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Updated: May 23, 2026

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans
Published on: October 17, 2018
The immunology of exercise: Mechanisms, mediators, and therapeutic opportunities
Catherine M Phelps1, Marlies Meisel2
1Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Graduate Program of Microbiology and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Abstract:
Exercise prevents disease and promotes health, yet the cellular and molecular drivers of these benefits remain incompletely resolved. A principal mechanism is immune modulation. This review synthesizes recent evidence from healthy individuals and disease contexts, focusing on cancer and autoimmunity, detailing how acute bouts and consistent training reshape the mobilization, fate, and function of innate and adaptive immune cells. We also delineate how exercise reprograms non-immune tissues, including skeletal muscle, adipose tissue, vasculature, and the gut microbiota, to shape immunity via exercise-induced signaling factors ("exerkines")-including cytokines, metabolites, catecholamines, and microbiota-derived products-that, together with hemodynamic cues, rewire leukocyte trafficking, phenotype, and effector activity. Recognizing exercise as a potent, context-dependent immunomodulator, we argue that deeper mechanistic insight will enable dosable, immune-informed exercise prescriptions and the development of exerkine-based therapeutics for patients unable to train.
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