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Effect of Moderate Aerobic Exercise on Complement Activation Pathways in Polycystic Ovary Syndrome Women

Ramanjaneya, Manjunath; Abdalhakam, Ibrahem; Bettahi, Ilham; Bensila, Milin; Jerobin, Jayakumar; Aye, Myint Myint; Alkasem, Meis; Sathyapalan, Thozhukat; Atkin, Stephen Lawrence; Abou-Samra, Abdul Badi


Manjunath Ramanjaneya

Ibrahem Abdalhakam

Ilham Bettahi

Milin Bensila

Jayakumar Jerobin

Myint Myint Aye

Meis Alkasem

Stephen Lawrence Atkin

Abdul Badi Abou-Samra


Background: The complement system is pivotal in host defense mechanisms, protecting against pathogenic infection by regulating inflammation and cell immunity. Complement-related protein activation occurs through three distinct pathways: classical, alternative, and lectin-dependent pathways, which are regulated by cascades of multiple proteins. Complement activation is recognized in polycystic ovary syndrome (PCOS) to be associated with obesity and insulin sensitivity. Exercise reduces insulin resistance and may help reduce obesity, and therefore, this study was undertaken to determine the effect of exercise on the activation of complement-related proteins in PCOS and control women. Subjects and Measurements: In this study, 10 controls and 11 PCOS subjects who were age- and weight-matched underwent an 8-week supervised exercise program at 60% maximal oxygen consumption. Weight was unchanged though insulin sensitivity was increased in PCOS subjects and controls. Fasting baseline and post-exercise samples were collected and 14 complement-related proteins belonging to classical, alternative, and lectin-dependent pathways were measured. Results: Baseline levels of complement C4b and complement C3b/iC3b were higher in PCOS (P < 0.05) compared with controls. Exercise reduced complement C1q (P < 0.05), C3 (P < 0.001), C4 (P < 0.01), factor B (P < 0.01), factor H (P < 0.01), and properdin (P < 0.05) in controls, but not in PCOS women. Conclusion: Exercise induced complement changes in controls that were not seen in PCOS subjects, suggesting that these pathways remain dysregulated even in the presence of improved insulin sensitivity and not improved by moderate aerobic exercise. Clinical Trial Registration: ISRCTN registry, ISRCTN42448814.


Ramanjaneya, M., Abdalhakam, I., Bettahi, I., Bensila, M., Jerobin, J., Aye, M. M., …Abou-Samra, A. B. (2022). Effect of Moderate Aerobic Exercise on Complement Activation Pathways in Polycystic Ovary Syndrome Women. Frontiers in endocrinology, 12, Article 740703.

Journal Article Type Article
Acceptance Date Dec 23, 2021
Online Publication Date Feb 17, 2022
Publication Date Feb 17, 2022
Deposit Date Mar 28, 2022
Publicly Available Date Oct 27, 2022
Journal Frontiers in Endocrinology
Print ISSN 1664-2392
Electronic ISSN 1664-2392
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 12
Article Number 740703
Keywords PCOS; T2D; Complement-related proteins; M value; VO2max; Exercise
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Copyright Statement
Copyright © 2022 Ramanjaneya, Abdalhakam, Bettahi, Bensila, Jerobin, Aye, Alkasem, Sathyapalan, Atkin and Abou-Samra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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