The effects of menstrual cycle phases on immune function and inflammation at rest and after acute exercise: A systematic review and meta-analysis

Impact of Menstrual Cycle and Oral Contraceptives on Haematological and Inflammatory Biomarkers in Highly Trained Female Athletes

Haematological and inflammatory biomarkers play an important role in athlete performance and health, with some of them used in the fight against doping. However, little is known about how they are modulated by sex hormone fluctuations in highly trained female athletes. We therefore measured the haematological parameters monitored in the athlete biological passport (ABP) as well as erythropoietin, serum markers of iron and inflammatory statuses (iron, ferritin, transferrin, transferrin saturation, albumin, creatinine, total protein, interleukin-6 and TNF-alpha) in 20 highly trained female athletes: 10 with normal menstrual cycle (NMC) during the early follicular and mid-luteal phases and 10 using a combined oral contraceptive (COC, i.e., ethinyloestradiol and levonorgestrel) during active and inactive hormone intake. Body composition, leptin and lipid profile (total cholesterol, HDL, LDL and triglycerides) were determined in parallel. No changes were observed throughout NMC phases. Irrespective of active/inactive pill intake, COC use increased transferrin, triglycerides as well as reticulocyte count (p < 0.05) and decreased interleukin-6 (p < 0.05), with no significant changes in the other parameters studied. In conclusion, given our results across NMC phases in highly trained athletes, it seems warranted to investigate whether intense physical training would mitigate the impact of endogenous sex hormones on body composition and haematological and inflammatory parameters. In addition, further studies are needed to determine the extent of the changes induced by COCs on these blood biomarkers in elite female athletes when subjected to extreme environments such as intensive training or competition in humid heat, cold and/or hypoxia or when using other medications in parallel.

The Order of Concurrent Training Affects Acute Immunological Stress Responses and Measures of Muscular Fitness in Female Youth Judo Athletes

This study aimed to examine the acute effects of concurrent muscle strength and sport-specific endurance exercise order on immunological stress responses, metabolic response, muscular-fitness, and rating-of-perceived-exertion (RPE) in highly trained youth female judo athletes. Thirteen female participants randomly performed two concurrent training (CT) sessions; strength-endurance and endurance-strength. Immune response, metabolic response, muscular fitness (i.e., countermovement jump-derived force and power [CMJ-force and CMJ-power]), and RPE were measured at different time points (i.e., PRE, MID, POST, POST6h, and POST22h). There were significant time × order interactions for lymphocytes (p = 0.006, ES = 1.31), granulocyte-lymphocyte ratio (p = 0.002, ES = 1.56), and systemic inflammation index (p = 0.029, ES = 1.11), blood glucose and lactate (p < 0.001, ES = 2.09 and p = 0.0018, ES = 1.51, respectively), CMJ-force (p = 0.033, ES = 1.26), and CMJ-power (p = 0.007, ES = 1.40) as well as RPE (p < 0.001, ES = 2.05). CT-induced acute (i.e., POST) but not delayed (i.e., POST6h and POST22h) order-dependent immune cell count alterations in highly trained youth female judo athletes. All markers of the immune system went back to baseline values at POST22h. Metabolic responses were slightly higher following the endurance exercise (irrespective of the applied exercise order). CMJ-measures and RPE fluctuated during both CT sessions but returned to baseline 6 h post-exercise.

Soluble Factors CD14, CD163, and Migration Inhibitory Factor Are Associated with Endometriosis-Related Infertility

OBJECTIVES

Myeloid cell-derived factors contribute to the immunopathology of endometriosis. Soluble CD14 (sCD14), CD163 (sCD163), and MIF serve as in vivo markers of myeloid function. However, these soluble molecules are largely unexplored in women with endometriosis-related infertility cases. We investigated three soluble markers, namely sCD14, sCD163, and MIF, in cases of infertility associated with endometriosis and correlated its level to the stage of endometriosis.

DESIGN

Eighty-seven women newly diagnosed with endometriosis or other benign gynecologic control cases linked to infertility were prospectively recruited and underwent diagnostic laparoscopy.

PARTICIPANTS

Forty-four patients with endometriosis were included in this study, comprising 19 patients with early-endometriosis (stages I and II) and 25 late-endometriosis (stages III and IV) based on the revised American Society for Reproductive Medicine (rASRM) classification. The remaining 43 patients constituted a control group with infertility due to other causes.

METHODS

The levels of sCD14, sCD163, and MIF in serum and peritoneal fluid were assessed using ELISA.

RESULTS

Endometriosis women exhibited significantly higher serum levels of sCD163 and MIF levels compared to the control group. Both sCD163 and MIF levels displayed a positive correlation with the rASRM adhesion score. Moreover, the MIF level in serum had a positive correlation with the rASRM endometriosis score. In receiver operating characteristic analysis, serum sCD163 and MIF could significantly discriminate endometriosis and non-endometriosis in infertility cases.

LIMITATIONS

Some limitations of the current study deserve to be underlined. First, the sensitive ELISA method was the sole-validated tool for detecting the markers in patient samples. Second, healthy or fertile women were not involved as the control group.

CONCLUSIONS

The elevated systemic levels of sCD163 and MIF correlated with the severity of endometriosis. These soluble molecules have a potential diagnostic capacity as a non-invasive biomarker. Furthermore, our data warrants future studies on the underlying mechanism of sCD163 and MIF in endometriosis-related infertility.