Abstract
Over the last decades the cellular immune inflammation markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII = NLR × platelets) have emerged in clinical context as markers of disease-related inflammation and are now widely appreciated due to their integrative character. Transferring these clinically established inflammation markers into exercise physiology seems highly beneficial, especially due to the low temporal, financial and infrastructural resources needed for assessment and calculation. Therefore, the aim of this review is to summarize evidence on the value of the integrative inflammation markers NLR, PLR and SII for depiction of exercise-induced inflammation and highlight potential applications in exercise settings. Despite sparse evidence, multiple investigations revealed responsiveness of the markers to acute and chronic exercise, thereby opening promising avenues in the field of exercise physiology. In performance settings, they might help to infer information for exercise programming by reflecting exercise strain and recovery status or periods of overtraining and increased infection risk. In health settings, application involves the depiction of anti-inflammatory effects of chronic exercise in patients exhibiting chronic inflammation. Further research should, therefore, focus on establishing reference values for these integrative markers in athletes at rest, assess the kinetics and reliability in response to different exercise modalities and implement the markers into clinical exercise trials to depict anti-inflammatory effects of chronic exercise in different patient collectives.
Highlights
Acute inflammation is a physiological response of the human body to local tissue damage, aiming at restoring tissue integrity and tissue homeostasis in both physiological context such as exercise (Chazaud 2016) and pathological context such as disease (Eming et al 2017)
If inflammatory processes do not result in restoration of homeostasis, acute inflammation remains unresolved, resulting in chronic inflammation, a hallmark and central risk factor of various medical conditions (Nathan and Ding 2010)
Further research investigating the reliability of the cellular immune inflammation markers in response to different exercise modalities is, strongly warranted. Other methodological approaches such as flow cytometry offer a more precise insight into cellular alterations of the immune system in response to exercise, calculation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII is much more feasible and facilitates frequent assessment in practical exercise settings such as competitive sport or rehabilitation programs. Implementing these markers into routine assessments might enable athletes and coaches to infer information on individual recovery needs and help clinical practitioners monitor the anti-inflammatory effects of long-term exercise in patients with chronic inflammation
Summary
Acute inflammation is a physiological response of the human body to local tissue damage, aiming at restoring tissue integrity and tissue homeostasis in both physiological context such as exercise (Chazaud 2016) and pathological context such as disease (Eming et al 2017). Since the integrative value of the markers is exploited in clinical context to adapt therapeutic measures to the patient’s inflammatory status (Cai et al 2021), conclusions in exercise settings could be drawn in a similar manner, e.g. to custom exercise programs to the individual recovery needs Considering these potential benefits, we seek to introduce the clinically established cellular immune inflammation markers NLR, PLR and SII in the field of exercise physiology, thereby highlighting their potential value in depiction of exercise-induced inflammation. The SII seems to depict anti-inflammatory effects of chronic exercise in a similar manner as the NLR, as indicated by a decrease in baseline values after 3 weeks of high intensity interval training in persons suffering from multiple sclerosis (Joisten et al 2020). Old males and females with symp- Treadmill exercise according to Bruce protocol toms of CAD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
