12 March 2026
read 2 minutes
key takeaways:
- Exercise may benefit inflammatory autoimmune diseases through ‘multiple pathways’.
- Rheumatologists should recommend exercise for their patients.
A growing body of research is describing Anti-inflammatory and immunomodulatory benefits of exerciseAccording to data presented at the Basic and Clinical Immunology for the Busy Clinician symposium.
“This is an emerging area,” said brian J. Andonian, MD, MHSC, Assistant Professor of Medicine at Duke University and member of the Duke Molecular Physiology Institute. “Most rheumatic diseases are not curable. At least for now, we must still strive for wellness.”

However Andonian addressed several pillars of well-being, including sleep, diet, stress reduction and relationships, He primarily explored the benefits of exercise on the immune system.
“Targeting muscle and fitness may have physiological benefits over inflammation,” he said. “Exercise improves immune function through multiple pathways.”
These pathways may include adrenergic benefits through immune signaling, muscle-to-immune crosstalk, environmental toxin elimination, increased natural killer cell activity and enhanced immune cell clearance, Andonian said. His group is studying the immune benefits of exercise rheumatoid arthritisGiven this, further research is needed in systemic lupus erythematosus, spondyloarthritis, myositis, and other rheumatic conditions.
“Muscle is an endocrine organ,” Andonian said, adding that “thousands of molecules” and substances such as interleukin-6 and microRNAs are released during exercise. “Intense practice of exercise leads to an immune activation state.”
Additionally, there is an ancillary benefit of exercise that may be especially important for rheumatologists to consider.
“It may counteract the adverse effects of our medications,” Andonian said.
According to Andonian, it may be possible to specify specific exercises for specific situations.
“We need to understand the mechanisms of each type of exercise,” he said. “We need to learn more about how exercise improves immune function.”
Meanwhile, ongoing research is examining how exercise may benefit other parameters of well-being, such as sleep and stress reduction.
“All these things are important, they work together, they synergize,” Andonian said.
As researchers learn more about this synergy, Andonian urged attendees to take action.
“It’s beyond belief that these things are good for our health,” he said. “We can actually prescribe these interventions.”
For patients who are more active, physicians may encourage higher intensity resistance or aerobic training. According to Andonian, a “slow progression” is recommended for patients who are starting out on the couch.
“Meet patients where they are,” he said. “Start with 5 minutes at a time and build up from there.”
For more information:
Brian J. Andonian, MD, MHSC, He can be reached at broan.andonian@duke.edu.
