Hutchinson Ganisha M, Cooper Andrea M, Billany Roseanne E, Nixon Daniel G D, Bishop Nicolette C, Smith Alice C
Department of Respiratory Sciences, University of Leicester, UK.
School of Sport, Exercise and Health Sciences, Loughborough University, UK.
Exerc Immunol Rev. 2022;28:100-115.
Kidney transplantations are seen to be a double-edge sword. Transplantations help to partially restore renal function, however there are a number of health-related co-morbidities associated with transplantation. Cardiovascular disease (CVD), malignancy and infections all limit patient and graft survival. Immunosuppressive medications alter innate and adaptive immunity and can result in immune dysfunction. Over suppression of the immune system can result in infections whereas under suppression can result in graft rejection. Exercise is a known therapeutic intervention with many physiological benefits. Its effects on immune function are not well characterised and may include both positive and negative influences depending on the type, intensity, and duration of the exercise bout. High intensity interval training (HIIT) has become more popular due to it resulting in improvements to tradional and inflammatory markers of cardiovascular (CV) risk in clinical and non-clinical populations. Though these improvements are similar to those seen with moderate intensity exercise, HIIT requires a shorter overall time commitment, whilst improvements can also be seen even with a reduced exercise volume. The purpose of this study was to explore the physiolocial and immunological impact of 8-weeks of HIIT and moderate intensity continuous training (MICT) in kidney transplan recipients (KTRs). In addition, the natural variations of immune and inflammatory cells in KTRs and non-CKD controls over a longitudinal period are explored. Newly developed multi-colour flow cytometry methods were devised to identify and characterise immune cell populations. Twenty-six KTRs were randomised into one of two HIIT protocols or MICT: HIIT A (n=8; 4-, 2-, and 1-min intervals; 80-90% VO2peak), HIIT B (n=8, 4x4 min intervals; 80-90% VO2peak), or MICT (n=8, ~40 min; 50-60% VO2peak) for 24 supervised sessions on a stationary bike (approx. 3x/week over 8 ± 2 weeks). Blood samples taken pre-training, mid training, post-training and 3 months later. Novel multi-colour flow cytometric panels were developed to characterise lymphoid and myeloid cell population from peripheral blood mononuclear cells. No changes were observed for circulating immune and inflammatory cells over the 8-week interventions. The feasibility study does not suggest that exercise programmes using HIIT and MICT protocols elicit adverse negative effects on immunity in KTRs. Therefore, such protocols may be immunologically safe for these patients. The inability of the participants to achieve the target exercise intensities may be due to physiological abnormalities in this population which warrants further investigation.
肾移植被视为一把双刃剑。移植有助于部分恢复肾功能，然而移植也伴随着一些与健康相关的合并症。心血管疾病（CVD）、恶性肿瘤和感染都会限制患者和移植物的存活。免疫抑制药物会改变固有免疫和适应性免疫，可能导致免疫功能紊乱。免疫系统过度抑制会导致感染，而抑制不足则会导致移植物排斥。运动是一种已知的具有多种生理益处的治疗干预措施。其对免疫功能的影响尚未得到充分表征，可能会根据运动的类型、强度和持续时间产生正面和负面影响。高强度间歇训练（HIIT）因其能改善临床和非临床人群心血管（CV）风险的传统和炎症标志物而变得更受欢迎。尽管这些改善与中等强度运动相似，但HIIT总体所需时间更短，而且即使运动量减少也能看到改善效果。本研究的目的是探讨8周的HIIT和中等强度持续训练（MICT）对肾移植受者（KTR）的生理和免疫影响。此外，还探讨了KTR和非慢性肾脏病（CKD）对照在纵向期间免疫和炎症细胞的自然变化。设计了新开发的多色流式细胞术方法来识别和表征免疫细胞群体。26名KTR被随机分为两种HIIT方案或MICT方案之一：HIIT A（n = 8；4分钟、2分钟和1分钟间歇；80 - 90%最大摄氧量峰值）、HIIT B（n = 8，4×4分钟间歇；80 - 90%最大摄氧量峰值）或MICT（n = 8，约40分钟；50 - 60%最大摄氧量峰值），在固定自行车上进行24次有监督的训练课程（约每周3次，共8 ± 2周）。在训练前、训练中期、训练后和3个月后采集血样。开发了新的多色流式细胞术面板来表征外周血单个核细胞中的淋巴细胞和髓细胞群体。在8周的干预期间，未观察到循环免疫和炎症细胞的变化。这项可行性研究并不表明使用HIIT和MICT方案的运动计划会对KTR的免疫产生不良负面影响。因此，这些方案对这些患者在免疫方面可能是安全的。参与者无法达到目标运动强度可能是由于该人群的生理异常，这值得进一步研究。
