Effects of aerobic training on innate and acquired immunity: a randomized and controlled trial

Abstract

Introduction: Asthma is a chronic inflammatory disease of the airways with different clinical phenotypes. Considering the effect of chronic airway inflammation and airflow obstruction triggered by asthma, strong evidence has pointed to the crucial role of the NLRP3 inflammasome in the pathophysiology of the disease. Regular physical exercise provides numerous benefits to these patients. However, little is known about the role of the inflammasome in the immune response in asthmatic individuals undergoing aerobic training. Objectives: The aims of the present study are: i) to evaluate the effect of aerobic training on the expression of inflammasome markers in patients with asthma; ii) to evaluate the activation of the NLRP3 inflammasome by caspase-1 in monocytes from patients with asthma; iii) to evaluate the expression of inflammasome components (NLRP1, NLRP3, NLRC4, AIM2, pro-IL-1² and pro-IL-18) in peripheral blood mononuclear cells, by RT qPCR; iv) determine the serum levels in cell culture supernatants of the markers IL-1², IL-1RA, IL-18, and IL-18 by the ELISA technique. Methods: This is a two-arm randomized clinical trial with blinded evaluation. The sample will be composed of 40 adult patients with asthma who are physically inactive and with uncontrolled asthma. Eligible patients will be randomized to aerobic training (GTA) or breathing exercises (control group). Aerobic training will be performed on a treadmill for 12 weeks (2xweek; 45 min/session) and the intensity will be monitored by the maximum heart rate established in a cardiopulmonary exercise test. The level of plasma inflammatory mediators will be assessed before and after the intervention in patients with asthma. Patients in both groups will undergo a 24-session breathing exercise program. Pre- and post-intervention assessments will include clinical asthma control (CAQ). The sample number was calculated in 40 patients. Time and group interactions will be evaluated using two-way repeated measures analysis of variance. The 2-way analysis of variance test (Two-way ANOVA) will be used to compare the groups and the significance level will be adjusted to 5% (p<0.05).