Document Type : Letter to Editor

Author

Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba’i University, Tehran, Iran.

Abstract

Purpose: Winter endurance training combines high aerobic load with repeated cold exposure, which can alter immune-related cellular signaling and increase vulnerability to upper respiratory tract infections (URTI), thereby threatening training continuity and performance. This structured abstract aimed to summarize a signaling-based rationale for immune-informed winter periodization in endurance runners. Method: A narrative, mechanistic synthesis was developed from exercise immunology and cold-stress evidence, focusing on how cold exposure and endurance exercise converge on sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis activation, downstream endocrine responses (catecholamines, cortisol), immune cell trafficking, airway barrier function, mucosal immunity (salivary IgA), and cytokine signaling (with emphasis on IL-6). Practical implications were translated into microcycle/mesocycle design principles and a tiered monitoring framework. Results: Cold exposure triggers thermoregulatory vasoconstriction and central blood redistribution and is accompanied by neuroendocrine shifts that can modify leukocyte behavior, adhesion signaling, and lymphocyte proliferation. Evidence indicates that respiratory barrier defenses may be impaired in cold conditions, while mucosal immunity (e.g., IgA-related protection) can be reduced in heavily trained athletes during winter, coinciding with increased URTI reports. IL-6 responses to exercise in the cold were context-dependent: some protocols show minimal temperature effects at moderate intensity, whereas others report higher IL-6 at colder temperatures, supporting a multi-marker and longitudinal interpretation rather than reliance on single measurements. Conclusion: Integrating cellular signaling knowledge enables temperature-aware planning of intensity, structured warm-up/rewarming routines, monotony control, and symptom-gated adjustments to reduce “vulnerability windows” without sacrificing adaptation. Immune-informed winter periodization, supported by feasible monitoring (load, sleep, symptoms, and optional IgA/cytokines), may preserve training availability and mitigate winter performance decrement in endurance runners.

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Brenner IK, Castellani JW, Gabaree C, et al. Immune changes in humans during cold exposure: effects of prior heating and exercise. J Appl Physiol. 1999;87:699–710.
Brenner, I. K. M., Castellani, J. W., Gabaree, C., Young, A. J., Zamecnik, J., Shephard, R. J., & Shek, P. N. (1999). Immune changes in humans during cold exposure: Effects of prior heating and exercise. Journal of Applied Physiology, 87(2), 699–710. 
Gagnon, D. D., Rintamäki, H., Gagnon, S. S., Cheung, S. S., & Herzig, K.-H. (2014). The effects of cold exposure on leukocytes, hormones and cytokines during acute exercise in humans. PLOS ONE, 9(10), e110774. 
Gleeson, M. (2000). Mucosal immunity and respiratory illness in elite athletes. International Journal of Sports Medicine, 21(S1), S33– S43. 
Gleeson, M. (2007). Immune function in sport and exercise. Journal of Applied Physiology, 103(2), 693–699. 
Gleeson, M. (2016). Respiratory inflammation and infections in highperformance athletes: A clinical perspective. Immunology and Cell Biology, 94(2), 124–131. 
Hess KL, Wilson TE, Sauder CL, et al. Aging affects the cardiovascular responses to cold stress in humans. J Appl Physiol. 2009;107: 1076–1082.
Ikäheimo, T. M. (2018). Cardiovascular diseases, cold exposure and exercise. Temperature, 5(2), 123–146. 
LaVoy, E. C. P., McFarlin, B. K., & Simpson, R. J. (2011). Immune responses to exercising in a cold environment. Wilderness & Environmental Medicine, 22(4), 343–351. 
Muza SR, Young AJ, Sawka MN, et al. Respiratory and cardiovascular responses to cold stress following repeated cold water immersion. Undersea Biomed. Res. 1988;15:165–178
Muza, S. R., Young, A. J., Sawka, M. N., Bogart, J. E., & Pandolf, K. B. (1988). Respiratory and cardiovascular responses to cold stress following repeated cold water immersion. Undersea Biomedical Research, 15(3), 165–178. 
Mylona E, Fahlman MM, Morgan AL, et al. s-IgA response in females following a single bout of moderate intensity exercise in cold and thermoneutral environments. Int J Sports Med. 2002;23:453–456.
Mylona, E., Fahlman, M. M., Morgan, A. L., Boardley, D., & Tsivitse, S. K. (2002). s-IgA response in females following a single bout of moderate intensity exercise in cold and thermoneutral environments. International Journal of Sports Medicine, 23(6), 453–456. 
Nieman, D. C. (1994). Exercise, upper respiratory tract infection, and the immune system. International Journal of Sports Medicine, 15(S3), S131–S141. 
Patterson S, Reid S, Gray S, et al. The response of plasma interleukin6 and its soluble receptors to exercise in the cold in humans. J Sports Sci. 2008;26:927–933.
Patterson, S., Reid, S., Gray, S., & Nimmo, M. (2008). The response of plasma interleukin-6 and its soluble receptors to exercise in the cold in humans. Journal of Sports Sciences, 26(9), 927–933. 
Pedersen, B. K., & Febbraio, M. A. (2007). Beneficial health effects of exercise—The role of IL-6 as a myokine. Trends in Pharmacological Sciences, 29(6), 137–144. 
Pedersen, B. K., & Febbraio, M. A. (2008). Muscle as an endocrine organ: Focus on muscle-derived interleukin-6. Physiological Reviews, 88(4), 1379–1406. 
Radomski MW, Boutelier C. Hormone response of normal and intermittent cold-preadapted humans to continuous cold. J Appl Physiol. 1982;53:610–616.
Radomski, M. W., & Boutelier, C. (1982). Hormone response of normal and intermittent cold-preadapted humans to continuous cold. Journal of Applied Physiology, 53(3), 610–616. 
Shephard, R. J. (1998). Cold exposure and immune function. Canadian Journal of Physiology and Pharmacology, 76(9), 828– 836. 
Solter M, Brkic K, Petek M, et al. Thyroid hormone economy in response to extreme cold exposure in healthy factory workers. J Clin Endocrinol Metab. 1989; 68:168–172.
Solter, M., Brkic, K., Petek, M., Posavec, L., & Sekso, M. (1989). Thyroid hormone economy in response to extreme cold exposure in healthy factory workers. The Journal of Clinical Endocrinology & Metabolism, 68(1), 168–172. 
Tomasi TB, Trudeau FB, Czerwinski D, et al. Immune parameters in athletes before and after strenuous exercise. J Clin Immunol. Jul 1982;2:173–178.
Tomasi, T. B., Trudeau, F. B., Czerwinski, D., & Erredge, S. (1982). Immune parameters in athletes before and after strenuous exercise. Journal of Clinical Immunology, 2(3), 173–178. 
Walsh, N. P. (2018). Recommendations to maintain immune health in athletes. European Journal of Sport Science, 18(6), 820–831. 
Walsh, N. P., Gleeson, M., Pyne, D. B., et al. (2011). Position statement part two: Maintaining immune health. Exercise Immunology Review, 17, 64–103. 
Walsh, N. P., Oliver, S. J., & others. (2016). Exercise, immune function and respiratory infection: An update on athlete immune health. Immunology and Cell Biology, 94(2), 124–131.