# The Immune System as a Biosensor of Health and Athletic Performance

**Authors:** Stefan Markus Reitzner, Petter Brodin

PMC · DOI: 10.1111/sms.70258 · Scandinavian Journal of Medicine & Science in Sports · 2026-03-17

## TL;DR

This paper explores how the immune system influences athletic performance and recovery, emphasizing a systems-level approach to understanding immunity in elite athletes.

## Contribution

The paper introduces a systems immunology perspective on immune function in elite athletes, integrating factors like nutrition and sleep.

## Key findings

- The immune system acts as a biosensor and regulator of recovery and performance in elite athletes.
- Resource allocation between immune function and physical performance is critical in injury-prone contexts.
- The J-shaped curve relationship between performance and infection risk is revisited for modern understanding.

## Abstract

Elite‐level physical performance pushes the boundaries of human physical capacity. The immune system extensively contributes to this effort by its continuous maintenance of skeletal muscle and other active tissues, orchestrating post‐exercise recovery, and as an important integrated sensor network throughout the body. A complexly regulated system with wide ranges of in‐ and outputs, cutting‐edge technologies can enable an increasingly individualized approach without the need for translation of results to human biology. The systems immunology idea of resource allocation plays a major role throughout the human life cycle, and great attention should be directed at the prioritization of these resources to either acute physical performance or immune function, particularly in injury‐ or disease‐prone contexts such as elite athletics. As such, this review aims at emphasizing the systems immunology perspective on immune system function and human performance, and its integration with other systems and factors relevant in physical activity such as nutrition, recovery, and sleep. It also attempts to revisit the previous concept of a J‐shaped curve relationship between performance levels and infection risk. Finally, it will point out key questions that remain unanswered, such as the implications of life‐long training on the composition of the immune system, resource allocation in the competition between immune function and acute exercise, and what implications such adaptations might have for athletic performance. Such an updated, integrated, systems‐level perspective on immunity may guide future research about improved recovery in athletes and more individualized exercise training approaches.

## Full-text entities

- **Genes:** IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IL1RN (interleukin 1 receptor antagonist) [NCBI Gene 3557] {aka CRMO2, DIRA, ICIL-1RA, IL-1RN, IL-1ra, IL-1ra3}, IL22 (interleukin 22) [NCBI Gene 50616] {aka IL-21, IL-22, IL-D110, IL-TIF, ILTIF, TIFIL-23}, CD79A (CD79a molecule) [NCBI Gene 973] {aka IGA, IGAlpha, MB-1, MB1}, POMC (proopiomelanocortin) [NCBI Gene 5443] {aka ACTH, CLIP, LPH, MSH, NPP, OBAIRH}, IL15 (interleukin 15) [NCBI Gene 3600] {aka IL-15}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}
- **Diseases:** inflammation (MESH:D007249), rhabdomyolysis (MESH:D012206), COVID-19 (MESH:D000086382), infectious diseases (MESH:D003141), multiple sclerosis (MESH:D009103), function (MESH:D003291), tissue injury (MESH:D017695), lupus erythematosus (MESH:D008180), autoimmune (MESH:D001327), sleep deprivation (MESH:D012892), rheumatoid arthritis (MESH:D001172), autoimmune tendencies (MESH:C536965), immunodeficiency (MESH:D007153), sleep loss (MESH:D012893), menstrual dysfunction (MESH:D004412), muscle (MESH:D019042), dysbiosis (MESH:D064806), malnourished (MESH:D044342), injuries (MESH:D014947), URTIs (MESH:D012141), infection (MESH:D007239)
- **Chemicals:** glucose (MESH:D005947), nadolol (MESH:D009248), carbohydrate (MESH:D002241), sucrose (MESH:D013395), fructose (MESH:D005632), fats (MESH:D005223), lipid (MESH:D008055), tryptophan (MESH:D014364), zinc (MESH:D015032), iron (MESH:D007501), Testosterone (MESH:D013739), catecholamine (MESH:D002395), A, D, E, B6, or B12 (-), cholesterol (MESH:D002784), cortisol (MESH:D006854)
- **Species:** Homo sapiens (human, species) [taxon 9606], gut metagenome (species) [taxon 749906], Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

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## References

111 references — full list in the complete paper: https://tomesphere.com/paper/PMC12994555/full.md

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Source: https://tomesphere.com/paper/PMC12994555