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Giosa L, Zadek F, Busana M, De Simone G, Brusatori S, Krbec M, Duska F, Brambilla P, Zanella A, Di Masi A, Caironi P, Perez E, Gattinoni L, Langer T. Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation. J Appl Physiol (1985) 2024; 136:966-976. [PMID: 38420681 DOI: 10.1152/japplphysiol.00917.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
It is commonly assumed that changes in plasma strong ion difference (SID) result in equal changes in whole blood base excess (BE). However, at varying pH, albumin ionic-binding and transerythrocyte shifts alter the SID of plasma without affecting that of whole blood (SIDwb), i.e., the BE. We hypothesize that, during acidosis, 1) an expected plasma SID (SIDexp) reflecting electrolytes redistribution can be predicted from albumin and hemoglobin's charges, and 2) only deviations in SID from SIDexp reflect changes in SIDwb, and therefore, BE. We equilibrated whole blood of 18 healthy subjects (albumin = 4.8 ± 0.2 g/dL, hemoglobin = 14.2 ± 0.9 g/dL), 18 septic patients with hypoalbuminemia and anemia (albumin = 3.1 ± 0.5 g/dL, hemoglobin = 10.4 ± 0.8 g/dL), and 10 healthy subjects after in vitro-induced isolated anemia (albumin = 5.0 ± 0.2 g/dL, hemoglobin = 7.0 ± 0.9 g/dL) with varying CO2 concentrations (2-20%). Plasma SID increased by 12.7 ± 2.1, 9.3 ± 1.7, and 7.8 ± 1.6 mEq/L, respectively (P < 0.01) and its agreement (bias[limits of agreement]) with SIDexp was strong: 0.5[-1.9; 2.8], 0.9[-0.9; 2.6], and 0.3[-1.4; 2.1] mEq/L, respectively. Separately, we added 7.5 or 15 mEq/L of lactic or hydrochloric acid to whole blood of 10 healthy subjects obtaining BE of -6.6 ± 1.7, -13.4 ± 2.2, -6.8 ± 1.8, and -13.6 ± 2.1 mEq/L, respectively. The agreement between ΔBE and ΔSID was weak (2.6[-1.1; 6.3] mEq/L), worsening with varying CO2 (2-20%): 6.3[-2.7; 15.2] mEq/L. Conversely, ΔSIDwb (the deviation of SID from SIDexp) agreed strongly with ΔBE at both constant and varying CO2: -0.1[-2.0; 1.7], and -0.5[-2.4; 1.5] mEq/L, respectively. We conclude that BE reflects only changes in plasma SID that are not expected from electrolytes redistribution, the latter being predictable from albumin and hemoglobin's charges.NEW & NOTEWORTHY This paper challenges the assumed equivalence between changes in plasma strong ion difference (SID) and whole blood base excess (BE) during in vitro acidosis. We highlight that redistribution of strong ions, in the form of albumin ionic-binding and transerythrocyte shifts, alters SID without affecting BE. We demonstrate that these expected SID alterations are predictable from albumin and hemoglobin's charges, or from the noncarbonic whole blood buffer value, allowing a better interpretation of SID and BE during in vitro acidosis.
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Affiliation(s)
- Lorenzo Giosa
- Department of Critical Care Medicine, Guy's and St. Thomas' National Health Service Foundation Trust, London, United Kingdom
- Centre for Human and Applied Physiological Sciences, King's College London, London, United Kingdom
| | - Francesco Zadek
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Mattia Busana
- Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Serena Brusatori
- Department of pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Martin Krbec
- Department of Anesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czechia
| | - Frantisek Duska
- Department of Anesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czechia
| | - Paolo Brambilla
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alberto Zanella
- Department of pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Pietro Caironi
- Department of Anesthesia and Critical Care, AOU S. Luigi Gonzaga, Turin, Italy
- Department of Oncology, University of Turin, Turin, Italy
| | - Emanuele Perez
- Department of biomedical and neuromotor sciences, Headquarter of Human physiology, University of Bologna, Bologna, Italy
| | - Luciano Gattinoni
- Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Langer
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
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Böning D, Kuebler WM, Vogel D, Bloch W. The oxygen dissociation curve of blood in COVID-19-An update. Front Med (Lausanne) 2023; 10:1098547. [PMID: 36923010 PMCID: PMC10008909 DOI: 10.3389/fmed.2023.1098547] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/03/2023] [Indexed: 03/02/2023] Open
Abstract
An impressive effect of the infection with SARS-Co-19 is the impairment of oxygen uptake due to lung injury. The reduced oxygen diffusion may potentially be counteracted by an increase in oxygen affinity of hemoglobin. However, hypoxia and anemia associated with COVID-19 usually decrease oxygen affinity due to a rise in [2,3-bisphosphoglycerate]. As such, COVID-19 related changes in the oxygen dissociation curve may be critical for oxygen uptake and supply, but are hard to predict. A Pubmed search lists 14 publications on oxygen affinity in COVID-19. While some investigations show no changes, three large studies found an increased affinity that was related to a good prognosis. Exact causes remain unknown. The cause of the associated anemia in COVID-19 is under discussion. Erythrocytes with structural alterations of membrane and cytoskeleton have been observed, and virus binding to Band 3 and also to ACE2 receptors in erythroblasts has been proposed. COVID-19 presentation is moderate in many subjects suffering from sickle cell disease. A possible explanation is that COVID-19 counteracts the unfavorable large right shift of the oxygen dissociation curve in these patients. Under discussion for therapy are mainly affinity-increasing drugs.
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Affiliation(s)
- Dieter Böning
- Institute of Physiology, Charité Medical University of Berlin, Berlin, Germany
| | - Wolfgang M. Kuebler
- Institute of Physiology, Charité Medical University of Berlin, Berlin, Germany
| | - Dominik Vogel
- Klinik für Interdisziplinäre Intensivmedizin, Vivantes Humboldt-Klinikum, Berlin, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
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Ruan Y, Song SJ, Yin ZF, Wang M, Huang N, Gu W, Ling CQ. Comprehensive evaluation of military training-induced fatigue among soldiers in China: A Delphi consensus study. Front Public Health 2022; 10:1004910. [PMID: 36523578 PMCID: PMC9745162 DOI: 10.3389/fpubh.2022.1004910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Military training-induced fatigue (MIF) often results into non-combat attrition. However, standard evaluation of MIF is unavailable. This study aimed to provide credible suggestions about MIF-evaluation. Methods A 3-round Delphi study was performed. The authority of the experts was assessed by the authority coefficient (Aa). In round 1, categories of indicators were collected via anonymous survey of experts, then potential indicators were selected via literature search. In round 2, experts should evaluate the clinical implication, practical value, and importance of each potential indicators, or recommend new indicators based on feedback of round 1. Indicators with recommendation proportions ≥ 70% and new recommended indicators would be included in round 3 to be rated on a 5-point Likert scale. "Consensus in" was achieved when coefficient of concordance (Kendall's W) of a round was between 0.2 and 0.5 and the coefficient of variation (CV) of each aspect for an indicator was < 0.5. If round 3 could not achieve "consensus in," more rounds would be conducted iteratively based on round 3. Indicators included in the recommendation set were ultimately classified into grade I (highly recommended) or grade II (recommended) according to the mean score and CV of the aspects. Results Twenty-three experts participated with credible authority coefficient (mean Aa = 0.733). "Consensus in" was achieved in round 3 (Kendall's W = 0.435, p < 0.001; all CV < 0.5). Round 1 recommended 10 categories with 73 indicators identified from 2,971 articles. After 3-round consultation, consensus was reached on 28 indicators focusing on the cardiovascular system (n = 4), oxygen transport system (n = 5), energy metabolism/metabolite level (n = 6), muscle/tissue damage level (n = 3), neurological function (n = 2), neuropsychological/psychological function (n = 3), endocrine function (n = 3), and exercise capacity (n = 2). Among these, 11 indicators were recommended as grade I: basic heart rate, heart-rate recovery time, heart rate variability, hemoglobin, blood lactic acid, urine protein, creatine kinase, reaction time, Borg Rating of Perceived Exertion Scale, testosterone/cortisol, and vertical jump height. Conclusion This study developed a reliable foundation for the comprehensive evaluation of MIF among soldiers.
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Affiliation(s)
- Yi Ruan
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,PLA Naval Medical Center, Shanghai, China
| | - Shang-jin Song
- Department of Traditional Chinese Medicine, Xingcheng Sanatorium of PLA Strategic Support Force, Xingcheng, China
| | - Zi-fei Yin
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Man Wang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Nian Huang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,*Correspondence: Wei Gu ;
| | - Chang-quan Ling
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,Chang-quan Ling
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Ruan Y, Xiang KF, Zhang HM, Qin Z, Sun Y, Wan JJ, Gu W, Liu X. Orosomucoid: a promising biomarker for the assessment of exercise-induced fatigue triggered by basic combat training. BMC Sports Sci Med Rehabil 2022; 14:100. [PMID: 35658935 PMCID: PMC9166395 DOI: 10.1186/s13102-022-00490-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
Background Orosomucoid (ORM) is a positive acute phase protein verified to be upregulated in various forms of exercise-induced fatigued (EIF) rodents. However, its association with EIF among human beings remained unknown. This study aimed to explore the association between serum ORM and EIF triggered by military basic combat training (BCT). Methods The degree of EIF were measured by Borg’s Rating of Perceived Exertion Scale (Borg-RPE-Scale®) as RPE score after BCT. Fifty-three male recruits were classified into three groups according to the RPE score: (1) group 1 (slight fatigue group): RPE score after BCT < 13; (2) group 2 (moderate fatigue group): RPE score after BCT = 13 or 14; (3) group 3 (severe fatigue group): RPE score after BCT > 14. The levels of blood ORM, lactate (LAC), cortisol and C-reactive protein (CRP) were determined before and after BCT. The diagnostic value of ORM was evaluated by receiver operating characteristic (ROC) curve analysis and logistic regression. Results After BCT, the level of LAC, CRP, and cortisol increased among all groups, but the changes had no significant between-group difference (all p > 0.05). The level of ORM had a specific significant increase in group 3 (p = 0.039), and the changes of ORM (ΔORM) had significant difference among groups (p = 0.033). ROC curve analysis showed that the estimated area under ROC curve for ΔORM was 0.724 (p = 0.009) with the recommended optimal cut-off value as 0.2565 mg/mL. Logistic analysis showed that recruits with ΔORM ≥ 0.2565 mg/mL had higher odds for suffering from severe EIF, 5.625 times (95% CI 1.542–20.523, p = 0.009) as large as those with ΔORM < 0.2565 mg/mL. Conclusion ORM might be a promising biomarker of severe EIF triggered by BCT among male recruits. Its potential optimal cut-off value regarding ΔORM was recommended to be 0.2565 mg/mL. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00490-6.
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Affiliation(s)
- Yi Ruan
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China.,School of Traditional Chinese Medicine, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Ke-Fa Xiang
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Hui-Min Zhang
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Zhen Qin
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Yang Sun
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Jing-Jing Wan
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Wei Gu
- School of Traditional Chinese Medicine, Naval Medical University (Second Military Medical University), Shanghai, 200433, China.
| | - Xia Liu
- Department of Pharmacology, School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai, 200433, China.
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Böning D, Kuebler WM, Bloch W. The oxygen dissociation curve of blood in COVID-19. Am J Physiol Lung Cell Mol Physiol 2021; 321:L349-L357. [PMID: 33978488 PMCID: PMC8384474 DOI: 10.1152/ajplung.00079.2021] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
COVID-19 hinders oxygen transport to the consuming tissues by at least two mechanisms: In the injured lung, saturation of hemoglobin is compromised, and in the tissues, an associated anemia reduces the volume of delivered oxygen. For the first problem, increased hemoglobin oxygen affinity [left shift of the oxygen dissociation curve (ODC)] is of advantage, for the second, however, the contrary is the case. Indeed a right shift of the ODC has been found in former studies for anemia caused by reduced cell production or hemolysis. This resulted from increased 2,3-bisphosphoglycerate (2,3-BPG) concentration. In three investigations in COVID-19, however, no change of hemoglobin affinity was detected in spite of probably high [2,3-BPG]. The most plausible cause for this finding is formation of methemoglobin (MetHb), which increases the oxygen affinity and thus apparently compensates for the 2,3-BPG effect. However, this "useful effect" is cancelled by the concomitant reduction of functional hemoglobin. In the largest study on COVID-19, even a clear left shift of the ODC was detected when calculated from measurements in fresh blood rather than after equilibration with gases outside the body. This additional "in vivo" left shift possibly results from various factors, e.g., concentration changes of Cl-, 2,3-BPG, ATP, lactate, nitrocompounds, glutathione, glutamate, because of time delay between blood sampling and end of equilibration, or enlarged distribution space including interstitial fluid and is useful for O2 uptake in the lungs. Under discussion for therapy are the affinity-increasing 5-hydroxymethyl-2-furfural (5-HMF), erythropoiesis-stimulating substances like erythropoietin, and methylene blue against MetHb formation.
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Affiliation(s)
- Dieter Böning
- Institute of Physiology, Charité Medical University of Berlin, Berlin, Germany
| | - Wolfgang M Kuebler
- Institute of Physiology, Charité Medical University of Berlin, Berlin, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
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Hostrup M, Cairns SP, Bangsbo J. Muscle Ionic Shifts During Exercise: Implications for Fatigue and Exercise Performance. Compr Physiol 2021; 11:1895-1959. [PMID: 34190344 DOI: 10.1002/cphy.c190024] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise causes major shifts in multiple ions (e.g., K+ , Na+ , H+ , lactate- , Ca2+ , and Cl- ) during muscle activity that contributes to development of muscle fatigue. Sarcolemmal processes can be impaired by the trans-sarcolemmal rundown of ion gradients for K+ , Na+ , and Ca2+ during fatiguing exercise, while changes in gradients for Cl- and Cl- conductance may exert either protective or detrimental effects on fatigue. Myocellular H+ accumulation may also contribute to fatigue development by lowering glycolytic rate and has been shown to act synergistically with inorganic phosphate (Pi) to compromise cross-bridge function. In addition, sarcoplasmic reticulum Ca2+ release function is severely affected by fatiguing exercise. Skeletal muscle has a multitude of ion transport systems that counter exercise-related ionic shifts of which the Na+ /K+ -ATPase is of major importance. Metabolic perturbations occurring during exercise can exacerbate trans-sarcolemmal ionic shifts, in particular for K+ and Cl- , respectively via metabolic regulation of the ATP-sensitive K+ channel (KATP ) and the chloride channel isoform 1 (ClC-1). Ion transport systems are highly adaptable to exercise training resulting in an enhanced ability to counter ionic disturbances to delay fatigue and improve exercise performance. In this article, we discuss (i) the ionic shifts occurring during exercise, (ii) the role of ion transport systems in skeletal muscle for ionic regulation, (iii) how ionic disturbances affect sarcolemmal processes and muscle fatigue, (iv) how metabolic perturbations exacerbate ionic shifts during exercise, and (v) how pharmacological manipulation and exercise training regulate ion transport systems to influence exercise performance in humans. © 2021 American Physiological Society. Compr Physiol 11:1895-1959, 2021.
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Affiliation(s)
- Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Simeon Peter Cairns
- SPRINZ, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand.,Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Böning D, Schmidt WF. Role of haemoglobin oxygen affinity for oxygen uptake during exercise. J Physiol 2020; 598:3531-3532. [PMID: 32449526 DOI: 10.1113/jp280054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Dieter Böning
- Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Bayreuth, 95440, Germany
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Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533512 DOI: 10.1111/vec.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
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Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
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Böning D, Maassen N. Relation between lactic acid and base excess during muscular exercise. Eur J Appl Physiol 2018; 118:863-864. [PMID: 29450628 DOI: 10.1007/s00421-018-3824-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 02/10/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Dieter Böning
- Institut für Physiologie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Norbert Maassen
- Institut für Sportmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
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Mota MR, Dantas RAE, Oliveira-Silva I, Sales MM, Sotero RDC, Venâncio PEM, Teixeira Júnior J, Chaves SN, de Lima FD. Effect of self-paced active recovery and passive recovery on blood lactate removal following a 200 m freestyle swimming trial. Open Access J Sports Med 2017; 8:155-160. [PMID: 28721108 PMCID: PMC5499938 DOI: 10.2147/oajsm.s127948] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to investigate the effect of self-paced active recovery (AR) and passive recovery (PR) on blood lactate removal following a 200 m freestyle swimming trial. Patients and methods Fourteen young swimmers (with a training frequency of 6–8 sessions per week) performed two maximal 200 m freestyle trials followed by 15 minutes of different recovery methods, on separate days. Recovery was performed with 15 minutes of passive rest or 5 minutes of passive rest and 10 minutes of self-paced AR. Performance variables (trial velocity and time), recovery variables (distance covered and AR velocity), and physiological variables (blood lactate production, blood lactate removal, and removal velocity) were assessed and compared. Results There was no difference between trial times in both conditions (PR: 125.86±7.92 s; AR: 125.71±8.21 s; p=0.752). AR velocity was 69.10±3.02% of 200 m freestyle trial velocity in AR. Blood lactate production was not different between conditions (PR: 8.82±2.47 mmol L−1; AR: 7.85±2.05 mmol L−1; p=0.069). However, blood lactate removal was higher in AR (PR: 1.76±1.70 mmol L−1; AR: 4.30±1.74 mmol L−1; p<0.001). The velocity of blood lactate removal was significantly higher in AR (PR: 0.18±0.17 mmol L−1 min−1; AR: 0.43±0.17 mmol L−1 min−1; p<0.001). Conclusion Self-paced AR shows a higher velocity of blood lactate removal than PR. These data suggest that athletes may be able to choose the best recovery intensity themselves.
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Affiliation(s)
- Márcio Rabelo Mota
- College of Education and Health Sciences, University Center of Brasília - UniCEUB, Brasília.,College of Physical Education, UniEVANGÉLICA, Anápolis, Goiás
| | - Renata Aparecida Elias Dantas
- College of Education and Health Sciences, University Center of Brasília - UniCEUB, Brasília.,College of Physical Education, UniEVANGÉLICA, Anápolis, Goiás
| | | | - Marcelo Magalhães Sales
- College of Physical Education, UniEVANGÉLICA, Anápolis, Goiás.,College of Physical Education, Universidade Estadual de Goiás -UEG, Quirinópolis, Goiás
| | | | | | | | - Sandro Nobre Chaves
- College of Physical Education, University of Brasília - UnB, Brasília, Brazil
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Biochemical responses and physical performance during high-intensity resistance circuit training in hypoxia and normoxia. Eur J Appl Physiol 2017; 117:809-818. [PMID: 28260202 DOI: 10.1007/s00421-017-3571-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to analyze the effect of hypoxia on metabolic and acid-base balance, blood oxygenation, electrolyte, and half-squat performance variables during high-resistance circuit (HRC) training. METHODS Twelve resistance-trained subjects participated in this study. After a 6RM testing session, participants performed three randomized trials of HRC: normoxia (NORM: FiO2 = 0.21), moderate hypoxia (MH: FiO2 = 0.16), or high hypoxia (HH: FiO2 = 0.13), separated by 72 h of recovery in normoxic conditions. HRC consisted of two blocks of three exercises (Block 1: bench press, deadlift and elbow flexion; Block 2: half-squat, triceps extension, and ankle extension). Each exercise was performed at 6RM. Rest periods lasted for 35 s between exercises, 3 min between sets, and 5 min between blocks. Peak and mean force and power were determined during half-squat. Metabolic, acid-base balance, blood oxygenation and electrolyte variables, arterial oxygen saturation (SaO2), and rating of perceived exertion (RPE) were measured following each block. RESULTS During the first set, peak force and power were significantly lower in HH than MH and NORM; whereas in the second set, mean and peak force and power were significantly lower in HH than NORM. At the end of the HRC training session, blood lactate and RPE in HH were significantly higher than in MH and NORM. SaO2, pH, HCO3-, and pO2 values were significantly lower in all hypoxic conditions than in NORM. CONCLUSION These results indicate that simulated hypoxia during HRC exercise reduce blood oxygenation, pH, and HCO3-, and increased blood lactate ultimately decreasing muscular performance.
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Opitz D, Lenzen E, Opiolka A, Redmann M, Hellmich M, Bloch W, Brixius K, Brinkmann C. Endurance training alters basal erythrocyte MCT-1 contents and affects the lactate distribution between plasma and red blood cells in T2DM men following maximal exercise. Can J Physiol Pharmacol 2015; 93:413-9. [PMID: 25844530 DOI: 10.1139/cjpp-2014-0467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chronic elevated lactate levels are associated with insulin resistance in patients with type 2 diabetes mellitus (T2DM). Furthermore, lactacidosis plays a role in limiting physical performance. Erythrocytes, which take up lactate via monocarboxylate transporter (MCT) proteins, may help transport lactate within the blood from lactate-producing to lactate-consuming organs. This study investigates whether cycling endurance training (3 times/week for 3 months) alters the basal erythrocyte content of MCT-1, and whether it affects lactate distribution kinetics in the blood of T2DM men (n = 10, years = 61 ± 9, body mass index = 31 ± 3 kg/m(2)) following maximal exercise (WHO step-incremental cycle ergometer test). Immunohistochemical staining indicated that basal erythrocyte contents of MCT-1 protein were up-regulated (+90%, P = 0.011) post-training. Erythrocyte and plasma lactate increased from before acute exercise (= resting values) to physical exhaustion pre- as well as post-training (pre-training: +309%, P = 0.004; +360%, P < 0.001; post-training: +318%, P = 0.008; +300%, P < 0.001), and did not significantly decrease during 5 min recovery. The lactate ratio (erythrocytes:plasma) remained unchanged after acute exercise pre-training, but was significantly increased after 5 min recovery post-training (compared with the resting value) (+22%, P = 0.022). The results suggest an increased time-delayed influx of lactate into erythrocytes following an acute bout of exercise in endurance-trained diabetic men.
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Affiliation(s)
- David Opitz
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
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Böning D, Littschwager A, Hütler M, Beneke R, Staab D. Hemoglobin oxygen affinity in patients with cystic fibrosis. PLoS One 2014; 9:e97932. [PMID: 24919182 PMCID: PMC4053337 DOI: 10.1371/journal.pone.0097932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 04/26/2014] [Indexed: 01/18/2023] Open
Abstract
In patients with cystic fibrosis lung damages cause arterial hypoxia. As a typical compensatory reaction one might expect changes in oxygen affinity of hemoglobin. Therefore position (standard half saturation pressure P50st) and slope (Hill’s n) of the O2 dissociation curve as well as the Bohr coefficients (BC) for CO2 and lactic acid were determined in blood of 14 adult patients (8 males, 6 females) and 14 healthy controls (6 males, 8 females). While Hill’s n amounted to approximately 2.6 in all subjects, P50st was slightly increased by 1mmHg in both patient groups (controls male 26.7±0.2, controls female 27.0±0.1, patients male 27.7±0.5, patients female 28.0±0.3 mmHg; mean and standard error, overall p<0.01). Main cause was a rise of 1–2 µmol/g hemoglobin in erythrocytic 2,3-biphosphoglycerate concentration. One patient only, clearly identified as an outlier and with the mutation G551D, showed a reduction of both P50st (24.5 mmHg) and [2,3-biphosphoglycerate] (9.8 µmol/g hemoglobin). There were no differences in BCCO2, but small sex differences in the BC for lactic acid in the controls which were not detectable in the patients. Causes for the right shift of the O2 dissociation curve might be hypoxic stimulation of erythrocytic glycolysis and an increased red cell turnover both causing increased [2,3-biphosphoglycerate]. However, for situations with additional hypercapnia as observed in exercising patients a left shift seems to be a more favourable adaptation in cystic fibrosis. Additionally when in vivo PO2 values were corrected to the standard conditions they mostly lay left of the in vitro O2 dissociation curve in both patients and controls. This hints to unknown fugitive factors influencing oxygen affinity.
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Affiliation(s)
- Dieter Böning
- Institut für Sportmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| | - Angela Littschwager
- Institut für Sportmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Hütler
- Institut für Sportmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralph Beneke
- Institut für Sportmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Doris Staab
- Klinik für Pädiatrische Pneumologie und Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
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14
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Björklund G, Laaksonen MS, Holmberg HC. Blood lactate recovery and respiratory responses during diagonal skiing of variable intensity. Eur J Sport Sci 2011. [DOI: 10.1080/17461391.2010.521580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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Wahl P, Yue Z, Zinner C, Bloch W, Mester J. A mathematical model for lactate transport to red blood cells. J Physiol Sci 2011; 61:93-102. [PMID: 21181323 PMCID: PMC10717242 DOI: 10.1007/s12576-010-0125-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022]
Abstract
A simple mathematical model for the transport of lactate from plasma to red blood cells (RBCs) during and after exercise is proposed based on our experimental studies for the lactate concentrations in RBCs and in plasma. In addition to the influx associated with the plasma-to-RBC lactate concentration gradient, it is argued that an efflux must exist. The efflux rate is assumed to be proportional to the lactate concentration in RBCs. This simple model is justified by the comparison between the model-predicted results and observations: For all 33 cases (11 subjects and 3 different warm-up conditions), the model-predicted time courses of lactate concentrations in RBC are generally in good agreement with observations, and the model-predicted ratios between lactate concentrations in RBCs and in plasma at the peak of lactate concentration in RBCs are very close to the observed values. Two constants, the influx rate coefficient C (1) and the efflux rate coefficient C (2), are involved in the present model. They are determined by the best fit to observations. Although the exact electro-chemical mechanism for the efflux remains to be figured out in the future research, the good agreement of the present model with observations suggests that the efflux must get stronger as the lactate concentration in RBCs increases. The physiological meanings of C (1) and C (2) as well as their potential applications are discussed.
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Affiliation(s)
- Patrick Wahl
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
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16
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Zinner C, Wahl P, Achtzehn S, Sperlich B, Mester J. Effects of bicarbonate ingestion and high intensity exercise on lactate and H+-ion distribution in different blood compartments. Eur J Appl Physiol 2011; 111:1641-8. [DOI: 10.1007/s00421-010-1800-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
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17
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Moll W, Gros G. Combined glycolytic production of lactate(-) and ATP(4-) derived protons (= dissociated lactic acid) is the only cause of metabolic acidosis of exercise--a note on the OH(-) absorbing function of lactate (1-) production. J Appl Physiol (1985) 2008; 105:366-7. [PMID: 18680794 DOI: 10.1152/japplphysiol.zdg-8016-pcpcomm.2008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Böning D, Maassen N. Last word on point:counterpoint: lactic acid is/is not the only physicochemical contributor to the acidosis of exercise. J Appl Physiol (1985) 2008; 105:368. [PMID: 18641216 DOI: 10.1152/japplphysiol.90583.2008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lindinger MI, Heigenhauser GJF. Counterpoint: Lactic acid is not the only physicochemical contributor to the acidosis of exercise. J Appl Physiol (1985) 2008; 105:359-61; discussion 361-2. [DOI: 10.1152/japplphysiol.00162.2008a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rebuttal from Drs. Böning and Maassen. J Appl Physiol (1985) 2008. [DOI: 10.1152/japplphysiol.00162.2008b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Böning D, Maassen N. Point:Counterpoint: Lactic acid is/is not the only physicochemical contributor to the acidosis of exercise. J Appl Physiol (1985) 2008; 105:358-9. [DOI: 10.1152/japplphysiol.00162.2008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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Böning D, Rojas J, Serrato M, Reyes O, Coy L, Mora M. Extracellular pH defense against lactic acid in untrained and trained altitude residents. Eur J Appl Physiol 2008; 103:127-37. [PMID: 18196263 DOI: 10.1007/s00421-008-0675-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2007] [Indexed: 11/25/2022]
Abstract
The assumption that buffering at altitude is deteriorated by bicarbonate (bi) reduction was investigated. Extracellular pH defense against lactic acidosis was estimated from changes (Delta) in lactic acid ([La]), [HCO3-], pH and PCO2 in plasma, which equilibrates with interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 10 untrained (UT) and 11 endurance-trained (TR) highlanders (2,600 m). During exercise the capacity of non-bicarbonate buffers (betanbi=-Delta[La]. DeltapH(-1)-Delta[HCO3-]. DeltapH(-1)) amounted to 40+/-2 (SEM) and 28+/-2 mmol l(-1) in UT and TR, respectively (P<0.01). During recovery beta (nbi) decreased to 20 (UT) and 16 (TR) mmol l(-1) (P<0.001) corresponding to values expected from hemoglobin, dissolved protein and phosphate concentrations related to extracellular fluid (ecf). This was accompanied by a larger decrease of base excess after than during exercise for a given Delta[La]. betabi amounted to 37-41 mmol l(-1) being lower than at sea level. The large exercise betanbi was mainly caused by increasing concentrations of buffers due to temporary shrinking of ecf. Tr has lower betanbi in spite of an increased Hb mass mainly because of an expanded ecf compared to UT. In highlanders betanbi is higher than in lowlanders because of larger Hb mass and reduced ecf and counteracts the decrease in [HCO3-]. The amount of bicarbonate is probably reduced by reduction of the ecf at altitude but this is compensated by lower maximal [La] and more effective hyperventilation resulting in attenuated exercise acidosis at exhaustion.
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Affiliation(s)
- D Böning
- Institute of Sports Medicine, Charité-Universitätsmedizin Berlin, Arnimallee 22, 14195 Berlin, Germany.
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McKenna MJ, Bangsbo J, Renaud JM. Muscle K+, Na+, and Cl− disturbances and Na+-K+ pump inactivation: implications for fatigue. J Appl Physiol (1985) 2008; 104:288-95. [DOI: 10.1152/japplphysiol.01037.2007] [Citation(s) in RCA: 184] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Membrane excitability is a critical regulatory step in skeletal muscle contraction and is modulated by local ionic concentrations, conductances, ion transporter activities, temperature, and humoral factors. Intense fatiguing contractions induce cellular K+ efflux and Na+ and Cl− influx, causing pronounced perturbations in extracellular (interstitial) and intracellular K+ and Na+ concentrations. Muscle interstitial K+ concentration may increase 1- to 2-fold to 11–13 mM and intracellular K+ concentration fall by 1.3- to 1.7-fold; interstitial Na+ concentration may decline by 10 mM and intracellular Na+ concentration rise by 1.5- to 2.0-fold. Muscle Cl− concentration changes reported with muscle contractions are less consistent, with reports of both unchanged and increased intracellular Cl− concentrations, depending on contraction type and the muscles studied. When considered together, these ionic changes depolarize sarcolemmal and t-tubular membranes to depress tetanic force and are thus likely to contribute to fatigue. Interestingly, less severe local ionic changes can also augment subtetanic force, suggesting that they may potentiate muscle contractility early in exercise. Increased Na+-K+-ATPase activity during exercise stabilizes Na+ and K+ concentration gradients and membrane excitability and thus protects against fatigue. However, during intense contraction some Na+-K+ pumps are inactivated and together with further ionic disturbances, likely precipitate muscle fatigue.
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Böning D, Klarholz C, Himmelsbach B, Hütler M, Maassen N. Extracellular bicarbonate and non-bicarbonate buffering against lactic acid during and after exercise. Eur J Appl Physiol 2007; 100:457-67. [PMID: 17450372 DOI: 10.1007/s00421-007-0453-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2007] [Indexed: 10/23/2022]
Abstract
Defense of extracellular pH constancy against lactic acidosis can be estimated from changes (Delta) in lactic acid ([La]), [HCO(3)(-)], pH and PCO(2) in blood plasma because it is equilibrated with the interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 13 untrained (UT) and 21 endurance-trained (TR) males to find out if acute and chronic exercise influence the defense. During exercise the capacity of non-bicarbonate buffers (beta(nbi) = -Delta[La] . DeltapH(-1) - Delta[HCO(3)(-)] . DeltapH(-1)) available for the extracellular fluid (mainly hemoglobin, dissolved proteins and phosphates) amounted to 32 +/- 2(SEM) and 20 +/- 2 mmol l(-1) in UT and TR, respectively (P < 0.02). During recovery beta(nbi) decreased to 14 (UT) and 12(TR) mmol l(-1) (both P < 0.001) corresponding to values previously found at rest by in vivo CO(2) titration. Bicarbonate buffering (beta(bi)) amounted to 44-48 mmol l(-1) during and after exercise. The large exercise beta(nbi) seems to be mainly caused by an increasing concentration of all buffers due to shrinking of the extracellular volume, exchange of small amounts of HCO(3)(-) or H(+) with cells and delayed HCO(3)(-) equilibration between plasma and interstitial fluid. Increase of [HCO(3)(-)] during titration by these mechanisms augments total beta and thus the calculated beta(nbi) more than beta(bi) because it reduces DeltapH and Delta[HCO(3)(-)] at constant Delta[La]. The smaller rise in exercise beta(nbi) in TR than UT may be caused by an increased extracellular volume and an improved exchange of La(-), HCO(3)(-) and H(+) between trained muscles and blood.
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Affiliation(s)
- Dieter Böning
- Institute of Sports Medicine, Charité - University Medicine Berlin, Berlin, Germany.
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