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Dimitriou L, Hill JA, Jehnali A, Dunbar J, Brouner J, McHugh MP, Howatson G. Influence of a montmorency cherry juice blend on indices of exercise-induced stress and upper respiratory tract symptoms following marathon running--a pilot investigation. J Int Soc Sports Nutr 2015; 12:22. [PMID: 25983669 PMCID: PMC4432790 DOI: 10.1186/s12970-015-0085-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/04/2015] [Indexed: 01/01/2023] Open
Abstract
Background Prolonged exercise, such as marathon running, has been associated with an increase in respiratory mucosal inflammation. The aim of this pilot study was to examine the effects of Montmorency cherry juice on markers of stress, immunity and inflammation following a Marathon. Methods Twenty recreational Marathon runners consumed either cherry juice (CJ) or placebo (PL) before and after a Marathon race. Markers of mucosal immunity secretory immunoglobulin A (sIgA), immunoglobulin G (IgG), salivary cortisol, inflammation (CRP) and self-reported incidence and severity of upper respiratory tract symptoms (URTS) were measured before and following the race. Results All variables except secretory IgA and IgG concentrations in saliva showed a significant time effect (P <0.01). Serum CRP showed a significant interaction and treatment effect (P < 0.01). The CRP increase at 24 and 48 h post-Marathon was lower (P < 0.01) in the CJ group compared to PL group. Mucosal immunity and salivary cortisol showed no interaction effect or treatment effect. The incidence and severity of URTS was significantly greater than baseline at 24 h and 48 h following the race in the PL group and was also greater than the CJ group (P < 0.05). No URTS were reported in the CJ group whereas 50 % of runners in the PL group reported URTS at 24 h and 48 h post-Marathon. Conclusions This is the first study that provides encouraging evidence of the potential role of Montmorency cherries in reducing the development of URTS post-Marathon possibly caused by exercise-induced hyperventilation trauma, and/or other infectious and non-infectious factors.
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Affiliation(s)
- Lygeri Dimitriou
- London Sport Institute, Middlesex University, Allianz Park, Greenland Way, NW4 1RLE London, UK
| | - Jessica A Hill
- School of Sport, Health and Applied Science, St Mary's University College, Twickenham, UK
| | | | | | - James Brouner
- School of Life Sciences, Kingston University, London, UK
| | - Malachy P McHugh
- Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY UK
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK ; Water Research Group, School of Biological Sciences, North West University, Potchefstroom, South Africa
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Effects of strenuous exercise on Th1/Th2 gene expression from human peripheral blood mononuclear cells of marathon participants. Mol Immunol 2014; 60:129-34. [PMID: 24853398 DOI: 10.1016/j.molimm.2014.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 03/05/2014] [Accepted: 03/18/2014] [Indexed: 11/23/2022]
Abstract
Physical stressors, such as strenuous exercise, can have numerous effects on the human body including the immune system. The aim of this study was to evaluate the gene expression profile of Th1/Th2 cytokines and related transcription factor genes in order to investigate possible immune imbalances before and after a marathon. Blood samples were collected from 16 normal volunteers 24-48 h before and one week after completing a marathon race. Gene expression of Th1 and Th2 related cytokines from human peripheral blood mononuclear cells (PBMC) was analyzed using Human Th1-Th2-Th3 RT(2) Profiler PCR Array and qRT-PCR that measured the transcript levels of 84 genes related to T cell activation. We found that PBMC express a characteristic Th2-like gene profile one week post-marathon compared to pre-marathon. The majority of genes up-regulated one week post-marathon such as IL-4, GATA3, and CCR4 were Th2 associated. For Th1-related genes, CXCR3 and IRF1 were up-regulated one week post-marathon. There was a trend of down-regulation of two Th1 related genes, T-bet and STAT1. Th3-related gene expression patterns did not change in the study. The ratios of both IFN-γ/IL-4 and T-bet/GATA3 gene expressions were significantly lower one week after marathon. These findings suggest that a Th1/Th2 immune imbalance persisted at least 1 week after completion of a marathon which offers a mechanistic rationale for the increased risk of upper respiratory tract infections often reported after strenuous exercise.
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Medical Services at Ultra-Endurance Foot Races in Remote Environments: Medical Issues and Consensus Guidelines. Sports Med 2014; 44:1055-69. [DOI: 10.1007/s40279-014-0189-3] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Teixeira RN, Mendes FA, Martins MA, Mickleborough TD, Carvalho CR. AQUA© as predictor of allergy in elite marathon runners. World Allergy Organ J 2014; 7:7. [PMID: 24708728 PMCID: PMC3983857 DOI: 10.1186/1939-4551-7-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 03/24/2014] [Indexed: 12/22/2022] Open
Abstract
Background The prevalence of allergy in athletes is increasing, and its risk varies across sports. The risk is dependent mainly on the ventilation rate and environmental factors; however, the prevalence of allergy in elite runners remains unknown. Therefore, the aim of this study was to screen allergy symptoms in elite marathon runners by using a validated questionnaire for screening allergy in athletes. Methods Two hundred and one elite marathoners, who participated in the most competitive Brazilian marathons and half-marathons during 2011, were invited to complete a validated self-report Allergy Questionnaire for Athletes (AQUA©), with additional questions pertaining to training history, such as running experience, running distance per week and their best race time in marathon or half-marathon events. Results Sixty percent of the assessed athletes reported allergy symptoms as defined by a positive AQUA outcome (score [greater than or equal to] 5). No significant differences (p > 0.05) between groups (AQUA + and AQUA-) were observed for gender, age, running experience, weekly training volume and best performance time in the half-marathon and marathon. The most frequently reported symptoms were related to the respiratory tract and physical effort. Conclusions This study demonstrates that AQUA© can be used to predict allergy in elite marathon runners. In addition, these athletes have a higher prevalence of allergy symptoms to elite athletes from other sports.
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Affiliation(s)
- Renata N Teixeira
- Department of Physical Therapy, School of Medicine, University of Sao Paulo, Av, Dr Arnaldo, 455, Room 1210, 01246-903 São Paulo, SP, Brazil.
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Randolph C. Pediatric exercise-induced bronchoconstriction: contemporary developments in epidemiology, pathogenesis, presentation, diagnosis, and therapy. Curr Allergy Asthma Rep 2014; 13:662-71. [PMID: 23925985 DOI: 10.1007/s11882-013-0380-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Exercise-induced bronchoconstriction is transient narrowing of the airways following strenuous exercise. It is the earliest sign of asthma and the last to resolve. EIB is found in 90 % of asthmatics and reflects underlying control of asthma. This review is focused on the contemporary developments in pediatric EIB: the epidemiology, pathogenesis, presentation, diagnosis and management. Proper diagnosis by objective pulmonary function and/or exercise challenge and therapy should allow the pediatric asthmatic to enjoy a healthy lifestyle including participation in the chosen sport.
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Affiliation(s)
- Christopher Randolph
- Center for Allergy, Asthma & Immunology, 1389 West Main Street Suite 205, Waterbury, CT, 06708, USA,
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Health and exercise-related medical issues among 1,212 ultramarathon runners: baseline findings from the Ultrarunners Longitudinal TRAcking (ULTRA) Study. PLoS One 2014; 9:e83867. [PMID: 24416176 PMCID: PMC3885517 DOI: 10.1371/journal.pone.0083867] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/08/2013] [Indexed: 11/19/2022] Open
Abstract
Regular exercise is associated with substantial health benefits; however, little is known about the health impact of extreme levels of exercise. This study examined the prevalence of chronic diseases, health-care utilization, and risk factors for exercise-related injuries among ultramarathon runners. Retrospective, self-reported enrollment data from an ongoing longitudinal observational study of 1,212 active ultramarathon runners were analyzed. The most prevalent chronic medical conditions were allergies/hay fever (25.1%) and exercise-induced asthma (13.0%), but there was a low prevalence of serious medical issues including cancers (4.5%), coronary artery disease (0.7%), seizure disorders (0.7%), diabetes (0.7%), and human immunodeficiency virus (HIV) infection (0.2%). In the year preceding enrollment, most (64.6%) reported an exercise-related injury that resulted in lost training days (median of 14 days), but little nonattendance of work or school due to illness, injury, or exercise-related medical conditions (medians of 0 days for each). The knee was the most common area of exercise-related injury. Prior year incidence of stress fractures was 5.5% with most (44.5%) involving the foot. Ultramarathon runners who sustained exercise-related injuries were younger (p<0.001) and less experienced (p<0.01) than those without injury. Stress fractures were more common (p<0.01) among women than men. We conclude that, compared with the general population, ultramarathon runners appear healthier and report fewer missed work or school days due to illness or injury. Ultramarathon runners have a higher prevalence of asthma and allergies than the general population, and the prevalence of serious medical issues was nontrivial and should be recognized by those providing medical care to these individuals. Ultramarathon runners, compared with shorter distance runners, have a similar annual incidence of exercise-related injuries but higher proportion of stress fractures involving the foot, and it is the younger and less experienced ultramarathoners who appear most at risk for injury.
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Williams PT. Inadequate exercise as a risk factor for sepsis mortality. PLoS One 2013; 8:e79344. [PMID: 24324580 PMCID: PMC3850902 DOI: 10.1371/journal.pone.0079344] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/30/2013] [Indexed: 12/29/2022] Open
Abstract
Objective Test whether inadequate exercise is related to sepsis mortality. Research Design and Methods Mortality surveillance of an epidemiological cohort of 155,484 National Walkers' and Runners' Health Study participants residing in the United States. Deaths were monitored for an average of 11.6-years using the National Death index through December 31, 2008. Cox proportional hazard analyses were used to compare sepsis mortality (ICD-10 A40-41) to inadequate exercise (<1.07 METh/d run or walked) as measured on their baseline questionnaires. Deaths occurring within one year of the baseline survey were excluded. Results Sepsis was the underlying cause in 54 deaths (sepsisunderlying) and a contributing cause in 184 deaths (sepsiscontributing), or 238 total sepsis-related deaths (sepsistotal). Inadequate exercise was associated with 2.24-fold increased risk for sepsisunderlying (95%CI: 1.21 to 4.07-fold, P = 0.01), 2.11-fold increased risk for sepsiscontributing (95%CI: 1.51- to 2.92-fold, P<10−4), and 2.13-fold increased risk for sepsistotal (95%CI: 1.59- to 2.84-fold, P<10−6) when adjusted for age, sex, race, and cohort. The risk increase did not differ significantly between runners and walkers, by sex, or by age. Sepsistotal risk was greater in diabetics (P = 10−5), cancer survivors (P = 0.0001), and heart attack survivors (P = 0.003) and increased with waist circumference (P = 0.0004). The sepsistotal risk associated with inadequate exercise persisted when further adjusted for diabetes, prior cancer, prior heart attack and waist circumference, and when excluding deaths with cancer, or cardiovascular, respiratory, or genitourinary disease as the underlying cause. Inadequate exercise also increased sepsistotal risk in 2163 baseline diabetics (4.78-fold, 95%CI: 2.1- to 13.8-fold, P = 0.0001) when adjusted, which was significantly greater (P = 0.03) than the adjusted risk increase in non-diabetics (1.80-fold, 95%CI: 1.30- to 2.46-fold, P = 0.0006). Conclusion Inadequate exercise is a risk factor for sepsis mortality, particular in diabetics.
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Affiliation(s)
- Paul T. Williams
- Donner Laboratory, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, California, United States of America
- * E-mail:
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Price OJ, Ansley L, Menzies-Gow A, Cullinan P, Hull JH. Airway dysfunction in elite athletes--an occupational lung disease? Allergy 2013; 68:1343-52. [PMID: 24117544 DOI: 10.1111/all.12265] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 11/28/2022]
Abstract
Airway dysfunction is prevalent in elite endurance athletes and when left untreated may impact upon both health and performance. There is now concern that the intensity of hyperpnoea necessitated by exercise at an elite level may be detrimental for an athlete's respiratory health. This article addresses the evidence of causality in this context with the aim of specifically addressing whether airway dysfunction in elite athletes should be classified as an occupational lung disease. The approach used highlights a number of concerns and facilitates recommendations to ensure airway health is maintained and optimized in this population. We conclude that elite athletes should receive the same considerations for their airway health as others with potential and relevant occupational exposures.
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Affiliation(s)
- O. J. Price
- Faculty of Health and Life Sciences; Northumbria University; Newcastle UK
| | - L. Ansley
- Faculty of Health and Life Sciences; Northumbria University; Newcastle UK
| | - A. Menzies-Gow
- Department of Respiratory Medicine; Royal Brompton Hospital; London UK
- National Heart and Lung Institute; Imperial College London; London UK
| | - P. Cullinan
- Department of Respiratory Medicine; Royal Brompton Hospital; London UK
- National Heart and Lung Institute; Imperial College London; London UK
| | - J. H. Hull
- Faculty of Health and Life Sciences; Northumbria University; Newcastle UK
- Department of Respiratory Medicine; Royal Brompton Hospital; London UK
- National Heart and Lung Institute; Imperial College London; London UK
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Perry C, Pick M, Bdolach N, Hazan-Halevi I, Kay S, Berr I, Reches A, Harishanu Y, Grisaru D. Endurance exercise diverts the balance between Th17 cells and regulatory T cells. PLoS One 2013; 8:e74722. [PMID: 24130669 PMCID: PMC3793976 DOI: 10.1371/journal.pone.0074722] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/04/2013] [Indexed: 12/16/2022] Open
Abstract
Endurance, marathon-type exertion is known to induce adverse changes in the immune system. Increased airway hyper-responsiveness and airway inflammation are well documented in endurance athletes and endurance exercise is considered a major risk factor for asthma in elite athletes. Yet, the mechanisms underlying this phenomenon are still to be deduced. We studied the effect of strenuous endurance exercise (marathon and half-ironman triathlon) on CD4+ lymphocyte sub-populations and on the balance between effector and regulatory CD4+ lymphocytes in the peripheral blood of trained athletes, Endurance exercise induced a significant increase in Th17 cells and a sustained decrease in peripheral blood regulatory T cells (Tregs). While interleukin (IL)-2 levels remained undetectable, post-race serum IL-6 and transforming growth factor (TGF) β levels were significantly elevated. Treg levels in sedentary controls' decreased in vitro after incubation with athletes' post-exercise serum, an effect that was attenuated by supplements of IL-2 or anti IL-6 neutralizing antibodies. Our data suggest that exercise-induced changes in serum cytokine levels promote alterations in Tregs and Th17 cell populations, which may divert the subtle balance in the immune system towards inflammation. This may explain allergic and autoimmune phenomena previously reported in endurance athletes and contribute to our understanding of exercise-related asthma.
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Affiliation(s)
- Chava Perry
- Department of Hematology and Bone Marrow Transplantation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- * E-mail:
| | - Marjorie Pick
- Department of Hematology, Hadassah University Hospital, The Hebrew University, Jerusalem, Israel
| | - Nir Bdolach
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Inbal Hazan-Halevi
- Department of Hematology and Bone Marrow Transplantation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sigi Kay
- Department of Hematology and Bone Marrow Transplantation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Idit Berr
- Department of Hematology and Bone Marrow Transplantation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adi Reches
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yair Harishanu
- Department of Hematology and Bone Marrow Transplantation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dan Grisaru
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Gill SK, Teixeira AM, Rama L, Rosado F, Hankey J, Scheer V, Robson-Ansley P, Costa RJS. Salivary antimicrobial protein responses during multistage ultramarathon competition conducted in hot environmental conditions. Appl Physiol Nutr Metab 2013; 38:977-87. [PMID: 23905664 DOI: 10.1139/apnm-2013-0005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Prolonged strenuous exercise is commonly reported to depress oral-respiratory immune status and increase the incidence of upper respiratory symptoms. This novel investigation aimed to determine the salivary antimicrobial responses and hydration status of ultraendurance runners (n = 23) during a 230-km multistage ultramarathon conducted in hot ambient conditions (32-40 °C). Body mass was measured and unstimulated saliva and venous blood samples were taken before and after each stage of the ultramarathon. Ad libitum fluid intake was permitted throughout each race day. Upper respiratory symptoms were monitored during and until 4 weeks after race completion. Samples were analyzed for salivary immunoglobulin A (IgA), lysozyme, α-amylase, and cortisol, as well as for plasma and saliva osmolality. Mean exercise-induced body mass loss over the 5 stages ranged from 1.3% to 2.4%. Overall mean pre- and post-stage plasma osmolality measurements in the ultraendurance runners were 279 ± 14 mOsmol·kg(-1) and 293 ± 15 mOsmol·kg(-1), respectively. Decreases in saliva flow rate (overall change 22%) and post-stage increases in saliva osmolality (36%) were observed in the ultraendurance runners during the ultramarathon. Reduced salivary IgA (32%) (p < 0.001 vs. pre-stage salivary IgA), enhanced salivary α-amylase (187%) (p < 0.001 vs. pre-stage salivary α-amylase), and no change in salivary lysozyme secretion rates were observed in the ultraendurance runners throughout the ultramarathon. Only 1 ultraendurance runner reported upper respiratory symptoms during and 1 month after competition. Observed depressions in salivary IgA secretion rates were offset by favourable increases in salivary α-amylase and unchanged lysozyme responses in the majority of runners during the competition. Ensuring euhydration throughout a multistage ultramarathon competition in the heat may play a role in protecting the upper respiratory tract.
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Affiliation(s)
- Samantha Kirsty Gill
- a Sport and Exercise Science Applied Research Group, Coventry University, Priory Street, Coventry CV1 5FB, United Kingdom
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Abstract
OBJECTIVE We have designed the present study to compare prevalent lifetime cases of diagnosed asthma or exercise-induced asthma, as well as current related respiratory symptoms, across two different levels of former athletes and non-athletes. METHODS Demographic, behavioral, and asthma history information, as well as current related respiratory symptoms, were obtained through a questionnaire from 627 subjects (290 former elite and 201 non-elite athletes that competed between 1969 and 2005, and 136 control subjects that had never been athletes). RESULTS Non-athletes presented a higher percentage of subjects reporting the existence of symptoms associated with exercise or vigorous activities. Former athletes who reported having practiced mostly in indoor facilities presented significant lower risk for asthma than outdoor athletes (Odds Ratio = 0.48, 95% CI = 0.25-0.94). Multiple regression analysis (where "B" refers to unstandardized coefficients) showed that former elite (B = -0.85, p < .001) and non-elite athletes (B = -0.70, p < .001) were less prone to be affected by asthma-related symptoms than non-athletes. Athletes with careers that lasted more than 20 years were more likely to possess asthma-related symptoms than the ones with shorter careers (3-7 years, B = -0.47, p < .001; 8-14 years, B = -0.42, p < .01; 15-20, B = -0.32, p < .05). CONCLUSIONS Non-athletes seem to have a higher prevalence of respiratory symptoms. Among former athletes, career characteristics seem to play a crucial role, with special emphasis to its duration, where the most lengthy seem to be more associated with respiratory symptoms.
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Affiliation(s)
- Cristiano Batista
- Centre of Research, Education, Innovation and Intervention in Sport, University of Porto, Porto, Portugal.
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Bishop NC. Overcoming microbial hurdles: keeping the Olympics infection-free. Future Microbiol 2013; 7:913-5. [PMID: 22913348 DOI: 10.2217/fmb.12.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Rehm KE, Elci OU, Hahn K, Marshall GD. The impact of self-reported psychological stress levels on changes to peripheral blood immune biomarkers in recreational marathon runners during training and recovery. Neuroimmunomodulation 2013; 20:164-76. [PMID: 23548735 DOI: 10.1159/000346795] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 12/21/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Marathon training is both physically and psychologically stressful, both of which can lead to altered immunity. The purpose of this study was to determine if the overall immunoregulatory changes associated with the physical stress of marathon training are affected by psychological stress. METHODS Nineteen recreational marathoners completed the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory (STAI) and Penn State Worry Questionnaire (PSWQ), and had levels of T cell subpopulations and cytokine (IFNγ, IL4 and IL10) production determined 4 weeks before (baseline), 24-48 h before (prerace) and 1 week after (recovery) participation in a marathon. RESULTS PSS scores decreased at the prerace visit compared to baseline and remained low at recovery. Compared to baseline, there were significant changes to numerous immune measures at the prerace visit, including decreases in Th1/Th2 ratio, Tc1/Tc2 ratio, Tr1 and Th3 cell populations as well as decreases in IFNγ/IL4 cytokine ratio and IL10 production. Most immune parameters had returned to near baseline values at the recovery visit. Higher levels of perceived stress, anxiety and worry exacerbated many of the alterations in immunity that were observed at the prerace visit. Higher levels of perceived stress and worry had significant effects on changes to Treg, IL4 production and the IFNγ/IL4 cytokine ratio. Stress had an additional impact on changes in IL10 production. High anxiety levels resulted in significant changes to Treg, Tr1 and Th3. CONCLUSION These data suggest that recreational marathon runners with higher levels of psychological stress may be more at risk for the immune alterations that are common during periods of prolonged physical training.
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Affiliation(s)
- Kristina E Rehm
- Laboratory of Behavioral Immunology Research, Department of Medicine, Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MI 39216, USA.
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65
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Abstract
Respiratory problems are common in athletes of all abilities and can significantly impact upon their health and performance. In this article, we provide an overview of respiratory physiology in athletes. We also discuss the assessment and management of common clinical respiratory conditions as they pertain to athletes, including airways disease, respiratory tract infection and pneumothorax. We focus on providing a pragmatic approach and highlight important caveats for the physician treating respiratory conditions in this highly specific population.
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Affiliation(s)
- James H Hull
- Centre for Clinical Pharmacology, Division of Biomedical Sciences, St George's, University of London, London.
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