Scientific Programme
Sports and Exercise Medicine and Health
IS-MH09 - Future directions in exercise immunology: overcoming conceptual and methodological barriers to prevent and manage respiratory infections in athletes
Date: 09.07.2026, Time: 17:00 - 18:15, Session Room: SG 1138 (EPFL)
Description
Exercise immunology research has over the last >40 years provided insight into how factors relating to athletes’ training, competition and lifestyle can affect their immune status and risk of illness, with a particular focus on upper respiratory infection risk. However, despite decades of research, the field is still grappling with methodological constraints and questions of biomarker interpretation and real-world applicability. By integrating clinical perspectives, methodological innovation, and nutritional and sex-specific considerations, this session aims to address some of the barriers to high-quality research in exercise immunology, and highlight the need for continued research efforts to inform evidence-based application of immunology in sport science.
Chair(s)
Helen Hanstock
Mid Sweden University, Swedish Winter Sports Research Centre
Sweden
Speaker A
Helen Hanstock
Mid Sweden University, Swedish Winter Sports Research Centre
Sweden
Read CVECSS Lausanne 2026: IS-MH09 [30720]
Are immune responses to exercise associated with respiratory infection risk?
Upper respiratory infections are the leading health concern at major sporting events. Exercise immunology has contributed substantially to understanding how training, competition and lifestyle factors influence immune function and illness risk in athletes, but methodological and conceptual issues persist. This presentation aims to critically examine both historical and contemporary evidence regarding the exercise and lifestyle factors that affect infection risk in athletes, and emphasise underexplored variables. Particular attention will be given to emerging data indicating that endocrine fluctations across the menstrual cycle may modulate immune responses and infection outcomes, and on the role of psychological stress in the immune response to exercise. Finally, the need to develop systems-wide and integrative models of immune responses to exercise will be discussed.
Speaker B
Glen Davison
University of Kent, School of Sport & Exercise Sciences
United Kingdom
Read CVECSS Lausanne 2026: IS-MH09 [13652]
Nutritional countermeasures to URTI: clinically relevant outcomes for robust evidence.
Nutritional strategies are frequently proposed as practical countermeasures for athletes to maintain immunity and reduce URTI risk. Research evidence in this area is often inconsistent. Some of this is due to over-interpretation of single biomarkers that do not necessarily align with clinical outcomes, and some is due to research focusing on the wrong mechanistic pathways for certain nutrients or substances. Traditional research relied heavily on ex vivo immune markers, which lack clinical relevance and overlook immune redundancy and robustness. It is therefore unsurprising that interventions affecting only these often fail to reflect URTI risk. Importantly, certain mechanisms by which nutritional practices influence infection risk may operate independently of immune system modulation (e.g. via direct antipathogenic effects, such as inhibiting viral attachment or replication - polyphenols being one such example). These non-immune pathways offer alternative mechanisms for reducing infection severity and duration, which has implications for interpreting immunity and URTI studies, especially when clinically relevant outcomes are not assessed and surrogate markers are used instead. More recently, evidence has emphasised the importance of in vivo immune markers and clinical outcomes to assess infection risk, and the role of interventions to mitigate this. Logically, certain combinations of exercise and sub-optimal nutrition will interact to reduce host defence and increase URTI risk. However, many previous studies in exercise and nutritional immunology lacked measures that truly reflect host defence. As such, much of the existing evidence base for consensuses in this field lacks valid “real-world” application. For nutritional interventions (including supplements), it is important to ensure evidence is robust. This includes confirming that deficiencies have been ruled out, studies are adequately powered, and clinically relevant endpoints are used. When isolated markers are used, there should be strong evidence linking them to URTI risk, with consideration of what constitutes clinically relevant changes. For future research, we recommend prioritising clinically relevant endpoints (e.g. validated URTI logs; pathogen screening); using in vivo markers representing the integrated immune response; ensuring studies are adequately powered and implementing stringent study controls.
Speaker C
Maarit Valtonen
Finnish Institute of High Performance Sport, KIHU
Finland
Read CVECSS Lausanne 2026: IS-MH09 [41467]
Application of point of care testing to assess respiratory infections in elite sport
Acute respiratory infections are the most common acute illnesses in elite athletes. Sports medicine clinicians must often determine whether respiratory symptoms are caused by infection, require antimicrobial treatment, or affect sport participation. Molecular respiratory point-of-care testing (ResPOCT) now allows rapid detection (within an hour) of viral and bacterial pathogens, offering a more accurate diagnosis outside laboratory settings. Studies in elite sport, including Olympic and World Championship teams, have shown that ResPOCT helps confirm infections, guide treatment (e.g. antivirals), reduce unnecessary antibiotics, and prevent outbreaks. However, questions remain about its cost-effectiveness, influence on isolation or return-to-play decisions, and overall impact on clinical outcomes. In this presentation we introduce the recent evidence how the use of ResPOCT has the potential to improve antibiotic stewardship, prevent nosocomial infection and enhance risk stratification.