Volume 412, January 2026, 120589Author links open overlay panelMathilde Mura a b, Amandine Thomas a, Michèle Weiss-Gayet c, Laurie Josset a, Chantal L. Rytz d, Emeraude Rivoire a e, Marie Chambion-Diaz a, Nellie Della-Schiava f g, Matthieu Arsicot a f, Anne Long a f, Bénédicte Chazaud c, Antoine Millon a e 1, Vincent Pialoux a 1Show moreHighlights•

Physical activity can stabilise the increase in classical pro-inflammatory monocyte observed in asymptomatic patients with carotid atherosclerotic.

•

Most of the cytokines are down regulated in the physical activity arm, while they are stable or increased in the control arm.

•

Home-based moderated physical activity intervention is accepted by patients, with good clinical outcomes.

AbstractBackground and aims

Up to 25 % of ischemic strokes are the consequence of a ruptured vulnerable carotid atherosclerotic plaque. Circulating pro-inflammatory classical and intermediate monocytes are known predictors of ischemic events and cardiovascular death. Interestingly, chronic physical activity can decrease inflammation, and is thereby associated with a reduction in pro-inflammatory monocytes.

Methods

In a randomized, controlled and monocentric trial, we recruited 56 patients (71 ± 8 years old) with asymptomatic carotid stenosis of ≥50 % who were ineligible for carotid endarterectomy. Blood analyses were completed to assess the phenotype of monocytes, as well as a multiplex assay and colorimetric assay for cytokines concentration and redox status, respectively.

Results

Classical monocyte count was increased in the control arm, while it remained stable in response to the physical activity intervention (−5215 ± 2307, [95 %CI -9878 to −551], p = 0.03). Moreover, the expression of most of pro-inflammatory cytokines was down-regulated in response to the physical activity intervention, while it was increased in the control arm.

Conclusions

The stabilization of classical monocytes and down-regulation of the expression of pro-inflammatory cytokines in response to the physical activity intervention suggest that chronic physical activity alleviate the pro-inflammatory state, and might thereby reduce carotid plaque vulnerability and the subsequent risk of ischemic events. These results highlight that home-based physical activity intervention is an efficient clinical care that induce biological changes in carotid atherosclerotic patients.

Graphical abstractDownload: Download high-res image (207KB)Download: Download full-size imagePrevious article in issueNext article in issueKeywords

Carotid atherosclerosis

Inflammation

Monocytes

Cytokines

Physical activity

eHealth

Recommended articles

© 2025 The Authors. Published by Elsevier B.V.