{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:40:05Z","timestamp":1788471605234,"version":"build-2803163510"},"reference-count":104,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo Investigaci\u00f3n Salud FIIS"},{"name":"Faculty of Medicine, University of Chile"},{"name":"ANID Fondecyt","award":["1230428"],"award-info":[{"award-number":["1230428"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Cancer survivors (CS) constitute an expanding population with underrecognized cardiometabolic risk. Despite substantial improvements in five-year survival rates, both childhood and adult survivors remain at high risk for premature morbidity and mortality. These risks are particularly pronounced following exposure to anthracyclines and\/or chest radiotherapy, typically in a dose-dependent manner. In Chile, the establishment of the National Pediatric Antineoplastic Drug Program (PINDA) in 1998 marked a milestone in improving equitable access to high-quality pediatric oncology care through evidence-based treatment protocols across the public health system; the adult counterpart (PANDA) has developed diagnostic, treatment, and monitoring protocols for hematological neoplasms. Few prospective cohort or mechanistic studies have clarified risk stratification or surveillance strategies in survivor populations. The regulated, short-term activation of inflammation and innate immunity can be an adaptive and protective response to tissue injury, whereas persistent low-grade inflammation may trigger neutrophil extracellular traps formation (NETosis) and other maladaptive pathways that accelerate endothelial injury, thrombosis, and adverse cardiovascular remodeling. NETosis represents a putative immunomodulatory target for therapeutic immunomodulation in heart failure and maladaptive left ventricular remodeling in preclinical models. Concurrently, skeletal muscle-derived and hormonal mediators known as exerkines\u2014together with increased NET activity\u2014may modulate the pathophysiology of chronic cardiometabolic disease and contribute to cancer progression, particularly in the context of obesity, diabetes, and insulin resistance. Structured exercise is a promising non-pharmacological intervention that modulates inflammatory and metabolic pathways and may thereby help prevent non-communicable diseases, including cancer. We synthesize basic and clinical evidence to (1) define how cancer therapies promote low-grade inflammation and NETosis; (2) describe how exerkines and structured exercise influence cardiometabolic biology; and (3) evaluate exercise as a mechanistic and clinically pragmatic strategy to reduce long-term CVD risk in pediatric and adult CS.<\/jats:p>","DOI":"10.3390\/ijms262210843","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T08:57:55Z","timestamp":1762765075000},"page":"10843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Exercise on Cardiovascular and Metabolic Responses in Adults and Childhood Cancer Survivors: The Role of NETosis and Low-Grade Inflammation as a Novel Therapeutic Target\u2014A Narrative Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0549-1326","authenticated-orcid":false,"given":"Rodrigo L.","family":"Castillo","sequence":"first","affiliation":[{"name":"Departamento de Medicina Interna Oriente, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile"},{"name":"Unidad de Paciente Cr\u00edtico, Hospital del Salvador, Santiago 7500922, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1316-738X","authenticated-orcid":false,"given":"Esteban G.","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Escuela de Obstetricia, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebasti\u00e1n, Santiago 7510602, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-367X","authenticated-orcid":false,"given":"Alejandro","family":"Gonz\u00e1lez-Candia","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, University of O\u2019Higgins, Rancagua 2820000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3830-7334","authenticated-orcid":false,"given":"Andrea","family":"del Campo","sequence":"additional","affiliation":[{"name":"Facultad de Qu\u00edmica y Farmacia, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 7820436, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Paris","sequence":"additional","affiliation":[{"name":"Unidad de Oncolog\u00eda, Hospital Calvo Mackenna, Santiago 7500539, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0977-3619","authenticated-orcid":false,"given":"Fernando","family":"Verdugo","sequence":"additional","affiliation":[{"name":"Laboratorio de Ecocardiograf\u00eda, Servicio de Cardiologia, Hospital Salvador, Santiago 8320000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morin","family":"Lang","sequence":"additional","affiliation":[{"name":"Departamento de Kinesiolog\u00eda, Facultad de Medicina, Universidad de Chile, Santiago 8580453, Chile"},{"name":"Facultad de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Cruz-Montecinos","sequence":"additional","affiliation":[{"name":"Departamento de Kinesiolog\u00eda, Facultad de Medicina, Universidad de Chile, Santiago 8580453, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Quezada","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8835-7525","authenticated-orcid":false,"given":"Robert A.","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad de los Andes, Santiago 7620086, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn","family":"Armijo","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna Oriente, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio","family":"Acevedo","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna Oriente, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9543-8619","authenticated-orcid":false,"given":"Rodrigo","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Centre, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11764-006-0002-x","article-title":"Defining cancer survivorship","volume":"1","author":"Feuerstein","year":"2007","journal-title":"J. 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