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The effects of exercise on complement system proteins in humans: a systematic scoping review

Rothschild-Rodriguez, Daniela; Causer, Adam J.; Brown, Frankie F.; Collier-Bain, Harrison D.; Moore, Sally; Murray, James; Turner, James E.; Campbell, John P.


Daniela Rothschild-Rodriguez

Adam J. Causer

Frankie F. Brown

Harrison D. Collier-Bain

Sally Moore

James Murray

James E. Turner

John P. Campbell


Background: The complement system is comprised of the classical , lectin and alternative pathways that result in the formation of: pro-inflammatory anaphylatoxins; opsonins that label cells for phagocytic removal; and, a membrane attack complex that directly lyses target cells. Complement-dependent cy-totoxicity (CDC)-cell lysis triggered by complement protein C1q binding to the Fc region of antibodies bound to target cells-is another effector function of complement and a key mechanism-of-action of several monoclonal antibody therapies. At present, it is not well established how exercise affects complement system proteins in humans. Methods: A systematic search was conducted to identify studies that included original data and investigated the association between soluble complement proteins in the blood of healthy humans, and: 1) an acute bout of exercise; 2) exercise training interventions; or, 3) measurements of habitual physical activity and fitness. Results: 77 studies were eligible for inclusion in this review, which included a total of 10,236 participants, and 40 complement proteins and constituent fragments. Higher levels of exercise training and cardiorespiratory fitness were commonly associated with reduced C3 in blood. Additionally, muscle strength was negatively associated with C1q. Elevated C3a-des-Arg, C4a-des-Arg and C5a, lower C1-inhibitor, and unchanged C3 and C4 were reported immediately post-laboratory based exercise, compared to baseline. Whereas, ultra-endurance running and resistance training increased markers of the alternative (fac-tor B and H), classical (C1s), and leptin (mannose binding lectin) pathways, as well as C3 and C6 family proteins, up to 72-h following exercise. Heterogeneity among studies may be due to discrepancies in blood sampling/handling procedures, analytical techniques, exercise interventions/measurements and fitness of included populations. Conclusions: Increased anaphylatoxins were observed immediately following an acute bout of exercise in a laboratory setting, whereas field-based exercise interventions of a longer duration (e.g. ultra-endurance running) or designed to elicit muscle damage (e.g. resistance training) increased complement proteins for up to 72-h. C3 in blood was mostly reduced by exercise training and associated with increased cardiorespiratory fitness, whereas C1q

Journal Article Type Review
Online Publication Date Dec 31, 2022
Publication Date 2022
Deposit Date Jan 12, 2023
Journal Exercise Immunology Review
Electronic ISSN 1077-5552
Peer Reviewed Peer Reviewed
Volume 28
Pages 58-92
Keywords Anaphylatoxins, Monoclonal Antibodies, Complement C1q, Complement System Proteins, Exercise, Humans
Publisher URL