Inflammatory and Adipose Response in Solid Organ Transplant Recipients After a Marathon Cycling Race.
BACKGROUND
Organ transplant recipients frequently have chronic inflammation, with a weighty impact on cardiovascular risk. These patients can benefit from exercise, although the role of intense training is unclear. We evaluated the effect of a 130-km cycling race on inflammatory cytokines and adiponectin levels in transplant recipients.


METHODS
Circulating interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and adiponectin were assayed in 35 healthy subjects vs 19 transplant recipients (10 kidney, 8 liver, 1 heart), matched for sex, age, body mass index, and preparation workout. The determinations were performed before the race, at the end, and after 18 to 24 hours. Baseline values of 32 sedentary transplant recipients also were evaluated to explore the possible chronic impact of lifestyle.


RESULTS
All cyclists had 6- to 8-fold increased IL-6 levels after the race that decreased, without returning to baseline, the day after. Conversely, serum TNF-α and IFN-γ showed a progressive increase starting during physical performance and enduring for the next 18 to 24 hours in healthy subjects, whereas they were unchanged over time in cyclists with transplants. In transplant recipients who did not perform exercise, all of the analytes were significantly higher in comparison to basal levels of physically active subjects.


CONCLUSIONS
Our data suggest that clinically stable and properly trained transplant recipients can safely perform and progressively benefit from exercise, even at a competitive level. The changes in inflammation parameters were temporary and parallel with those of the healthy subjects. The comparison with sedentary transplant recipients revealed an overall amelioration of inflammatory indexes as a possible effect of regular physical activity on systemic inflammation.
Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy.
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Cappuccilli
Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
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Mosconi
Isokinetic Medical Group, Bologna, Italy.
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Roi
Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
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De Fabritiis
Emilia Romagna Transplant Reference Centre (CRT-ER), ANED Sport, S. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
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Totti
Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
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Merni
Italian National Transplant Centre, Rome, Italy.
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Trerotola
Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy.
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Marchetti
Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy.
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La Manna
Italian National Transplant Centre, Rome, Italy. Electronic address: daniela.storani@iss.it.
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Nanni Costa
D052242:Adiponectin / Q000097:blood; D000328:Adult; D001642:Bicycling / Q000502:physiology*; D002318:Cardiovascular Diseases; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D015444:Exercise / Q000502:physiology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007249:Inflammation / Q000097:blood; D007371:Interferon-gamma / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007558:Italy; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057185:Sedentary Behavior; D066027:Transplant Recipients; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
C499918:ADIPOQ protein, human; D052242:Adiponectin; D016207:Cytokines; C508600:IL6 protein, human; D015850:Interleukin-6; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma