ECSS Paris 2023: OP-MH23
INTRODUCTION: Physical exercise triggers a systemic immune response, influencing both innate and adaptive immunity. Natural killer (NK) cells and CD4+ T cells play crucial roles in immune surveillance and regulation, with aging and physical activity significantly influencing their distribution and function. NK cells are divided into cytotoxic (CD56dimCD16bright) and effector (CD56brightCD16dim) subpopulations, which contribute to immune homeostasis and defense mechanisms. Meanwhile, inhibitory receptors such as PD-1 (CD279) and TIGIT on CD4+ T cells are associated with immune exhaustion and regulatory functions. TIGIT is known to play a key role in immune regulation by inhibiting T cell activation and promoting immune tolerance. Aging is often accompanied by immune alterations, including shifts in NK cell composition and T cell inhibitory receptor expression. However, regular physical activity has been suggested to mitigate some of these immunological changes. Understanding how exercise influences these immune parameters may provide insights into potential protective mechanisms against age-related immune decline. This study examines the impact of lifelong exercise (LLE) on NK cell subpopulations and CD4+ T cell inhibitory receptor expression. We hypothesize that LLE is associated with an increased proportion of cytotoxic, and effector NK cells and altered expression of inhibitory receptors on CD4+ T cells. METHODS: Two groups, 17 master athletes (MA, aged 53±6.22 years) and 15 sedentary men (SG, aged 50.2±6.24 years) performed an incremental test until exhaustion on a cycle ergometer. Peripheral blood samples were collected before (Pre) and after the exercise protocol (Post). The blood samples were lysed with red blood cell lysing buffer, stained with anti-CD16 FITC, anti-CD56 PECy7, anti-CD4 PE, anti CD8 APCR700, anti CD279 BV605 anti-CD94 APC, anti-CD159c BV786 and read on a BD FACSLyric™ flow cytometer. Descriptive analysis was performed using GraphPad software. RESULTS: The percentages of total NK cells, NK CD56dimCD16bright cytotoxic subpopulation and NK CD56brightCD16dim effector cells subpopulations showed a higher average in MA compared SG. However, in subpopulation CD4+CD279+TIGIT cells were lower in MA when compared to SG. There was a trend for an increase in cytotoxic NK subpopulations for MA when compared to the sedentary controls, but this difference was not statistically significant. CONCLUSION: We found that MA exhibited higher percentages of total NK cells and of the cytotoxic CD56dimCD16brighNK subpopulation, suggesting enhanced immune surveillance and cytotoxic activity. However, the percentage of CD4+279+TIGIT was lower in MA compared to SG, which might indicate a lower exhaustion and regulatory T cell activity in MA. These findings support the notion that lifelong exercise may promote a more efficient immune profile, characterized by enhanced NK cell activity and lower proportion of exhausted CD4+ T cells.
Read CV Ana PedrosaECSS Paris 2023: OP-MH23
INTRODUCTION: Inspiratory muscle training (IMT) enhances inspiratory muscle strength (IMS) and can induce changes in other capacities, such as balance or functional mobility [1]. NW has shown improvements in older adults (OA) functionality [2] but its effect on IMS remains unknown. This study (GESMED-Marcha) aims to compare the effect of two different short interventions (8 weeks) combining NW+IMT on IMS and peripheral strength in a group of OA referred from Primary Care. NW program was equal, but IMT load were 15% (IMT15) or 50% (IMT50) of the S-Index (dynamic IMS: dIMS). METHODS: Seventy-one OA were randomly assigned to each group. 51 compressed the final sample: IMT15 [n=22; 68.30(4.03) y; 69.01(8.90) kg] and IMT50 [n=29; 67.32(4.34) y; 72.58(12.47) Kg]. Only NW was supervised (1hr, 3 days/week) while IMT was auto administrated (30 inspirations, twice daily, 7 days/week). Upper and lower limb strength (HG & STSSPPB) and dIMS were assessed PRE-POST intervention and 8-weeks after detraining (DET). After normality testing, a repeated measures ANOVA with the type of IMT load as intergroup factor, or Friedmann test, were applied, followed by Bonferroni or Wilcoxon post hoc tests. RESULTS: Regarding peripheral muscles, STSSPPB improved after training (STSSPPB: F=6.447, p=0.003, η²=0.157, observed power= 0.892) with no interaction effect (time*program). Indeed, only IMT15 improved significantly between PRE and DET (p=0.006). Conversely, HG showed no significant improvements. dIMS improved significantly (p<0.001): specifically, IMT15 PRE-POST p=0.001; POST-DET p=0.025; PRE-DET p<0.001 and IMT50 PRE-POST p<0.001; PRE-DET p<0.001. CONCLUSION: NW+IMT was successful to improve dIMS in IMT15, contradicting existing literature where the 15% load serves as a placebo [3]. The engagement of CORE muscles during NW may contribute to this improvement and alternatively may facilitate enough motor unit recruitment and coordination in the inspiratory muscles [4] in this population, facilitating further load progressions. However, STSSPPB only improved in IMT15 (PRE-DET), so the 50% load may add fatigue that limits its progress. Further research on IMT protocols is needed to clarify their benefits in non-pathological populations and its role and loads as a complementary training tool. REFERENCES 1. Sheraz, S., et al., (2023). Postgrad Med, 135(7), 690-700. 2. Bullo, V., et al., (2018).. Rejuvenation Res, 21(2), 141-161. 3. Bostanci, Ö., et al., (2019). Respiratory physiology & neurobiology, 264, 28-32. 4. Arend, M., Kivastik, J., & Mäestu, J. (2016). Respir Physiol Neurobiol, 230, 11-15.
Read CV Ainoa RoldanECSS Paris 2023: OP-MH23
INTRODUCTION: Among cardiovascular diseases, acute coronary syndrome (ACS) remains the leading cause of morbidity and mortality. Cardiac rehabilitation and secondary prevention programs make significant contributions to the continuum of care in patients, and physical activity has been recognized as core part of such interventions. However, despite the documented benefits, older patients diagnosed with acute coronary syndrome (ACS) are less likely to attend traditional center-based programs limiting the efficacy of the intervention. This situation has emphasized the importance of more comprehensive and sustainable intervention strategies. Thus, the aim of the study was to examine functional changes of older patients with ACS involved in a center- and home-based secondary prevention program after one year of intervention. METHODS: A subsample of 254 consecutive patients (mean age 75 years) with ACS extracted from the ITER registry (NCT05817305) was analyzed. The proposed intervention program consisted of 6 individual on-site sessions including functional evaluation along with continuous motivational reinforcement to reach exercise goals and stably maintain an active lifestyle. The home-based exercise prescription was based on the results of the validated 1km-Treadmill Walking Test. Functional variables were assessed during each visit. Main outcomes were changes in self-reported weekly physical activity, average walking speed (WS) registered during the test and estimated cardiorespiratory fitness (VO2peak). RESULTS: Physical activity levels significantly increased and were maintained during the follow-up period (median MET-h/week 3.0, 12.0, and 9.0 at baseline, 6-, and 12 months, respectively; p<0.0001). These results were associated with increasing mean WS (2.9, 3.9, 4.1 km/h, respectively, p<0.0001), and VO2peak (16.9, 20.0, 20.5 mL/kg/min, respectively, p<0.0001). CONCLUSION: The proposed intervention demonstrated a stable adherence to physically active lifestyle, along with improved walking capacity and estimated VO2peak in older patients with ACS. Results therefore highlight the importance of exercise testing and training in older patients and the effectiveness of the program. This may provide valuable insights for the development of more efficient and patient-centered exercise-based secondary prevention programs. • Brown TM, Pack QR, Aberegg E, et al. Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2024 Oct 29;150(18):e328-e347. • Chiaranda G, Myers J, Mazzoni G, et al. Peak oxygen uptake prediction from a moderate, perceptually regulated, 1-km treadmill walk in male cardiac patients. J Cardiopulm Rehabil Prev. 2012 Sep-Oct;32(5):262-9. • Raisi A, Zerbini V, Myers J, et al. A Novel Motivational Approach in the Management of Older Patients With Cardiovascular Disease. J Cardiopulm Rehabil Prev. 2023 Jul 1;43(4):309-3f
Read CV Andrea RaisiECSS Paris 2023: OP-MH23