Chinese Medical Journal study highlights exercise-induced vascular growth as anti-aging strategy

The trend of global population aging is becoming increasingly prominent, and age-related diseases are imposing a heavy burden on the field of public health. Aging is associated with the decline of various physiological functions, such as the reduction of vascular function and the weakening of the immune system. These changes enhance the risk of chronic diseases and undermine the body's repair ability.

Recently, a review published in Volume 138, Issue 20 of the Chinese Medical Journal on October 20, 2025, presents a brand-new perspective on exercise-induced angiogenesis and lymphangiogenesis in combating aging and disease. This review, authored by a team of scientists led by Junjie Xiao from the Cardiac Regeneration and Ageing Lab, Institute of Geriatrics, School of Medicine, Shanghai University, China, indicates that exercise, being a natural physiological stimulus, can trigger angiogenesis and lymphangiogenesis within the body. As Dr. Xiao explains, "Exercise acts as a powerful, natural stimulus that triggers both angiogenesis and lymphangiogenesis, processes essential for maintaining vascular health and immune function as we age. By enhancing these mechanisms, exercise offers a promising therapeutic strategy to combat age-related decline and disease."

Angiogenesis pertains to the process where new blood vessels develop from existing ones, which is essential for maintaining tissue oxygen supply, nutrient transportation, and wound healing. Lymphangiogenesis involves the formation and expansion of lymphatic vessels and is highly significant for immune function, tissue fluid balance, and metabolic regulation. As people grow older, the functions of blood vessels and lymphatic vessels gradually deteriorate, resulting in insufficient tissue perfusion, accumulation of metabolic waste, and weakened immune function, thereby accelerating the aging process and heightening the risk of diseases.

Exercise promotes angiogenesis and lymphangiogenesis through the activation of multiple molecular signaling pathways. For instance, exercise can up-regulate the expression of vascular endothelial growth factor (VEGF) and its receptors, enhance the proliferation and migration ability of endothelial cells, and thereby facilitate the formation of new blood vessels. Moreover, exercise can also activate transcription factors related to angiogenesis, such as hypoxia-inducible factor-1 α (HIF-1α), as well as microRNAs (miRNAs) that regulate angiogenesis, to regulate vascular physiological functions at multiple levels. Regarding lymphangiogenesis, exercise activates specific receptors (such as VEGFR-3) on the surface of lymphatic endothelial cells, promoting the growth and remodeling of lymphatic vessels. These physiological changes induced by exercise can effectively enhance the blood supply and lymphatic return of tissues and boost the body's metabolic capacity and immune response.

In different organs, exercise-induced angiogenesis and lymphangiogenesis exert unique anti-aging effects. In the cardiovascular system, exercise facilitates the regeneration and repair of blood vessels in the heart, enhances the blood perfusion and function of the myocardium, and lowers the risk of cardiovascular diseases. For skeletal muscles, angiogenesis induced by exercise supplies a more abundant blood supply to the muscles, boosts the delivery of oxygen and nutrients, helps maintain muscle strength and endurance, and delays muscle atrophy and functional deterioration.

In the brain, exercise stimulates the growth and remodeling of cerebral blood vessels, strengthens the function of neurovascular units, improves cognitive ability and the brain's resistance to diseases, and holds potential value for the prevention and alleviation of neurodegenerative disorders. Additionally, exercise can ameliorate metabolic diseases such as complications of diabetes and obesity, thereby conferring comprehensive benefits to the body.

However, at present, the research on exercise-induced angiogenesis and lymphangiogenesis still faces numerous challenges. For instance, whether there is a correlation among the molecular signals of various organs in response to exercise remains unclear. The impacts of different types, intensities, and durations of exercise on angiogenesis and lymphangiogenesis are ambiguous. The regulatory mechanisms of individual differences in the effect of exercise have not been fully elucidated. Excessive exercise may cause damage to various organs, especially for the elderly and patients with diseases. Thus, exercise protocols need to be more precisely individualized.

Additionally, how to combine exercise intervention with existing medical treatment approaches to achieve the best anti-aging and disease treatment effects still requires further exploration. As Dr. Xiao comments, "While the benefits of exercise-induced vascular and lymphatic growth are clear, we still face important challenges such as tailoring exercise protocols to individual needs and combining physical activity with medical treatments. Our ongoing research aims to optimize these strategies for safe and effective anti-aging interventions."

This review offers a comprehensive and systematic summary, enabling us to profoundly understand the influence of exercise on the vascular and lymphatic systems and revealing the significant potential of exercise-induced angiogenesis and lymphatic production in anti-aging and disease treatment. Nevertheless, to translate this theory into practical clinical applications, a considerable amount of research work is still necessary to verify and optimize the exercise intervention strategies.

Future research should focus on exploring the specific molecular mechanisms through which exercise promotes angiogenesis and lymphangiogenesis, determining the optimal exercise regimens for different populations, and evaluating their long-term health benefits and safety. Through these endeavors, it is anticipated that more effective, safe, and personalized exercise intervention measures will be provided for the elderly and patients with chronic diseases, thereby improving their physical health, enhancing their quality of life, and prolonging their lifespan.

***

Reference
DOI: 10.1097/CM9.0000000000003831