许多与运动有关的促进健康的效果可归因于有益的免疫调节作用。免疫稳态的恢复是取决于上下文的，意味着要么增加抗炎信号以抵消非传染性（自身免疫）疾病的疾病进展，要么增强（局部）促炎症免疫细胞的活动以减缓或抑制癌症进展。调节性CD4+ T细胞（Tregs）代表了适应性免疫系统的主要调节成分，在细调炎症反应、将其控制在可接受的范围内并防止长期的自身免疫反应方面发挥作用。由于在各种疾病背景下常常失控，新兴的治疗方法旨在以高度疾病特异性的方式调节它们的数量或内在的抗炎和免疫抑制功能。运动代表一种非药物策略，可用于疾病预防和康复，并可能是一种有效的治疗方法，几乎没有副作用，以抵消Tregs的失调。迄今为止，已经有几项研究评估了运动对Treg相关结果的影响。本综述旨在提供对人类和动物模型中急性和慢性运动后血液或组织源性Treg计数、比例和功能变化的全面概述。从60篇审查的研究中，可以得出对动物模型中慢性运动对Treg水平的总体疾病特异性有益影响的结论，而在人类研究中急性和慢性效应都不那么明确。然而，动物研究中Treg表型分析不如人类研究充分。只有有限数量的研究调查了Treg功能。研究设计、人口或动物模型、运动协议和Treg结果测量规范存在很大异质性，这使得比较结果并得出明确结论变得困难。研究结果在运动免疫学的现有概念背景下进行讨论。最后，提供未来展望和方法学建议，以促进该领域的研究。版权所有©2021国际运动和免疫学学会。保留所有权利。

Many of the exercise-related health-promoting effects are attributed to beneficial immunomodulation. The restoration of immune homeostasis is context-dependent, meaning either to increase anti-inflammatory signaling to counteract disease progression of non-communicable (auto)inflammatory diseases or to enhance (local) activity of proinflammatory immune cells to slow down or inhibit cancer progression. Regulatory CD4+ T cells (Tregs) represent the main regulatory component of the adaptive immune system that fine-tunes inflammatory responses, keeps them in check and prevents long-lasting autoimmunity. Because often dysregulated in the context of various diseases, emerging treatment approaches aim to modulate their number or inherent anti-inflammatory and immunosuppressive function in a highly disease-specific way. Exercise represents a non-pharmacologic strategy in disease prevention and rehabilitation and may be an effective treatment with few to no side effects to counteract dysregulation of Tregs. To date, several studies have evaluated the effect of exercise on Treg-related outcomes. This review aims at providing a comprehensive overview on alterations of blood- or tissue-derived Treg counts, proportion and functionality following acute and chronic exercise in humans and animal models. From the 60 reviewed studies, an overall disease-specific beneficial effect of chronic exercise on Treg levels in animal models can be stated, while both acute and chronic effects in human studies are less definite. However, Treg phenotyping is less sufficient in the animal studies compared to human studies. Only a limited number of studies investigated Treg functionality. There is a large heterogeneity concerning study design, human population or animal model, exercise protocol, and Treg outcome measure specification which makes it difficult to compare results and draw clear conclusions. Study results are discussed in the context of current concepts in exercise immunology. Finally, future perspectives and methodological recommendations are provided to promote research in this field.Copyright © 2021 International Society of Exercise and Immunology. All rights reserved.