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Meta-Analysis
. 2020 Nov;8(22):e14635.
doi: 10.14814/phy2.14635.

The serological responses to acute exercise in humans reduce cancer cell growth in vitro: A systematic review and meta-analysis

Affiliations
Meta-Analysis

The serological responses to acute exercise in humans reduce cancer cell growth in vitro: A systematic review and meta-analysis

Samuel T Orange et al. Physiol Rep. 2020 Nov.

Abstract

We systematically reviewed and meta-analyzed the effects of acute exercise-conditioned serum on cancer cell growth in vitro. Five literature databases were systematically searched for studies that measured cancer cell growth after exposure to human sera obtained before and immediately after an acute bout of exercise. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using a three-level random-effects model. Meta-regressions were also performed with participant age and disease status, exercise type, cell line TP53 status, and serum incubation time entered as covariates. Seven studies met the inclusion criteria encompassing a total of 21 effect estimates and 98 participants. Exercise-conditioned serum significantly reduced cancer cell growth compared with preexercise serum (SMD = -1.23, 95% CI: -1.96 to -0.50; p = .002; I2 = 75.1%). The weighted mean reduction as a percentage of preexercise values was 8.6%. The overall treatment effect and magnitude of heterogeneity were not statistically influenced by any covariate. There were concerns regarding the risk of bias within individual studies and Egger's test of the intercept showed evidence of small study effects (β = -3.6, p = .004). These findings provide in vitro evidence that the transient serological responses to acute exercises reduce cancer cell growth, although many questions remain regarding the underlying mechanistic pathways and potential effect modifiers. To strengthen this evidence-base, future studies should seek to reduce the risk of bias by using more rigorous experimental designs, and consider using 3D cell culture models to better replicate in vivo tumor conditions. PROSPERO registration: CRD42020161333.

Keywords: biomarkers; cancer prevention; exercise physiology; physical activity; serum.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram of the systematic search and included studies
FIGURE 2
FIGURE 2
Funnel plot of the standardized mean differences from individual studies against the corresponding sampling variances
FIGURE 3
FIGURE 3
Risk of Bias plot illustrating the proportion of included studies with each bias rating (low, high, or unclear risk) for each item in the RTI Bank Tool
FIGURE 4
FIGURE 4
Forest plot of the results from a three‐level random‐effects meta‐analysis on the effects of exercise‐conditioned serum on cancer cell growth. Data are presented as standardized mean differences (SMDs) between pre and postexercise timepoints with corresponding 95% confidence intervals (CIs)

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