Exercise training, circulating cytokine levels and immune function in cancer survivors: A meta-analysis
- PMID: 31454519
- DOI: 10.1016/j.bbi.2019.08.187
Exercise training, circulating cytokine levels and immune function in cancer survivors: A meta-analysis
Abstract
Background: Anti-cancer therapies lead to chronic non-resolving inflammation and reduced immune function. One potential therapy is exercise training, but the effectiveness of these interventions to improve immune-related outcomes, the gaps in the literature, and recommendations to progress the field need to be determined.
Objectives: (1) to conduct separate meta-analyses in cancer survivors to determine the effects of exercise training on pro- and anti-inflammatory markers, and immune cell proportions and function; and (2) to perform subgroup analyses to determine whether exercise modality, cancer type, and specific markers help to explain heterogeneity in each meta-analysis.
Data sources: Electronic databases (PubMed/MEDLINE, EMBASE, CENTRAL, and CINAHL) from inception to March 2018. The reference lists of eligible articles and relevant reviews were also checked.
Study selection: Inclusion criteria were adult cancer survivors from randomized controlled trials performing structured exercise intervention (aerobic, resistance or combined training or Tai Chi/yoga) compared to usual care control group and included pro-inflammatory, anti-inflammatory, and/or immune cell outcomes.
Appraisal and synthesis methods: A total of 5349 potentially eligible articles were identified, of which 26 articles (27 trials) met the inclusion criteria. Effect sizes were calculated as standardized mean differences (SMD), where <0.2 was defined as trivial, 0.2-0.3 as small, 0.4-0.8 as moderate, and >0.8 as a large effect.
Results: Exercise training decreased pro-inflammatory markers (SMD: -0.2, 95% CI: -0.4, -0.1, p < 0.001). Sub-group analysis for the pro-inflammatory markers indicated that combined aerobic and resistance training had the greatest effect (SMD: -0.3, 95% CI: -0.5, -1.9, p < 0.001), that prostate (SMD: -0.5, 95% CI: -0.8, 0.1, p = 0.004) and breast cancer populations were most responsive (SMD: -0.2, 95% CI: -0.3, -0.1, p = 0.001), and that C-reactive protein (SMD: -0.5, 95% CI: -0.9, -0.06, p = 0.025) and tumor necrosis factor (SMD: -0.3, 95% CI: -0.5, -0.06, p = 0.004) were the most sensitive to change. Exercise training tended to decrease anti-inflammatory markers (p = 0.072) but had no effect on natural killer or natural killer T cell proportions or cytotoxic activity.
Conclusions: Exercise training reduces pro-inflammatory markers in cancer survivors, with the strongest evidence for combined training and for prostate and breast cancer survivors. Further research is warranted to determine if these changes are clinically relevant or are associated with improvements in symptoms. To strengthen future research, focusing on novel immune populations that include functional parameters and standardized reporting of key immune outcomes is recommended.
Keywords: Aerobic training; Exercise oncology; Immune system; Inflammation; Resistance training.
Copyright © 2019 Elsevier Inc. All rights reserved.
Similar articles
-
Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Sports Sci Med. 2024 Jun 1;23(2):366-395. doi: 10.52082/jssm.2024.366. eCollection 2024 Jun. J Sports Sci Med. 2024. PMID: 38841642 Free PMC article. Review.
-
Home-based exercise improves quality of life in breast and prostate cancer survivors: A meta-analysis.PLoS One. 2023 Apr 20;18(4):e0284427. doi: 10.1371/journal.pone.0284427. eCollection 2023. PLoS One. 2023. PMID: 37079635 Free PMC article.
-
The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis.Support Care Cancer. 2019 Oct;27(10):3701-3716. doi: 10.1007/s00520-019-04911-0. Epub 2019 Jun 24. Support Care Cancer. 2019. PMID: 31236699
-
Yoga Treatment for Chronic Non-Specific Low Back Pain (2017).Explore (NY). 2017 Jul-Aug;13(4):281-284. doi: 10.1016/j.explore.2017.04.018. Epub 2017 Apr 22. Explore (NY). 2017. PMID: 28688789
-
Exercise programs for people with dementia.Cochrane Database Syst Rev. 2013 Dec 4;(12):CD006489. doi: 10.1002/14651858.CD006489.pub3. Cochrane Database Syst Rev. 2013. Update in: Cochrane Database Syst Rev. 2015 Apr 15;(4):CD006489. doi: 10.1002/14651858.CD006489.pub4. PMID: 24302466 Updated. Review.
Cited by
-
The Impact of Exercise on Interleukin-6 to Counteract Immunosenescence: Methodological Quality and Overview of Systematic Reviews.Healthcare (Basel). 2024 May 7;12(10):954. doi: 10.3390/healthcare12100954. Healthcare (Basel). 2024. PMID: 38786366 Free PMC article. Review.
-
Effectiveness of Yoga in Modulating Markers of Immunity and Inflammation: A Systematic Review and Meta-Analysis.Cureus. 2024 Apr 3;16(4):e57541. doi: 10.7759/cureus.57541. eCollection 2024 Apr. Cureus. 2024. PMID: 38707001 Free PMC article. Review.
-
Transcriptomics and metabonomics study on the effect of exercise combined with curcumin supplementation on breast cancer in mice.Heliyon. 2024 Mar 29;10(7):e28807. doi: 10.1016/j.heliyon.2024.e28807. eCollection 2024 Apr 15. Heliyon. 2024. PMID: 38576560 Free PMC article.
-
Combined aerobic and strength exercise training on biological ageing in Singaporean breast cancer patients: protocol for the Breast Cancer Exercise Intervention (BREXINT) Pilot Study.Geroscience. 2024 Mar 28. doi: 10.1007/s11357-024-01145-9. Online ahead of print. Geroscience. 2024. PMID: 38546907
-
Effect of physical exercise on immune, inflammatory, cardiometabolic biomarkers, and fatty acids of breast cancer survivors: results from the MAMA_MOVE Gaia After Treatment trial.Support Care Cancer. 2024 Feb 21;32(3):174. doi: 10.1007/s00520-024-08365-x. Support Care Cancer. 2024. PMID: 38378875
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous