Royal College of Surgeons in Ireland
Effect of Moderate Aerobic Exercise on Complement Activation Pathways in Polycystic Ovary Syndrome Women.pdf (1.26 MB)

Effect of moderate aerobic exercise on complement activation pathways in polycystic ovary syndrome women

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journal contribution
posted on 2022-11-22, 09:18 authored by Manjunath Ramanjaneya, Ibrahem Abdalhakam, Ilham Bettahi, Milin Bensila, Jayakumar Jerobin, Myint Myint Aye, Meis Alkasem, Thozhukat Sathyapalan, Stephen AtkinStephen 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.


Qatar Metabolic Institute, Medical Research Center, Hamad Medical Corporation, Doha, Qatar



The original article is available at

Published Citation

Ramanjaneya M. et al. Effect of moderate aerobic exercise on complement activation pathways in polycystic ovary syndrome women. Front Endocrinol (Lausanne). 2022;12:740703.

Publication Date

17 February 2022

PubMed ID



  • RCSI Bahrain


Frontiers Research Foundation


  • Published Version (Version of Record)