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The effect of immunosuppression therapy on immune system responses to exercise
Secondary Supervisor(s): Professor Lettie Bishop (Loughborough)
University of Registration: Coventry University
BBSRC Research Themes: Understanding the Rules of Life (Immunology)
Project Outline
Regular moderate exercise reduces the risk of infection compared with a sedentary lifestyle, but very prolonged bouts of exercise and periods of intensified training are associated with an increased infection risk (Gleeson and Walsh, 2011). Exercise and training can therefore have positive and negative effects on the immune system.
A novel approach to advance understanding the immune systems responses to exercise is examining individuals with immune system suppression, such as solid organ transplantees (SOT). Uniquely, SOT undergo deliberate immunosuppressive therapy to prevent organ rejection. Thus, immune suppression is a result of medication rather than primary pathology per se. Few studies have examined immune responses of SOT in relation to exercise. Cappuccilli et al, (2016) observed immune responses of SOT cyclists before and after a 130 km race. Responses of inflammatory cytokines interleukin (IL)-6, tumour necrosis factor (TNF)-a and interferon (IFN)-g paralleled those of non-SOT cyclists in the same race, however, greater values were observed for the SOT at rest, at the end of the race (IL-6) and 18-24 hours post-race (TNF-a), indicating dysregulated immune responses. Examining immune responses, infection rates and perceived wellbeing in SOT will help to further understand the ‘window of infection’ observed post exercise.
Objectives
The proposed research aims to determine the effects of exercise on immunological responses and infection rates in suppressed and non-suppressed immune systems and in relation to training status. Specific objectives are; to assess immune responses in compromised and non-compromised immune systems to 1) a resting immune challenge, 2) a standardised exercise challenge, 3) a period of intensified exercise training, and 4) to determine infection rates and participant wellbeing following each of objectives 1 to 3.
Methods
Participants will involve groups of individuals with SOT (immune suppressed group) and those without SOT (control group) and different training status. As the most common SOT undertaken is kidney transplantation, it is assumed that these individuals will be the target population, however, other SOT types will be considered. The following proposed methods to examine resting and exercise immune function challenges are similar. In assessing responses to acute exercise participants would be invited to the laboratory to undertake standardised acute exercise bout representative of typical exercise sessions (e.g. steady state aerobic exercise, 30-60 min). Immune function markers (such as; IL-6, TNF-a, IFN-g, immunoglobulin A [Ig-A]) and cortisol would be determined from blood samples at baseline, post exercise and at 24 and 48 hours of recovery. The number and function of the immune cells (e.g. toll-like receptors, regulatory T cells) and other biomarkers will be correlated with susceptibility to infection. Measures of kidney function will be taken at baseline and the same time points as immune system measures. Conventional exercise physiology techniques will be incorporated to determine the intensity of exercise undertaken (i.e. oxygen consumption, carbon dioxide production, respiratory exchange ratio, blood lactate concentration, heart rate, ratings of perceived exertion). These markers will be taken in conjunction with detailed self-reported incidences of infection and wellbeing diaries and conventional quantitative measures of physical activity (i.e. duration, heart rate and ratings of perceived exertion etc.). A similar approach can be utilised to determine changes pre and post a period of intensified exercise or repeated bouts of exercise.
References
Cappuccilli, M., et al. (2016). Inflammatory and Adipose Response in Solid Organ Transplant Recipients After a Marathon Cycling Race. Transplantation proceedings, 48(2), 408–414.
Gleeson, M., Walsh, N. P. (2012). The BASES expert statement on exercise, immunity, and infection. Journal of sports sciences, 30(3), 321–324.
