Following the decline in Physical Activity (PA) due to COVID-19 restrictions in the form of government mandated lockdowns and closures of public spaces, the modulatory effect of physical exercise on immunity is being heavily revisited. In an attempt to comprehend the wide discrepancy in patient response to COVID-19 and the factors that potentially modulate it, we summarize the findings relating PA to inflammation and immunity. A distinction is drawn between moderate intensity and high intensity physical exercise based on the high lactate production observed in the latter. We hypothesize that, the lactate production associated with high intensity anaerobic exercise is implicated in the modulation of several components of the innate and adaptive immunity. In this review, we also summarize these immunomodulatory effects of lactate. These include increasing serum IL-6 levels, the main mediator of cytokine storms, as well as affecting NK cells, Macrophages, Dendritic cells and cytotoxic T-lymphocytes. The implications of high lactate levels in athletic performance are highlighted where athletes should undergo endurance training to increase VO2 max and minimize lactate production. Tumor models of hypoxia were also reported where lactate levels are elevated leading to increased invasiveness and angiogenesis. Accordingly, the novel lactate blocking strategy employed in cancer treatment is evaluated for its potential benefit in COVID-19 in addition to the readily available beta-blockers as an antagonist to lactate. Finally, we suggest the diagnostic/prognostic purpose of the elevated lactate levels that can be determined through sweat lactate testing. It is the detrimental effect of lactate on immunity and its presence in sweat that qualify it to be used as a potential non-invasive marker of poor COVID-19 outcome.
About The Expert
Antoine Fakhry AbdelMassih
Rahma Menshawey
Rafeef Hozaien
Aya Kamel
Fady Mishriky
Reem J Husseiny
Aia Mohamed Hanoura
Elaria Yacoub
Nada AlShehry
Esraa Menshawey
Nadine El-Husseiny
Reem Yasser
Mariem Arsanyous
Lauren Nathan
Mahmoud Seyam
Doaa Massoud
Nada Ali
Assem Kassim
Mostafa AmanAllah
Rokaya Elsayed
Hesham Sheashaa
Yousef Husseiny
Nourhan Hatem Hassan
Kirollos Badr
Amr Elkhateb
Verina Fouad
Mayada Elfishawy
Omar Medhat
Mai Mustafa
Noha Khalil
Rawan Elsayed
Youssef Nada
Passant Elshawarbi
Noha Abdelmoneim
Nada Gamal
Mariam Messiha
Marihan Ghazy
Emmy Abdelfatah
Febronia Nasry
Ramy Gayed
Marian Eesa
Merna Luis
Estfana Eskandar
Shenoda Yacoub
Alaa Saud
Maram Rajab
Mariam Abdelaziz
Nadine Elgamal
Hutaf Jaber
Sara Tayssir
Mark Michael
Ahmed Sabry
Joseph Shehata
Rania Abdelaziz
Sherry Rateb
Ahmed El-Maghraby
Yara Mahjoub
Alaa Amr
Amin Mabrouk
Peter Kelada
Shahd Ragab
Basant Eltaher
Rahma Hassan Galal
Omnya Mahmoud Aly
Taquwa Aly
Rana AbdelHaleem
Areeg ElShaarawy
Omnia Mohamed
References
PubMed
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