Evidence for Anti-Inflammatory Effects of Exercise in CKD

Abstract

CKD is associated with a complex state of immune dysfunction characterized by immune depression, predisposing patients to infections, and immune activation, resulting in inflammation that associates with higher risk of cardiovascular disease. Physical exercise may enhance immune function and exert antiinflammatory effects, but such effects are unclear in CKD. We investigated the separate effects of acute and regular moderate-intensity aerobic exercise on neutrophil degranulation (elastase release), activation of T lymphocytes (CD69 expression) and monocytes (CD86 and HLA-DR expression), and plasma inflammatory markers (IL-6, IL-10, soluble TNF-receptors, and C-reactive protein) in patients with predialysis CKD. A single 30-minute (acute) bout of walking induced a normal pattern of leukocyte mobilization and had no effect on T-lymphocyte and monocyte activation but improved neutrophil responsiveness to a bacterial challenge in the postexercise period. Furthermore, acute exercise induced a systemic anti-inflammatory environment, evidenced by a marked increase in plasma IL-10 levels (peaked at 1 hour postexercise), that was most likely mediated by increased plasma IL-6 levels (peaked immediately postexercise). Six months of regular walking exercise (30 min/d for 5 times/wk) exerted anti-inflammatory effects (reduction in the ratio of plasma IL-6 to IL-10 levels) and a downregulation of T-lymphocyte and monocyte activation, but it had no effect on circulating immune cell numbers or neutrophil degranulation responses. Renal function, proteinuria, and BP were also unaffected. These findings provide compelling evidence that walking exercise is safe with regard to immune and inflammatory responses and has the potential to be an effective anti-inflammatory therapy in predialysis CKD.

Effects of intradialytic exercise on systemic cytokine in patients with chronic kidney disease

“…In the present study, the lack of significant increase in IL-6 may also be related to the intensity and duration of the workout, since the magnitude of the increase appears to be protocoldependent and determined by the combination of the type, intensity and duration of the exercise performed. 25 Most importantly, the same anti-inflammatory effect observed in this study and others 23,26 has not been observed in studies involving systematic physical training for over 12 weeks. They did not observed any changes in the levels of TNF-a, IL-1b or C-reactive protein.…”

“…Acute modulations in systemic TNF-a remain controversial, and this response is linked to the volume of the exercise performed. 22 In CKD, for Viana et al, 23 30 min of aerobic exercise in pre-dialysis individuals induced significant elevation of IL-6 and IL-10, with little effect in the TNF receptors (sTNF-RI and sTNF-RII) in post exercise. After one hour from the exercise session, IL-6 and IL-10 remained in higher concentrations and an increase in sTNF-RII was found.…”

Protective effect of regular physical activity on major depressive episodes in patients with early stages of chronic kidney disease

“…CKD is associated with profound changes in innate and adaptive immunity, which predispose CKD patients to infectious complications and chronic inflammation. Viana et al [31] reported that moderate intensity exercise exert ant-inflammatory effects in patients with predialysis CKD. Accumulating evidence suggests inflammatory response may play an important role in the pathogenesis of depression [32][33][34].…”

Effect of Yoga Module on Pro- Inflammatory and Anti-Inflammatory Cytokines in Industrial Workers of Lonavla: A Randomized Controlled Trial

“…According to another study, intense physical exercises induced a systemic anti-inflammatory response, evidenced by a marked increase in plasma IL-10 levels (peaked at 1 hour post exercise) that was most likely mediated by increased plasma IL-6 levels (peaked immediately post exercise) [38]. It was also observed that exercise initially increases pro-inflammatory cytokines, which then activate anti-inflammatory cytokine [39][40][41][42].…”