{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:06:30Z","timestamp":1784603190748,"version":"3.55.0"},"reference-count":118,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: As a non-weight-bearing full-body exercise, swimming may reduce inflammation and boost anti-inflammatory agents to decrease the risk of cardiovascular, neurological, and rheumatological disorders. This systematic review examines the current evidence on the role of swimming exercise in modulating immune responses through inflammatory pathways. Methods: First, the PubMed and Scopus databases were searched through December 2024 for studies on swimming and inflammation. The initial search using keywords yielded 509 articles; 102 met the inclusion criteria after screening for relevance, language, and full-text availability. Results: This study suggests that regular swimming reduces neuroinflammation by enhancing BDNF, CREB, and PI3K\/Akt signaling while suppressing both mRNA and protein levels of NF-\u03baB, TNF-\u03b1, and IL-6 in the brain. In metabolic tissues, it activates SIRT1 and PGC-1\u03b1, improving mitochondrial biogenesis and antioxidant defense. Swimming also upregulates PPAR-\u03b1 and eNOS while downregulating iNOS, leading to reduced vascular inflammation, oxidative stress, and fibrosis in renal and cardiac tissues. Moreover, the enhanced production of IL-10 and the decreasing levels of IL-1\u03b2 and CRP contribute to systemic anti-inflammatory effects. Conclusions: Consequently, the available evidence suggests that swimming can be a low-impact, full-body exercise with potential therapeutic options in managing inflammation-related conditions such as cardiovascular disease, diabetes, and obesity. Future studies should focus on human clinical trials, investigate mechanisms, and assess longer time frames.<\/jats:p>","DOI":"10.3390\/brainsci15101121","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:18:54Z","timestamp":1760948334000},"page":"1121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["How Swimming Modulates Inflammatory Pathways in Pain, Neurodegenerative, and Metabolic Disorders"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0563-493X","authenticated-orcid":false,"given":"Mahdiyeh","family":"Kooshki","sequence":"first","affiliation":[{"name":"Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0782-3917","authenticated-orcid":false,"given":"Rozhin","family":"Rezeai-Farimani","sequence":"additional","affiliation":[{"name":"Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Student Research Committee, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Azadi Sq, Vakil Abad Highway, Mashhad 9177948564, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4346-6081","authenticated-orcid":false,"given":"Amirmohammad","family":"Moradpour","sequence":"additional","affiliation":[{"name":"Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Student Research Committee, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Azadi Sq, Vakil Abad Highway, Mashhad 9177948564, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vafa","family":"Baradaran Rahimi","sequence":"additional","affiliation":[{"name":"Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9268-6270","authenticated-orcid":false,"given":"Vahid Reza","family":"Askari","sequence":"additional","affiliation":[{"name":"Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Student Research Committee, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran"},{"name":"Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Azadi Sq, Vakil Abad Highway, Mashhad 9177948564, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9206875","DOI":"10.1155\/2023\/9206875","article-title":"Diet Control and Swimming Exercise Ameliorate HFD-Induced Cognitive Impairment Related to the SIRT1-NF-\u03baB\/PGC-1\u03b1 Pathways in ApoE\u2212\/\u2212 Mice","volume":"2023","author":"Wei","year":"2023","journal-title":"Neural Plast."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s40798-024-00692-x","article-title":"Health Benefits of Different Sports: A Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants","volume":"10","author":"Oja","year":"2024","journal-title":"Sports Med.-Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/pmrj.12503","article-title":"An Updated Review of the Epidemiology of Swimming Injuries","volume":"13","author":"Trinidad","year":"2021","journal-title":"PMR"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mahdirejei, H.A., Peeri, M., Azarbayjani, M.A., and Fattahi Masrour, F. 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