Does High Cardiorespiratory Fitness Confer Some Protection Against Proinflammatory Responses After Infection by SARS-CoV-2?
Hermann Zbinden-Foncea, Marc Francaux, Louise Deldicque, John A Hawley, Hermann Zbinden-Foncea, Marc Francaux, Louise Deldicque, John A Hawley
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in China in late 2019 and has since spread rapidly to every continent in the world. This pandemic continues to cause widespread personal suffering, along with severe pressure on medical and health care providers. The symptoms of SARS-CoV-2 and the subsequent prognosis are worsened in individuals who have preexisting comorbidities prior to infection by the virus. Individuals with obesity or overweight, insulin resistance, and diabetes typically have chronic low-grade inflammation characterized by increased levels of several proinflammatory cytokines and the inflammasome; this state predisposes to greater risk for infection along with more adverse outcomes. Here, we consider whether a high level of cardiorespiratory fitness induced by prior exercise training may confer some innate immune protection against COVID-19 by attenuating the "cytokine storm syndrome" often experienced by "at risk" individuals.
Conflict of interest statement
The authors declared no conflict of interest
© 2020 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society (TOS).
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7264673/bin/OBY-28-1378-g001.jpg)
References
- Muniyappa R, Gubbi S. COVID‐19 pandemic, corona viruses, and diabetes mellitus. Am J Physiol Endocrinol Metab 2020;318:E736‐E741.
- Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID‐ 19: evidence from meta‐analysis. Aging (Albany NY) 2020;12:6049‐6057.
- Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: how will COVID‐19 and global trends in physical inactivity and sedentary behavior affect one another? (Published online April 8, 2020) Prog Cardiovasc Dis 2020. doi:10.1016/j.pcad.2020.04.005
- Shi Y, Wang Y, Shao C, et al. COVID‐19 infection: the perspectives on immune responses. Cell Death Differ 2020;27:1451‐1454.
- Yan R, Zhang Y, Li Y, Xia L, Guo Y, Zhou Q. Structural basis for the recognition of SARS‐CoV‐2 by full‐length human ACE2. Science 2020;367:1444‐1448.
- Sun P, Lu X, Xu C, Sun W, Pan B. Understanding of COVID‐19 based on current evidence. J Med Virol 2020;92:548‐551.
- Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006;444:860‐867.
- Hill MA, Mantzoros C, Sowers JR. Commentary: COVID‐19 in patients with diabetes. Metabolism 2020;107:154217. doi:10.1016/j.metabol.2020.154217
- Simonnet A, Chetboun M, Poissy J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation. Obesity (Silver Spring) 2020;28:1195‐1199.
- Mehta P, McAuley DF, Brown M, et al. COVID‐19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395:1033‐1034.
- Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130:2620‐2629.
- Moon C. Fighting COVID‐19 exhausts T cells. Nat Rev Immunol 2020;20:277.
- Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270‐273.
- Santos SH, Andrade JM. Angiotensin 1‐7: a peptide for preventing and treating metabolic syndrome. Peptides 2014;59:34‐41.
- Dinarello CA. Overview of the IL‐1 family in innate inflammation and acquired immunity. Immunol Rev 2018;281:8‐27.
- Wang G, Cao K, Liu K, et al. Kynurenic acid, an IDO metabolite, controls TSG‐6‐mediated immunosuppression of human mesenchymal stem cells. Cell Death Differ 2018;25:1209‐1223.
- Pedersen BK, Saltin B. Exercise as medicine ‐ evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015;25:1‐72.
- 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.
- Laddu DR, Lavie CJ, Phillips SA, Arena R. Physical activity for immunity protection: inoculating populations with healthy living medicine in preparation for the next pandemic [published online April 9, 2020]. Prog Cardiovasc Dis 2020. doi:10.1016/j.pcad.2020.04.006
- Lancaster GI, Febbraio MA. The immunomodulating role of exercise in metabolic disease. Trends Immunol 2014;35:262‐269.
- Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus on muscle‐derived interleukin‐6. Physiol Rev 2008;88:1379‐1406.
- Abbasi A, Hauth M, Walter M, et al. Exhaustive exercise modifies different gene expression profiles and pathways in LPS‐stimulated and un‐stimulated whole blood cultures. Brain Behav Immun 2014;39:130‐141.
- Lancaster GI, Khan Q, Drysdale P, et al. The physiological regulation of toll‐like receptor expression and function in humans. J Physiol 2005;563:945‐955.
- Flynn MG, McFarlin BK, Phillips MD, Stewart LK, Timmerman KL. Toll‐like receptor 4 and CD14 mRNA expression are lower in resistive exercise‐trained elderly women. J Appl Physiol 2003;95:1833‐1842.
- Collao N, Rada I, Francaux M, Deldicque L, Zbinden‐Foncea H. Anti‐inflammatory effect of exercise mediated by toll‐like receptor regulation in innate immune cells ‐ a review. Int Rev Immunol 2020;39:39‐52.
- Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti‐inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol 2011;11:607‐615.
- Rada I, Deldicque L, Francaux M, Zbinden‐Foncea H. Toll like receptor expression induced by exercise in obesity and metabolic syndrome: a systematic review. Exerc Immunol Rev 2018;24:60‐71.
- Nold MF, Nold‐Petry CA, Zepp JA, Palmer BE, Bufler P, Dinarello CA. IL‐37 is a fundamental inhibitor of innate immunity. Nat Immunol 2010;11:1014‐1022.
- Fernandes P, de Mendonca Oliveira L, Bruggemann TR, Sato MN, Olivo CR, Arantes‐Costa FM. Physical exercise induces immunoregulation of TREG, M2, and pDCs in a lung allergic inflammation model. Front Immunol 2019;10:854. doi:10.3389/fimmu.2019.00854
- Cardoso GH, Petry DM, Probst JJ, et al. High‐intensity exercise prevents disturbances in lung inflammatory cytokines and antioxidant defenses induced by lipopolysaccharide. Inflammation 2018;41:2060‐2067.
- Rigonato‐Oliveira NC, Mackenzie B, Bachi ALL, et al. Aerobic exercise inhibits acute lung injury: from mouse to human evidence Exercise reduced lung injury markers in mouse and in cells. Exerc Immunol Rev 2018;24:36‐44.
- Budinger GR, Urich D, DeBiase PJ, et al. Stretch‐induced activation of AMP kinase in the lung requires dystroglycan. Am J Respir Cell Mol Biol 2008;39:666‐672.
- Cholewa JM, Paolone VJ. Influence of exercise on airway epithelia in cystic fibrosis: a review. Med Sci Sports Exerc 2012;44:1219‐1226.
- Zhang J, Dong J, Martin M, et al. AMP‐activated protein kinase phosphorylation of angiotensin‐converting enzyme 2 in endothelium mitigates pulmonary hypertension. Am J Respir Crit Care Med 2018;198:509‐520.
- Prata LO, Rodrigues CR, Martins JM, et al. Original research: ACE2 activator associated with physical exercise potentiates the reduction of pulmonary fibrosis. Exp Biol Med (Maywood) 2017;242:8‐21.
Source: PubMed