Kurowski Marcin, Seys Sven, Bonini Matteo, Del Giacco Stefano, Delgado Luis, Diamant Zuzana, Kowalski Marek L, Moreira André, Rukhadze Maia, Couto Mariana
Department of Immunology and Allergy, Medical University of Łódź, Łódź, Poland.
Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Allergy. 2022 Sep;77(9):2653-2664. doi: 10.1111/all.15328. Epub 2022 May 9.
This review presents state-of-the-art knowledge and identifies knowledge gaps for future research in the area of exercise-associated modifications of infection susceptibility. Regular moderate-intensity exercise is believed to have beneficial effects on immune health through lowering inflammation intensity and reducing susceptibility to respiratory infections. However, strenuous exercise, as performed by professional athletes, may promote infection: in about half of athletes presenting respiratory symptoms, no causative pathogen can be identified. Acute bouts of exercise enhance the release of pro-inflammatory mediators, which may induce infection-like respiratory symptoms. Relatively few studies have assessed the influence of regularly repeated exercise on the immune response and systemic inflammation compared to the effects of acute exercise. Additionally, ambient and environmental conditions may modify the systemic inflammatory response and infection susceptibility, particularly in outdoor athletes. Both acute and chronic regular exercise influence humoral and cellular immune response mechanisms, resulting in decreased specific and non-specific response in competitive athletes. The most promising areas of further research in exercise immunology include detailed immunological characterization of infection-prone and infection-resistant athletes, examining the efficacy of nutritional and pharmaceutical interventions as countermeasures to infection symptoms, and determining the influence of various exercise loads on susceptibility to infections with respiratory viruses, including SARS-CoV-2. By establishing a uniform definition of an "elite athlete," it will be possible to make a comparable and straightforward interpretation of data from different studies and settings.
本综述介绍了运动对感染易感性影响方面的最新知识，并指出了未来研究中的知识空白。定期进行中等强度运动被认为通过降低炎症强度和减少呼吸道感染易感性，对免疫健康有有益影响。然而，职业运动员进行的剧烈运动可能会促进感染：在出现呼吸道症状的运动员中，约有一半无法确定致病病原体。急性运动发作会增强促炎介质的释放，这可能会诱发类似感染的呼吸道症状。与急性运动的影响相比，相对较少的研究评估了定期重复运动对免疫反应和全身炎症的影响。此外，环境和外界条件可能会改变全身炎症反应和感染易感性，尤其是对户外运动员而言。急性和慢性定期运动都会影响体液和细胞免疫反应机制，导致竞技运动员的特异性和非特异性反应降低。运动免疫学中最有前景的进一步研究领域包括对易感染和抗感染运动员进行详细的免疫学特征分析，研究营养和药物干预作为感染症状对策的有效性，以及确定各种运动负荷对包括SARS-CoV-2在内的呼吸道病毒感染易感性的影响。通过建立“精英运动员”的统一定义，将有可能对来自不同研究和环境的数据进行可比且直接的解读。
