Physical exercise, the immune system and infection risk: implications for prehabilitation and rehabilitation for solid organ transplantation candidates and recipients.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9717388 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-7013 (Electronic) Linking ISSN: 10872418 NLM ISO Abbreviation: Curr Opin Organ Transplant Subsets: MEDLINE

Publication: <2003->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Philadelphia, PA : Rapid Science Publishers,

Organ Transplantation*/adverse effects; Humans ; Risk Factors ; Immune System/immunology ; Immune System/drug effects ; Immunosuppressive Agents/adverse effects ; Treatment Outcome ; Exercise/physiology ; Risk Assessment ; Preoperative Exercise ; Graft Survival/drug effects ; Graft Rejection/immunology ; Graft Rejection/prevention & control ; Exercise Therapy ; Immunocompromised Host

Purpose of Review: Solid organ transplantation recipients have an increased risk of infection, exacerbated by immunosuppressant medications that need to finely balance suppression of the immune system to prevent allograft rejection while avoiding over-suppression leading to infections and malignancy. Exercise modulates immune functions, with moderate-intensity activities particularly associated with enhanced antiviral immunity and reduced infection incidence. However, investigations of the effects of exercise and physical activity on immune function and infection risk posttransplantation are scarce. This review highlights areas where the relationship between exercise, immune function and infection risk has greatest potential for benefit for solid organ transplantation and therefore greatest need for investigation.
Recent Findings: Moderate and higher intensity exercise do not appear to cause adverse immunological effects in kidney transplantation recipients, although evidence from other organ transplantation is lacking. Evidence from healthy younger and older adults suggests that regular exercise can reduce risk of respiratory infections and latent herpesvirus reactivation and improves antibody responses to vaccination, which is of great importance for organ transplantation recipients.
Summary: There is a strong need for research to investigate the role of exercise on immune function and infection risk in solid organ transplantation to improve both allograft survival and long-term health of the recipient.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100:126–131.
Walsh NP, Gleeson M, Shephard RJ, et al. Position statement. Part 1. Immune function and exercise. Exerc Immunol Rev 2011; 17:6–63.
Chastin SFM, Abaraogu U, Bourgois JG, et al. Effects of regular physical activity on the immune system, vaccination and risk of community-acquired infectious disease in the general population: systematic review and meta-analysis. Sports Med 2021; 51:1673–1686.
Simpson RJ, Campbell JP, Gleeson M, et al. Can exercise affect immune function to increase susceptibility to infection? Exerc Immunol Rev 2020; 26:8–22.
Janaudis-Ferreira T, Mathur S, Deliva R, et al. Exercise for solid organ transplant candidates and recipients: a joint position statement of the Canadian Society of Transplantation and CAN-RESTORE. Transplantation 2019; 103:e220–e238.
Bamoulid J, Staeck O, Halleck F, et al. Immunosuppression and results in renal transplantation. Eur Urol Suppl 2016; 15:415–429.
Bitterman R, Kumar D. Respiratory viruses in solid organ transplant recipients. Viruses 2021; 13:2146.
Matthews CE, Ockene IS, Freedson PS, et al. Moderate to vigorous physical activity and risk of upper-respiratory tract infection. Med Sci Sports Exerc 2002; 34:1242–1248.
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; 45:987–992.
Highton PJ, White AEM, Nixon DGD, et al. Influence of acute moderate- to high-intensity aerobic exercise on markers of immune function and microparticles in renal transplant recipients. Am J Physiol Renal Physiol 2020; 318:F76–F85.
Hutchinson GM, Cooper AM, Billany RE, et al. Effect of high intensity interval training and moderate intensity continuous training on lymphoid, myeloid and inflammatory cells in kidney transplant recipients. Exerc Immunol Rev 2022; 28:100–115.
Duggal NA, Niemiro G, Harridge SDR, et al. Can physical activity ameliorate immunosenescence and thereby reduce age-related multimorbidity? Nat Rev Immunol 2019; 19:563–572.
Duggal NA, Pollock RD, Lazarus NR, et al. Major features of immunesenescence, including reduced thymic output, are ameliorated by high levels of physical activity in adulthood. Aging Cell 2018; 17:e12750.
Spielmann G, McFarlin BK, O’Connor DP, et al. Aerobic fitness is associated with lower proportions of senescent blood T-cells in man. Brain Behav Immun 2011; 25:1521–1529.
Donovan T, Bain AL, Tu W, et al. Influence of exercise on exhausted and senescent T cells: a systematic review. Front Physiol 2021; 12:668327.
Spielmann G, Bollard CM, Bigley AB, et al. The effects of age and latent cytomegalovirus infection on the redeployment of CD8+ T cell subsets in response to acute exercise in humans. Brain Behav Immun 2014; 39:142–151.
Simpson RJ, Hussain M, Baker F, et al. Cardiorespiratory fitness is associated with better control of latent herpesvirus infection in a large ethnically diverse community sample: evidence from the Texas City Stress and Health Study. Brain Behav Immun 2017; 66: (Suppl): e35.
Agha NH, Mehta SK, Rooney BV, et al. Exercise as a countermeasure for latent viral reactivation during long duration space flight. FASEB J 2020; 34:2869–2881.
Pergam SA, Limaye AP. AST Infectious Diseases Community of Practice. Varicella zoster virus in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13622.
Razonable RR, Humar A. Cytomegalovirus in solid organ transplant recipients—guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13512.
Spielmann G, Bollard CM, Kunz H, et al. A single exercise bout enhances the manufacture of viral-specific T-cells from healthy donors: implications for allogeneic adoptive transfer immunotherapy. Sci Rep 2016; 6:25852.
Kunz HE, Agha NH, Hussain M, et al. The effects of (1 and (1+2 adrenergic receptor blockade on the exercise-induced mobilization and ex vivo expansion of virus-specific T cells: implications for cellular therapy and the antiviral immune effects of exercise. Cell Stress Chaperones 2020; 25:993–1012.
Chong PP, Avery RK. A comprehensive review of immunization practices in solid organ transplant and hematopoietic stem cell transplant recipients. Clin Ther 2017; 39:1581–1598.
Meshram HS, Kute V, Rane H, et al. Humoral and cellular response of COVID-19 vaccine among solid organ transplant recipients: a systematic review and meta-analysis. Transpl Infect Dis 2022; 24:e13926.
Viganò M, Beretta M, Lepore M, et al. Vaccination recommendations in solid organ transplant adult candidates and recipients. Vaccines (Basel) 2023; 18:1611.
Danziger-Isakov L, Kumar D. AST ID Community of Practice. Vaccination of solid organ transplant candidates and recipients: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13563.
Boutin CA, Alamri M, Ison MG. Update on COVID-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors. Curr Opin Organ Transplant 2023; 28:76–84.
Walti LN, Mugglin C, Mombelli M, et al. Vaccine-preventable infections among solid organ transplant recipients in Switzerland. JAMA Netw Open 2023; 6:e2310687.
Mombelli M, Neofytos D, Huynh-Do U, et al. Immunogenicity of high-dose versus MF59-adjuvanted versus standard influenza vaccine in solid organ transplant recipients: The Swiss/Spanish Trial in Solid Organ Transplantation on Prevention of Influenza (STOP-FLU Trial). Clin Infect Dis 2024; 78:48–56.
Edwards KM, Burns VE, Allen LM, et al. Eccentric exercise as an adjuvant to influenza vaccination in humans. Brain Behav Immun 2007; 21:209–217.
Edwards KM, Pung MA, Tomfohr LM, et al. Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine 2012; 30:6389–6395.
Ranadive SM, Cook M, Kappus RM, et al. Effect of acute aerobic exercise on vaccine efficacy in older adults. Med Sci Sports Exerc 2014; 46:455–461.
Hallam J, Jones T, Alley J, Kohut ML. Exercise after influenza or COVID-19 vaccination increases serum antibody without an increase in side effects. Brain Behav Immun 2022; 102:1–10.
Bohn-Goldbaum E, Lee VY, Skinner SR, et al. Acute exercise does not improve immune response to HPV vaccination series in adolescents. Papillomavirus Res 2019; 8:1–3.
Bohn-Goldbaum E, Pascoe A, Singh MF, et al. Acute exercise decreases vaccine reactions following influenza vaccination among older adults. Brain Behav Immun Health 2020; 1:1–7.
Long JE, Ring C, Drayson M, et al. Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain Behav Immun 2012; 26:680–687.4.

0 (Immunosuppressive Agents)

Date Created: 20240607 Date Completed: 20240702 Latest Revision: 20240702

20240703

10.1097/MOT.0000000000001156

38847176