Influence of acute moderate- to high-intensity aerobic exercise on markers of immune function and microparticles in renal transplant recipients.

Patrick J Highton,Alice C Smith,Nicolette C Bishop,Thomas J Wilkinson,Alice E M White,Daniel G D Nixon,Jill Neale,Naomi Martin

doi:10.1152/ajprenal.00332.2019

Abstract

Renal transplant recipients (RTRs) and patients with nondialysis chronic kidney disease display elevated circulating microparticle (MP) counts, while RTRs display immunosuppression-induced infection susceptibility. The impact of aerobic exercise on circulating immune cells and MPs is unknown in RTRs. Fifteen RTRs [age: 52.8 ± 14.5 yr, estimated glomerular filtration rate (eGFR): 51.7 ± 19.8 mL·min-1·1.73 m-2 (mean ± SD)] and 16 patients with nondialysis chronic kidney disease (age: 54.8 ± 16.3 yr, eGFR: 61.9 ± 21.0 mL·min-1·1.73 m-2, acting as a uremic control group), and 16 healthy control participants (age: 52.2 ± 16.2 yr, eGFR: 85.6 ± 6.1 mL·min-1·1.73 m-2) completed 20 min of walking at 60-70% peak O2 consumption. Venous blood samples were taken preexercise, postexercise, and 1 h postexercise. Leukocytes and MPs were assessed using flow cytometry. Exercise increased classical (P = 0.001) and nonclassical (P = 0.002) monocyte subset proportions but decreased the intermediate subset (P < 0.001) in all groups. Exercise also decreased the percentage of platelet-derived MPs that expressed tissue factor in all groups (P = 0.01), although no other exercise-dependent effects were observed. The exercise-induced reduction in intermediate monocyte percentage suggests an anti-inflammatory effect, although this requires further investigation. The reduction in the percentage of tissue factor-positive platelet-derived MPs suggests reduced prothrombotic potential, although further functional assays are required. Exercise did not cause aberrant immune cell activation, suggesting its safety from an immunological standpoint (ISRCTN38935454).

Highlights

Renal transplant recipients (RTRs) display an elevated cardiovascular disease (CVD) risk, attributed to both traditional and nontraditional risk factors [7, 24]
Fifteen RTRs, sixteen patients with nondialysis chronic kidney disease (ND-CKD), and sixteen healthy control (HC) participated in the study (Table 1)
Platelet count was lower in RTRs than HCs and patients with ND-CKD (P Յ 0.001), resulting in a value below the platelet reference range (RTRs: 55.18 ϫ 109 platelets/L, reference range: 150 – 450 ϫ 109 platelets/L) [38]

Summary

Introduction

Renal transplant recipients (RTRs) display an elevated cardiovascular disease (CVD) risk, attributed to both traditional (e.g., hypertension and dyslipidemia) and nontraditional (e.g., chronic systemic inflammation) risk factors [7, 24]. More, RTRs display immunosuppression-induced infection susceptibility [2]. While patients with ND-CKD display impaired leukocyte function and altered subset distribution [43], immune function is further worsened in RTRs by immunosuppressive medication that inhibits T lymphocyte proliferation and function [18]. In RTRs, a fine balance must be struck concerning immunosuppression (undersuppression increases allograft rejection risk, whereas oversuppression increases infection susceptibility and malignancy risk), and so immune function must be closely monitored

Methods

Results

Conclusion