope
• host immune response
• acute exercise & IR
• chronic exercise & IR
• neuro-endocrine &immunity
• clinical implication
stress hormone release
attenuate specific immune defense
? tissue damage
Too much and continuous stress and distress can lead to
permanent depression of specific immune response
Neuro-endocrine & immunityNeuro-endocrine & immunity
epinephrine
norepinephrine
growth hormone
-endorphin
insulin
cortisol
Plasma level of stress hormonePlasma level of stress hormone
Runconc
etra
tion
Time (h)1 2 3 4 5 6 7 87
cortisol: psychological stress
catecholamine: physical stress
CD16,56 (NK cell)
CD19 (B cell)
(CD4/CD8)CD8 (T suppressor)
CD4 (T helper)
Lymphocyte count
Monocyte count
Neutrophil count
afterduringNumber of immune cells
Effect of strenuous exercise on the immune system
E
E, GH, cortisol
cortisol
Effect of strenuous exercise on the immune system
Killer cell activity (lymphokine activated)
NK cell activity *
Delayed type hypersensitivity
Salivary IgA
Ab response in vitro
Proliferative response
Lymphocyte apoptosis
after exercise
during exercise
Function of immune cells
- endorphin – maintain NK activity in chronic exercise only
sex H
sex H
PsychoneuroimmunologyPsychoneuroimmunology
Adrenals
Macrophages T-cells B-cells
Lymphokines
stress (physical, psychological)
CNS
Hypothalamus
Corticotropin RF (CRF)
Hypophysis
ACTH
corticosteroids
innervations oflymphatic tissue
catecholamines
sympathetic nervous system
IL1TNFIL-6Neopterin
IFIL-2
CRFcorticosteroidcatecholaminesendorphineencephaline
ScopeScope
• host immune response
• acute exercise & IR
• chronic exercise & IR
• neuro-endocrine &immunity
• clinical implication
viral infection (myocartitis, poliomyelitis,URI)
cancer prevention
HIV patient care
Clinical implication ?Clinical implication ?
in
Effect of strenuous exercise on the immune system
Killer cell activity (lymphokine activated)
NK cell activity
Delayed type hypersensitivity
Salivary IgA
Ab response in vitro
Proliferative response
Lymphocyte apoptosis
after exercise
during exercise
Function of immune cells
• mod. exercise NK cell activity, while intense exercise NK cell activity.
number L.
Ab production
L. activity
• clinical findings : normal Ab response to vaccine, skin test
viral infection (myocartitis, poliomyelitis,URI)
cancer prevention
HIV patient care
Clinical implication ?Clinical implication ?
in
Can sports support treatment ofimmunodeficiency diseases & cancer ?
Can sports support treatment ofimmunodeficiency diseases & cancer ?
enhances immune function
low to moderate intensity
It is helpful: as long as you have fun
If one does not like sport: workout means stress,
and this may impair immune functions.
If one does not like sport: workout means stress,
and this may impair immune functions.
Psychological stress alone can affect immune systemPsychological stress alone can affect immune system
Test exam (students)
Mourning(death of relative)
General distress
↓ NK
↓ IL-2
↓ lymphocyte activation
↑susceptibility to infection
Sports and immunity: the “dose” is the key element
Sports and immunity: the “dose” is the key element
+
-
non-
spec
ific
adap
tatio
n
positiveadaptation
effects of stress and distress overweight
overcompensation
number, volume &intensity of physical &psychological load.(workout, competition..)
benefit
impair
SUMMARYSUMMARY• host immune response
window of decrease host protection (CMIR)
increase NK cell activity
catecholaminecortisol
-endorphin
• precaution of infection after heavy training
• limit physical activity during incubation period
• acute exercise & IR
• neuro-endocrine &immunity
• chronic exercise & IR
• clinical implication
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