Participants randomized to cardiovascular exercise experienced improvements in influenza seroprotection throughout the entire influenza season, whereas those in the balance and flexibility intervention did not. Although there were no differences in reported respiratory tract infections, the exercise group exhibited reduced overall illness severity and sleep disturbance. These data support the hypothesis that regular endurance exercise improves influenza vaccine responses.
Based upon a prior cross-sectional study, we hypothesized that an aerobic exercise intervention in sedentary older adults would improve a primary T cell-dependent immune response. Participants were a subset of older subjects from a large, ongoing exercise intervention study who were randomly assigned to either an aerobic exercise (Cardio, n=30, 68.9 ± 0.8 yrs) or flexibility/balance (Flex, n=20, 69.9 ± 1.2 yrs) intervention. The intervention consisted of either 3 aerobic sessions for 30-60 min at 55-70% VO 2 max or two 60 min flexibility/balance sessions weekly for 10 months. Eight months into the intervention, samples were collected before intramuscular administration of KLH (125 µg), followed by sampling at 2, 3, and 6 wks post-KLH. Serum anti-KLH IgM, IgG1, and IgG2 was measured by ELISA. Physiological and psychosocial measures were also assessed pre-and postintervention. While there was no difference in the anti-KLH IgG2 response between groups, Cardio displayed significantly (p ≤ 0.05) higher anti-KLH IgG1 (at wks 2, 3, and 6 post) and IgM responses when compared to Flex. Despite cardiovascular intervention-induced improvement in physical fitness (~11% vs. 1% change in VO 2 peak in Cardio vs. Flex, respectively), we found no relationship between improved fitness and enhanced anti-KLH antibody responses. Optimism, perceived stress, and affect were all associated with enhanced immune response. We have shown for the first time that cardiovascular training in previously sedentary elderly results in significantly higher primary IgG1 and IgM antibody responses, while having no effect on IgG2 production.
The purpose of this study was to examine whether cardiovascular fitness, independent of confounding factors, was associated with immune responsiveness to clinically relevant challenges in older adults (60-76 yr). Thirteen sedentary, low-fit (LF; maximal O(2) uptake = 21.1 +/- 1.1 ml.kg(-1).min(-1)) and 13 physically active, high-fit (HF; maximal O(2) uptake = 46.8 +/- 3.4 ml.kg(-1).min(-1)) older adults participated in this study. Dietary intake was assessed, and a battery of psychosocial tests was administered. In vivo antibody and ex vivo proliferative and cytokine responses to influenza (Fluzone) and tetanus toxoid (TT) vaccination and delayed-type hypersensitivity skin tests were performed. HF elderly individuals displayed a higher antibody response to two of the three strains included in the Fluzone vaccine as measured by hemagluttination inhibition, but there was no difference between groups in influenza-specific ex vivo proliferation or IFN-gamma or IL-10 production. HF elderly individuals exhibited a lower IgG(1) response and a tendency for a higher IgG(2) response to the TT vaccine. There were, however, no differences in TT-specific ex vivo proliferation or IFN-gamma or IL-10 production. In contrast, HF subjects had higher proliferative responses to phytohemagluttinin. In addition, there were no differences in delayed-type hypersensitivity responses to fungal antigens between groups. These results suggest that, after accounting for confounding factors, HF elderly individuals have higher antibody responses to Fluzone vaccine and a Th2 skewing of the antibody response to TT. There was little evidence that HF mounted better cell-mediated immune responses to the Fluzone or TT vaccine measured in peripheral blood cells or to other recall antigens in vivo.
Many strategies have been used to improve immune function in the aged. Unfortunately, many of these interventions have been disappointing, impractical, costly to develop and administer, or accompanied by adverse side effects. Aside from dietary manipulation (caloric restriction without malnutrition or antioxidant supplementation), research involving behavioral preventative or restorative therapies has been lacking. Moderate exercise training has been shown to elicit beneficial outcomes in both the prevention and rehabilitation of many diseases of the elderly. It has been hypothesized that moderate levels of exercise improves, whereas strenuous exercise or overtraining suppresses, various immune function measures. Three general approaches have been implemented to study the impact of exercise on immune functioning in the elderly: (1) cross-sectional studies, (2) longitudinal studies, and (3) animal studies. In general, cross-sectional studies examining highly active elderly have demonstrated improved in vitro T cell responses to polyclonal stimulation when compared to sedentary elderly. This is corroborated by several animal studies that have shown improved splenic T cell responses in vitro. Unfortunately, human prospective studies have failed to demonstrate consistent improvements in various measures of immune function in older adults. However, it should be cautioned that these studies have included small samples followed over a short duration, measuring a limited number of in vitro immune parameters, with some failing to account for potential confounding influences. Although such findings have the potential to be of substantial public health importance, very few systematic studies have been conducted.
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