Changes in natural killer cell subpopulations over a winter training season in elite swimmers

The untapped potential of cold water therapy as part of a lifestyle intervention for promoting healthy aging

Healthy aging is a crucial goal in aging societies of the western world, with various lifestyle strategies being employed to achieve it. Among these strategies, hydrotherapy stands out for its potential to promote cardiovascular and mental health. Cold water therapy, a hydrotherapy technique, has emerged as a lifestyle strategy with the potential capacity to evoke a wide array of health benefits. This review aims to synthesize the extensive body of research surrounding cold water therapy and its beneficial effects on various health systems as well as the underlying biological mechanisms driving these benefits. We conducted a search for interventional and observational cohort studies from MEDLINE and EMBASE up to July 2024. Deliberate exposure of the body to cold water results in distinct physiological responses that may be linked to several health benefits. Evidence, primarily from small interventional studies, suggests that cold water therapy positively impacts cardiometabolic risk factors, stimulates brown adipose tissue and promotes energy expenditure-potentially reducing the risk of cardiometabolic diseases. It also triggers the release of stress hormones, catecholamines and endorphins, enhancing alertness and elevating mood, which may alleviate mental health conditions. Cold water therapy also reduces inflammation, boosts the immune system, promotes sleep and enhances recovery following exercise. The optimal duration and temperature needed to derive maximal benefits is uncertain but current evidence suggests that short-term exposure and lower temperatures may be more beneficial. Overall, cold water therapy presents a potential lifestyle strategy to enhancing physical and mental well-being, promoting healthy aging and extending the healthspan, but definitive interventional evidence is warranted.

Immunosurveillance associated with upper respiratory symptoms in elite swimmers: The 8-month period leading into Commonwealth Games

OBJECTIVES

To monitor individual mucosal immunity and identify potential risk factors of upper respiratory symptoms in elite swimmers over a competitive season.

DESIGN

Eight-month longitudinal study, observing mucosal immunity, Epstein-Barr virus status, training loads and illness symptoms of elite international swimmers, leading into the Commonwealth Games 2018.

METHODS

Participants were fourteen elite swimmers (age ± standard deviation = 19.9 ± 0.8 years, height = 178.9 ± 6.3 cm, and mass = 75.0 ± 7.7 kg). Self-reported upper respiratory symptoms, training load and saliva samples were collected weekly. Venous blood samples were taken at study commencement to determine Epstein-Barr virus status.

RESULTS

Throughout the study, 70 episodes of upper respiratory symptoms were recorded resulting in 34 days of missed training. Incidence (p = 0.001), severity (p = 0.022), and duration of upper respiratory symptoms (p = 0.001) were significantly higher during high training loads, compared to low. Eight swimmers (61 %) had evidence of past infection with Epstein-Barr virus, but this had no relationship with incidence, severity, or duration of upper respiratory symptoms (p > 0.05). Relative individual salivary immunoglobulin A concentration was 12 % lower when upper respiratory symptoms were present but was not statistically significant (p = 0.101).

CONCLUSIONS

This study highlights the importance of individual athlete monitoring, to identify swimmers at increased illness risk. Identification of possible risk factors for upper respiratory symptoms, such as increased training load, may allow for modifications in training or other illness preventative strategies for elite swimmers.

Natural killer cells immunosenescence and the impact of lifestyle management

Natural killer cells (NKs) are lymphocytes of the innate immune system that quickly respond to viruses, infections, and tumors during their short cell life cycle. However, it was recently found that NKs undergo quantitative, distributional, structural, and functional phenotypic changes during aging that suppress immune responses, which is known as immunosenescence. The aging host environment, cytokine regulation, cytomegalovirus status, and hypothalamic‒pituitary‒adrenal axis have significant effects on NK function. Different lifestyle management interventions modulate the number and cytotoxic activity of NKs, which are essential for rebuilding the immune barrier against pathogens in elderly individuals. Based on recent studies, we review the phenotypic changes of and potential threats of NKs during aging and explore the underlying mechanisms. By summarizing the effects of lifestyle management on NKs and their application prospects, we aim to provide evidence for enhancing immune system function against immune diseases in elderly individuals.

Effect of intensive training on immune system cells in elite female weightlifters

OBJECTIVE

This study aimed to investigate the effects of intense weightlifting training on lymphocyte and natural killer cell subgroups, which are the major cells of the immune system, in elite female weightlifters.

METHODS

A total of 20 elite female weightlifters were evaluated using flow cytometry before training (pre-T), immediately after training (post-T), and after a 120-min rest period (rest-T).

RESULTS

Post-T and rest-T showed significant decreases in helper T (Th) and cytotoxic T compared with pre-T (p=0.045, p<0.001 and p=0.05, p<0.001, respectively). B and natural killer cells were higher in post-T and rest-T than in pre-T. The increase in B cells was significant in pre-T/rest-T (p<0.001) but not in pre-T/post-T (p=0.122). Intense training significantly increased natural killer cells in both post-T and rest-T (p<0.001). CD56bright and CD56dim natural killer cell subgroups were significantly lower in post-T and rest-T than in pre-T (p=0.005, p=0.006 and p<0.001, p=0.004, respectively).

CONCLUSION

This study shows that intense weightlifting alters peripheral lymphocyte and natural killer subgroup ratios, being the first investigation in this field.

Exercise Immunology Applied to Pediatric Sport and the Importance of Monitoring Stages of Puberty and Biological Maturation

CONTEXT

Exercise immunology is aimed at understanding how exercise sessions can affect the immune system in athletic subjects of different age groups. The objective of the current study was to discuss in which stage of biological maturation (BM) young athletes may be more vulnerable in relation to the immune system, and whether there is a BM range in which it is safer to perform sports training with strenuous exercise loads.

EVIDENCE ACQUISITION

Evidence from scientific research from several scientific disciplines (eg, immunology, sport immunology, pediatrics, sports medicine, human development) was gathered to holistically examine the main particularities of exercise immunology as applied to pediatric sport.

STUDY DESIGN

Narrative review.

LEVEL OF EVIDENCE

Level 5.

RESULTS

In pediatric patients, lymphoid tissue expands during puberty and involutes after puberty until it returns to pre-expansion values. This suggests that there is a specific period in which the immune system may be stronger, which may provide opportunities for strenuous exercise in pediatric athletes. However, the chronological period when puberty occurs will be determined by BM, which is the rate at which the biological systems of the human body improves. This may affect the period of lymphoid tissue expansion and, consequently, the behavior of the immune system in pediatric subjects of the same age category.

CONCLUSION

During puberty, there is a significant increase in the proinflammatory profile; to compensate for this, there is an expansion of lymphoid tissue that may favor the efficiency of the immune system. The period in which puberty is reached may vary according to the stages of BM. Therefore, in exercise immunology applied to pediatric sports, in addition to external and internal training loads, it is necessary to consider BM and puberty, which have been shown to be safer biomarkers than chronological age for determining immune system behavior in pediatric athletes.

STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT)

Evidence B level 3.

Natural Killer Cell Derived Microvesicles Affect the Function of Trophoblast Cells

The interaction of natural killer (NK) and trophoblast cells underlies the formation of immune tolerance in the mother-fetus system and the maintenance of the physiological course of pregnancy. In addition, NK cells affect the function of trophoblast cells, interacting with them via the receptor apparatus and through the production of cytokines. Microvesicles (MVs) derived from NK cells are able to change the function of target cells. However, in the overall pattern of interactions between NK cells and trophoblasts, the possibility that both can transmit signals to each other via MVs has not been taken into account. Therefore, the aim of this study was to assess the effect of NK cell-derived MVs on the phenotype, proliferation, and migration of trophoblast cells and their expression of intracellular messengers. We carried out assays for the detection of content transferred from MV to trophoblasts. We found that NK cell-derived MVs did not affect the expression of CD54, CD105, CD126, CD130, CD181, CD119, and CD120a receptors in trophoblast cells or lead to the appearance of CD45 and CD56 receptors in the trophoblast membrane. Further, the MVs reduced the proliferation but increased the migration of trophoblasts with no changes to their viability. Incubation of trophoblast cells in the presence of MVs resulted in the activation of STAT3 via pSTAT3(Ser727) but not via pSTAT3(Tyr705). The treatment of trophoblasts with MVs did not result in the phosphorylation of STAT1 and ERK1/2. The obtained data indicate that NK cell-derived MVs influence the function of trophoblast cells, which is accompanied by the activation of STAT3 signaling.

Acute and chronic effects of physical exercise on IgA and IgG levels and susceptibility to upper respiratory tract infections: a systematic review and meta-analysis

This systematic review and meta-analysis aimed at evaluating acute and chronic effects of physical exercise on IgA and IgG levels, as well as its relationship with the susceptibility to develop upper respiratory tract infections (URTI). This systematic review and meta-analysis was conducted and reported in accordance with PRISMA statement. A systematic search of PubMed, Web of Science, and EMBASE was performed in July 2020. This systematic review and meta-analysis included studies in which participants performed acute exercise or chronic physical training and were subjected to analyses of URTI incidence and concentrations of IgA and IgG. The selected studies for systematic review were divided into the following three groups: (I) trials that evaluated the effects of acute exercise in sedentary subjects, (II) trials that evaluated the effects of acute exercise in athletes/trained individuals, and (III) trials that evaluated the effects of chronic physical training on the incidence of URTI, as well as on the levels of IgA and IgG. Acute exercise increases the IgA levels in trained subjects but does not affect its levels in untrained subjects. Such increase in IgA levels induced by acute exercise is greater in trained individual that performed ultramarathon. On the other hand, chronic physical training reduces IgA levels in both trained and untrained subjects, does not change IgA levels in non-military subjects, besides from not affecting IgG levels. The present systematic review and meta-analysis indicates that acute exercise positively influences IgA levels in trained individuals, being this effect pronounced when a strenuous exercise such as ultramarathon is executed. Chronic physical training, in turn, does not affect IgG levels.

Effects of different training intensities in high-intensity interval training (HIIT) on maximal aerobic velocity, hematological and muscle-damage markers in healthy young adults

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG₁₀₀) while group 2 (n = 10) exercised at 110% MAV (EG₁₁₀). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG₁₁₀ compared to EG₁₀₀ after HIIT (p < 0.01, η_p² = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p < 0.01; 0.02 < η_p² < 0.11) in EG₁₁₀ compared to EG₁₀₀. Moreover, post-hoc tests indicated that LY decreased significantly (p < 0.001, η_p² = 0.21) only for EG₁₁₀. Furthermore, there were significant positive correlations for both EG₁₀₀ and EG₁₁₀ between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG₁₀₀ and EG₁₁₀ between MAV and LY (r = 0.79, p < 0.01; r = 0.72, p < 0.05, respectively). Concerning the relationship between MAV and NE, there was a significant positive correlation (r = 0.66; p < 0.05) only for EG₁₁₀. Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage.

Supply of Antioxidants vs. Recruit Firefighters' Cellular Immune Status: A Randomized Double-Blinded Placebo-Controlled Parallel-Group Trial

Background: Physical exercise can affect the immune system. We studied the effect of antioxidants on hematological and immune biomarkers after heavy training. Methods: 24 well-trained and well-fed male firefighters were randomly divided into supplemented and placebo groups, and tested for immunology-related variables using venous blood samples in the fasting state, pre- (M1) and post- (M2) five weeks of daily micronutrient supplementation (15 mg of beta-carotene, 200 mg of vitamin C, 136 mg of vitamin E, 200 μg of selenium, 15 mg of zinc, 100 mg of magnesium). Total leukocytes and a differential count for five populations were determined using standard procedures (MAXM—Beckman Coulter Diagnostics; Brea, CA, USA). Lymphocyte subsets were determined through immunophenotyping. Results: Although all values were within the normal range for healthy adults and athletes in the supplemented group (SG), mean CD3+CD8+, CD8+ and CD16+CD56+ decreased (p < 0.05; small to moderate effects), while mean CD4+, CD19+ and CD4+/CD8+ increased (p < 0.05; small effects) after five-weeks. Regarding the placebo group (PG), higher total leukocyte count (p < 0.05; trivial effect) and natural killer cells percentage (CD16+CD56+; p < 0.05; moderate effect) were observed when comparing M1 and M2. Conclusions: Antioxidants supplementation did not alter well-fed male firefighters recruit firefighters’ immune cell response during the five-week physical training program.

Inflammatory cytokines and metabolic responses to high-intensity intermittent training: effect of the exercise intensity

To examine the effects of two high-intensity intermittent training (HIIT) programs of varying intensities (100% vs. 110% of maximal aerobic velocity [MAV]) on metabolic, hormonal and inflammatory markers in young men. Thirty-seven active male volunteers were randomly assigned into: HIIT experimental groups (100% MAV [EG₁₀₀, n = 9] and 110% MAV [EG₁₁₀, n = 9]) and a control groups (CG₁₀₀, n = 9 and CG₁₁₀, n = 9). Particpants performed high intesity intermittent exercise test (HIIE) at 100% or 110% MAV. Venous blood samples were obtained before, at the end of HIIE and at 15 min of recovery, and before and after 8 weeks of HIIT programs. After training, Glucose was lower (p < 0.01) in EG₁₀₀ (d = 0.72) and EG₁₁₀ (d = 1.20) at the end of HIIE, and at 15 min recovery only in EG₁₁₀ (d = 0.95). After training, Insulin and Cortisol were lower than before training in EG₁₀₀ and EG₁₁₀ at the end of HIIE (p < 0.001). After HIIT, IL-6 deceased (p < 0.001) in EG₁₀₀ (d = 1.43) and EG₁₁₀ (d = 1.56) at rest, at the end of HIIE (d = 1.03; d = 1.75, respectively) and at 15 min of recovery (d = 0.88;d = 1.7, respectively). This decrease was more robust (p < 0.05) in EG₁₁₀ compared to EG₁₀₀. After HIIT, TNF-α deceased (p < 0.001) in EG₁₀₀ (d = 1.43) and EG₁₁₀ (d = 0.60) at rest, at the end of HIIE (0.71 < d < 0.98) and at 15 min of recovery (0.70 < d < 2.78). HIIT with 110% MAV is more effective in young males on the improvements of some metabolic (Glucose), hormonal (Cortisol) and inflammatory (IL-6) markers at rest, at the end of HIIE and 15 min of recovery than training at 100 % MAV.

Risk factors associated with acute respiratory illnesses in athletes: a systematic review by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’

Objective

To review risk factors associated with acute respiratory illness (ARill) in athletes, including non-infectious ARill and suspected or confirmed acute respiratory infections (ARinf).

Design

Systematic review.

Data sources

Electronic databases: PubMed-Medline, EbscoHost and Web of Science.

Eligibility criteria

Original research articles published between January 1990 and July 2020 in English were searched for prospective and retrospective full text studies that reported quantitative data on risk factors associated with ARill/ARinf in athletes, at any level of performance (elite/non-elite), aged 15–65 years.

Results

48 studies (n=19 390 athletes) were included in the study. Risk factors associated with ARill/ARinf were: increased training monotony, endurance training programmes, lack of tapering, training during winter or at altitude, international travel and vitamin D deficits. Low tear-(SIgA) and salivary-(IgA) were immune biomarkers associated with ARill/ARinf.

Conclusions

Modifiable training and environmental risk factors could be considered by sports coaches and athletes to reduce the risk of ARill/ARinf. Clinicians working with athletes can consider assessing and treating specific nutritional deficiencies such as vitamin D. More research regarding the role and clinical application of measuring immune biomarkers in athletes at high risk of ARill/ARinf is warranted.

PROSPERO registration number

CRD42020160928.

Incidence of acute respiratory illnesses in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE

To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Electronic databases: PubMed-Medline, EbscoHost and Web of Science.

ELIGIBILITY CRITERIA

Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15-65 years.

RESULTS

Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3).

SUMMARY/CONCLUSIONS

These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported.

PROSPERO REGISTRATION NUMBER

CRD42020160472.

Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE

To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, EBSCOhost, Web of Science, January 1990-July 2020.

ELIGIBILITY CRITERIA

Original research articles published in English on athletes/military recruits (15-65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill.

RESULTS

767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0-8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).

CONCLUSIONS

In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.

PROSPERO REGISTRATION NUMBER

CRD42020160479.

An Uneven Playing Field: Athlete Injury, Illness, Load, and Daily Training Environment in the Year Before the FINA (Aquatics) World Championships, 2017

OBJECTIVE

To assess athlete's training environment and health problems before the FINA World Championships (WC) (2017) and to analyze the differences between the 6 disciplines, gender, and countries with different medal rankings during the championships.

DESIGN

Retrospective anonymous questionnaire.

SETTING

FINA WC 2017.

PARTICIPANTS

Registered aquatic athletes (swimmers, divers, high divers, water polo players, artistic swimmers, open water swimmers).

MAIN OUTCOME MEASURES

The outcome measures included the following: training and competition load, availability of support staff, performance of injury prevention exercises, and prevalence of health problems. The independent variables included gender, aquatic discipline, and country group based on medal ranking.

RESULTS

In the 12 months preceding the Championships, 67% of the athletes reported physical complaints and 41% trained or competed with a diagnosed injury. Only half of the athletes reported that injury prevention exercises were always (29.9%) or often (23.4%) a regular part of their daily training. In the daily training environment, support staff (excluding coach) was not available or available only if the athlete pays in 28.4% (specialized trainer) to 58.9% (sport scientist) of cases. About one-quarter of the athletes rated the support offered by their National Team program as poor or very poor. There were discrepancies in training loads and support staff among the 6 aquatic disciplines. Availability of support staff, athlete's satisfaction with their training environment/support, and regular use of injury prevention exercises were higher in countries that ranked higher in the medal list.

CONCLUSIONS

Injury prevention strategies should be promoted in aquatic sports, with prospective surveillance for the early identification of physical complaints. The facilitation of access to sport-specific experts could improve athlete's health and performance, especially in countries with low medal ranking.

Polymorphonuclear leucocyte phagocytic function, γδ T-lymphocytes and testosterone as separate stress-responsive markers of prolonged, high-intensity training programs

Excessive exercise with limited recovery may lead to detrimental states of overreaching or the overtraining syndrome. Chronic maladaptation in endocrine and immune mechanisms occur with the incidence of these states. Exercise-induced cortisol and testosterone responses have been proposed as biomarkers of overreaching, with blunted responses following intensified-training periods. Yet, limited information on the effects of overreaching in immunity is available. Healthy individuals completed a 30-min running protocol (the RPE_TP) before and after a 12-day intensified-training period. Blood and saliva were collected before, after and 30min after RPE_TP at pre-training and post-training. Plasma and salivary cortisol and testosterone, leucocyte proliferation and polymorphonuclear leucocyte phagocytic activity were examined. Plasma and salivary cortisol were acutely unaffected pre-training (-14% and 0%, p ​> ​0.05) and post-training (-14% and +46%, p ​> ​0.05). Comparing pre-training with post-training, blunted responses were observed in plasma testosterone (43%-19%, p ​< ​0.05) and salivary testosterone (55%-24%, p ​> ​0.05). No acute or resting changes in total leucocyte counts or most leucocyte subsets occurred pre-training or post-training. Yet, a 194% acute elevation in γδ T-lymphocyte number occurred pre-training (p ​< ​0.05), and average resting concentrations were 174% higher post-training. Baseline phagocytic activity was 47% lower post-training (p ​< ​0.05). Intensified training was detrimental, significantly reducing phagocytic activity. Testosterone blunted post-training, indicating an excessive training-related hypothalamic-pituitary gonadal dysfunction. The γδ T-lymphocytes sensitivity to exercise was noted, rendering it as a potential stress-responsive cellular marker. The usefulness of the RPE_TP to track the onset of overreaching is proposed.

Exercise and the immune system: taking steps to improve responses to cancer immunotherapy

The remarkable success of cancer immunotherapies has provided new hope to cancer patients. Unfortunately, a significant proportion of patients remain unable to respond to immunotherapy or maintain durable clinical responses. The lack of objective responses likely results from profound immune dysfunction often observed in patients with cancer. There is substantial evidence that exercise and physical activity can reduce incidence and improve outcomes in cancer patients. As the immune system is highly responsive to exercise, one potential avenue to improve immune function is through exercise and physical activity. A single event of dynamic exercise results in the substantial mobilization of leukocytes with increased functional capacities into the circulation. Chronic, or long-term, exercise leads to higher physical fitness in terms of greater cardiorespiratory function and/or muscle strength and endurance. High aerobic capacity, as measured by maximal oxygen uptake, has been associated with the reduction of dysfunctional T cells and improvements in the abundance of some T cell populations. To be sure, however, the mechanisms of exercise-mediated immune changes are both extensive and diverse. Here, we examine the evidence and theorize how acute and chronic exercise could be used to improve responses to cancer immunotherapies including immune checkpoint inhibitors, dendritic cell vaccines, natural killer cell therapies, and adoptive T cell therapies such as chimeric antigen receptor (CAR) T cells. Although the parameters of optimal exercise to yield defined outcomes remain to be determined, the available current data provide a compelling justification for additional human studies and clinical trials investigating the adjuvant use of exercise in immuno-oncology.

Long-term physical training in adolescent sprint and middle distance swimmers alters the composition of circulating T and NK cells which correlates with soluble ICAM-1 serum concentrations

Purpose

It remains unknown how different training intensities and volumes chronically impact circulating lymphocytes and cellular adhesion molecules. First, we aimed to monitor changes in NK and T cells over a training season and relate these to training load. Second, we analyzed effects of training differences between swimmers on these cells. Finally, we examined if changes in lymphocytes were associated with sICAM-1 concentrations.

Methods

We analyzed weekly training volume, training intensity, proportions of T and NK cells and serum sICAM-1 in eight sprint (SS) and seven middle-distance swimmers (MID) at three points over a 16-week training period: at the start (t₀), after 7 weeks of increased training load (t₇) and after 16 weeks, including 5-day taper (t₁₆).

Results

Training volume of all swimmers was statistically higher and training intensity lower from t₀–t₇ compared to t₇–t₁₆ (p = 0.001). Secondly, training intensity was statistically higher in SS from t₀–t₇ (p = 0.004) and t₇–t₁₆ (p = 0.015), while MID had a statistically higher training volume from t₇–t₁₆ (p = 0.04). From t₀–t₇, NK (p = 0.06) and CD45RA⁺CD45RO⁺CD4⁺ cells (p < 0.001) statistically decreased, while CD45RA⁻CD45RO⁺CD4⁺ cells (p = 0.024) statistically increased. In a subgroup analysis, SS showed statistically larger increases in NK cells from t₇–t₁₆ than MID (p = 0.012). Lastly, sICAM-1 concentrations were associated with changes in CD45RA⁻CDRO⁺CD4⁺ cells (r = − 0.656, p = 0.08).

Conclusion

These results indicate that intensified training in swimmers resulted in transient changes in T and NK cells. Further, NK cells are sensitive to high training volumes. Lastly, sICAM-1 concentrations may be associated with the migration and maturation of CD4⁺ cells in athletes.

Practical Recommendations Relevant to the Use of Resistance Training for COVID-19 Survivors

The novel coronavirus disease (COVID-19) has emerged at the end of 2019 and caused a global pandemic. The disease predominantly affects the respiratory system; however, there is evidence that it is a multisystem disease that also impacts the cardiovascular system. Although the long-term consequences of COVID-19 are not well-known, evidence from similar diseases alerts for the possibility of long-term impaired physical function and reduced quality of life, especially in those requiring critical care. Therefore, rehabilitation strategies are needed to improve outcomes in COVID-19 survivors. Among the possible strategies, resistance training (RT) might be particularly interesting, since it has been shown to increase functional capacity both in acute and chronic respiratory conditions and in cardiac patients. The present article aims to propose evidence-based and practical suggestions for RT prescription for people who have been diagnosed with COVID-19 with a special focus on immune, respiratory, and cardiovascular systems. Based on the current literature, we present RT as a possible safe and feasible activity that can be time-efficient and easy to be implemented in different settings.

Resistance Training Safety during and after the SARS-Cov-2 Outbreak: Practical Recommendations

In December of 2019, there was an outbreak of a severe acute respiratory syndrome caused by the coronavirus 2 (SARS-CoV-2 or COVID-19) in China. The virus rapidly spread into the whole world causing an unprecedented pandemic and forcing governments to impose a global quarantine, entering an extreme unknown situation. The organizational consequences of quarantine/isolation are absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, and inappropriate training conditions. The reduction of mobility imposed to contain the advance of the SARS-Cov-2 pandemic can negatively affect the physical condition and health of individuals leading to muscle atrophy, progressive loss of muscle strength, and reductions in neuromuscular and mechanical capacities. Resistance training (RT) might be an effective tool to counteract these adverse consequences. RT is considered an essential part of an exercise program due to its numerous health and athletic benefits. However, in the face of the SARS-Cov-2 outbreak, many people might be concerned with safety issues regarding its practice, especially in indoor exercise facilities, such as gyms and fitness centers. These concerns might be associated with RT impact in the immune system, respiratory changes, and contamination due to equipment sharing and agglomeration. In this current opinion article, we provide insights to address these issues to facilitate the return of RT practices under the new logistical and health challenges. We understand that RT can be adapted to allow its performance with measures adopted to control coronavirus outbreak such that the benefits would largely overcome the potential risks. The article provides some practical information to help on its implementation.

Upper respiratory symptoms (URS) and salivary responses across a season in youth soccer players: A useful and non-invasive approach associated to URS susceptibility and occurrence in young athletes

This study examined the effect of a competitive season on salivary responses [cortisol (sC), testosterone (sT), Testosterone/Cortisol ratio (sT/C), Immunoglobulin A (sIgA), sIgA secretion rate (srIgA), alpha-amylase (sAA)] and upper respiratory symptoms (URS) occurrence in three teams of male soccer players (Under-15, Under-17 and Under-19 yrs.). Training and competition volumes, salivary biomarkers and URS were determined monthly. No differences were found for monthly training volume between teams. Incidence of URS was higher for the U15 (44.9% of the total cases). Higher sT and srIgA were observed for the U19, lower sC were found for the U17 and sAA showed higher values for the U15 throughout the season. In the U15, significant difference (p = .023) was found for sIgA concentration with higher concentration values in January compared to December (-42.7%; p = .008) and the sT showed seasonal variation (p < .001) with the highest value in January significantly different from October (-40.2%; p = .035), November (-38.5%; p = 0.022) and December (-51.6%; p = .008). The U19 presented an increase in sC in March compared to February (-66.1%, p = .018), sT/C were higher in February compared to March (-58.1%; p = .022) and sAA increased in March compared to September (-20.5%; p = .037). Negative correlations, controlled for age group, were found between URS occurrence and srIgA (r = -0.170, p = .001), sAA (r = -0.179, p = .001) and sT (r = -0.107, p = .047). Monitoring salivary biomarkers provides information on mucosal immunity with impact in URS occurrence. Coaches could manipulate training loads to attenuate the physical stressors imposed on athletes, especially at demanding and stressful periods.

Bioimpedance Vector Patterns Changes in Response to Swimming Training: An Ecological Approach

BACKGROUND AND AIM

Monitoring bioelectric phase angle (PhA) provides important information on the health and the condition of the athlete. Together with the vector length, PhA constitutes the bioimpedance vector analysis (BIVA) patterns, and their joint interpretation exceeds the limits of the evaluation of the PhA alone. The present investigation aimed to monitor changes in the BIVA patterns during a training macrocycle in swimmers, trying to ascertain if these parameters are sensitive to training load changes across a 13-week training period.

METHODS

Twelve national and international level swimmers (four females; eight males; 20.9 ± 1.9 years; with a competitive swimming background of 11.3 ± 1.8 years; undertaking 16-20 h of pool training and 4-5 h of dry-land training per week and 822.0 ± 59.0 International Swimming Federation (FINA) points) were evaluated for resistance (R) and reactance (Xc) using a single frequency phase sensitive bioimpedance device at the beginning of the macrocycle (M1), just before the beginning of the taper period (M2), and just before the main competition of the macrocycle (M3). At the three-time assessment points, swimmers also performed a 50 m all-out first stroke sprint with track start (T50 m) while time was recorded.

RESULTS

The results of the Hotelling T2 test showed a significant vector displacement due to simultaneous R and Xc changes (p < 0.001), where shifting from top to bottom along the major axis of the R-Xc graph from M1 to M2 was observed. From M2 to M3, a vector displacement up and left along the minor axis of the tolerance ellipses resulted in an increase in PhA (p < 0.01). The results suggest a gain in fluid with a decrease in cellular density from M1 to M2 due to decrements in R and Xc. Nevertheless, the reduced training load characterizing taper seemed to allow for an increase in PhA and, most importantly, an increase of Xc, thus demonstrating improved cellular health and physical condition, which was concomitant with a significant increase in the T50 m performance (p < 0.01).

CONCLUSIONS

PhA, obtained by bioelectrical R and Xc, can be useful in monitoring the condition of swimmers preparing for competition. Monitoring BIVA patterns allows for an ecological approach to the swimmers' health and condition assessment without resorting to equations to predict the related body composition variables.

The Cellular Composition of the Innate and Adaptive Immune System Is Changed in Blood in Response to Long-Term Swimming Training

Competitive swimming requires high training load cycles including consecutive sessions with little recovery in between which may contribute to the onset of fatigue and eventually illness. We aimed to investigate immune changes over a 7-month swimming season. Fifty-four national and international level swimmers (25 females, 29 males), ranging from 13 to 20 years of age, were evaluated at rest at: M1 (beginning of the season), M2 (after the 1st macrocycle’s main competition), M3 (highest training load phase of the 2nd macrocycle) and M4 (after the 2nd macrocycle’s main competition) and grouped according to sex, competitive age-groups, or pubertal Tanner stages. Hemogram and the lymphocytes subsets were assessed by automatic cell counting and by flow cytometry, respectively. Self-reported Upper Respiratory Symptoms (URS) and training load were quantified. Although the values remained within the normal range reference, at M2, CD8⁺ decreased (M1 = 703 ± 245 vs. M2 = 665 ± 278 cell μL⁻¹; p = 0.032) and total lymphocytes (TL, M1 = 2831 ± 734 vs. M2 = 2417 ± 714 cell μL⁻¹; p = 0.007), CD3⁺ (M1 = 1974 ± 581 vs. M2 = 1672 ± 603 cell μL⁻¹; p = 0.003), and CD4⁺ (M1 = 1102 ± 353 vs. M2 = 929 ± 329 cell μL⁻¹; p = 0.002) decreased in youth. At M3, CD8⁺ remained below baseline (M3 = 622 ± 245 cell μL⁻¹; p = 0.008), eosinophils (M1 = 0.30 ± 0.04 vs. M3 = 0.25 ± 0.03 10⁹ L^–1; p = 0.003) and CD16⁺56⁺ (M1 = 403 ± 184 vs. M3 = 339 ± 135 cell μL⁻¹; p = 0.019) decreased, and TL, CD3⁺, and CD4⁺ recovered in youth. At M4, CD19⁺ were elevated (M1 = 403 ± 170 vs. M4 = 473 ± 151 cell μL⁻¹; p = 0.022), CD16⁺56⁺ continued to decrease (M4 = 284 ± 131 cell μL⁻¹; p < 0.001), eosinophils remained below baseline (M4 = 0.29 ± 0.05 10⁹ L^–1; p = 0.002) and CD8⁺ recovered; monocytes were also decreased in male seniors (M1 = 0.77 ± 0.22 vs. M4 = 0.57 ± 0.16 10⁹ L^–1; p = 0.031). The heaviest training load and higher frequency of URS episodes happened at M3. The swimming season induced a cumulative effect toward a decrease of the number of innate immune cells, while acquired immunity appeared to be more affected at the most intense period, recovering after tapering. Younger athletes were more susceptible at the beginning of the training season than older ones.

Allostatic stress load and CMV serostatus impact immune response to maximal exercise in collegiate swimmers

Collegiate athletes are exposed to varying levels of academic and physical stressors, placing them at increased risk for stress-activated latent viral infections. However, the impact of allostatic stress load on the immune response to maximal exercise in athletes remains largely unknown. This study examined the effects of a 7-mo training period and cytomegalovirus (CMV) serostatus on immune cell response to high-intensity swim tests within a group of collegiate swimmers. Samples were collected from 15 National Collegiate Athletic Association Division I swimmers (9 men, 6 women: 19.87 ± 0.64 yr) before and after exhaustive in-pool swims at 2 time points (V₁: immediately post-season 1 and V₃: beginning of season 2). An additional off-season (V₂) time point was collected in a subset of 9 swimmers. Natural killer (NK) cell, B cell, and T cells were quantified by flow cytometry. Linear mixed models were used to determine the effects of exercise, time point, and CMV serostatus (α = 0.05). Resting senescent CD8+ T cells were higher in CMV-seropositive participants at V₃ (P = 0.005). CMV-seronegative participants had a decrease in resting senescent CD8+ T cells from V₁ to V₃ (P = 0.021). After acute exercise, CMV-seropositive participants had lower naïve CD8+ T cells (P < 0.001) and higher senescent CD8+ T cells (P < 0.001). Increased cumulative stress levels did not appear to affect B-cell and NK-cell compartments. Immune response to exercise was impacted by CMV serostatus and allostatic stress load. Young CMV-seropositive athletes exposed to elevated stressors should be monitored to determine long-term effects of training and academic stressors.NEW & NOTEWORTHY Allostatic stress load is associated with impaired immune response to maximal exercise in cytomegalovirus (CMV)-seropositive subjects but not in CMV-seronegative young healthy adults.

The role of glucose homeostasis on immune function in response to exercise: The impact of low or higher energetic conditions

Immune cells are bioenergetically expensive during activation, which requires tightly regulated control of metabolic pathways. Both low and high glycemic conditions can modulate immune function. States of undernourishment depress the immune system, and in the same way, excessive intake of nutrients, such as an obesity state, compromise its functioning. Multicellular organisms depend on two mechanisms to survive: the regulation and ability to store energy to prevent starvation and the ability to fight against infection. Synergic interactions between metabolism and immunity affect many systems underpinning human health. In a chronic way, the breakdown of glycemic homeostasis in the body can influence cells of the immune system and consequently contribute to the onset of diseases such as type II diabetes, obesity, Alzheimer's, and fat and lean mass loss. On the contrary, exercise, recognized as a primary strategy to control hyperglycemic disorders, also induces a coordinated immune-neuro-endocrine response that acutely modulates cardiovascular, respiratory, and muscle functions and the immune response to exercise is widely dependent on the intensity and volume that may affect an immunodepressive state. These altered immune responses induced by exercise are modulated through the "stress hormones" adrenaline and cortisol, which are a threat to leukocyte metabolism. In this context, carbohydrates appear to have a positive acute response as a strategy to prevent depression of the immune system by maintaining plasma glucose concentrations to meet the energy demand from all systems involved during strenuous exercises. Therefore, herein, we discuss the mechanisms through which exercise may promotes changes on glycemic homeostasis in the metabolism and how it affects immune cell functions under higher or lower glucose conditions.

The compelling link between physical activity and the body's defense system

This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators: (1) acute and chronic effects of exercise on the immune system, (2) clinical benefits of the exercise-immune relationship, (3) nutritional influences on the immune response to exercise, and (4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers, and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches (i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise immunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the personalized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.

Long-term swimming training modifies acute immune cell response to a high-intensity session

PURPOSE

Long-term training influence on athletes' immune cell response to acute exercise has been poorly studied, despite the complexity of both chronic and acute adaptations induced by training. The purpose of the study is to study the influence of a 4-month swimming training cycle on the immune cell response to a high-intensity training session, during 24 h of recovery, considering sex, maturity, and age group.

METHODS

Forty-three swimmers (16 females, 14.4 ± 1.1 years; 27 males, 16.2 ± 2.0) performed a standardized high-intensity session, after the main competition of the first (M1), and second (M2) macrocycles. Blood samples were collected before (Pre), immediately after (Post), 2 h after (Post2h) and 24 h after (Post24h) exercise. Haemogram and lymphocytes subsets were assessed by an automatic cell counter and by flow cytometry, respectively. Subjects were grouped according to sex, competitive age groups, or pubertal Tanner stages. Results express the percentage of relative differences from Pre to Post, Post2h and Post24h. Upper respiratory symptoms (URS) and training load were quantified.

RESULTS

At M2, we observed smaller increases of leukocytes (M1: 14.0 ± 36.3/M2: 2.33 ± 23.0%) and neutrophils (M1: 57.1 ± 71.6/M2: 38.9 ± 49.9%) at Post; and less efficient recoveries of total lymphocytes (M1: - 22.0 ± 20.1/M2: - 30.0 ± 18.6%) and CD19⁺ (M1: 4.09 ± 31.1/M2: - 19.1 ± 24.4%) at Post2h. At Post2h, the increment of CD4⁺/CD8⁺ was smaller in youth (M1: 21.5 ± 16.0/M2: 9.23 ± 21.4%), and bigger in seniors (M1: 3.68 ± 9.21/M2: 23.2 ± 15.0%); and at Post24h late pubertal swimmers' CD16⁺56⁺ recovered less efficiently (M1: - 0.66 ± 34.6/M2: - 20.5 ± 34.2%).

CONCLUSIONS

The training cycle induced an attenuated immune change immediately after exercise and a less efficient recovery of total lymphocytes, involving an accentuated CD19⁺ decrease. The concomitant higher URS frequency suggests a potential immune depression and a longer interval of susceptibility to infection.

Immune biomarkers in older adults: Role of physical activity

Aging is associated with a decline in the normal functioning of the immune system. Several studies described the relationship between immunological alterations, including immunosenescence and inflammation, and aging or age-related outcomes, such as sarcopenia, depression, and neurodegenerative disorders. Physical activity is known to improve muscle function and to exert a number of benefits on older adult health, including reduced risk for heart and metabolic system chronic diseases. However, the positive influence of physical activity on the immune system has not been elucidated. In order to shed light on the role of physical activity in immune responses of older individuals, a number of immunological parameters comprising % lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD19⁺, and CD16⁺56⁺) and serum levels of neopterin and tryptophan metabolism products were evaluated in peripheral blood samples of older adults performing normal (N = 170) or reduced (N = 89) physical activity. In addition, the potential influence of other clinical and epidemiological factors was also considered. Results showed that subjects with reduced physical activity displayed significantly higher levels of CD4⁺/CD8⁺ ratio, kynurenine/tryptophan ratio, and serum neopterin, along with lower %CD19⁺ cells and tryptophan concentrations. Further, some immunological biomarkers were associated with cognitive impairment and functional status. These data contribute to reinforce the postulation that physical activity supports healthy aging, particularly by helping to protect the immunological system from aging-related changes.

How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness

The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load—including rapid changes in training and competition load, competition calendar congestion, psychological load and travel—and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified.

Comparison of immunohematological profile between endurance- and power-oriented elite athletes

There is general perception that elite athletes are highly susceptible to changes in immunohematological profile. The objective of this study was to compare immunohematological parameters of elite athletes of different aerobic and muscular strength sports and analyze changes over 2 months. Sixteen judoists and 14 swimmers were evaluated 2 months before (M1) and immediately prior to competition (M2). Hemogram and lymphocytes subpopulations were assessed with automatic counter and flow cytometry, respectively. Judoists had higher neutrophils and lower monocytes and eosinophils percentages than swimmers at M1 and M2. At M2 judoists had lower red blood cells (RBC), hemoglobin, and hematocrit than swimmers. At M2 judoists' hematocrit and CD16 decreased while swimmers' hemoglobin and hematocrit increased. In conclusion, neither sports characteristics nor intense training seem to displace the athletes' immunohematological profile out of the clinical range, despite the possibility of occurrence of microlesions that may stimulate production of leukocytes and reduction of RBC in judoists.

Physiological Adaptations to Training in Competitive Swimming: A Systematic Review

The purpose of this systematic review was to summarize longitudinal studies on swimming physiology and get implications for daily practice. A computerized search of databases according to the PRISMA statement was employed. Studies were screened for eligibility on inclusion criteria: (i) present two testing points; (ii) on swimming physiology; (iii) using adult elite swimmers; (iv) no case-studies or with small sample sizes. Two independent reviewers used a checklist to assess the methodological quality of the studies. Thirty-four studies selected for analysis were gathered into five main categories: blood composition (n=7), endocrine secretion (n=11), muscle biochemistry (n=7), cardiovascular response (n=8) and the energetic profile (n=14). The mean quality index was 10.58 ± 2.19 points demonstrating an almost perfect agreement between reviewers (K = 0.93). It can be concluded that the mixed findings in the literature are due to the diversity of the experimental designs. Micro variables obtained at the cellular or molecular level are sensitive measures and demonstrate overtraining signs and health symptoms. The improvement of macro variables (i.e. main physiological systems) is limited and may depend on the athletes' training background and experience.

The Impaired Function of Macrophages Induced by Strenuous Exercise Could Not Be Ameliorated by BCAA Supplementation

The aim of this study was to evaluate the effect of strenuous exercise on the functions of peritoneal macrophages in rats and to test the hypothesis that branched-chain amino acid (BCAA) supplementation will be beneficial to the macrophages of rats from strenuous exercise. Forty male Wistar rats were randomly divided into five groups: (C) Control, E) Exercise, (E1) Exercise with one week to recover, (ES) Exercise + Supplementation and (ES1) Exercise + Supplementation with 1 week to recover. All rats except those of the sedentary control were subjected to four weeks of strenuous exercise. Blood hemoglobin, serum testosterone and BCAA levels were tested. Peritoneal macrophages functions were also determined at the same time. The data showed that hemoglobin, testosterone, BCAA levels, and body weight in group E decreased significantly as compared with that of group C. Meanwhile, phagocytosis capacity (decreased by 17.07%, p = 0.031), reactive oxygen species (ROS) production (decreased by 26%, p = 0.003) and MHC II mRNA (decreased by 22%, p = 0.041) of macrophages decreased in the strenuous exercise group as compared with group C. However, the chemotaxis of macrophages did not change significantly. In addition, BCAA supplementation could slightly increase the serum BCAA levels of rats from strenuous exercise (increased by 6.70%, p > 0.05). Moreover, the body weight, the blood hemoglobin, the serum testosterone and the function of peritoneal macrophages in group ES did not change significantly as compared with group E. These results suggest that long-term intensive exercise impairs the function of macrophages, which is essential for microbicidal capability. This may represent a novel mechanism of immunosuppression induced by strenuous exercise. Moreover, the impaired function of macrophage induced by strenuous exercise could not be ameliorated by BCAA supplementation in the dosing and timing used for this study.

Training-related risk of common illnesses in elite swimmers over a 4-yr period

PURPOSE

The objective of this study is to investigate the relation between sport training and the risk of common illnesses: upper respiratory tract and pulmonary infections (URTPI), muscular affections (MA), and all-type pathologies in highly trained swimmers.

METHODS

Twenty-eight French professional swimmers were monitored weekly for 4 yr. Training variables included 1) in-water and dryland intensity levels: low-load, high-load, resistance, maximal strength, and general conditioning training (expressed as the percentage of the maximal load performed by each subject, at each intensity level over the study period); and 2) training periods: moderate, intensive, taper, competition, and postcompetition. Illnesses were diagnosed by a sports physician using a standardized questionnaire. Mixed-effects logistic regression analyses were used to model odds ratios for the association between common illnesses and training variables, adjusted for sport season, semiseason (summer or winter), age, competition level, sex, and history of recent events, whereas controlling for heterogeneity among swimmers.

RESULTS

The risk of common illnesses was significantly higher in winter months, for national swimmers (for URTPI), and in cases of history of recent event (notably for MA). The odds of URTPI increased 1.08 (95% CI, 1.01-1.16) and 1.10 (95% CI, 1.01-1.19) times for every 10% increase in resistance and high-load trainings, respectively. The odds of MA increased by 1.49 (95% CI, 1.14-1.96) and 1.63 (95% CI, 1.20-2.21) for each 10% increase in high load and general conditioning training, respectively. The odds of illnesses were 50%-70% significantly higher during intensive training periods.

CONCLUSION

Particular attention must be paid to illness prevention strategies during periods of intensive training, particularly in the winter months or in case of the recent medical episode.

Changes in naïve and memory T-cells in elite swimmers during a winter training season

High intensity training regimens appear to put athletes at a higher risk of illness. As these have been linked to alterations in the proportions of differentiated T cells, how training load affects these populations could have important implications for athlete susceptibility to disease. This study examined the effect of a winter training season on the proportions of circulating naïve and memory T cells subsets of high competitive level swimmers. Blood samples were taken at rest at 4 time-points during the season: before the start of the season (t0-September), after 7weeks of an initial period of gradually increasing training load (t1-November), after 6weeks of an intense training cycle (t2-February) and 48h after the main competition (t3-April) and from eleven non-athlete controls at 2 similar time-points (t2 and t3). CD4, CD8 and gamma-delta (γδ) T cells expressing the naïve (CCR7(+)CD45RA(+)), central-memory (CM-CCR7(+)CD45RA(-)), effector-memory (EM-CCR7(-)CD45RA(-)) and terminal effector (TEMRA-CCR7(-)CD45RA(+)) were quantified by flow cytometry. Statistical analyses were performed using multilevel modeling regression. Both T CD4(+) naïve and CM presented a linear increase in response to the first moment of training exposure, and had an exponential decrease until the end of the training exposure. As for TCD4(+) EM, changes were observed from t2 until the end of the training season with an exponential trend, while TCD4(+) TEMRA increased linearly throughout the season. TCD8(+) naïve increased at t1 and decreased exponentially thereafter. TCD8(+) TEMRA values decreased at t1 and increased exponentially until t3. γδT-EM had an increase at t1 and an exponential decrease afterwards. In contrast, γδT-TEMRA decreased at t1 and exponentially increased during the remaining 20weeks of training. An increase in TEMRA and EM T cells alongside a decrease in naïve T cells could leave athletes more susceptible to illness in response to variation in training stimulus during the season.

Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season

The objective of the present study was to monitor the immunological and hormonal responses and the occurrence of upper respiratory symptoms in adolescent basketball athletes during the different stages of a sports season. Anthropometric measures, biochemical analyses (interleukin-6, interleukin-10, tumour necrosis factor-alpha, C-reactive protein, testosterone and cortisol), neuromuscular evaluations (standing vertical jumping ability, agility and estimated VO2max) and leukocyte counts were performed at four moments: 72 h before the season (-72 h); before the season (Pre-season); after six weeks, at the end of the preparatory period (Preparatory); and after 20 weeks, at the end of the competitive period (Competitive). Also, the occurrence of upper respiratory symptoms was collected weekly during all stages of the season. There were significant increases in monocytes, cortisol, tumour necrosis factor-alpha and C-reactive protein at the Competitive moment as compared to the Pre-season. In addition, interleukin-10 decreased at the Competitive moment as compared to the Pre-season. Occurrence of upper respiratory symptoms demonstrated increases (38%) during the competitive period as compared to the preparatory. These results suggest that periods of training and competition could increase the occurrence of upper respiratory symptoms in adolescent athletes and this may be due to the unwanted effects of an inflammatory process in response to the excessive stress of training and competition.

Differences in plasma cytokine levels between elite kayakers and nonathletes

Regular moderate exercise has been shown to have anti-inflammatory effects that help prevent several chronic diseases. However, the effects of chronic training an elite athletes have not been the focus of much research. This study aimed to determine whether there were differences in cytokine levels (IL-1β, IL-1ra, IL-6, IL-10, IL-18, IFN-γ, and TNF-α) in circulating peripheral blood (PB) between elite kayakers and nonathletes. Subjects were 13 elite male kayakers, aged 20.0 ± 3 years, with average body mass of 75.0 ± 7.9 kg and 177.3 ± 7.1 cm height and with a VO_2max of 58.3 ± 7.8 mL·kg⁻¹·min⁻¹. The nonathletes were 7 men, aged 18.2 ± 1.1 years, body mass of 81.3 ± 13.8 kg, and 171.9 ± 4.5 cm height. Blood samples were collected after six weeks of offtraining and before the start of a new training season. PB leukocyte populations were determined by flow cytometry. Cytokine levels were quantified by ELISA. When nonathletes were compared with the kayakers, the latter exhibited lower plasma concentrations of IL-1β, IL-18, and IFN-γ as well as a lower concentration of IL-1ra. Positive correlations between IL-18 and B cells in the athletes were also found. These results seem to reinforce the anti-inflammatory role of regular training.