Plasma accumulation of hypoxanthine, uric acid and creatine kinase following exhausting runs of differing durations in man

Discovery of Hypoxanthine and Inosine as Robust Biomarkers for Predicting the Preanalytical Quality of Human Plasma and Serum for Metabolomics

In cold human blood, the anomalous dynamics of adenosine triphosphate (ATP) result in the progressive accumulation of adenosine diphosphate (ADP), adenosine monophosphate (AMP), inosine monophosphate (IMP), inosine, and hypoxanthine. While the ATP, ADP, AMP, and IMP are confined to red blood cells (RBCs), inosine and hypoxanthine are excreted into plasma/serum. The plasma/serum levels of inosine and hypoxanthine depend on the temperature of blood and the plasma/serum contact time with the RBCs, and hence they represent robust biomarkers for evaluating the preanalytical quality of plasma/serum. These biomarkers are highly specific since they are generally absent or at very low levels in fresh plasma/serum and are highly sensitive since they are derived from ATP, one of the most abundant metabolites in blood. Further, whether blood was kept at room temperature or on ice could be predicted based on inosine levels. An analysis of >2000 plasma/serum samples processed for metabolomics-centric analyses showed alarmingly high levels of inosine and hypoxanthine. The results highlight the gravity of sample quality challenges with high risk of grossly inaccurate measurements and incorrect study outcomes. The discovery of these robust biomarkers provides new ways to address the longstanding and underappreciated preanalytical sample quality challenges in the blood metabolomics field.

Caffeine Does Not Alter Performance, Perceptual Responses, and Oxidative Stress After Short Sprint Interval Training

Despite the abundance of research investigating the efficacy of caffeine supplementation on exercise performance, the physiological and biochemical responses to caffeine supplementation during intermittent activities are less evident. This study investigated the acute effects of caffeine supplementation on measures of exercise performance, ratings of perceived exertion, and biomarkers of oxidative stress induced by an acute bout of sprint interval training. In a randomized crossover design, 12 healthy males (age: 26 ± 4 years, height: 177.5 ± 6 cm, body mass: 80.7 ± 7.6 kg) ingested 6 mg/kg of caffeine or placebo 60 min prior to performing sprint interval training (12 × 6 s "all-out sprints" interspersed by 60 s of rest). Performance scores and ratings of perceived exertion were assessed after every sprint. Blood samples were collected before supplementation, prior to and following each sprint, and 5 and 60 min after the last sprint. Caffeine had no effect on any performance measures, ratings of perceived exertion, or biomarkers of oxidative stress (p > .05). In conclusion, caffeine supplementation does not improve performance or decrease oxidative stress after an acute bout of sprint interval training.

Blood-Based Biomarkers for Managing Workload in Athletes: Perspectives for Research on Emerging Biomarkers

At present, various blood-based biomarkers have found their applications in the field of sports medicine. This current opinion addresses biomarkers that warrant consideration in future research for monitoring the athlete training load. In this regard, we identified a variety of emerging load-sensitive biomarkers, e.g., cytokines (such as IL-6), chaperones (such as heat shock proteins) or enzymes (such as myeloperoxidase) that could improve future athlete load monitoring as they have shown meaningful increases in acute and chronic exercise settings. In some cases, they have even been linked to training status or performance characteristics. However, many of these markers have not been extensively studied and the cost and effort of measuring these parameters are still high, making them inconvenient for practitioners so far. We therefore outline strategies to improve knowledge of acute and chronic biomarker responses, including ideas for standardized study settings. In addition, we emphasize the need for methodological advances such as the development of minimally invasive point-of-care devices as well as statistical aspects related to the evaluation of these monitoring tools to make biomarkers suitable for regular load monitoring.

Potential Role of Oxidative Stress in the Production of Volatile Organic Compounds in Obesity

Obesity is associated with numerous health issues such as sleep disorders, asthma, hepatic dysfunction, cancer, renal dysfunction, diabetes, cardiovascular complications, and infertility. Previous research has shown that the distribution of excess body fat, rather than excess body weight, determines obesity-related risk factors. It is widely accepted that abdominal fat is a serious risk factor for illnesses associated with obesity and the accumulation of visceral fat promotes the release of pro-oxidants, pro-inflammatory, and reactive oxygen species (ROS). The metabolic process in the human body produces several volatile organic compounds (VOCs) via urine, saliva, breath, blood, skin secretions, milk, and feces. Several studies have shown that VOCs are released by the interaction of ROS with underlying cellular components leading to increased protein oxidation, lipid peroxidation, or DNA damage. These VOCs released via oxidative stress in obese individuals may serves as a biomarker for obesity-related metabolic alterations and disease. In this review, we focus on the relationship between oxidative stress and VOCs in obesity.

Hypothetical Mechanism of Exercise-Induced Acute Kidney Injury Associated with Renal Hypouricemia

Renal hypouricemia (RHUC) is a hereditary disease that presents with increased renal urate clearance and hypouricemia due to genetic mutations in the urate transporter URAT1 or GLUT9 that reabsorbs urates in the renal proximal tubule. Exercise-induced acute kidney injury (EIAKI) is known to be a complication of renal hypouricemia. In the skeletal muscle of RHUC patients during exhaustive exercise, the decreased release of endothelial-derived hyperpolarization factor (EDHF) due to hypouricemia might cause the disturbance of exercise hyperemia, which might increase post-exercise urinary urate excretion. In the kidneys of RHUC patients after exhaustive exercise, an intraluminal high concentration of urates in the proximal straight tubule and/or thick ascending limb of Henle’s loop might stimulate the luminal Toll-like receptor 4–myeloid differentiation factor 88–phosphoinositide 3-kinase–mammalian target of rapamycin (luminal TLR4–MyD88–PI3K–mTOR) pathway to activate the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome and may release interleukin-1β (IL-1β), which might cause the symptoms of EIAKI.

Comparison of human erythrocyte purine nucleotide metabolism and blood purine and pyrimidine degradation product concentrations before and after acute exercise in trained and sedentary subjects

This study aimed at evaluating the concentration of erythrocyte purine nucleotides (ATP, ADP, AMP, IMP) in trained and sedentary subjects before and after maximal physical exercise together with measuring the activity of purine metabolism enzymes as well as the concentration of purine (hypoxanthine, xanthine, uric acid) and pyrimidine (uridine) degradation products in blood. The study included 15 male elite rowers [mean age 24.3 ± 2.56 years; maximal oxygen uptake (VO_2max) 52.8 ± 4.54 mL/kg/min; endurance and strength training 8.2 ± 0.33 h per week for 6.4 ± 2.52 years] and 15 sedentary control subjects (mean age 23.1 ± 3.41 years; VO_2max 43.2 ± 5.20 mL/kg/min). Progressive incremental exercise testing until refusal to continue exercising was conducted on a bicycle ergometer. The concentrations of ATP, ADP, AMP, IMP and the activities of adenine phosphoribosyltransferase (APRT), hypoxanthine-guanine phosphoribosyltransferase (HGPRT) and phosphoribosyl pyrophosphate synthetase (PRPP-S) were determined in erythrocytes. The concentrations of hypoxanthine, xanthine, uric acid and uridine were determined in the whole blood before exercise, after exercise, and 30 min after exercise testing. The study demonstrated a significantly higher concentration of ATP in the erythrocytes of trained subjects which, in part, may be explained by higher metabolic activity on the purine re-synthesis pathway (significantly higher PRPP-S, APRT and HGPRT activities). The ATP concentration, just as the ATP/ADP ratio, as well as an exercise-induced increase in this ratio, correlates with the VO_2max level in these subjects which allows them to be considered as the important factors characterising physical capacity and exercise tolerance. Maximal physical exercise in the group of trained subjects results not only in a lower post-exercise increase in the concentration of hypoxanthine, xanthine and uric acid but also in that of uridine. This indicates the possibility of performing high-intensity work with a lower loss of not only purine but also pyrimidine.

Hypoxanthine: A Universal Metabolic Indicator of Training Status in Competitive Sports

Cardiorespiratory and biochemical indicators typically used by contemporary elite athletes seem to have limited applicability. According to some recent studies, purine metabolism better reflects exercise response and muscle adaptation in this group. We propose using purine derivatives, especially plasma hypoxanthine concentration, as indicators of training status in consecutive training phases in highly trained athletes.

Effects of allopurinol on exercise-induced muscle damage: new therapeutic approaches?

Intensive muscular activity can trigger oxidative stress, and free radicals may hence be generated by working skeletal muscle. The role of the enzyme xanthine oxidase as a generating source of free radicals is well documented and therefore is involved in the skeletal muscle damage as well as in the potential transient cardiovascular damage induced by high-intensity physical exercise. Allopurinol is a purine hypoxanthine-based structural analog and a well-known inhibitor of xanthine oxidase. The administration of the xanthine oxidase inhibitor allopurinol may hence be regarded as promising, safe, and an economic strategy to decrease transient skeletal muscle damage (as well as heart damage, when occurring) in top-level athletes when administered before a competition or a particularly high-intensity training session. Although continuous administration of allopurinol in high-level athletes is not recommended due to its possible role in hampering training-induced adaptations, the drug might be useful in non-athletes. Exertional rhabdomyolysis is the most common form of rhabdomyolysis and affects individuals participating in a type of intense exercise to which they are not accustomed. This condition can cause exercise-related myoglobinuria, thus increasing the risk of acute renal failure and is also associated with sickle cell trait. In this manuscript, we have reviewed the recent evidence about the effects of allopurinol on exercise-induced muscle damage. More research is needed to determine whether allopurinol may be useful for preventing not only exertional rhabdomyolysis and acute renal damage but also skeletal muscle wasting in critical illness as well as in immobilized, bedridden, sarcopenic or cachectic patients.

Uridine--an indicator of post-exercise uric acid concentration and blood pressure

Studies have shown that uridine concentration in plasma may be an indicator of uric acid production in patients with gout. It has been also postulated that uridine takes part in blood pressure regulation. Since physical exercise is an effective tool in treatment and prevention of cardio-vascular diseases that are often accompanied by hyperuricemia and hypertension, it seemed advisable to attempt to evaluate the relationship between oxypurine concentrations (Hyp, Xan and UA) and that of Urd and BP after physical exercise in healthy subjects. Sixty healthy men (17.2+/-1.71 years, BMI 23.2+/-2.31 kg m(-2), VO(2max) 54.7+/-6.48 ml kg(-1) min(-1)) took part in the study. The subjects performed a single maximal physical exercise on a bicycle ergometer. Blood for analyses was sampled three times: immediately before exercise, immediately after exercise, and in the 30th min of rest. Concentrations of uridine and hypoxanthine, xanthine and uric acid were determined in whole blood using high-performance liquid chromatography. We have shown in this study that the maximal exercise-induced increase of uridine concentration correlates with the post-exercise increase of uric acid concentration and systolic blood pressure. The results of our study show a relationship between uridine concentration in blood and uric acid concentration and blood pressure. We have been the first to demonstrate that a maximal exercise-induced increase in uridine concentration is correlated with the post-exercise and recovery-continued increase of uric acid concentration in healthy subjects. Thus, it appears that uridine may be an indicator of post-exercise hyperuricemia and blood pressure.

Urinary Hypoxanthine as a Measure of Increased ATP Utilization in Late Preterm Infants

OBJECTIVE

To examine the effect of neonatal morbidity on ATP breakdown in late preterm infants.

STUDY DESIGN

Urinary hypoxanthine concentration, a marker of ATP breakdown, was measured from 82 late preterm infants on days of life (DOL) 3 to 6 using high-performance liquid chromatography. Infants were grouped according to the following diagnoses: poor nippling alone (n = 8), poor nippling plus hyperbilirubinemia (n = 21), poor nippling plus early respiratory disease (n = 26), and respiratory disease alone (n = 27).

RESULTS

Neonates with respiratory disease alone had significantly higher urinary hypoxanthine over DOL 3 to 6 when compared with neonates with poor nippling (P = .020), poor nippling plus hyperbilirubinemia (P < .001), and poor nippling plus early respiratory disease (P = .017). Neonates with poor nippling who received respiratory support for 2 to 3 days had significantly higher hypoxanthine compared with infants who received respiratory support for 1 day (P = .017) or no days (P = .007).

CONCLUSIONS

These findings suggest that respiratory disorders significantly increase ATP degradation in late premature infants.

Free radicals and sprint exercise in humans

Sprint exercise ability has been critical for survival. The remarkably high-power output levels attained during sprint exercise are achieved through strong activation of anaerobic, and to a lesser extent, aerobic energy supplying metabolic reactions, which generate reactive oxygen and nitrogen species (RONS). Sprint exercise may cause oxidative stress leading to muscle damage, particularly when performed in severe acute hypoxia. However, with training oxidative stress is reduced. Paradoxically, total plasma antioxidant capacity increases during the subsequent 2 h after a short sprint due to the increase in plasma urate concentration. The RONS produced during and immediately after sprint exercise play a capital role in signaling the adaptive response to sprint. Antioxidant supplementation blunts the normal AMPKα and CaMKII phosphorylation in response to sprint exercise. However, under conditions of increased glycolytic energy turnover and muscle acidification, as during sprint exercise in severe acute hypoxia, AMPKα phosphorylation is also blunted. This indicates that an optimal level of RONS-mediated stimulation is required for the normal signaling response to sprint exercise. Although RONS are implicated in fatigue, most studies convey that antioxidants do not enhance sprint performance in humans. Although currently controversial, it has been reported that antioxidant ingestion during training may jeopardize some of the beneficial adaptations to sprint training.

Alterations in purine metabolism in middle-aged elite, amateur, and recreational runners across a 1-year training cycle

Changes in purine derivatives may be considered as signs of training-induced metabolic adaptations. The purpose of this study was to assess the effect of a 1-year training cycle on the response of hypoxanthine (Hx) concentration and Hx-guanine phosphoribosyltransferase (HGPRT) activity. Three groups of middle-aged male runners were examined: 11 elite master runners (EL; 46.0 ± 3.8 years), 9 amateur runners (AM; 45.1 ± 4.7 years), and 10 recreational runners (RE; 45.9 ± 6.1 years). Plasma Hx concentration and erythrocyte HGPRT activity were measured in three characteristic training phases of the annual cycle. Significant differences in post-exercise Hx concentration and resting HGPRT activity were demonstrated between the EL, AM, and RE groups across consecutive training phases. The EL group showed lowest Hx concentration and highest HGPRT activity compared to the AM and RE groups. Analogous differences were observed between the AM and RE groups during specific preparation. For the EL group, the changes were observed across all examinations and the lowest Hx concentration and highest HGPRT activity were found in the competition phase. Significant change was also revealed in the AM group between the general and specific preparation, but not in the competition phase. No significant changes were found in the RE runners who did not use anaerobic exercise in their training. In conclusion, a long-lasting endurance training, incorporating high-intensity exercise, results in significant changes in purine metabolism, whereas training characterized by constant low-intensity exercise does not. Plasma Hx concentration and erythrocyte HGPRT activity may be sensitive indicators of training adaptation and training status in middle-aged athletes.

Effects of acute creatine supplementation on iron homeostasis and uric acid-based antioxidant capacity of plasma after wingate test

Background

Dietary creatine has been largely used as an ergogenic aid to improve strength and athletic performance, especially in short-term and high energy-demanding anaerobic exercise. Recent findings have also suggested a possible antioxidant role for creatine in muscle tissues during exercise. Here we evaluate the effects of a 1-week regimen of 20 g/day creatine supplementation on the plasma antioxidant capacity, free and heme iron content, and uric acid and lipid peroxidation levels of young subjects (23.1 ± 5.8 years old) immediately before and 5 and 60 min after the exhaustive Wingate test.

Results

Maximum anaerobic power was improved by acute creatine supplementation (10.5 %), but it was accompanied by a 2.4-fold increase in pro-oxidant free iron ions in the plasma. However, potential iron-driven oxidative insult was adequately counterbalanced by proportional increases in antioxidant ferric-reducing activity in plasma (FRAP), leading to unaltered lipid peroxidation levels. Interestingly, the FRAP index, found to be highly dependent on uric acid levels in the placebo group, also had an additional contribution from other circulating metabolites in creatine-fed subjects.

Conclusions

Our data suggest that acute creatine supplementation improved the anaerobic performance of athletes and limited short-term oxidative insults, since creatine-induced iron overload was efficiently circumvented by acquired FRAP capacity attributed to: overproduction of uric acid in energy-depleted muscles (as an end-product of purine metabolism and a powerful iron chelating agent) and inherent antioxidant activity of creatine.

Allopurinol intake does not modify the slow component of V(.)O(2) kinetics and oxidative stress induced by severe intensity exercise

The aim of this study was to test the hypothesis that allopurinol ingestion modifies the slow component of V(.)O(2) kinetics and changes plasma oxidative stress markers during severe intensity exercise. Six recreationally active male subjects were randomly assigned to receive a single dose of allopurinol (300 mg) or a placebo in a double-blind, placebo-controlled crossover design, with at least 7 days washout period between the two conditions. Two hours following allopurinol or placebo intake, subjects completed a 6-min bout of cycle exercise with the power output corresponding to 75 % V(.)O(2)max. Blood samples were taken prior to commencing the exercise and then 5 minutes upon completion. Allopurinol intake caused increase in resting xanthine and hypoxanthine plasma concentrations, however it did not affect the slow component of oxygen uptake during exercise. Exercise elevated plasma inosine, hypoxanthine, and xanthine. Moreover, exercise induced a decrease in total antioxidant status, and sulfhydryl groups. However, no interaction treatment x time has been observed. Short term severe intensity exercise induces oxidative stress, but xanthine oxidase inhibition does not modify either the kinetics of oxygen consumption or reactive oxygen species overproduction.

Uric acid responses to endurance racing and relationships with performance, plasma biochemistry and metabolic alterations

REASONS FOR PERFORMING STUDY

There is limited understanding of the uric acid response to endurance races.

OBJECTIVES

To demonstrate uric acid increments and its relationship to diverse biochemical and performance parameters, in horses subjected to a prolonged effort, with and without presentation of metabolic alterations.

METHODS

Blood samples were taken from horses the day before, and 5-10 mins after, successfully finishing a 121 km (Assay 1, n = 24) or 164 km endurance race (Assay 2, n = 17), and from 19 animals eliminated by metabolic disorders during several endurance races (Assay 3). Plasma was obtained and determinations of CK, AST, LDH, AP, uric acid (UA), creatinine (Cr), urea, lactate (La) and plasma proteins (PP) carried out. Sex, age, time in competition, average speed and total recovery time were also recorded. Assays 1 and 2 were arithmetically subdivided into 3 groups each in order to categorise time in competition, average speed and total recovery time. Changes among the groups were evaluated with ANOVA and Fisher's PLSD test. Student's paired t test was used to assess pre- and post exercise differences. A value of P< or =0.05 was considered significantly different. Pearson correlation coefficient was used to assess the relationship between all the variables and UA increases.

RESULTS

Average speed of the sampled horses was significantly higher in Assay 1 compared to Assay 2. However, there were no significant differences in plasma biochemistry values between both groups. The fastest horses showed significantly higher UA levels, compared with the slowest (Assays 1 and 2) and medium horses (Assay 1). The animals with alterations in metabolism had significantly higher UA, CK and PP compared with those that adequately concluded the race. There were significant correlations between UA and CK in Assays 1, 2, and 3 and between UA and PP in Assays 1 and 3.

CONCLUSIONS

UA rises in horses after a prolonged effort, this increase being higher in animals with metabolic commitment, and in the fastest horses. This increase has a direct correlation with CK.

POTENTIAL RELEVANCE

UA could be useful in the assessment of metabolic response during endurance exercise.

Protective effects of L-arginine on pulmonary oxidative stress and antioxidant defenses during exhaustive exercise in rats

AIM

To assess the effects of L-arginine (L-Arg) supplementation on pulmonary oxidative stress and antioxidant defenses in rats after exhaustive exercise.

METHODS

Rats were randomly divided into four groups: sedentary control (SC), sedentary control with L-Arg treatment (SC+Arg), exhaustive exercise with control diet (E) and exhaustive exercise with L-Arg treatment (E+Arg). Rats in groups SC+Arg and E+Arg received a 2% L-Arg diet. Rats in groups E and E+Arg underwent an exhaustive running test on a motorized treadmill. Pulmonary oxidative stress indices [xanthine oxidase (XO), myeloperoxidase (MPO), and malondialdehyde (MDA)] and antioxidant defense systems [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione reductase (GR), and glutathione (GSH)] were investigated in this study.

RESULTS

L-Arg supplementation significantly reduced exercise-induced elevations of XO and MPO activities in lung. L-Arg reversed the exercise-induced increase in SOD and GR activities, but increased CAT and GPX activities. L-Arg administration also significantly increased the GSH levels in plasma.

CONCLUSION

L-Arg supplementation can prevent elevations of XO and MPO activities in the lung and favorably influence pulmonary antioxidant defense systems after exhaustive exercise.

Physiological adaptations to exercise in people with spinal cord injury

The number of patients that suffer some type of spinal cord lesion in recent years are high and have increased because of factors such as traffic accidents. Although their life expectancy has increased, cardiovascular illnesses is one of the main causes of morbidity and mortality. Since the degree of physical fitness is an important factor regarding the risk of cardiovascular disease, the objective of the present study was to examine the global adaptation (cardiorespiratory, metabolic and thermoregulatory response) of the organism to exercise and the application of this data to the habitual practice of physical activity to improve state of health. A group of 42 patients with spinal injury, 85% of whom were paraplegic and the remaining 15% tetraplegic performed 42 exercise tests on a cycloergometer. Body temperature (tympanum, surface of the deltoids and surface of the back), metabolic parameters (plasma uric acid, glycemia, plasma lactate), cardiocirculatory adaptation (heart rate, blood pressure arm, blood pressure leg) and ventilatory adaptation (VO2, VCO2, fr Vt, VE) were monitored. Blood pressure in the arm, blood concentrations of lactate and ventilatory parameters showed an evolution statistically dependent on the work to which the subject was submitted. Heart rate showed a statistically significant correlation with the ventilatory parameters and work load. The proportional response of the cardioventilatory parameters to the increase in the work load allowed us to evaluate the repercussion of a given exercise and thus avoid exercise of an excessive intensity that could produce cardiocirculatory changes that might entail an added risk. Heart rate presents an excellent correlation, shown in this work, with the oxygen consumption and could therefore be used to quantify the cardiorespiratory and metabolic repercussion of the exercise carried out. Furthermore, this quantification may allow for the adaptation of exercise intensity to the patient thus improving the results obtained from the practice of exercise that has been proven so necessary in these patients.

Ophidian envenomation strategies and the role of purines

Snake envenomation employs three well integrated strategies: prey immobilization via hypotension, prey immobilization via paralysis, and prey digestion. Purines (adenosine, guanosine and inosine) evidently play a central role in the envenomation strategies of most advanced snakes. Purines constitute the perfect multifunctional toxins, participating simultaneously in all three envenomation strategies. Because they are endogenous regulatory compounds in all vertebrates, it is impossible for any prey organism to develop resistance to them. Purine generation from endogenous precursors in the prey explains the presence of many hitherto unexplained enzyme activities in snake venoms: 5'-nucleotidase, endonucleases (including ribonuclease), phosphodiesterase, ATPase, ADPase, phosphomonoesterase, and NADase. Phospholipases A(2), cytotoxins, myotoxins, and heparinase also participate in purine liberation, in addition to their better known functions. Adenosine contributes to prey immobilization by activation of neuronal adenosine A(1) receptors, suppressing acetylcholine release from motor neurons and excitatory neurotransmitters from central sites. It also exacerbates venom-induced hypotension by activating A(2) receptors in the vasculature. Adenosine and inosine both activate mast cell A(3) receptors, liberating vasoactive substances and increasing vascular permeability. Guanosine probably contributes to hypotension, by augmenting vascular endothelial cGMP levels via an unknown mechanism. Novel functions are suggested for toxins that act upon blood coagulation factors, including nitric oxide production, using the prey's carboxypeptidases. Leucine aminopeptidase may link venom hemorrhagic metalloproteases and endogenous chymotrypsin-like proteases with venom L-amino acid oxidase (LAO), accelerating the latter. The primary function of LAO is probably to promote prey hypotension by activating soluble guanylate cyclase in the presence of superoxide dismutase. LAO's apoptotic activity, too slow to be relevant to prey capture, is undoubtedly secondary and probably serves principally a digestive function. It is concluded that the principal function of L-type Ca(2+) channel antagonists and muscarinic toxins, in Dendroaspis venoms, and acetylcholinesterase in other elapid venoms, is to promote hypotension. Venom dipeptidyl peptidase IV-like enzymes probably also contribute to hypotension by destroying vasoconstrictive peptides such as Peptide YY, neuropeptide Y and substance P. Purines apparently bind to other toxins which then serve as molecular chaperones to deposit the bound purines at specific subsets of purine receptors. The assignment of pharmacological activities such as transient neurotransmitter suppression, histamine release and antinociception, to a variety of proteinaceous toxins, is probably erroneous. Such effects are probably due instead to purines bound to these toxins, and/or to free venom purines.

The influence of exercise-induced plasma volume changes on the interpretation of biochemical parameters used for monitoring exercise, training and sport

A number of studies have demonstrated considerable plasma volume changes during and after exposure to different environmental and physiological conditions. These changes are thought to result from transient fluid shifts into (haemodilution) and out of (haemoconcentration) the intravascular space. If the levels of plasma constituents are to be routinely measured for research purposes or used as indicators of training adaptation or the health of an athlete, then it is important to consider the dynamic nature of plasma volume. Controversy still exists over the relevance of plasma volume interactions with plasma constituent levels, and while some investigators have taken plasma volume shifts into account, others have chosen to ignore these changes. Bouts of acute exercise have been shown to produce a transient haemoconcentration immediately after long distance running, bicycle ergometry and both maximal and submaximal swimming exercise. While these changes are transient, lasting only a few hours, other studies have reported a longer term haemodilution following acute exercise. In addition, endurance training has been shown to cause long term expansion of the plasma volume. It would, therefore, seem important to consider the influence of plasma volume changes on plasma solutes routinely measured for research, and as markers of training adaptation, prior to arriving at conclusions and recommendations based purely on their measured plasma level. To further confound this issue, plasma volume changes are known to be associated with heat acclimatisation, hydration state, physical training and postural changes, all of which may differ from one experiment or exercise bout to the next, and should thus be taken into account.

Urate uptake and lowered ATP levels in human muscle after high-intensity intermittent exercise

The exchange of purines in exercised and rested muscle and their relation to muscle ATP levels after intense intermittent exercise were investigated. Seven subjects performed one-legged knee extensor exercise on the following two occasions: without (control; C) and with (high purines; HP) additional arm exercise. There was a greater net release of hypoxanthine by the exercised muscle during the recovery period in HP compared with C [185 +/- 44 vs. 101 +/- 30 (SE) mumol/kg muscle; P < 0.05]. During recovery, the arterial urate concentration was higher in HP compared with C (peak: 585 +/- 48 vs. 355 +/- 20 mumol/l; P < 0.05). The exercised but not the rested muscle extracted a marked amount of urate (330 mumol/kg muscle) from plasma in the HP trial. Muscle ATP levels after 90 min of recovery in HP were lower than at rest (24.3 +/- 0.6 vs. 20.1 +/- 1.1 mmol/kg dry wt). The present data suggest that a single session of long-term high-intensity intermittent exercise causes a significant release of purines from the muscle into blood, which contributes to a sustained lowered level of the muscle ATP concentration. Furthermore, intensely exercised muscle extracts urate when plasma urate is elevated, an event that may be of importance for the replenishment of oxidized muscle urate stores.

Energy supply and muscle fatigue in humans

Limitations in energy supply is a classical hypothesis of muscle fatigue. The present paper reviews the evidence available from human studies that energy deficiency is an important factor in fatigue. The maximal rate of energy expenditure determined in skinned fibres is close to the rate of adenosine triphosphate (ATP) utilisation observed in vivo and data suggest that performance during short bursts of exercise (<5 s duration) primarily is limited by other factors than energy supply (e.g. Vmax of myosine adenosine triphosphatase (ATPase), motor unit recruitment, engaged muscle mass). Within 10 s of exercise maximal power output decreases considerably and coincides with depletion of phosphocreatine. During recovery, maximal force and power output is restored with a similar time course as the resynthesis of phosphocreatine. Increases in muscle store of phosphocreatine through dietary supplementation with creatine increases performance during high-intensity exercise. These findings support the hypothesis that energy supply limits performance during high-intensity exercise. It is well documented that pre-exercise muscle glycogen content is related to performance during moderate intensity exercise. Recent data indicates that the interfibre variation in phosphocreatine is large after prolonged exercise to fatigue and that some fibres are depleted to the same extent as after high-intensity exercise. Despite relatively small decreases in ATP, the products of ATP hydrolysis (Pi and free ADP) may increase considerably. Free ADP calculated from the creatine kinase reaction increases 10-fold both after high-intensity exercise and after prolonged exercise to fatigue. It is suggested that local increases in ADP may reach inhibitory levels for the contraction process.

Accumulation of uric acid in plasma after repeated bouts of exercise in the horse

Plasma concentration of uric acid, total peroxyl radical-trapping antioxidative parameter (TRAP), blood lactate concentration and plasma activity of xanthine oxidase (XO) were measured in six Standardbreed trotters after six bouts of exercise with increasing intensity on two separate days three days apart. Blood samples were taken immediately, 5, 10, 15, 30 and 60 min after each heat and 2, 4, and 6 hr after the last heat. Exercise caused an increase in TRAP and in the concentrations of lactate and uric acid. Plasma uric acid concentration increased exponentially with respect to time after the last heat performed maximal speed, indicating a rapid increase in the rate of purine degradation. Plasma XO activity increased during exercise, but the intensity of exercise had only a minor effect on the level of XO activity. In conclusion, these data suggest that a threshold for the plasma accumulation of uric acid in terms of the intensity of exercise may exist and that XO may play a role in the formation of uric acid in horse plasma. Intense exercise causes an increase in the plasma antioxidant capacity that in the horse is mainly caused by the increase in the plasma uric acid concentration.

Skeletal muscle metabolism during short duration high-intensity exercise: influence of creatine supplementation

Seven male subjects performed repeated bouts of high-intensity exercise, on a cycle ergometer, before and after 6 d of creatine supplementation (20 g Cr H2O day-1). The exercise protocol consisted of five 6-s exercise periods performed at a fixed exercise intensity, interspersed with 30-s recovery periods (Part I), followed (40 s later) by one 10 s exercise period (Part II) where the ability to maintain power output was evaluated. Muscle biopsies were taken from m. vastus lateralis at rest, and immediately after (i) the fifth 6 s exercise period in Part I and (ii) the 10 s exercise period in Part II. In addition, a series of counter movement (CMJ) and squat (SJ) jumps were performed before and after the administration period. As a result of the creatine supplementation, total muscle creatine [creatine (Cr) + phosphocreatine (PCr)] concentration at rest increased from (mean +/- SEM) 128.7 (4.3) to 151.5 (5.5) mmol kg-1 dry wt (P < 0.05). This was accompanied by a 1.1 (0.5) kg increase in body mass (P < 0.05). After the fifth exercise bout in Part I of the exercise protocol, PCr concentration was higher [69.7 (2.3) vs. 45.6 (7.5) mmol kg-1 dry wt, P < 0.05], and muscle lactate was lower [26.2 (5.5) vs. 44.3 (9.9) mmol kg-1 dry wt, P < 0.05] after vs. before supplementation. In Part II, after creatinine supplementation, subjects were better able to maintain power output during the 10-s exercise period (P < 0.05). There was no change in jump performance as a result of the creatine supplementation (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Renal hypouricemia: prevention of exercise-induced acute renal failure and a review of the literature

Isolated renal hypouricemia from defective uric acid reabsorption and/or secretion is a well-described entity, with a prevalence of 0.12% to 0.20% in Japan. It is rarely associated with exercise-induced acute renal failure (ARF). The etiology of ARF is debated. Prevention of ARF in renal hypouricemia has not been previously addressed. A 29-year-old Pakistani man had recurrent exercise-induced ARF. He was found to have isolated renal hypouricemia; serum uric acid 0.5 mg/dL, 24-hour urine uric acid 472 +/- 25 mg (+/- SD), and fractional excretion of uric acid 55.2% to 69.4%. Both pyrazinamide and probenecid decreased fractional excretion of uric acid and uric acid excretion rate (UV(Urate)) in our patient, suggesting either a partial presecretory and postsecretory reabsorption defect or increased secretion. We investigated renal uric acid excretion during exercise in our patient and four control subjects. All five subjects underwent a physical fitness test (PFT). Our patient developed ARF. Uric acid excretion rate increased in our patient, from 0.48 mg/min at baseline to 1.49 mg/min 4 hours after the PFT, as did the urine uric acid to urine creatinine ratio (UUa)/UCr) (0.29 to 1.49). In the controls, UV(Urate) and UUA/UCr were unchanged after the PFT: UV(Urate) was 0.46 +/- 0.10 mg/min at baseline and 0.59 +/- 0.04 mg/min 4 hours after the PFT, while UUA/UCr was 0.30 +/- 0.04 at baseline and 0.36 +/- 0.04 at 4 hours. All five subjects took allopurinol 300 mg daily for 5 days and repeated the PFT. In our patient, allopurinol prevented the ARF as well as the exercise-induced increases in UV(Urate) (0.28 mg/min to 0.22 mg/min) and UUA/UCr (0.25 to 0.17). In the controls, the UV(Urate) and UUA/UCr responses to exercise were not altered. We conclude that increased renal excretion of uric acid during exercise was responsible for the ARF in our patient with renal hypouricemia and that successful prophylaxis with allopurinol is possible.

Influence of carbohydrate-electrolyte drinks on marathon running performance

The aim of this study was to compare the effects of drinking two carbohydrate (CHO) electrolyte solutions and water on marathon running performance. Seven endurance-trained runners completed three 42.2-km treadmill time-trials which were randomly assigned and 4 weeks apart. On each occasion the subjects ingested 3 ml.Kg-1 body weight of either water (W), a 6.9% CHO solution (O) or a 5.5% CHO solution (L) immediately prior to the start of the run and 2 ml.kg-1 body weight every 5 km thereafter. The total volume of fluid ingested [mean (SEM)] was 1112 (42), 1116 (44) and 1100 (44) ml, respectively. Running times for W, O and L trials were 193.9 (5.0), 192.4 (3.3) and 190.0 (3.9) min, respectively. Performance time for the L trial was faster (P < 0.05) compared with that of the W trial. Running speed was maintained in the L trial, whereas it decreased after 10 km (P < 0.05) in the W and after 25 km (P < 0.05) in the O trial. Blood glucose and lactate, and hormonal responses to fluid ingestion were similar in all three trials. Higher plasma free fatty acid and glycerol concentrations were observed at the end of the W trial compared with those obtained after the O and L trials, respectively (P < 0.05). Plasma ammonia concentration was higher (P < 0.01) at the end of the L trial compared with the W trial. Plasma creatine kinase concentration was higher (P < 0.05) 24 h after the completion of the L trial than after the W trial.(ABSTRACT TRUNCATED AT 250 WORDS)

Reduced oxygen availability during high intensity intermittent exercise impairs performance

This study examined the influence of reduced oxygen availability on the ability to perform repeated bouts of high intensity exercise on a cycle ergometer. Seven male physical education students performed 10 exercise bouts (of 6 s each), interspersed with 30-s recovery periods, under hypoxic and normoxic conditions. The hypoxic condition was carried out in a low pressure chamber at 526 mmHg. Subjects were instructed to try to maintain a target pedalling speed of 140 rev min-1 during each exercise period. The mean power output of the first exercise bout was approximately 950 W. In both experimental conditions, all subjects were able to maintain the target speed for the first 3 s of each of the 10 exercise bouts. During the last 3-s interval of each exercise period the target speed was not maintained in both conditions over the 10 sprints. However, the reduction was greater in the hypoxic condition (P < 0.05). Post-exercise blood lactate accumulation was higher with hypoxia [10.3 (0.7) vs. 8.5 (0.8) mmol l-1, P < 0.05]. Oxygen uptake, measured during the exercise and recovery periods of sprints 6-9, was lower in the hypoxic condition [3.03 (0.2) vs. 3.19 (0.2) 1 min-1, P < 0.05]. These results indicate that a reduction in oxygen availability during high intensity intermittent exercise results in a higher accumulation of blood lactate and a lower oxygen uptake. The ability to maintain a high power output is impaired.

The effect of high-intensity training on purine metabolism in man

The effect of intermittent high-intensity training on the activity of enzymes involved in purine metabolism and on the concentration of plasma purines following acute short-term intense exercise was investigated. Eleven subjects performed sprint training three times per week for 6 weeks. Muscle biopsies for determination of enzyme activities were obtained prior to and 24 h after the training period. After training, the activity of adenosine 5'-phosphate (AMP) deaminase was lower (P < 0.001) whereas the activities of hypoxanthine phosphoribosyl transferase (HPRT) and phosphofructokinase were significantly higher compared with pre-training levels. The higher activity of HPRT with training suggests an improved potential for rephosphorylation of intracellular hypoxanthine to inosine monophosphate (IMP) in the trained muscle. Before and after the training period the subjects performed four independent 2-min tests at intensities from a mean of 106 to 135% of VO2max. Venous blood was drawn prior to and after each test. The accumulation of plasma hypoxanthine following the four tests was lower following training compared with prior to training (P < 0.05). The accumulation of uric acid was significantly lower (46% of pre-training value) after the test performed at 135% of VO2max (P < 0.05). Based on the observed alterations in muscle enzyme activities and plasma purine accumulation, it is suggested that high intensity intermittent training leads to a lower release of purines from muscle to plasma following intense exercise and, thus, a reduced loss of muscle nucleotides.

Physiological responses to maximal intensity intermittent exercise

Physiological responses to repeated bouts of short duration maximal-intensity exercise were evaluated. Seven male subjects performed three exercise protocols, on separate days, with either 15 (S15), 30 (S30) or 40 (S40) m sprints repeated every 30 s. Plasma hypoxanthine (HX) and uric acid (UA), and blood lactate concentrations were evaluated pre- and postexercise. Oxygen uptake was measured immediately after the last sprint in each protocol. Sprint times were recorded to analyse changes in performance over the trials. Mean plasma concentrations of HX and UA increased during S30 and S40 (P less than 0.05), HX increasing from 2.9 (SEM 1.0) and 4.1 (SEM 0.9), to 25.4 (SEM 7.8) and 42.7 (SEM 7.5) mumol.l-1, and UA from 372.8 (SEM 19) and 382.8 (SEM 26), to 458.7 (SEM 40) and 534.6 (SEM 37) mumol.l-1, respectively. Postexercise blood lactate concentrations were higher than pretest values in all three protocols (P less than 0.05), increasing to 6.8 (SEM 1.5), 13.9 (SEM 1.7) and 16.8 (SEM 1.1) mmol.l-1 in S15, S30 and S40, respectively. There was no significant difference between oxygen uptake immediately after S30 [3.2 (SEM 0.1) l.min-1] and S40 [3.3 (SEM 0.4) l.min-1], but a lower value [2.6 (SEM 0.1) l.min-1] was found after S15 (P less than 0.05). The time of the last sprint [2.63 (SEM 0.04) s] in S15 was not significantly different from that of the first [2.62 (SEM 0.02) s]. However, in S30 and S40 sprint times increased from 4.46 (SEM 0.04) and 5.61 (SEM 0.07) s (first) to 4.66 (SEM 0.05) and 6.19 (SEM 0.09) s (last), respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)