The immunomodulatory effects of physical activity

Current Pharmaceutical Design

Volumn 22, Issue 24, 2016, Pages 3730-3748

  Krüger, Karsten ^a   Mooren, Frank Christoph ^a   Pilat, Christian ^a  

^a JUSTUS LIEBIG UNIVERSITY   (Germany)

Author keywords

Adaptive immune system; Anti inflammatory effects of exercise; Cytokines; Exercise; Infection risk; Innate immune system; Lymphocytosis; Lymphopenia; Muscle; Training

Indexed keywords

CHEMOKINE; CYTOKINE; STRESS HORMONE;

ADIPOSE TISSUE; ATHLETE; CARDIOVASCULAR DISEASE; CELLULAR IMMUNITY; CHRONIC DISEASE; CYTOKINE RELEASE; CYTOKINE RESPONSE; DENDRITIC CELL; DNA METHYLATION; ENDURANCE TRAINING; EPIDEMIOLOGICAL DATA; EPIGENETICS; FITNESS; GRANULOCYTE; HORMONE RELEASE; HUMAN; HUMORAL IMMUNITY; IMMUNE DYSREGULATION; IMMUNOCOMPETENCE; IMMUNOREGULATION; INFECTION PREVENTION; INFECTION RISK; LYMPHOCYTE; MACROPHAGE; METABOLIC DISORDER; MONOCYTE; MUCOSAL IMMUNITY; MUSCLE RELAXATION; NATURAL KILLER CELL; NONHUMAN; OBSERVATIONAL STUDY; PHYSICAL ACTIVITY; PRIORITY JOURNAL; REVIEW; RISK FACTOR; RISK REDUCTION; SEDENTARY LIFESTYLE; VIRUS REACTIVATION; ADAPTATION; EXERCISE; IMMUNE SYSTEM; IMMUNOLOGY; INFLAMMATION; METABOLISM; PHYSIOLOGY; SKELETAL MUSCLE;

ADAPTATION, PHYSIOLOGICAL; CYTOKINES; EXERCISE; HUMANS; IMMUNE SYSTEM; INFLAMMATION; MUSCLE, SKELETAL;

EID: 84978229429     PISSN: 13816128     EISSN: 18734286     Source Type: Journal    
DOI: 10.2174/1381612822666160322145107     Document Type: Review

References (265)

1. Kruk J. Physical activity in the prevention of the most frequent chronic diseases: an analysis of the recent evidence. Asian Pac J Cancer Prev 2007; 8(3): 325-38.
2. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39: 1435-45.
3. Global recommendations on physical activity for health. Geneva, Switzerland: World Health Organization 2010.
4. Walsh NP, Gleeson M, Pyne DB, et al. Position statement. Part two: Maintaining immune health. Exerc Immunol Rev 2011; 17: 64-103.
5. Schulz G. Experimentelle untersuchung über das vorkommen und die diagnostische bedeutung der leucocytose. Dtsch Archiv Klin Med 1893; 51: 234-81.
6. Brenner IK, Shek PN, Shephard RJ. Infection in athletes. Sports Med 1994; 17: 86-107.
7. Shephard RJ. Physical activity, training and the immune response. Carmel: Cooper Publishing Group 1997.
8. Hara M, Yuasa S, Shimoji K, et al. G-CSF influences mouse skeletal muscle development and regeneration by stimulating myoblast proliferation. J Exp Med 2011; 208(4): 715-27.
9. Nieman DC, Nehlsen-Cannarella SL, Markoff PA, et al. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med 1990; 11: 467-73.
10. Nieman DC. Exercise, infection, and immunity. Int J Sports Med 1994; 15: S1-41.
11. Shephard RJ, Kavanagh T, Mertens DJ, Qureshi S, Clark M. Personal health benefits of Masters athletics competition. Br J Sports Med 1995; 29: 35-40.
12. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100(2): 126-3.
13. Cesta MF. Normal structure, function, and histology of mucosaassociated lymphoid tissue. Toxicol Pathol 2006; 34(5): 599-608.
14. Elmore SA. Enhanced histopathology of mucosa-associated lymphoid tissue. Toxicol Pathol 2006; 34(5): 687-96.
15. He CS, Bishop NC, Handzlik MK, Muhamad AS, Gleeson M. Sex differences in upper respiratory symptoms prevalence and oralrespiratory mucosal immunity in endurance athletes. Exerc Immunol Rev 2014; 20: 8-22.
16. Gleeson M, Nieman DC, Pedersen BK. Exercise, nutrition and immune function. J Sports Sci 2004; 22: 115-25.
17. Allgrove JE, Gomes E, Hough J, Gleeson M. Effects of exercise intensity on salivary antimicrobial proteins and markers of stress in active men. J Sports Sci 2008; 26(6): 653-61.
18. Fortes MB, Diment BC, Di Felice U, Walsh NP. Dehydration decreases saliva antimicrobial proteins important for mucosal immunity. Appl Physiol Nutr Metab 2012; 37(5): 850-9.
19. McKune A, Starzak D, Semple S. Repeated bouts of eccentrically biased endurance exercise stimulate salivary IgA secretion rate. Biol Sport 2015; 32(1): 21-5.
20. Shimizu K, Kimura F, Akimoto T, Akama T, Kuno S, Kono I. Effect of free-living daily physical activity on salivary secretory IgA in elderly. Med Sci Sports Exerc 2007; 39(4): 593-8.
21. McCarthy DA, Dale MM. The leucocytosis of exercise. A review and model. Sports Med 1988; 6(6): 333-63.
22. Ahlborg B, Ahlborg G. Exercise leukocytosis with and without beta-adrenergic blockade. Acta Med Scand 1970; 187: 241-6.
23. Eskola J, Ruuskanen O, Soppi E, et al. Effect of sport stress on lymphocyte transformation and antibody formation. Clin Exp Immunol 1978; 32(2): 339-45.
24. Nagatomi R. The implication of alterations in leukocyte subset counts on immune function. Exerc Immunol Rev 2006; 12: 54-71.
25. Nieman DC, Nehlsen-Cannarella SL, Henson DA, et al. Immune response to exercise training and/or energy restriction in obese women. Med Sci Sports Exerc 1998; 30(5): 679-86.
26. Robson PJ, Blannin AK, Walsh NP, Castell LM, Gleeson M. Effects of exercise intensity, duration and recovery on in vitro neutrophil function in male athletes. Int J Sports Med 1999; 20(2): 128-3.
27. Pham, CT. Neutrophil serine proteases: specific regulators of inflammation. Nat Rev Immunol 2006; 6: 541-50.
28. Nijhuis J, Rensen SS, Slaats Y, van Dielen FM, Buurman WA, Greve JW. Neutrophil activation in morbid obesity, chronic activation of acute inflammation. Obesity (Silver Spring) 2009; 17(11): 2014-8.
29. Nadif R, Zerimech F, Bouzigon E, Matran R. The role of eosinophils and basophils in allergic diseases considering genetic findings. Curr Opin Allergy Clin Immunol 2013; 13(5): 507-13.
30. Ortega E. Neuroendocrine mediators in the modulation of phagocytosis by exercise: physiological implications. Exerc Immunol Rev 2003; 9: 70-93.
31. Peake JM. Exercise-induced alterations in neutrophil degranulation and respiratory burst activity: possible mechanisms of action. Exerc Immunol Rev 2002; 8: 49-100.
32. Hack V, Strobel G, Rau JP, Weicker H. The effect of maximal exercise on the activity of neutrophil granulocytes in highly trained athletes in a moderate training period. Eur J Appl Physiol Occup Physiol 1992; 65(6): 520-4.
33. Ortega E, Collazos ME, Maynar M, Barriga C, De la Fuente M. Stimulation of the phagocytic function of neutrophils in sedentary men after acute moderate exercise. Eur J Appl Physiol Occup Physiol 1993; 66(1): 60-4.
34. Mooren FC, Lechtermann A, Pospiech S, Fromme A, Thorwesten L, Völker K. Decoupling of intracellular calcium signaling in granulocytes after exhaustive exercise. Int J Sports Med 2001; 22(5): 323-8.
35. Chinda D, Nakaji S, Umeda T, et al. A competitive marathon race decreases neutrophil functions in athletes. Luminescence 2003; 18(6): 324-9.
36. Suzuki M, Nakaji S, Umeda T, et al. Effects of weight reduction on neutrophil phagocytic activity and oxidative burst activity in female judoists. Luminescence 2003; 18(4): 214-7.
37. Peake J, Suzuki K.Neutrophil activation, antioxidant supplements and exercise-induced oxidative stress. Exerc Immunol Rev 2004; 10: 129-41.
38. Mooren FC, Völker K, Klocke R, Nikol S, Waltenberger J, Krüger K. Exercise delays neutrophil apoptosis by a G-CSF-dependent mechanism. J Appl Physiol (1985) 2012; 113(7): 1082-90.
39. Beiter T, Fragasso A, Hartl D, Nieß AM. Neutrophil extracellular traps: a walk on the wild side of exercise immunology. Sports Med 2015; 45(5): 625-40.
40. Lewicki R, Tchórzewski H, Denys A, Kowalska M, Goli_ska A. Effect of physical exercise on some parameters of immunity in conditioned sportsmen. Int J Sports Med 1987; 8(5): 309-14.
41. Ziegler-Heitbrock L. CD14+ CD16+ blood monocytes: their role in infection and inflammation. J Leukoc Biol 2007; 81(3): 584-92.
42. Gleeson M, editor. Immune function in sport and exercise. Edinburgh, New York: Churchill Livingstone Elsevier 2006.
43. Armstrong L, Medford AR, Hunter KJ, Uppington KM, Millar AB. Differential expression of Toll-like receptor (TLR)-2 and TLR-4 on monocytes in human sepsis. Clin Exp Immunol 2004; 136(2): 312-9.
44. Shantsila E, Tapp LD, Wrigley BJ, et al. The effects of exercise and diurnal variation on monocyte subsets and monocyte-platelet aggregates. Eur J Clin Invest 2012; 42(8): 832-9.
45. Simpson RJ, McFarlin BK, McSporran C, Spielmann G, ó Hartaigh B, Guy K. Toll-like receptor expression on classic and proinflammatory blood monocytes after acute exercise in humans. Brain Behav Immun 2009; 23(2): 232-9.
46. Gleeson M, Pyne DB, Callister R.The missing links in exercise effects on mucosal immunity. Exerc Immunol Rev 2004; 10: 107-28.
47. Timmerman KL, Flynn MG, Coen PM, Markofski MM, Pence BD. Exercise training-induced lowering of inflammatory (CD14+CD16+) monocytes: a role in the anti-inflammatory influence of exercise? J Leukoc Biol 2008; 84: 1271-8.
48. Markowski MM, Flynn MG, Carrillo AE, Armstrong CL, Campbell WW, Sedlock DA. Resistance exercise training-induced decrease in circulating inflammatory CD14+CD16+ monocyte percentage without weight loss in older adults. Eur J Appl Physiol 2014; 114(8): 1737-48.
49. Kawanishi N, Yano H, Yokogawa Y, Suzuki K. Exercise training inhibits inflammation in adipose tissue via both suppression of macrophage infiltration and acceleration of phenotypic switching from M1 to M2 macrophages in high-fat-diet-induced obese mice. Exerc Immunol Rev 2010; 16: 105-18.
50. Nourshargh S, Alon R. Leukocyte migration into inflamed tissues. Immunity 2014; 20; 41(5): 694-707.
51. Ivanova EA, Orekhov AN. T Helper lymphocyte subsets and plasticity in autoimmunity and cancer: an overview. Biomed Res Int 2015; 2015: 327-470.
52. Schmitt N, Ueno H. Regulation of human helper T cell subset differentiation by cytokines. Curr Opin Immunol 2015; 34: 130-6.
53. Meng X, Yang J, Dong M, et al. Regulatory T cells in cardiovascular diseases. Nat Rev Cardiol 2016; 13(3): 167-79.
54. Nieman DC, Nehlsen-Cannarella SL, Donohue KM, et al. The effects of acute moderate exercise on leukocyte and lymphocyte subpopulations. Med Sci Sports Exerc 1991; 23(5): 578-85.
55. Hay JB, Andrade WN. Lymphocyte recirculation, exercise, and immune responses. Can J Physiol Pharmacol 1998; 76(5): 490-6.
56. Krüger K, Mooren FC. T cell homing and exercise. Exerc Immunol Rev 2007; 13: 37-54.
57. Krüger K, Lechtermann A, Fobker M, Völker K, Mooren FC. Exercise- induced redistribution of T lymphocytes is regulated by adrenergic mechanisms. Brain Behav Immun 2008; 22(3): 324-38.
58. Shek PN, Sabiston BH, Buguet A, Radomski MW. Strenuous exercise and immunological changes: a multiple-time-point analysis of leukocyte subsets, CD4/CD8 ratio, immunoglobulin production and NK cell response. Int J Sports Med 1995; 16(7): 466-74.
59. Navalta JW, Tibana RA, Fedor EA, Vieira A, Prestes J. Three consecutive days of interval runs to exhaustion affects lymphocyte subset apoptosis and migration. Biomed Res Int 2014; 2014: 694801.
60. Simpson RJ, Florida-James GD, Cosgrove C, et al. High-intensity exercise elicits the mobilization of senescent T lymphocytes into the peripheral blood compartment in human subjects. J Appl Physiol (1985) 2007; 103(1): 396-401.
61. Zhao G, Zhou S, Davie A, Su Q. Effects of moderate and high intensity exercise on T1/T2 balance. Exerc Immunol Rev 2012; 18: 98-114.
62. Krüger K, Mooren FC. Exercise-induced leukocyte apoptosis. Exerc Immunol Rev 2014; 20: 117-34.
63. Krüger K, Alack K, Ringseis R, et al. Apoptosis of low differentiated, highly differentiated and regulatory T cells is differently affected by high-intensity interval exercise compared to isocaloric continuous exercise. 2016; [Epub ahead of print].
64. Simpson RJ. Aging, persistent viral infections, and immunosenescence: can exercise "make space"? Exerc Sport Sci Rev 2011; 39(1): 23-33.
65. Mooren FC, Krüger K. Apoptotic lymphocytes induce progenitor cell mobilization after exercise. J Appl Physiol (1985) 2015; 119(2): 135-9.
66. Adams V, Linke A, Breuckmann F, et al. Circulating progenitor cells decrease immediately after marathon race in advanced-age marathon runners. Eur J Cardiovasc Prev Rehabil 2008; 15(5): 602-7.
67. Green KJ, Rowbottom DG, Mackinnon LT. Acute exercise and Tlymphocyte expression of the early activation marker CD69. Med Sci Sports Exerc 2003; 35(4): 582-8.
68. Bishop NC, Fitzgerald C, Porter PJ, Scanlon GA, Smith AC. Effect of caffeine ingestion on lymphocyte counts and subset activation in vivo following strenuous cycling. Eur J Appl Physiol 2005; 93(5-6): 606-13.
69. Gleeson M, Bishop NC. The T cell and NK cell immune response to exercise. Ann Transplant 2005; 10(4): 43-8.
70. Lowder T, Dugger K, Deshane J, Estell K, Schwiebert LM. Repeated bouts of aerobic exercise enhance regulatory T cell responses in a murine asthma model. Brain Behav Immun 2010; 24(1): 153-9.
71. Rehm K, Sunesara I, Marshall GD. Increased Circulating Antiinflammatory Cells in Marathon-trained Runners. Int J Sports Med 2015; 36(10): 832-6.
72. Fehrenbach E, Niess AM, Voelker K, Northoff H, Mooren FC. Exercise intensity and duration affect blood soluble HSP72. Int J Sports Med 2005; 26(7): 552-7.
73. Kohut ML, Arntson BA, Lee W, et al. Moderate exercise improves antibody response to influenza immunization in older adults. Vaccine 2004; 22(17-18): 2298-306.
74. Verde T, Thomas S, Shephard RJ. Potential markers of heavy training in highly trained distance runners. Br J Sports Med 1992; 26: 167-75.
75. Lancaster GI, Halson SL, Khan Q, et al. Effects of acute exhaustive exercise and chronic exercise training on type 1 and type 2 T lymphocytes. Exerc Immunol Rev 2004; 10: 91-106.
76. Maltseva DV, Sakharov DA, Tonevitsky EA, Northoff H, Tonevitsky AG. Killer cell immunoglobulin-like receptors and exercise. Exerc Immunol Rev 2011; 17: 150-63.
77. Timmons BW, Cieslak T. Human natural killer cell subsets and acute exercise: a brief review. Exerc Immunol Rev 2008; 14: 8-23.
78. Pedersen BK, Hoffman-Goetz L. Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev 2000; 80(3): 1055-81.
79. Nieman DC, Henson DA, Gusewitch G, et al. Physical activity and immune function in elderly women. Med Sci Sports Exerc 1993; 25(7): 823-31.
80. Woods JA, Ceddia MA, Wolters BW, Evans JK, Lu Q, McAuley E. Effects of 6 months of moderate aerobic exercise training on immune function in the elderly. Mech Ageing Dev 1999; 109(1): 1-19.
81. Stein JV. T Cell Motility as Modulator of Interactions with Dendritic Cells. Front Immunol 2015; 6: 559.
82. Suchánek O, Podrazil M, Fischerová B, et al. Intensive physical activity increases peripheral blood dendritic cells. Cell Immunol 2010; 266(1): 40-5.
83. Liao HF, Chiang LM, Yen CC, et al. Effect of a periodized exercise training and active recovery program on antitumor activity and development of dendritic cells. J Sports Med Phys Fitness 2006; 46(2): 307-14.
84. Suzuki K, Totsuka M, Nakaji S, et al. Endurance exercise causes interaction among stress hormones, cytokines, neutrophil dynamics, and muscle damage. J Appl Physiol 1999; 87: 1360-1367.
85. Peake JM, Nosaka K, Muthalib M, Suzuki K. Systemic inflammatory responses to maximal versus submaximal lengthening contractions of the elbow flexors. Exerc Immunol Rev 2006; 12: 72-85.
86. Graves DT, Jiang Y. Chemokines, a family of chemotactic cytokines. Crit Rev Oral Biol Med 1995; 6(2): 109-18.
87. Akdis M, Burgler S, Crameri R, et al. Interleukins, from 1 to 37, and interferon-_: receptors, functions, and roles in diseases. J Allergy Clin Immunol 2011; 127(3): 701-21.e1-70.
88. Nielsen AR, Pedersen BK. The biological roles of exercise-induced cytokines: IL-6, IL-8, and IL-15. Appl Physiol Nutr Metab 2007; 32: 833-839.
89. Suzuki K, Nakaji S, Yamada M, Totsuka M, Sato K, Sugawara K. Systemic inflammatory response to exhaustive exercise. Cytokine kinetics. Exerc Immunol Rev 2002; 8: 6-48.
90. Steensberg A, Fischer CP, Keller C, Møller K, Pedersen BK. IL-6 enhances plasma IL-1ra, IL-10, and cortisol in humans. Am J Physiol Endocrinol Metab 2003; 285: E433-7.
91. Peake JM, Della Gatta P, Suzuki K, Nieman DC. Cytokine expression and secretion by skeletal muscle cells: regulatory mechanisms and exercise effects. Exerc Immunol Rev 2015; 21: 8-25.
92. Pedersen BK, Steensberg A, Fischer C, Keller C, Ostrowski K, Schjerling P. Exercise and cytokines with particular focus on muscle- derived IL-6. Exerc Immunol Rev 2001; 7: 18-31.
93. Pedersen BK. Muscle as a secretory organ. Compr Physiol 2013; 3(3): 1337-62.
94. Cornish SM, Johnson ST. Systemic cytokine response to three bouts of eccentric exercise. Results Immunol 2014; 4: 23-9.
95. Kanda K, Sugama K, Hayashida H, et al. Eccentric exerciseinduced delayed-onset muscle soreness and changes in markers of muscle damage and inflammation. Exerc Immunol Rev 2013; 19: 72-85.
96. McHugh MP, Connolly DA, Eston RG, Gleim GW. Exerciseinduced muscle damage and potential mechanisms for the repeated bout effect. Sports Med 1999; (3): 157-70.
97. Egger G, Liang G, Aparicio A, Jones PA. Epigenetics in human disease and prospects for epigenetic therapy. Nature 2004; 429(6990): 457-63.
98. McCullough LE, Chen J, White AJ, et al. Global DNA methylation, measured by the luminometric methylation assay (LUMA), associates with postmenopausal breast cancer in non-obese and physically active women. J Cancer 2015; 6(6): 548-54.
99. Luttropp K, Nordfors L, Ekstrom TJ, Lind L. Physical activity is associated with decreased global DNA methylation in Swedish older individuals. Scand J Clin Lab Invest 2013; 73: 184-5.
100. Guan X, Sagara J, Yokoyama T, et al. ASC/TMS1, a caspa se- 1 activating adaptor, is downregulated by aberrant methylation in human melanoma. Int J Cancer 2003; 107(2): 202-8.
101. Yokoyama T, Sagara J, Guan X, et al. Methylation of ASC/TMS1, a proapoptotic gene responsible for activating procaspase-1, in human colorectal cancer. Cancer Lett 2003; 202(1): 101-8.
102. Makarova JA, Maltseva DV, Galatenko VV, et al.. Exercise immunology meets MiRNAs. Exerc Immunol Rev 2014; 20: 135-64.
103. Hoene M, Weigert C. The stress response of the liver to physical exercise. Exerc immunol rev 2010; 16: 163-83.
104. Matsakas A, Patel K. Skeletal muscle fibre plasticity in response to selected environmental and physiological stimuli. Histol histopath 2009; 24(5): 611-29.
105. Kjaer M, Langberg H, Heinemeier K, et al. From mechanical loading to collagen synthesis, structural changes and function in human tendon. Scand J Med Sci Sports 2009; 19(4): 500-10.
106. Fortin CF, Larbi A, Dupuis G, et al. GM-CSF activates the Jak/STAT pathway to rescue polymorphonuclear neutrophils mfrom spontaneous apoptosis in young but not elderly individuals. Biogerontology 2007; 8(2): 173-87.
107. O’Shea JJ, Murray PJ. Cytokine signaling modules in inflammatory responses. Immunity 2008; 28(4): 477-87.
108. Radom-Aizik S, Zaldivar F Jr, Oliver S, Galassetti P, Cooper DM. Evidence for microRNA involvement in exercise-associated neutrophil gene expression changes. J Appl Physiol (1985) 2010; 109(1): 252-61.
109. Radom-Aizik S, Zaldivar F, Haddad F, Cooper DM. Impact of brief exercise on peripheral blood NK cell gene and microRNA expression in young adults. J Appl Physiol (1985) 2013; 114(5): 628-36.
110. Keller P, Vollaard NB, Gustafsson T, et al.. A transcriptional map of the impact of endurance exercise training on skeletal muscle phenotype. J Appl Physiol (1985) 2011; 110: 46-59.
111. Beiter T, Hoene M, Prenzler F, et al. Exercise, skeletal muscle and inflammation: ARE-binding proteins as key regulators in inflammatory and adaptive networks. Exerc Immunol Rev 2015; 21: 42-57.
112. Krüger K, Dischereit G, Seimetz M, Wilhelm J, Weissmann N, Mooren FC.Time course of cigarette smoke-induced changes of systemic inflammation and muscle structure. Am J Physiol Lung Cell Mol Physiol 2015; 309(2): L119-28.
113. Bowen TS, Schuler G, Adams V. Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training. J Cachexia Sarcopenia Muscle 2015; 6(3): 197-207.
114. Wright CR, Brown EL, Della Gatta PA, et al. Regulation of granulocyte colony-stimulating factor and its receptor in skeletal muscle is dependent upon the type of inflammatory stimulus. J Interferon Cytokine Res 2015; 35(9): 710-9.
115. Hayashiji N, Yuasa S, Miyagoe-Suzuki Y, et al. G-CSF supports long-term muscle regeneration in mouse models of muscular dystrophy. Nat Commun 2015; 6: 6745.
116. Keane M. Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health. Seventh ed. USA: Saunders 2003.
117. Bellos A, Mulholland K, O'Brien KL, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Conflict Health 2010; 4: 3.
118. Thomas M. The management of acute lower respiratory tract infection in adults in primary care. Prim Care Respir J 2000; 9(1): 4-7.
119. World Health Organization. Acute respiratory infections in children- case management in small hospitals in developing countries. A Manual for Doctors and Senior Health Workers 1990; Vol. 1: 72.
120. Del Mar C. Understanding the global burden of acute respiratory infections. Annales Nestle 2000; 58: 41-8.
121. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Org 2008; 86: 408-16.
122. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2013; 31; 1: CD000980.
123. Lee HK, Hwang IH, Kim SY, Pyo SY. The effect of exercise on prevention of the common cold: a meta-analysis of randomized controlled trial studies. Korean J Fam Med 2014; 35: 119-26.
124. Cohen S, Tyrrell DA, Russell MA, Jarvis MJ, Smith AP. Smoking, alcohol consumption, and susceptibility to the common cold. Am J Public Health 1993; 83: 1277-83.
125. Roth DE, Le Caulfield, Ezzati M, Black RE. Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions. Bull World Health Org 2008; 86: 356-64.
126. Jefferson T, Del Mar C, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. Cochrane Database Syst Rev 2010; 20(1): CD006207.
127. Pyne DB, Gleeson M. Effects of intensive exercise training on immunity in athletes. Int J Sports Med 1998; 19 (Suppl 3): S183-91; discussion S191-4.
128. Fricker PA, Gleeson M, Flanagan A, Pyne DB, McDonald WA, Clancy RL. A clinical snapshot: Do elite swimmers experience more upper respiratory illness than nonathletes? Clin Exerc Physiol 2000; 2: 155-8.
129. Cox AJ, Gleeson M, Pyne DB, Callister R, Hopkins WG, Fricker PA. Clinical and laboratory evaluation of upper respiratory symptoms in elite athletes. Clin J Sport Med 2008; 18: 438-45.
130. Alonso JM, Edouard P, Fischetto G, Adams B, Depiesse F, Mountjoy M. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. Br J Sports Med 2012; 46: 505-14.
131. Fricker PA, McDonald WA, Gleeson M, Clancy RL. Exerciseassociated hypogammaglobulinemia. Clin J Sport Med 1999; 9: 46-8.
132. Gleeson M, Ginn E, Francis JL. Salivary immunoglobulin monitoring in an elite kayaker. Clin J Sport Med 2000; 10: 206-8.
133. Gleeson M. Mucosal immune responses and risk of respiratory illness in elite athletes. Exerc Immunol Rev 2000; 6: 5-42.
134. Peters EM, Bateman ED. Ultramarathon running and upper respiratory tract infections. An epidemiological survey. S Afr Med J 1983; 64: 582-4.
135. Nieman DC, Henson DA, Dumke CL, Lind RH, Shooter LR, Gross SJ. Relationship between salivary IgA secretion and upper respiratory tract infection following a 160-km race. J Sports Med Phys Fitness 2006; 46: 158-62.
136. Cox AJ, Gleeson M, Pyne DB, Saunders PU, Callister R, Fricker PA. Respiratory symptoms and inflammatory responses to Difflam throat-spray intervention in half-marathon runners: a randomised controlled trial. Brit J Sports Med 2010; 44: 127-33.
137. Nieman DC, Johanssen LM, Lee JW, Arabatzis K. Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness 1990; 30: 316-28.
138. Gleeson M, McDonald WA, Pyne DB, et al. Salivary IgA levels and infection risk in elite swimmers. Med Sci Sports Exerc 1999; 31: 67-73.
139. Bury T, Marechal R, Mahieu P, Pirnay F. Immunological status of competitive football players during the training season. Int J Sports Med 1998; 19: 364-8.
140. Novas Am, Rowbottom DG, Jenkins DG. Tennis, incidence of URTI and salivary IgA. Int J Sports Med 2003; 24: 223-9.
141. Fahlman MM, Engels HJ. Mucosal IgA and URTI in American college football players: a year longitudinal study. Med Sci Sports Exerc 2005; 37: 374-80.
142. Spence L, Brown WJ, Pyne DB, et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes. Med Sci Sports Exerc 2007; 39: 577-86.
143. Neville V, Gleeson M, Folland JP. Salivary IgA as a risk factor for upper respiratory infections in elite professional athletes. Med Sci Sports Exerc 2008; 40: 1228-36.
144. Nieman DC. Sportimmunologie: Aktuelle Perspektiven fuer den Sportler. Deut Z Sportmed 2000; 51(9): 291-6.
145. Baj Z, Kantorski J, Majewska E, et al. Immunological status of competitive cyclists before and after the training season. Int J Sports Med 1994; 15: 319-24.
146. Lancaster GI, Khan Q, Drysdale P, et al. The physiological regulation of toll-like receptor expression and function in humans. J Physiol (Lond) 2005; 563: 945-55.
147. Moldoveanu AI, Shephard RJ, Shek PN. Exercise elevates plasma levels but not gene expression of IL-1beta, IL-6, and TNF-alpha in blood mononuclear cells. J Appl Physiol 2000; 89: 1499-504.
148. Gleeson M, Bishop N, Oliveira M, McCauley T, Tauler P, Muhamad AS. Respiratory infection risk in athletes: association with antigen-stimulated IL-10 production and salivary IgA secretion. Scand J Med Sci Sports 2012, 22: 410-7.
149. Wang J, Song H, Tang X, et al. Effect of exercise training intensity on murine T-regulatory cells and vaccination response. Scand J Med Sci Sports 2012; 22: 643-52.
150. Gleeson M, Bishop NC. URI in athletes: are mucosal immunity and cytokine responses key risk factors? Exerc Sport Sci Rev 2013; 41: 148-53.
151. Belisle SE, Hamer DH, Leka LS, et al. IL-2 and IL-10 gene polymorphisms are associated with respiratory tract infection and may modulate the effect of vitamin E on lower respiratory tract infections in elderly nursing home residents. Am J Clin Nutr 2010; 92: 106-14.
152. Rossen RD, Butler WT, Waldman RH, et al. The proteins in nasal secretion. II. A longitudinal study of IgA and neutralizing antibody levels in nasal washings from men infected with influenza virus. JAMA 1970; 211: 1157-61.
153. Tiollier E, Gomez-Merino D, Burnat P, et al. Intense training: mucosal immunity and incidence of respiratory infections. Eur J Appl Physiol 2005; 93: 421-8.
154. Whitham M, Laing SJ, Dorrington M, et al. The influence of an arduous military training program on immune function and upper respiratory tract infection incidence. Mil Med 2006; 171: 703-9.
155. Allgrove JE. Factors influencing the mucosal immune responses to exercise. PhD thesis, Loughborough University 2007.
156. Gleeson M. Immune function in sport and exercise. J Appl Physiol 2007; 103: 693-9.
157. Reid VL, Gleeson M, Williams N, Clancy RL. Clinical investigation of athletes with persistent fatigue and/or recurrent infections. Br J Sports Med 2004; 38: 42-5.
158. Helenius I, LummeA, Haahtela T.Asthma, airway inflammation and treatment in elite athletes. Sports Med 2005; 35: 565-74.
159. Gleeson M, McDonald WA, Cripps AW, et al. Exercise, stress and mucosal immunity in elite swimmers. In: Mestecky J, Ed. Advances in Mucosal Immunity. NewYork: Plenum Press 1995; 571-4.
160. Gleeson M, Pyne DB, Austin JP, et al. Epstein-Barr virus reactivation and upper-respiratory illness in elite swimmers. Med Sci Sports Exerc 2002; 34: 411-7.
161. Peake J, Nosaka K, Suzuki, K Characterization of inflammatory responses to eccentric exercise in humans. Exerc Immunol Rev 2005; 11: 64-85.
162. Bermon S. Airway inflammation and upper respiratory tract infection in athletes: is there a link? Exerc Immunol Rev 2007; 13: 6-14.
163. Pyne DB, Gleeson M, McDonald WA, Clancy RL, Perry C, Jr., Fricker PA. Training strategies to maintain immunocompetence in athletes. Int J Sports Med 2000; 21 Suppl 1: S51-S60.
164. Meeusen R, Duclos M, Gleeson M, Rietjems J, Steinacker JM, Urhausen A. Prevention, diagnosis and treatment of the Overtraining Syndrome. Eur J Sport Sci 2006; 6: 1-14.
165. Mujika I. The influence of training characteristics and tapering on the adaptation in highly trained individuals: a review. Int J Sports Med 1998; 19: 439-46.
166. Cohen S, Tyrrell DAJ, Smith AP. Psychological stress and susceptibility to the common cold. New Eng J Med 1990; 325: 606-12.
167. Smith RS. The immune system is a key factor in the etiology of psychosocial disease. Med Hypotheses 1991; 34: 49-57
168. Urhausen A, Gabriel HHW, Weiler B, Kindermann W. Ergometric and psychological findings during overtraining: a long-term followup study in endurance athletes. Int J Sports Med 1998; 19: 114-20.
169. Dhabhar FS, McEwen BS. Acute stress enhances while chronic stress suppresses cell-mediated immunity in vivo: a potential role for leukocyte trafficking. Brain Behav Immun 1997; 11: 286-306.
170. Dhabhar FS, Miller AH, McEwen BS, Spencer RL. Differential activation of adrenal steroid receptors in neural and immune tissues of Sprague Dawley, Fischer 344, and Lewis rats. J Neuroimmunol 1995; 56: 77-90.
171. Dhabhar FS, McEwen BS. Stress-induced enhancement of antigenspecific cellmediated immunity. J Immunol 1996; 156: 2608-15.
172. Dhabhar FS. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation 2006; 16: 300-17.
173. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med 1998; 338: 171-9.
174. Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction: implications for health. Nat Rev Immunol 2005; 5: 243-51.
175. Dhabhar FS. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection versus immunopathology. Allergy Asthma Clin Immunol 2008; 4: 2-11.
176. Cohen S, Miller GE, Rabin BS. Psychological stress and antibody response to immunization: a critical review of the human literature. Psychosom Med 2001; 63: 7-18.
177. Ader R, Ed. Psychoneuroimmunology IV. San Diego: Academic Press 2006.
178. Irwin MR. Human psychoneuroimmunology: 20 years of discovery. Brain Behav Immun 2008; 22: 129-39.
179. Epel ES. Psychological and metabolic stress: a recipe for accelerated cellular aging? Hormones (Athens) 2009; 8: 7-22.
180. Phillips AC, Burns VE, Lord JM. Stress and exercise: Getting the balance right for aging immunity. Exerc Sport Sci Rev 2007; 35: 35-9.
181. Woods JA, Vieira VJ, Keylock KT. Exercise, inflammation, and innate immunity. Immunol Allergy Clin North Am 2009; 29: 381-93.
182. Miller BP. Team athletes. In: Bloomfield J, Fricker PA, Fitch KD, Eds. Science and Medicine in Sport. Melbourne: Blackwell Science 1995; pp. 182-93.
183. Grove JR, Gordon AMD. The psychological aspects of i jury in sport. In: Bloomfield J, Fricker A, Fitch KD, Eds. Science and Medicine in Sport. Melbourne: Blackwell Science 1995; 194-205.
184. Currie A, Potts SG, DonovanW, Blackwood D. Illness behaviour in elite middle and long distance runners. Br J Sports Med 1999; 33: 19-21.
185. Shephard RJ, Shek PN. Interactions between sleep, other body rhythms, immune responses and exercise. Can J Appl Physiol 1996; 22: 95-116.
186. Chandra RK. Nutritional regulation of immunity and risk of infection in old age. Immunology 1989; 67: 141-7.
187. Chandra RK. 1990 McCollum Award Lecture: nutrition and immunity- lessons from the past and new insights into the future. Am J Clin Nutr 1991; 53: 1087-101.
188. Sherman AR. Zinc, copper and iron nutrition and immunity. J Nutr 1992; 122: 604-9.
189. Shephard RJ, Shek PN. Exercise training and immune function. In: Hoffman-Goetz L, Ed. Exercise and Immune Function. Boca Raton: CRC Press 1996: 93-119.
190. Nieman DC. Immunonutrition support for athletes. Nutr Rev 2008; 66: 310-20.
191. Nieman DC, Henson DA, McAnulty SR, et al. Influence of vitamin C supplementation on oxidative and immune changes after an ultramarathon. J Appl Physiol 2002; 92: 1970-7.
192. Nieman DC, Henson DA, McAnulty SR, et al. Vitamin E and immunity after the kona triathlonworld championship. Med Sci Sports Exerc 2004; 36: 1328-35.
193. Davison G, Gleeson M. Influence of acute vitamin C and/or carbohydrate ingestion on hormonal, cytokine, and immune responses to prolonged exercise. Int J Sport Nutr Exerc Metab 2005; 15: 465-79.
194. Davison G, Gleeson M. The effect of 2 weeks vitamin C supplementation on immunoendocrine responses to 2.5 h cycling exercise in man. Eur J Appl Physiol 2006; 97: 454-61.
195. Krzywkowski K, Petersen EW, Ostrowski K, Kristensen JH, Boza J and Pedersen BK. Effect of glutamine supplementation on exercise- induced changes in lymphocyte function. Am J Physiol Cell Physiol 2001; 281: C1259-65.
196. Gleeson M. Dosing and efficacy of glutamine supplementation in human exercise and sport training. J Nutr 2008; 138: 2045S-9S.
197. Nieman DC. Influence of carbohydrate on the immune response to intensive, prolonged exercise. Exerc Immunol Rev 1998; 4: 64-76.
198. Nieman DC, Henson DA, Gojanovich G et al. Influence of carbohydrate on immune function following 2 h cycling. Res Sports Med 2006; 14: 225-37.
199. Chen YJ, Wong SH, Wong CK, Lam CW, Huang YJ, Siu PM. The effect of a preexercise carbohydrate meal on immune responses to an end urance performance run. Br J Nutr 2008; 100: 1260-8.
200. Lyall KA, Hurst SM, Cooney J et al. Short-term blackcurrant extract consumption modulates exercise-induced oxidative stress and lipopolysaccharide-stimulated inflammatory responses. Am J Physiol Regul Integr Comp Physiol 2009; 297: R70-81.
201. Murphy EA, Davis JM, Carmichael MD, Mayer EP and Ghaffar A. Benefits of oat beta-glucan and sucrose feedings on infection and macrophage antiviral resistance following exercise stress. Am J Physiol Regul Integr Comp Physiol 2009; 297: R1188-94.
202. Nieman DC, Henson DA, Maxwell KR et al. Effects of quercetin and EGCG on mitochondrial biogenesis and immunity. Med Sci Sports Exerc 2009; 41: 1467-75.
203. Bakker GC, van Erk MJ, Pellis L et al. An antiinflammatory dietary mix modulates inflammation and oxidative and metabolic stress in overweight men: a nutrigenomics approach. Am J Clin Nutr 2010; 91: 1044-59.
204. Nieman DC, Williams AS, Shanely RA et al. Quercetin's influence on exercise performance and muscle mitochondrial biogenesis. Med Sci Sports Exerc 2010; 42: 338-45.
205. Nieman DC, Henson DA, Gross SJ, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Med Sci Sports Exerc 2007; 39: 1561-9.
206. Nieman DC. Quercetin's bioactive effects in human athletes. Curr Topic Nutraceut Res 2010; 8: 33-44.
207. Dick EC, Jennings LC, Mink KA, Wartgow CD, Inhorn SL. Aerosol transmission of rhinovirus colds. J Infect Dis 1987; 156: 442-8
208. McLatchie GR. Infections in sport. In: McLatchie GR, Ed. Essentials of Sports Medicine. Edinburgh: Churchill Livingstone 1993; 112-25.
209. Mast EE, Goodman RA. Prevention of infectious disease transmission in sports. Sports Med 1997; 24: 1-7
210. Casey JM, Dick EC. Acute respiratory infections. In: Casey JM, Foster C, Hixson EG, Eds. Winter sports medicine. Philadelphia: F. A. Davis 1990; 112-8
211. Weidner TG. Sport and exercise participation during a common cold. Athletic Therapy Today 1996; 1: 5-8
212. Walsh NP, Whitham M. Exercising in environmental extremes: A greater threat to immune function? Sports Med 2006; 36: 941-76.
213. Shephard RJ. Immune changes induced by exercise in an adverse environment. Can J Physiol Pharmacol 1998; 76: 539-46.
214. Pugh LG, Corbett JL, Johnson RH. Rectal temperatures, weight losses, and sweat rates in marathon running. J Appl Physiol 1967; 23: 347-52.
215. Meehan RT. Immune suppression at high altitude. Ann Emerg Med 1987; 16: 974-9.
216. Asea A. Chaperokine-induced signal transduction pathways. Exerc Immunol Rev 2003; 9: 25-33
217. Castellani JW, IK MB and Rhind SG. Cold exposure: human immune responses and intracellular cytokine expression. Med Sci Sports Exerc 2002; 34: 2013-20.
218. Lackovic V, Borecky L, Vigas M and Rovensky J. Activation of NK cells in subjects exposed to mild hyper- or hypothermic load. J Interferon Res 1988; 8: 393-402.
219. Brenner IK, Castellani JW, Gabaree C et al. Immune changes in humans during cold exposure: effects of prior heating and exercise. J Appl Physiol 1999; 87: 699-710.
220. Costa RJ, Smith AH, Oliver SJ et al. The effects of two nights of sleep deprivation with or without energy restriction on immune indices at rest and in response to cold exposure. Eur J Appl Physiol 2010; 109: 417-28.
221. Wenisch C, Narzt E, Sessler DI et al. Mild intraoperative hypothermia reduces production of reactive oxygen intermediates by polymorphonuclear leukocytes. Anesth Analg 1996; 82: 810-6.
222. Walsh NP, Bishop NC, Blackwell J, Wierzbicki SG and Montague JC. Salivary IgA response to prolonged exercise in a cold environment in trained cyclists. Med Sci Sports Exerc 2002; 34: 1632-7.
223. Gore CJ, Hahn A, Rice A et al. Training at 2690m does not increase total haemoglobin mass or sea level VO2max in world champion track cyclists. J Sci Med Sport 1998; 1: 156-70.
224. Singh I, Chohan IS, Lal M, et al. Effects of high altitude stay on the incidence of common diseases in man. Int J Biometeorol 1977; 21: 93-122.
225. Sarnquist FH. Physicians on Mount Everest. A clinical account of the 1981 american medical research expedition to everest. West J Med 1983; 139: 480-5.
226. Murdoch DR. Symptoms of infection and altitude illness among hikers in the Mount Everest region of Nepal. Aviat Space Environ Med 1995; 66: 148-51.
227. Kleessen B, Schroedl W, Stueck M, Richter A, Rieck O, Krueger M. Microbial and immunological responses relative to high-altitude exposure in mountaineers. Med Sci Sports Exerc 2005; 37: 1313-8.
228. Mazzeo, RS, Wolfel EE, Butterfield GE, Reeves JT. Sympathetic responses during 21 days at high altitude (4,300 m) as determined by urinary and arterial catecholamines. Metabolism 1994; 43: 1226-32.
229. Mazzeo, RS, Brooks GA, Butterfield GE, Podolin DA, Wolfel EE, Reeves JT. Acclimatization to high altitude increases muscle sympathetic activity both at rest and during exercise. Am J Physiol 1995; 269: R201-7.
230. Mazzeo RS, Child A, Butterfield GE, et al. Sympathoadrenal responses to submaximal exercise in women after acclimatization to 4,000 m. Metabolism 2000; 49: 1036-42.
231. Chohan IS, Singh I, Balakrishnan K and Talwar GP. Immune response in human subjects at high altitude. Int J Biometeorol 1975; 19: 137-43.
232. Mazzeo, RS, Donovan D, M. Fleshner, et al. Interleukin-6 response to exercise and high-altitude exposure: Influence of _-adrenergic blockade. J Appl Physiol 2001; 91: 2143-9.
233. Chohan IS, Singh I. Cell mediated immunity at high altitude. Int J Biometeorol 1979; 23: 21-30.
234. Meehan R, Duncan U, Neale L, et al. Operation Everest II: alterations in the immune system at high altitudes. J Clin Immunol 1988; 8: 397-406.
235. Biselli R, Le Moli S, Matricardi PM, et al. The effects of hypobaric hypoxia on specific B cell responses following immunization in mice and humans. Aviat Space Environ Med 1991; 62: 870-4.
236. Pyne DB, McDonald WA, Morton DS, et al. Inhibition of interferon, cytokine, and lymphocyte proliferative responses in elite swimmers with altitude exposure. J Interferon Cytokine Res 2000; 20: 411-8.
237. Facco M, Zilli C, Siviero M, et al. Modulation of immune response by the acute and chronic exposure to high altitude. Med Sci Sports Exerc 2005; 37: 768-74.
238. Nieman DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Exerc 1994; 26: 128-39.
239. Chubak J, McTiernan A, Sorensen B, et al. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Am J Med 2006; 119: 937-42.
240. Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med 2011; 45: 987-92.
241. Fondell E, Lagerros YT, Sundberg CJ, et al. Physical activity, stress, and self-reported upper respiratory tract infection. Med Sci Sports Exerc 2011; 43: 272-9.
242. Barrett B, Hayney MS, Muller D et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Ann Fam Med 2012; 10(4): 337-46.
243. Sloan CA, Engels HJ, Fahlman MM, Yarandi HE, Davis JE. Effects of exercise on S-IGA and URS in postmenopausal women. Int J Sports Med 2013; 34 (1): 81-6.
244. Nieman DC. Risk of upper respiratory tract infection in athletes: an epidemiologic and immunologic perspective. J Athl Train 1997; 32(4): 344-9.
245. Weidner TG, Cranston T, Schurr T, Kaminsky LA. The effect of exercise training on the severity and duration of a viral upper respiratory illness. Med Sci Sports Exerc 1998; 30(11): 1578-83.
246. Klentrou P, Cieslak T, MacNeil M, Vintinner A, Plyley M. Effect of moderate exercise on salivary immunoglobulin A and infection risk in humans. Eur J Appl Physiol 2002; 87(2): 153-8.
247. Weidner T, Schurr T. Effect of exercise on upper respiratory tract infection in sedentary subjects. Br J Sports Med 2003; 37(4): 304-6.
248. Manzaneque JM, Vera FM, Maldonado EF, et al. Assessment of immunological parameters following a qigong training program. Med Sci Monit 2004; 10(6): 264-70.
249. Cilolu F. The effect of exercise on salivary IgA levels and the incidence of upper respiratory tract infections in postmenopausal women. Kulak Burun Bogaz Ihtis Derg 2005; 15(5-6): 112-6.
250. Mathur N, Pedersen BK. Exercise as a mean to control low-grade systemic inflammation. Mediat Inflamm 2008; 2008: 109502.
251. Huh JY, Park YJ, Ham M, Kim JB. Crosstalk between adipocytes and immune cells in adipose tissue inflammation and metabolic dysregulation in obesity. Mol Cells 2014; 37(5): 365-71.
252. Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 2003; 112(12): 1796-808.
253. Ito A, Suganami T, Yamauchi A, et al. Role of CC chemokine receptor 2 in bone marrow cells in the recruitment of macrophages into obese adipose tissue. J Biol Chem 2008; 283(51): 35715-23.
254. Feuerer M, Hill JA, Mathis D, Benoist C. Foxp3+ regulatory T cells: differentiation, specification, subphenotypes. Nat Immunol 2009; 10(7): 689-95.
255. Nishimura S, Manabe I, Nagai R. Adipose tissue inflammation in obesity and metabolic syndrome. Discov Med 2009; 8(41): 55-60.
256. Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 1993; 259(5091): 87-91.
257. Xu, H. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 2003; 112: 1821-30.
258. Ringseis R, Eder K, Mooren FC, Krüger K. Metabolic signals and innate immune activation in obesity and exercise. Exerc Immunol Rev 2015; 21: 58-68.
259. Mattusch F, Dufaux B, Heine O, Mertens I, Rost R. Reduction of the plasma concentration of C-reactive protein following nine months of endurance training. Int J Sports Med 2000; 21(1): 21-4.
260. Karstoft K, Pedersen BK. Exercise and type 2 diabetes: focus on metabolism and inflammation. Immunol Cell Biol 2016; 94(2): 146-50.
261. da Luz G, Frederico MJ, da Silva S et al. Endurance exercise training ameliorates insulin resistance and reticulum stress in adipose and hepatic tissue in obese rats. Eur J Appl Physiol 2011; 111: 2015-23.
262. Mardare C, Krüger K, Liebisch G, et al. Endurance as well as resistance training affect high fat diet induced increase of ceramides, inflammasom expression and systemic inflammation in mice. J Diabetes Res 2016; 2016: 4536470.
263. Pedersen B. K, Edward F. Adolph Distinguished Lecture: Muscle as an endocrine organ: IL6 and other myokines. J Appl Physiol 2009; 107: 1006-14.
264. Sepa-Kishi DM, Ceddia RB. Exercise-mediated effects on white and brown adipose tissue plasticity and metabolism. Exerc Sport Sci Rev 2016; 44(1): 37-44.
265. Walsh NP, Gleeson M, Shephard RJ et al. Position statement. Part one: Immune function and exercise. Exerc Immunol Rev 2011; 17: 6-63.