In a small pilot trial, exercise training changed extracellular-vesicle RNA responses during exertion rather than at rest.
Evidence
This single-center clinical trial sequenced serum EV long RNA from 14 adults before and after a 10-week aerobic exercise program, finding no virus-related RNAs and 53 only at post-training peak exercise versus rest.
Caveat
The study was small, single-center, and biomarker-focused, so it cannot prove that EV RNA changes caused symptom improvement or recovery.
Simplified
The Persistence of SARS-CoV-2 in tissues has been proposed as a driver of prolonged symptoms in . Pulmonary rehabilitation with exercise training is a well-established intervention for improving symptoms, functional capacity, and inflammation in chronic cardiorespiratory diseases. To investigate whether long COVID is associated with persistent viral or immune-related signals, we analyzed the long RNA profile of circulating (EVs) to determine the presence of virus-related transcripts and assess changes in response to exercise training. Fourteen adults with long COVID participated in this single-center pilot clinical trial and completed a 10-week aerobic exercise training program (twenty 1.5 h sessions). Serum-derived EV RNA profiles were analyzed via sequencing at rest (T0) and peak cardiopulmonary exercise testing (T1), before (V2) and after (V24) exercise training. (DEGs) were identified (q < 0.05), and pathway activation analysis was performed. Serum EVs carried diverse RNA species, including protein-coding RNAs, long non-coding RNAs, short non-coding RNAs, and pseudogenes, with no virus-related RNAs detected. No significant DEGs were identified at rest between pre- and post-training, nor in response to acute exercise at pre-training. However, following training, 53 DEGs were found at peak exercise (V24T1) compared to rest (V24T0), including three upregulated genes (ANK3, FTO, FCN1) and 50 downregulated genes (TOP 5: MYL9, NRGN, H2AC6, MAP3K7CL, B2M). These genes were primarily involved in inflammation and metabolism. Pathway analysis revealed significant regulation of 100 pathways at post-training compared to pre training, predominantly inactivated, including pathways involved in inflammation (STAT3 signaling) and metabolism (O-linked glycosylation). Acute exercise and exercise training modulated EV-associated gene expression in long COVID, primarily through transcriptional downregulation. Suppression of inflammation- and immune-related genes post-training highlights potential molecular mechanisms underlying symptom improvement and identifies candidate biomarkers of recovery biology in long COVID. Importantly, while exercise training did not substantially alter EV RNA content at rest, it enhanced the body's ability to mount a dynamic EV-mediated molecular response during exertion, reflecting improved physiological adaptability.Clinical trial registration number: NCT05398692.
Key numbers
53
Identified
found at after training.
100
Pathways Regulated
Significant pathway regulation observed after training.
14 of 21
Participants Completing Training
Number of participants who completed all exercise trials.
Full Text
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Long Covid