Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

The Effect of High-Intensity Aerobic Exercise on IL18, IL6, and B-type Natriuretic Peptide (BNP) Concentrations in Operational Male Firefighters.

Document Type : Original Article

Authors
M Naseif Hami Jasem Allhateib 1
F Taghian 1
H>H Atiyah 2
Kh Jalali Dehkordi 1
1 Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2 Faculty of Physical Education and Sports Sciences, Baghdad, Mustansiriyah University
10.22038/jpsr.2025.86133.2685
Abstract
Purpose:
Firefighting is known to be a very high-risk occupation due to its dangerous and difficult characteristics. Therefore, the present study aimed to investigate the effect of eight weeks of high-intensity aerobic training on IL18, IL6, and B-type natriuretic peptide (BNP) concentrations in operational male firefighters. IL18 and IL6 are inflammatory cytokines that play a role in immune responses. BNP is also known as a marker of heart failure that is secreted in response to excessive strain on heart muscle cells, and there is a relationship between inflammation and heart problems in chronic diseases.
Methods:
The present study is a quasi-experimental study with a pre-test and post-test design. In this study, 48 male firefighters were selected purposively and conveniently and were randomly and equally divided into two groups (n=24): control and high-intensity aerobic training groups. The training program included a 15-minute warm-up at a slow pace and 30-second interval running at 100% intensity in the first and second weeks, which increased to 150-200% of heart rate reserve in the seventh and eighth weeks. Data analysis was evaluated using the analysis of covariance (ANCOVA) method and the equivalent nonparametric test, Quade Nonparametric ANCOVA. The tests were performed at a 5% error level and using a SPSS version 27.
Results:
The results showed that HIIT training had a significant effect on the concentration of IL18 (p<0.001, η2=0.58), IL6 (p<0.001, η2=0.43), and B-type natriuretic peptide (BNP) (p<0.001, η2=0.48). The concentration of IL18, IL6, and BNP decreased significantly as a result of high-intensity aerobic training.
Conclusion:
High-intensity aerobic training has been shown to reduce IL18, IL6, and BNP concentrations. It has been suggested that high-intensity aerobic training improves the physiological performance of firefighters.
Keywords
Firefighters
Aerobic Exercise
IL6
IL18
BNP
  1. Jeung D-Y, Hyun D-S, Kim I, Chang S-J. Effects of emergency duties on cardiovascular diseases in firefighters: a 13-year retrospective cohort study. J Occup Environ Med 2022; 64(6): 510-514.
  2. Christodoulou A, Christophi CA, Sotos-Prieto M, Moffatt S, et al. The dietary inflammatory index and cardiometabolic parameters in US firefighters. Front Nutr 2024; 11: 1382306.
  3. Mendes HA, Canto NE, Lima LRA, Speretta GF. Heart Rate Reactivity to Acute Mental Stress is Associated with Parasympathetic Withdrawal and Adiposity in Firefighters. International Journal of Cardiovascular Sciences 2024; 37: e20210234.
  4. Dzikowicz DJ, Al-Zaiti SS, Carey MG. Cardiovascular Function and Deleterious Adaptations Among Firefighters: Implications for Smart Firefighting. Intelligent Building Fire Safety and Smart Firefighting: Springer 2024; 455-473.
  5. Soteriades ES, Kim J, Christophi CA, Kales SN. Cancer incidence and mortality in firefighters: A state-of-the-art review and meta-analysis. Asian Pacific journal of cancer prevention: Asian Pac J Cancer Prev 2019; 20(11): 3221-3231.
  6. Soteriades ES, Smith DL, Tsismenakis AJ, Baur DM, Kales SN. Cardiovascular disease in US firefighters: a systematic review. Cardiol Rev 2011; 19(4): 202-215.
  7. Soteriades ES, Kales SN, Liarokapis D, Christiani DC. Prospective surveillance of hypertension in firefighters. J Clin Hypertens 2003; 5(5): 315-320.
  8. Smith DL, Barr DA, Kales SN. Extreme sacrifice: sudden cardiac death in the US Fire Service. Extrem Physiol Med 2013; 2(1): 6.
  9. T Martin Z, Schlaff RA, Hemenway JK, Coulter JR, et al. Cardiovascular disease risk factors and physical fitness in volunteer firefighters. Int J Exerc Sci 2019; 12(2): 764-776.
  10. Day CA, Berkowsky RS, Zaleski AL, Chen M-H, et al. The influence of vigorous physical exertion on cardiac demand under conditions of daily living among firefighters with elevated blood pressure. Hear Lung. 2024; 68: 208-216.
  11. Orysiak J, Młynarczyk M, Piec R, Jakubiak A. Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters. Environ Sci Pollut Res Int 2022; 29(49): 73741-7368.
  12. Smith DL, Friedman NM, Bloom SI, Armero WL, et al. Firefighting induces acute inflammatory responses that are not relieved by aspirin in older firefighters. J Occup Eenviron Med 2019; 61(7): 617-622.
  13. Hussain SA, Aziz TA, Mahwi TO, Ahmed ZA. Gingko biloba extract improves the lipid profile, inflammatory markers, leptin level and the antioxidant status of T2DM patients poorly responding to metformin: A double-blind, randomized, placebo-controlled trial. Brazilian Journal of Pharmaceutical Sciences. 2022; 58: e19516.
  14. Li Y, Zhu X, Wang K, Zhu L, et al. The potential of Ginkgo biloba in the treatment of human diseases and the relationship to Nrf2–mediated antioxidant protection. J Pharm Pharmacol 2022; 74(12): 1689-1699.
  15. Krüger S, Graf Jü, Kunz D, Stickel T, et al. Brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure. J Am Coll Cardiol 2002; 40(4): 718-722.
  16. Mori Y, Fukuma S, Yamaji K, Mizuno A, et al. Machine learning‐based prediction of elevated N terminal pro brain natriuretic peptide among US general population. ESC Heart Fail 2025; 12(2): 859-868.
  17. Yumita Y, Xu Z, Diller G-P, Kempny A, et al. B-type natriuretic peptide levels predict long-term mortality in a large cohort of adults with congenital heart disease. Eur Heart J 2024; 45(23): 2066-2075.
  18. Stretton SM, MacDermid JC. The Link Between Stress and Cardiac Outcomes In Firefighters. Occupational Stress Injuries: Operational and Organizational Stressors Among Public Safety Personnel. 2024.
  19. Achmat G, Malema M, Erasmus C, Kanaley J, Leach L. Perceptions Experiences and Challenges of Physical Activity among Firefighters with Coronary Heart Disease Risk Factors in the City of Cape Town Fire and Rescue Services. The Open Public Health J 2024;17(1): E18749445327343
  20. Stretton SM, MacDermid JC. The Link between Stress and Cardiac Outcomes in Firefighters: An Example of Critical Analysis of Causation. Occupational Stress Injuries: Routledge; 2024; 155-175.
  21. Abedpoor N, Taghian F, Jalali Dehkordi K, Safavi K. The role of Sparasis Latifolia and Aerobic Exercise on Anti-inflammatory Activities and Regulation of Inflammatory Factors in the Intestine of Mice with Colon Cancer Under Chemotherapy. Iranian J Nutr Sci Food Technol 2025; 19(4): 13-24.
  22. Fuentes GC, Castañer O, Warnberg J, Subirana I, et al. Prospective association of physical activity and inflammatory biomarkers in older adults from the PREDIMED-Plus study with overweight or obesity and metabolic syndrome. Clin Nutr 2020; 39(10): 3092-3098.
  23. Makiel K, Suder A, Targosz A, Maciejczyk M, Haim A. Exercise-induced alternations of adiponectin, interleukin-8 and indicators of carbohydrate metabolism in males with metabolic syndrome. Biomolecules. 2023; 13(5): 852.
  24. Luo B, Xiang D, Ji X, Chen X, et al. The anti-inflammatory effects of exercise on autoimmune diseases: A twenty-year systematic review. J Sport Health Sci 2024; 13(3): 353-367.
  25. Abedpoor N, Taghian F, Jalali Dehkordi K, Safavi K. Sparassis latifolia and exercise training as complementary medicine mitigated the 5-fluorouracil potent side effects in mice with colorectal cancer: bioinformatics approaches, novel monitoring pathological metrics, screening signatures, and innovative management tactic. Cancer Cell Int 2024; 24(1): 141.
  26. Abedpoor N, Taghian F, Hajibabaie F. Physical activity ameliorates the function of organs via adipose tissue in metabolic diseases. Acta Histochem. 2022; 124(2): 151844.
  27. Jafari M, Zolaktaf V, Ghasemi G. Functional movement screen composite scores in firefighters: effects of corrective exercise training. J Sport Rehabil 2020; 29(1): 102-106.
  28. Feito Y, Hoffstetter W, Serafini P, Mangine G. Changes in body composition, bone metabolism, strength, and skill-specific performance resulting from 16-weeks of HIFT. PloS One 2018; 13(6): e0198324.
  29. Zhang L, Liu J, Geng T. Ginkgetin aglycone attenuates the apoptosis and inflammation response through nuclear factor-kB signaling pathway in ischemic-reperfusion injury. J Cell Biochem. 2019; 120(5): 8078-8085.
  30. Jacob N, So I, Sharma B, Marzolini S, et al. Effects of high-intensity interval training on blood lactate levels and cognition in healthy adults: protocol for systematic review and network meta-analyses. Sport Med 2023; 53(5): 977-991.
  31. Rohnejad B, Monazzami A. Effects of high-intensity intermittent training on some inflammatory and muscle damage indices in overweight middle-aged men. Apunts Sports Medicine 2023; 58(217): 100404.
  32. Amiri R, Sadeghi H, Borhani Kakhki Z. The Effect of Cardio, Aerobic and Concurrent Rehabilitation on Hemodynamic and Biomechanical Indicators in Older Men With Coronary Artery Disease. The Scientific Journal of Rehabilitation Medicine. 2023; 12(3): 432-445.
  33. Gao K, Su Z, Meng J, Yao Y, et al. Effect of exercise training on some anti-inflammatory adipokines, high sensitivity C-reactive protein, and clinical outcomes in Sedentary adults with metabolic syndrome. Biol Res Nurs. 2024; 26(1): 125-138.
  34. Chichagi F, Alikhani R, Hosseini MH, Azadi K, et al. The effects of high-intensity interval training and moderate-intensity continuous training on patients underwent Coronary Artery Bypass Graft surgery; a systematic review. Am J Cardiovasc Dis 2024; 14(6): 306-317.
  35. Sansuwito TB. The Comparative Study of Physical Exercise Towards Brain Natriuretic Peptide (BNP) and Malondialdehyde (MDA) as Oxidative Stress Markers in Rattus Novergicus Wistar Strain Rats. International J Advancement in Life Sciences Research 2024; 7(2): 170-177.
  36. Furon Y, Dang Van S, Blanchard S, Saulnier P, Baufreton C. Effects of high-intensity inspiratory muscle training on systemic inflammatory response in cardiac surgery-A randomized clinical trial. Physiother Theory Pract 2024; 40(4): 778-788.
  37. Li Z, McKenna Z, Fennel Z, Nava RC, et al. The combined effects of exercise-induced muscle damage and heat stress on acute kidney stress and heat strain during subsequent endurance exercise. Eur J Appl Physiol 2022; 122(5): 1239-1248.
  38. Małkowska P, Sawczuk M. Cytokines as biomarkers for evaluating physical exercise in trained and non-trained individuals: a narrative review. Int J Mol Sci 2023; 24(13): 11156.
  39. Khakroo Abkenar I, Rahmani-Nia F, Lombardi G. The effects of acute and chronic aerobic activity on the signaling pathway of the inflammasome NLRP3 complex in young men. Medicina 2019; 55(4): 105.
  40. Hajibabaie F, Aali F, Abedpoor N. Pathomechanisms Of Non-Coding RNAs, Hub Genes, and Lifestyle Related To The Oxidative Stress In Type 2 Diabetes And Cardiac Complications. F1000Research. 2023; 11: 1132.
  41. Hajibabaie F, Abedpoor N, Javanmard SH, Hasan A, et al. The molecular perspective on the development of melanoma and genome engineering of T-cells in targeting therapy. Environ Res 2023; 237(pt 2): 116980.
  42. Kaviani E, Hajibabaie F, Abedpoor N, Safavi K, et al System biology analysis to develop diagnostic biomarkers, monitoring pathological indexes, and novel therapeutic approaches for immune targeting based on maggot bioactive compounds and polyphenolic cocktails in mice with gastric cancer. Environ Res 2023; 238(pt 2): 117168.
  43. Tao Y, Lu J, Lv J, Zhang L. Effects of high-intensity interval training on depressive symptoms: A systematic review and meta-analysis. J Psychosom Res 2024; 180: 111652.
  44. Zhang J-Y, Fu S-K, Tai H-L, Tseng K-W, et al. A Comparative Study: Cardioprotective Effects of High-Intensity Interval Training Versus Ischaemic Preconditioning in Rat Myocardial Ischaemia–Reperfusion. Life. 2024; 14(3): 310
  45. Gonzalez DE, Forbes SC, Zapp A, Jagim A, et al. Fueling the Firefighter and Tactical Athlete with Creatine: A Narrative Review of a Key Nutrient for Public Safety. Nutrients. 2024; 16(19): 3285.
  46. Pardo M, Li C, Zimmermann R, Rudich Y. Health impacts of biomass burning aerosols: Relation to oxidative stress and inflammation. Aerosol Science and Technology. 2024; 58(10): 1093-1113.
  47. Allaouat S, Yli-Tuomi T, Tiittanen P, Kukkonen J, et al. Long-term exposures to low concentrations of source-specific air pollution, road-traffic noise, and systemic inflammation and cardiovascular disease biomarkers. Environ Res 2024; 262(pt 1): 119846.
  48. Lv J, Tan Z, An Z, Xu R, et al. Co-exposure to polystyrene nanoplastics and F-53B induces vascular endothelial cell pyroptosis through the NF-κB/NLRP3 pathway. J Hazard Mater 2025; 486: 137114.
  49. Zhang J, Zhang H, Wei T, Kang P, et al Predicting angiographic coronary artery disease using machine learning and high-frequency QRS. BMC Med Inform Decis Mak 2024; 24(1): 217.
  50. Azzo JD, Dib M-J, Zagkos L, Zhao L, et al. Proteomic associations of NT-proBNP (N-terminal pro-B-type natriuretic peptide) in heart failure with preserved ejection fraction. Circ Heart Fail 2024; 17(2): e011146.
  51. Afsar B, Afsar RE, Caliskan Y, Lentine KL. Brain natriuretic peptide and N-terminal pro b-type natriuretic peptide in kidney transplantation: More than just cardiac markers. Transplant Rev 2024; 38(4): 100869.
Journal of Paramedical Sciences & Rehabilitation
Volume 14, Issue 2
Summer 2025
Pages 82-96