***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The effect of 8 wk of progressive bicycle training on the immune system was evaluated in a controlled study on 18 patients with rheumatoid arthritis and moderate disease activity .  Maximal O2 uptake increased significantly , whereas heart rate at stage 2 and rate of perceived exertion decreased significantly , in the training group compared with the controls . Resting levels of a number of immune parameters were measured before and after 4 and 8 wk of training . Training did not induce changes in blood mononuclear cell sub population s , proliferative response , or natural killer cell activity . Furthermore the plasma concentrations of interleukin-1 alpha , interleukin-1 beta , and interleukin-6 did not change in response to training . It is concluded that 8 wk of bicycle training does not influence the immune system of patients with rheumatoid arthritis Regular exercise reduces functional loss associated with multiple sclerosis ( MS ) . However , the impact of exercise on inflammatory mediators associated with disease activity remains relatively unexplored . The purpose of this study was to determine whether ambulatory MS subjects would respond similarly to aerobic cycle training compared with matched controls on circulating immune variables , interleukin (IL)-6 , tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma .  Eleven MS and 11 non-MS control subjects ( 8 women and 3 men in both groups ) matched in age , height , body mass , body fat , and peak O(2 ) uptake completed the study . Subjects completed 30 min of cycle ergometry at 60 % of peak O(2 ) uptake , 3 day/wk for 8 wk . Plasma cytokine concentrations were determined before and after exercise at weeks 0 , 4 , and 8 . MS and control subjects showed a similar cytokine responses to exercise .  IL-6 at rest tended to decrease ( P = 0.08 ) with training in both groups . Resting plasma TNF-alpha tended to be higher in MS compared with controls throughout the study ( P = 0.08 ) . MS subjects showed elevated resting TNF-alpha in MS at the end of the 8-wk program ( P = 0.04 ) , whereas resting TNF-alpha remained unchanged in controls ( P > 0.05 ) . Resting plasma IFN-gamma at rest was elevated in MS subjects ( P = 0.008 ) and unchanged in controls at the end of the intervention ( P > 0.05 ) . The response of plasma IL-6 , TNF-alpha , and IFN-gamma after a single bout of exercise was similar between MS and control subjects ( P > 0.05 ) . Additional research to underst and the impact of exercise on immune variables in MS is warranted BACKGROUND Despite recent advances in pharmacologic and device therapy , morbidity and mortality from heart failure ( HF ) remain high . Yoga combines physical and breathing exercises that may benefit patients with HF . We hypothesized that an 8-week regimen of yoga in addition to st and ard medical therapy would improve exercise capacity , inflammatory markers , and quality of life ( QoL ) in patients with HF . METHODS AND RESULTS New York Heart Association Class I-III HF patients were r and omized to yoga treatment ( YT ) or st and ard medical therapy ( MT ) .  Measurements included a grade d exercise test ( GXT ) to V O(2Peak ) and the following serum biomarkers : interleukin-6 ( IL-6 ) , high-sensitivity C-reactive protein ( hsCRP ) , and extracellular superoxide dismutase ( EC-SOD ) . The Minnesota Living with Heart Failure Question naire ( MLHFQ ) was administered to assess changes in QoL. A total of 19 patients were enrolled after the initial screening . Of the 19 patients , 9 were r and omized to YT and 10 to MT . Patients had a mean EF of 25 % .  GXT time and V O(2Peak ) were significantly improved in the YT versus MT groups ( + 18 % in the YT and -7.5 % in MT ; P = .03 vs. control and + 17 in YT and -7.1 in MT ; P = .02 , respectively ) . There were statistically significant reductions in serum levels of IL-6 and hsCRP and an increase in EC-SOD in the YT group ( all P < .005 vs. MT ) . MLHFQ scores improved by 25.7 % in the YT group and by 2.9 % in the MT group . CONCLUSIONS Yoga improved exercise tolerance and positively affected levels of inflammatory markers in patients with HF , and there was also a trend toward improvements in BACKGROUND A proinflammatory state is recognized in chronic heart failure and the degree of immune activation corresponds to disease severity and prognosis . Training is known to improve symptoms in heart failure but less is known about the effects of specific forms of training on the proinflammatory state . METHODS Forty-six patients with stable chronic heart failure underwent a home-based program of exercise training for 30 minutes a day , 5 days per week over a 6-week period . Twenty-four used a bicycle ergometer and 22 used an electrical muscle stimulator applied to quadriceps and gastrocnemius muscles .  Tumour necrosis factor-alpha ( TNF-alpha ) , TNF-alpha soluble receptors 1 and 2 , interleukin 6 , and C-reactive protein were measured before and after the training period . RESULTS Significant improvements in markers of exercise performance were seen in both training groups . Soluble TNF-alpha receptor 2 levels decreased after training in the bike group only ( 2900 + /- 1069 pg/mL to 2625 + /- 821 pg/mL , P = .013 ) . Trends towards a decrease in levels of TNF-alpha and soluble receptor 1 were also seen in the bike group only . No change in circulating inflammatory markers was observed after stimulator training . CONCLUSIONS Physical training improves exercise capacity for patients with chronic heart failure but degree of attenuation of the proinflammatory response may depend on the mode of training despite similar improvements in exercise capacity McArdle disease is caused by inherited deficit of human muscle glycogen phosphorylase with subsequent blockade in muscle glycogenolysis . Patients usually experience severe exercise intolerance and ' chronic ' skeletal muscle damage . We determined circulating levels of 27 cytokines in a group of 31 adult McArdle patients ( 15 male 16 female ; mean ( + /-S.E.M. ) age : 39+/-3 years ) and 29 healthy sedentary controls ( 14 male , 15 female ) before and after an acute exercise bout involving no muscle damage ( cycling ) . Patients had an ongoing state of muscle breakdown even when following a sedentary lifestyle ( serum creatine kinase activity at baseline of 2590+/-461 Ul(-1 ) vs. 97+/-5 Ul(-1 ) in controls ) . Under resting conditions , neutrophil count ( + 20 % ) and circulating levels of several cytokines were significantly higher ( P < or=0.05 ) in patients than in controls : tumor necrosis factor ( TNF-alpha ) , interleukin (IL)-1ra , IL-10 , IL-12 and IL-17 . The myokine IL-6 significantly increased with exercise ( P<0.05 ) in both groups . Our results suggest that McArdle disease is associated with low-level systemic inflammation whereas appropriate exercise induces a similar response in McArdle patients and healthy controls , with a significant increase in the anti-inflammatory myokine IL-6 . Our results support the rationale for prescribing carefully supervised exercise training in these patients The proinflammatory cytokine interleukin-6 ( IL-6 ) may modulate the onset and progression of complications of diabetes . As this cytokine increases after exercise , and many other exercise responses are altered by prior glycemic fluctuations , we hypothesized that prior hyperglycemia might exacerbate the IL-6 response to exercise . Twenty children with type 1 diabetes ( 12 boys/8 girls , age 12 - 15 yr ) performed 29 exercise studies ( 30-min intermittent cycling at approximately 80 % peak O2 uptake ) . Children were divided into four groups based on highest morning glycemic reading [ blood glucose ( BG ) < 150 , BG 151 - 200 , BG 201 - 300 , or BG > 300 mg/dl ] . All exercise studies were performed in the late morning , after hyperglycemia had been corrected and steady-state conditions ( plasma glucose < 120 mg/dl , basal insulin infusion ) had been maintained for > or = 90 min . Blood sample s for IL-6 , growth factors , and counterregulatory hormones were drawn at pre- , end- , and 30 min postexercise time points . At all time points , circulating IL-6 was lowest in BG < 150 and progressively higher in the other three groups . The  exercise-induced increment also followed a similar dose-response pattern ( BG < 150 , 0.6 + /- 0.2 ng/ml ; BG 151 - 200 , 1.2 + /- 0.8 ng/ml ; BG 201 - 300 , 2.1 + /- 1.1 ng/ml ; BG > 300 , 3.2 + /- 1.4 ng/ml ) . Other measured variables ( growth hormone , IGF-I , glucagon , epinephrine , cortisol ) were not influenced by prior hyperglycemia . Recent prior hyperglycemia markedly influenced baseline and exercise-induced  levels of IL-6 in a group of peripubertal children with type 1 diabetes . While exercise is widely encouraged and indeed often considered part of diabetic management , our data underscore the necessity to completely underst and all adaptive mechanisms associated with physical activity , particularly in the context of the developing diabetic child Recent studies demonstrate an unexpected reduction in circulating levels of IGF-I after 5 wk of endurance-type exercise training in adolescent boys and girls and prepubertal girls . We hypothesized that the reduction in IGF-I would be accompanied by a training-associated stimulation of proinflammatory cytokines IL-1β , IL-6 , or tumor necrosis factor-α ( TNF-α ) , each of which can inhibit the GH→IGF-I axis . Healthy boys ( age range 9–11 y old , mean Tanner 1.7 ) volunteered for the study and were r and omized to control ( n = 14 ) and training groups ( n = 12 ) for 5 wk . After the intervention , significant increase in fitness was observed in the training group but not control group . Although IGF-I was correlated at baseline to peak oxygen consumption in all subjects , there was a significant decrease in IGF-I and IGF binding protein-3 in the training subjects ( −12.8 ± 7.3 % and −17.5 ± 7 % , respectively , p < 0.05 ) . In contrast , IGF binding protein-2 , known to inhibit anabolic effects of IGF-I , increased in the training subjects ( 27.8 ± 11 % , p < 0.02 ) as did IL-1β and TNF-α ( 51.5 ± 30.22 % , p < 0.02 , and 44.5 ± 23.2 % , p < 0.02 , respectively ) . Finally , we also found that GHBP was inversely correlated with fitness , suggesting altered GH function in more-sedentary boys . Thus , these data support the hypothesis that a sustained increase in physical activity can stimulate proinflammatory cytokines , which may contribute to suppression of the GH→IGF-I axis . Physical activity can influence growth and development through its influence on anabolic and catabolic mediators OBJECTIVES The aim of this study was to assess the effects of regular physical exercise on local inflammatory parameters in the skeletal muscle of patients with chronic heart failure ( CHF ) . BACKGROUND Inflammatory activation with increased serum cytokine levels and expression of inducible nitric oxide synthase ( iNOS ) in the myocardium and peripheral skeletal muscles has been described in CHF . METHODS Twenty male patients with stable CHF ( left ventricular ejection fraction 25 + /- 2 % ; age 54 + /- 2 years ) were r and omized to a training group ( n = 10 ) or a control group ( n = 10 ) . At baseline and after six months , serum sample s and vastus lateralis muscle biopsies were obtained . Serum tumor necrosis factor (TNF)-alpha , interleukin (IL)-6 , and IL-1-beta levels were measured by enzyme-linked immunosorbent assay , local cytokine , and iNOS expression by real-time polymerase chain reaction . RESULTS Exercise training improved peak oxygen uptake by 29 % in the training group ( from 20.3 + /- 1.0 to 26.1 + /- 1.5 ml/kg . min ; p < 0.001 vs. control group ) . While serum levels of TNF-alpha , IL-6 , and IL-1-beta remained unaffected by training , local skeletal muscle TNF-alpha decreased from 1.9 + /- 0.4 to 1.2 + /- 0.3 relative U ( p < 0.05 for change vs. control group ) , IL-6 from 71.3 + /- 16.5 to 41.3 + /- 8.8 relative U ( p < 0.05 vs 
    Output:
    
Single bouts of exercise might elicit an aggravated inflammatory response in patients ; this was reported for patients with type I diabetes mellitus , cystic fibrosis and chronic obstructive pulmonary disease .
More severely affected patients may experience a more aggravated inflammatory response .
Levels ofinflammatory markers , principally IL-6 but also T-cells , total leukocytes and lymphocytes , remained elevated longer into the recovery period following an acute bout of exercise in patients compared with healthy controls .
Evidence was found that chronic endurance exercise training programs can attenuate systemic inflammation in patients with chronic heart failure and type 2 diabetes mellitus .
CONCLUSIONS In patients with a chronic inflammatory disease , both acute and chronic exercise might elicit different inflammatory responses ( i.e. , exaggerated after acute exercise & attenuated after training ) compared to healthy matched controls .