The Role of Circulating Therapeutic MicroRNAs in Pulmonary and Muscular Function in Post-COVID-19 Athletes
Therapeutic miRNAs in pulmonary and muscular function in post-COVID-19 athletes
,
Abstract
SARS-CoV-2 infection causes significant acute and long-term morbidity, including persistent pulmonary and muscular dysfunction in athletes. Physical exercise alters circulating microRNA (miR) profiles, and specific microRNAs have documented roles in inflammation, immune regulation, muscle metabolism, and regeneration. This study characterizes circulating microRNAs relevant to COVID-19 pathogenesis and post-viral recovery, including miR-155, miR-146a, the let-7 family, miR-21, miR-424, miR-1, miR-133, miR-499, miR-208, miR-486, and miR-22, and examines how different exercise modalities may modulate these microRNAs to support pulmonary and muscular function in post-COVID-19 athletes. miR-155 and miR-146a are highlighted as modulators of innate and adaptive inflammatory signaling and as mediators of cytokine responses implicated in severe COVID-19. Moreover, several microRNAs, such as miR-21, miR-155, miR-146a, and the let-7 family, converge on NF-κB and related pathways, linking altered miR expression to immune dysregulation and cytokine-driven tissue injury. Additionally, muscle-enriched and metabolism-associated microRNAs regulate myogenesis, mitochondrial biogenesis, and key metabolic pathways (PGC-1α, AMPK, mTOR)-processes essential for muscle repair, endurance recovery, and respiratory muscle support after SARS-CoV-2 infection. Different types of exercise produce distinct miR signatures; notably, moderate-intensity exercise consistently promotes anti-inflammatory and pro-repair miR patterns. We emphasize the therapeutic potential of moderate-intensity exercise as a non-pharmacological strategy to regulate miR expression, reduce cytokine-mediated damage, and support functional recovery in post-COVID-19 athletes. To our knowledge, this is the first study to link exercise-driven miR changes with functional pulmonary and muscular recovery in athletic populations recovering from COVID-19, supporting moderate-intensity exercise as a promising strategy for rehabilitation and performance restoration.
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3. Parums DV. Long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC) and the urgent need to identify diagnostic biomarkers and risk factors. Med Sci Monit. 2024;30:e946512.
4. Liu Y, He L, Wang W. Systematic assessment of microRNAs associated with lung cancer and physical exercise. Front Oncol. 2022;12:917667.
5. Furtado GE, Letieri RV, Caldo-Silva A, Sardão VA, Teixeira AM, de Barros MP, et al. Sustaining efficient immune functions with regular physical exercise in the COVID-19 era and beyond. Eur J Clin Invest. 2021;51(5):e13485.
6. Han Y, Zhang G, Lv X, Ren L. Critical role of cellular microRNAs in virus infection: decades of progress. Anim Zoonoses. 2025;1:1–12.
7. Kosaka N, Iguchi H, Ochiya T. Circulating microRNA in body fluid: a new potential biomarker for cancer diagnosis and prognosis. Cancer Sci. 2010;101(10):2087–2092.
8. Hardin LT, Xiao N. miRNAs: the key regulator of COVID-19 disease. Int J Cell Biol. 2022;2022:1645366.
9. Aloi MS, Prater KE, Sopher B, Davidson S, Jayadev S, Garden GA. The pro-inflammatory microRNA miR-155 influences fibrillar β-amyloid catabolism by microglia. Glia. 2021;69(7):1736–48.
10. Mahesh G, Biswas R. MicroRNA-155: a master regulator of inflammation. J Interferon Cytokine Res. 2019;39(6):321–30.
11. Wang D, Tang M, Zong P, Liu H, Zhang T, Liu Y, et al. miRNA-155 regulates the Th17/Treg ratio by targeting SOCS1 in severe acute pancreatitis. Front Physiol. 2018;9:686.
12. Xu L, Leng H, Shi X, Ji J, Fu J, Leng H. miR-155 promotes cell proliferation and inhibits apoptosis via PTEN signaling in psoriasis. Biomed Pharmacother. 2017;90:524–30.
13. Li D, Wang P, Wei W, Wang C, Zhong Y, Lv L, et al. Serum microRNA expression patterns after 5-km exercise are associated with cardiovascular adaptation. Front Physiol. 2021;12:642470.
14. Rhim J, Baek W, Seo Y, Kim JH. Understanding microRNA-21 in cancer. Cells. 2022;11(18):2853.
15. Khalaji A, Mehrtabar S, Jabraeilipour A, Doustar N, Rahmani Youshanlouei H, Tahavvori A, et al. Inhibitory effect of microRNA-21 on cardiac fibrosis pathways. Ther Adv Cardiovasc Dis. 2024;18:17539447241253134.
16. Kang H. Role of microRNAs in TGF-β signaling pathway-mediated pulmonary fibrosis. Int J Mol Sci. 2017;18(12):2527.
17. Cojocaru E, Cojocaru T, Pînzariu GM, Vasiliu I, Armașu I, Cojocaru C. Perspectives on post-COVID-19 pulmonary fibrosis treatment. J Pers Med. 2023;14(1):32.
18. Yuan H, Xin S, Huang Y, Bao Y, Jiang H, Zhou L, et al. Downregulation of PDCD4 by miR-21 suppresses tumor transformation. Oncol Lett. 2017;14(3):3371–8.
19. Chawra HS, Agarwal M, Mishra A, Chandel SS, Singh RP, Dubey G, et al. MicroRNA-21 in PTEN suppression and PI3K/AKT activation. Pathol Res Pract. 2024;254:155091.
20. Bannazadeh Baghi H, Bayat M, Mehrasa P, Alavi SMA, Lotfalizadeh MH, Memar MY, et al. Regulatory role of microRNAs in virus-mediated inflammation. J Inflamm (Lond). 2024;21(1):43.
21. Gaytán-Pacheco N, Ibáñez-Salazar A, Herrera-Van Oostdam AS, Oropeza-Valdez JJ, Magaña-Aquino M, López JA, et al. miR-146a, miR-221, and miR-155 in severe COVID-19. Diagnostics (Basel). 2023;13(1):89.
22. Saba R, Sorensen DL, Booth SA. MicroRNA-146a: a dominant negative regulator of innate immunity. Front Immunol. 2014;5:578.
23. Hou J, Deng Q, Deng X, Zhong W, Liu S, Zhong Z. miR-146a-5p alleviates LPS-induced inflammasome injury. Ann Transl Med. 2021;9(18):1433.
24. Zhou C, Zhao L, Wang K, Qi Q, Wang M, Yang L, et al. MicroRNA-146a inhibits NF-κB activation. Exp Ther Med. 2019;18(4):3078–84.
25. Lin Z, Ge J, Wang Z, Ren J, Wang X, Xiong H, et al. Let-7e modulates inflammatory response via ceRNA crosstalk. Sci Rep. 2017;7(1):42498.
26. Pessôa RL, da Rosa Abreu G, de Oliveira RB. MicroRNA let-7 in COVID-19 immunopathology. Immunol. 2023;3(1):112–121.
27. Afzal M, Greco F, Quinzi F, Scionti F, Maurotti S, Montalcini T, et al. Effect of physical activity on miRNA expression. Int J Mol Sci. 2024;25(13):6813.
28. Zyulina V, Yan KK, Ju B, Schwarzenberger E, Passegger C, Tam-Amersdorfer C, et al. miR-424/503 regulates inflammatory DC differentiation. Cell Rep. 2021;35(4):109049.
29. Umar T, Ma X, Yin B, Umer S, Zahoor A, Akhtar M, et al. miR-424-5p inhibits inflammatory response via IRAK2. J Reprod Immunol. 2022;150:103471.
30. Güller I, Russell AP. MicroRNAs in skeletal muscle. J Physiol. 2010;588(Pt 21):4075–87.
31. Hitachi K, Tsuchida K. Role of microRNAs in skeletal muscle hypertrophy. Front Physiol. 2014;4:408.
32. Pieri M, Vayianos P, Nicolaidou V, Felekkis K, Papaneophytou C. Circulating miRNAs after SARS-CoV-2 infection. Int J Mol Sci. 2023;24(3):2380.
33. Rhim C, Kraus WE, Truskey GA. Biomechanical effects on microRNA expression. AIMS Bioeng.* 2020;7(3):147–64.
34. Yoon MS. mTOR as a regulator of skeletal muscle mass. Front Physiol. 2017;8:788.
35. Samidurai A, Kukreja RC, Das A. mTOR signaling-related miRNAs in cardiovascular diseases. Oxid Med Cell Longev. 2018;2018:6141902.
36. Hsieh TH, Hsu CY, Tsai CF, Long CY, Wu CH, Wu DC, et al. HDAC inhibitors induce apoptosis via miR-125a-5p. Mol Ther. 2015;23(4):656–66.
37. Wang F, Wang J, He J, Li W, Li J, Chen S, et al. Serum miRNAs as biomarkers for muscle atrophy. Biomed Res Int. 2017;2017:8361237.
38. Li X, Bi H, Xie S, Cui W. miR-208b regulates skeletal muscle fiber conversion. *Front Genet.* 2022;13:820464.
39. Callis TE, Pandya K, Seok HY, Tang RH, Tatsuguchi M, Huang ZP, et al. MicroRNA-208a in cardiac hypertrophy. J Clin Invest. 2009;119(9):2772–2786.
40. Yu Y, Chu W, Chai J, Li X, Liu L, Ma L. miRNAs in skeletal muscle atrophy. Mol Med Rep. 2016;13(2):1470–4.
41. Aoi W, Ichikawa H, Mune K, Tanimura Y, Mizushima K, Naito Y, et al. Circulating miR-486 response to exercise. Front Physiol. 2013;4:80.
42. Alexander MS, Casar JC, Motohashi N, Vieira NM, Eisenberg I, Marshall JL, et al. miR-486 modulation improves muscular dystrophy. J Clin Invest. 2014;124(6):2651–67.
43. Malvandi AM, Faraldi M, Sansoni V, Gerosa L, Jaworska J, Lombardi G. Circulating myo-miRs in exercise. Adv Exerc Health Sci. 2024;1(2):86–98.
44. Chalchat E, Martin V, Charlot K, Bourrilhon C, Baugé S, Bourdon S, et al. Circulating microRNAs after muscle damage. Am J Physiol Regul Integr Comp Physiol. 2023;324(1):R58–R69.
45. Serocki M, Bartoszewska S, Janaszak-Jasiecka A, Ochocka RJ, Collawn JF, Bartoszewski R. miRNAs regulate HIF switch during hypoxia. Angiogenesis. 2018;21(2):183–202.
46. Wang D, Jiang DM, Yu RR, Zhang LL, Liu YZ, Chen JX, et al. Aerobic exercise and mitochondrial oxidative capacity. *J Diabetes Res.* 2022;2022:3780156.
47. Abu Shelbayeh O, Arroum T, Morris S, Busch KB. PGC-1α and mitochondrial lifecycle regulation. Antioxidants (Basel). 2023;12(5):1012.
48. Denham J, Prestes PR. Exercise-regulated muscle-enriched microRNAs. Front Genet. 2016;7:196.
49. Li N, Zhou H, Tang Q. miR-133 in cardiac remodeling. Front Pharmacol. 2018;9:903.
50. Zhang GQ, Wang SQ, Chen Y, Fu LY, Xu YN, Li L, et al. MicroRNAs regulating mitochondrial function. Front Pharmacol. 2021;12:663450.
51. Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, et al. Mechanical overload-induced muscle hypertrophy. Physiol Rev. 2023;103(4):2679–2757.
52. Takamura D, Iwata K, Inoue S, Hatakeyama J, Moriyama H. Circulating miRNAs as indicators of resistance exercise intensity. Cureus. 2024;16(12):e76212.
53. Reynolds TH, Supiano MA, Dengel DR. Resistance training and glucose disposal. Metabolism. 2004;53(3):397–402.
54. Caturano A, Galiero R, Vetrano E, Sardu C, Rinaldi L, Russo V, et al. Insulin–heart axis. Int J Mol Sci. 2024;25(15):8369.
55. Torma F, Gombos Z, Jokai M, Takeda M, Mimura T, Radak Z. HIIT and skeletal muscle molecular adaptation. Sports Med Health Sci. 2019;1(1):24–32.
56. Pashaei Z, Malandish A, Alipour S, Jafari A, Laher I, Hackney AC, et al. HIIT and miRNA expression in obesity. BMC Sports Sci Med Rehabil. 2024;16(1):123.
57. Balchin C, Tan AL, Wilson OJ, McKenna J, Stavropoulos-Kalinoglou A. MicroRNAs, inflammation, and exercise in RA. Rheumatol Adv Pract. 2023;7(1):rkac110.
58. Ayari S, Abellard A, Carayol M, Guedj É, Gavarry O. Exercise modalities reducing inflammatory cytokines. Exp Gerontol. 2023;175:112141.
59. Silva MJA, Ribeiro LR, Gouveia MIM, Marcelino BDR, Santos CSD, Lima KVB, et al. Hyperinflammatory response in COVID-19. Viruses. 2023;15(2):391.
60. Nejad C, Stunden HJ, Gantier MP. Guide to miRNAs in inflammation. FEBS J. 2018;285(20):3695–3716.
61. Faraj SS, Jalal PJ. Cytokine cooperation in COVID-19. Ann Med Surg (Lond). 2023;85(6):2291–7.
62. Shirvani H. Exercise and COVID-19. Iran J Med Sci. 2020;45(4):311–2.
63. Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Post-COVID-19 syndrome and exercise. Int J Environ Res Public Health. 2021;18(10):5329.
64. Bo W, Xi Y, Tian Z. Exercise in rehabilitation of COVID-19 patients. Sports Med Health Sci. 2021;3(4):194–201.
65. Walzik D, Wences Chirino TY, Zimmer P, Joisten N. Molecular insights of exercise therapy. Signal Transduct Target Ther. 2024;9(1):138.
2. Krynytska I, Marushchak M, Birchenko I, Dovgalyuk A, Tokarskyy O. COVID-19-associated acute respiratory distress syndrome versus classical acute respiratory distress syndrome: a narrative review. Iran J Microbiol. 2021;13(6):737–47.
3. Parums DV. Long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC) and the urgent need to identify diagnostic biomarkers and risk factors. Med Sci Monit. 2024;30:e946512.
4. Liu Y, He L, Wang W. Systematic assessment of microRNAs associated with lung cancer and physical exercise. Front Oncol. 2022;12:917667.
5. Furtado GE, Letieri RV, Caldo-Silva A, Sardão VA, Teixeira AM, de Barros MP, et al. Sustaining efficient immune functions with regular physical exercise in the COVID-19 era and beyond. Eur J Clin Invest. 2021;51(5):e13485.
6. Han Y, Zhang G, Lv X, Ren L. Critical role of cellular microRNAs in virus infection: decades of progress. Anim Zoonoses. 2025;1:1–12.
7. Kosaka N, Iguchi H, Ochiya T. Circulating microRNA in body fluid: a new potential biomarker for cancer diagnosis and prognosis. Cancer Sci. 2010;101(10):2087–2092.
8. Hardin LT, Xiao N. miRNAs: the key regulator of COVID-19 disease. Int J Cell Biol. 2022;2022:1645366.
9. Aloi MS, Prater KE, Sopher B, Davidson S, Jayadev S, Garden GA. The pro-inflammatory microRNA miR-155 influences fibrillar β-amyloid catabolism by microglia. Glia. 2021;69(7):1736–48.
10. Mahesh G, Biswas R. MicroRNA-155: a master regulator of inflammation. J Interferon Cytokine Res. 2019;39(6):321–30.
11. Wang D, Tang M, Zong P, Liu H, Zhang T, Liu Y, et al. miRNA-155 regulates the Th17/Treg ratio by targeting SOCS1 in severe acute pancreatitis. Front Physiol. 2018;9:686.
12. Xu L, Leng H, Shi X, Ji J, Fu J, Leng H. miR-155 promotes cell proliferation and inhibits apoptosis via PTEN signaling in psoriasis. Biomed Pharmacother. 2017;90:524–30.
13. Li D, Wang P, Wei W, Wang C, Zhong Y, Lv L, et al. Serum microRNA expression patterns after 5-km exercise are associated with cardiovascular adaptation. Front Physiol. 2021;12:642470.
14. Rhim J, Baek W, Seo Y, Kim JH. Understanding microRNA-21 in cancer. Cells. 2022;11(18):2853.
15. Khalaji A, Mehrtabar S, Jabraeilipour A, Doustar N, Rahmani Youshanlouei H, Tahavvori A, et al. Inhibitory effect of microRNA-21 on cardiac fibrosis pathways. Ther Adv Cardiovasc Dis. 2024;18:17539447241253134.
16. Kang H. Role of microRNAs in TGF-β signaling pathway-mediated pulmonary fibrosis. Int J Mol Sci. 2017;18(12):2527.
17. Cojocaru E, Cojocaru T, Pînzariu GM, Vasiliu I, Armașu I, Cojocaru C. Perspectives on post-COVID-19 pulmonary fibrosis treatment. J Pers Med. 2023;14(1):32.
18. Yuan H, Xin S, Huang Y, Bao Y, Jiang H, Zhou L, et al. Downregulation of PDCD4 by miR-21 suppresses tumor transformation. Oncol Lett. 2017;14(3):3371–8.
19. Chawra HS, Agarwal M, Mishra A, Chandel SS, Singh RP, Dubey G, et al. MicroRNA-21 in PTEN suppression and PI3K/AKT activation. Pathol Res Pract. 2024;254:155091.
20. Bannazadeh Baghi H, Bayat M, Mehrasa P, Alavi SMA, Lotfalizadeh MH, Memar MY, et al. Regulatory role of microRNAs in virus-mediated inflammation. J Inflamm (Lond). 2024;21(1):43.
21. Gaytán-Pacheco N, Ibáñez-Salazar A, Herrera-Van Oostdam AS, Oropeza-Valdez JJ, Magaña-Aquino M, López JA, et al. miR-146a, miR-221, and miR-155 in severe COVID-19. Diagnostics (Basel). 2023;13(1):89.
22. Saba R, Sorensen DL, Booth SA. MicroRNA-146a: a dominant negative regulator of innate immunity. Front Immunol. 2014;5:578.
23. Hou J, Deng Q, Deng X, Zhong W, Liu S, Zhong Z. miR-146a-5p alleviates LPS-induced inflammasome injury. Ann Transl Med. 2021;9(18):1433.
24. Zhou C, Zhao L, Wang K, Qi Q, Wang M, Yang L, et al. MicroRNA-146a inhibits NF-κB activation. Exp Ther Med. 2019;18(4):3078–84.
25. Lin Z, Ge J, Wang Z, Ren J, Wang X, Xiong H, et al. Let-7e modulates inflammatory response via ceRNA crosstalk. Sci Rep. 2017;7(1):42498.
26. Pessôa RL, da Rosa Abreu G, de Oliveira RB. MicroRNA let-7 in COVID-19 immunopathology. Immunol. 2023;3(1):112–121.
27. Afzal M, Greco F, Quinzi F, Scionti F, Maurotti S, Montalcini T, et al. Effect of physical activity on miRNA expression. Int J Mol Sci. 2024;25(13):6813.
28. Zyulina V, Yan KK, Ju B, Schwarzenberger E, Passegger C, Tam-Amersdorfer C, et al. miR-424/503 regulates inflammatory DC differentiation. Cell Rep. 2021;35(4):109049.
29. Umar T, Ma X, Yin B, Umer S, Zahoor A, Akhtar M, et al. miR-424-5p inhibits inflammatory response via IRAK2. J Reprod Immunol. 2022;150:103471.
30. Güller I, Russell AP. MicroRNAs in skeletal muscle. J Physiol. 2010;588(Pt 21):4075–87.
31. Hitachi K, Tsuchida K. Role of microRNAs in skeletal muscle hypertrophy. Front Physiol. 2014;4:408.
32. Pieri M, Vayianos P, Nicolaidou V, Felekkis K, Papaneophytou C. Circulating miRNAs after SARS-CoV-2 infection. Int J Mol Sci. 2023;24(3):2380.
33. Rhim C, Kraus WE, Truskey GA. Biomechanical effects on microRNA expression. AIMS Bioeng.* 2020;7(3):147–64.
34. Yoon MS. mTOR as a regulator of skeletal muscle mass. Front Physiol. 2017;8:788.
35. Samidurai A, Kukreja RC, Das A. mTOR signaling-related miRNAs in cardiovascular diseases. Oxid Med Cell Longev. 2018;2018:6141902.
36. Hsieh TH, Hsu CY, Tsai CF, Long CY, Wu CH, Wu DC, et al. HDAC inhibitors induce apoptosis via miR-125a-5p. Mol Ther. 2015;23(4):656–66.
37. Wang F, Wang J, He J, Li W, Li J, Chen S, et al. Serum miRNAs as biomarkers for muscle atrophy. Biomed Res Int. 2017;2017:8361237.
38. Li X, Bi H, Xie S, Cui W. miR-208b regulates skeletal muscle fiber conversion. *Front Genet.* 2022;13:820464.
39. Callis TE, Pandya K, Seok HY, Tang RH, Tatsuguchi M, Huang ZP, et al. MicroRNA-208a in cardiac hypertrophy. J Clin Invest. 2009;119(9):2772–2786.
40. Yu Y, Chu W, Chai J, Li X, Liu L, Ma L. miRNAs in skeletal muscle atrophy. Mol Med Rep. 2016;13(2):1470–4.
41. Aoi W, Ichikawa H, Mune K, Tanimura Y, Mizushima K, Naito Y, et al. Circulating miR-486 response to exercise. Front Physiol. 2013;4:80.
42. Alexander MS, Casar JC, Motohashi N, Vieira NM, Eisenberg I, Marshall JL, et al. miR-486 modulation improves muscular dystrophy. J Clin Invest. 2014;124(6):2651–67.
43. Malvandi AM, Faraldi M, Sansoni V, Gerosa L, Jaworska J, Lombardi G. Circulating myo-miRs in exercise. Adv Exerc Health Sci. 2024;1(2):86–98.
44. Chalchat E, Martin V, Charlot K, Bourrilhon C, Baugé S, Bourdon S, et al. Circulating microRNAs after muscle damage. Am J Physiol Regul Integr Comp Physiol. 2023;324(1):R58–R69.
45. Serocki M, Bartoszewska S, Janaszak-Jasiecka A, Ochocka RJ, Collawn JF, Bartoszewski R. miRNAs regulate HIF switch during hypoxia. Angiogenesis. 2018;21(2):183–202.
46. Wang D, Jiang DM, Yu RR, Zhang LL, Liu YZ, Chen JX, et al. Aerobic exercise and mitochondrial oxidative capacity. *J Diabetes Res.* 2022;2022:3780156.
47. Abu Shelbayeh O, Arroum T, Morris S, Busch KB. PGC-1α and mitochondrial lifecycle regulation. Antioxidants (Basel). 2023;12(5):1012.
48. Denham J, Prestes PR. Exercise-regulated muscle-enriched microRNAs. Front Genet. 2016;7:196.
49. Li N, Zhou H, Tang Q. miR-133 in cardiac remodeling. Front Pharmacol. 2018;9:903.
50. Zhang GQ, Wang SQ, Chen Y, Fu LY, Xu YN, Li L, et al. MicroRNAs regulating mitochondrial function. Front Pharmacol. 2021;12:663450.
51. Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, et al. Mechanical overload-induced muscle hypertrophy. Physiol Rev. 2023;103(4):2679–2757.
52. Takamura D, Iwata K, Inoue S, Hatakeyama J, Moriyama H. Circulating miRNAs as indicators of resistance exercise intensity. Cureus. 2024;16(12):e76212.
53. Reynolds TH, Supiano MA, Dengel DR. Resistance training and glucose disposal. Metabolism. 2004;53(3):397–402.
54. Caturano A, Galiero R, Vetrano E, Sardu C, Rinaldi L, Russo V, et al. Insulin–heart axis. Int J Mol Sci. 2024;25(15):8369.
55. Torma F, Gombos Z, Jokai M, Takeda M, Mimura T, Radak Z. HIIT and skeletal muscle molecular adaptation. Sports Med Health Sci. 2019;1(1):24–32.
56. Pashaei Z, Malandish A, Alipour S, Jafari A, Laher I, Hackney AC, et al. HIIT and miRNA expression in obesity. BMC Sports Sci Med Rehabil. 2024;16(1):123.
57. Balchin C, Tan AL, Wilson OJ, McKenna J, Stavropoulos-Kalinoglou A. MicroRNAs, inflammation, and exercise in RA. Rheumatol Adv Pract. 2023;7(1):rkac110.
58. Ayari S, Abellard A, Carayol M, Guedj É, Gavarry O. Exercise modalities reducing inflammatory cytokines. Exp Gerontol. 2023;175:112141.
59. Silva MJA, Ribeiro LR, Gouveia MIM, Marcelino BDR, Santos CSD, Lima KVB, et al. Hyperinflammatory response in COVID-19. Viruses. 2023;15(2):391.
60. Nejad C, Stunden HJ, Gantier MP. Guide to miRNAs in inflammation. FEBS J. 2018;285(20):3695–3716.
61. Faraj SS, Jalal PJ. Cytokine cooperation in COVID-19. Ann Med Surg (Lond). 2023;85(6):2291–7.
62. Shirvani H. Exercise and COVID-19. Iran J Med Sci. 2020;45(4):311–2.
63. Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Franco-López F, Sánchez-Alcaraz Martínez BJ, et al. Post-COVID-19 syndrome and exercise. Int J Environ Res Public Health. 2021;18(10):5329.
64. Bo W, Xi Y, Tian Z. Exercise in rehabilitation of COVID-19 patients. Sports Med Health Sci. 2021;3(4):194–201.
65. Walzik D, Wences Chirino TY, Zimmer P, Joisten N. Molecular insights of exercise therapy. Signal Transduct Target Ther. 2024;9(1):138.
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How to Cite
1.
Eslami Z, Mirghani SJ, Eghbal Moghanlou A, Ghaderi M. The Role of Circulating Therapeutic MicroRNAs in Pulmonary and Muscular Function in Post-COVID-19 Athletes. Iran J Allergy Asthma Immunol. 2026;:1-7.
