Beta-endorphin and adrenocorticotropin response to supramaximal treadmill exercise in trained and untrained males

Can we improve exercise-induced hypoalgesia with exercise training? An overview and suggestions for future studies

Exercise-induced hypoalgesia refers to a reduction in pain sensitivity following a single bout of exercise, which has been shown to be diminished or impaired with aging and chronic pain. Exercise training (repeated bouts of exercise over time) is often recommended as a non-pharmacological treatment for chronic pain and age-related functional declines. However, whether exercise training can augment the exercise-induced hypoalgesia has not been well studied. The purpose of this paper is to 1) provide an overview of the existing literature investigating the effect of exercise training on the magnitude of exercise-induced hypoalgesia, and 2) discuss potential underlying mechanisms as well as considerations for future research. Given the paucity of randomized controlled trials in this area, the effects of exercise training on exercise-induced hypoalgesia are still unclear. Several potential mechanisms have been proposed to explain the impaired exercise-induced hypoalgesia in chronic pain and older individuals (e.g., endogenous opioid, cardiovascular, and immune system). Exercise training appears to induce physiological changes in those systems, however, further investigations are necessary to test whether this will lead to improved exercise-induced hypoalgesia. Future research should consider including a time- and age-matched non-training group and utilizing the same exercise protocol for testing exercise-induced hypoalgesia across intervention groups.

Current pharmacological strategies for symptomatic reduction of persistent breathlessness - a literature review

INTRODUCTION

Persistent breathlessness is a debilitating symptom that is prevalent in the community, particularly in people with chronic and life-limiting illnesses. Treatment includes different steps, including pharmacological treatment aiming to improve the symptom and optimize people's wellbeing.

AREAS COVERED

PubMed and Google Scholar were screened using 'chronic breathlessness' OR 'persistent breathlessness,' AND 'pharmacological treatment,' OR 'opioids.' This review focuses on pharmacological treatments to reduce persistent breathlessness and discusses possible mechanisms involved in the process of breathlessness reduction through pharmacotherapy. Research gaps in the field of persistent breathlessness research are outlined, and future research directions are suggested.

EXPERT OPINION

Regular, low-dose (≤30 mg/day), sustained-release morphine is recommended as the first-line pharmacological treatment for persistent breathlessness. Inter-individual variation in response needs to be investigated in future studies in order to optimize clinical outcomes. This includes 1) better understanding the centrally mediated mechanisms associated with persisting breathlessness and response to pharmacological therapies, 2) understanding benefit from the perspective of people experiencing persistent breathlessness, small and meaningful gains in physical activity.

Aerobic Fitness Is Associated with Cerebral μ-Opioid Receptor Activation in Healthy Humans

INTRODUCTION

Central μ-opioid receptors (MORs) modulate affective responses to physical exercise. Individuals with higher aerobic fitness report greater exercise-induced mood improvements than those with lower fitness, but the link between cardiorespiratory fitness and the MOR system remains unresolved. Here we tested whether maximal oxygen uptake (V̇O2peak) and physical activity level are associated with cerebral MOR availability and whether these phenotypes predict endogenous opioid release after a session of exercise.

METHODS

We studied 64 healthy lean men who performed a maximal incremental cycling test for V̇O2peak determination, completed a questionnaire assessing moderate-to-vigorous physical activity (MVPA; in minutes per week), and underwent positron emission tomography with [11C]carfentanil, a specific radioligand for MOR. A subset of 24 subjects underwent additional positron emission tomography scan also after a 1-h session of moderate-intensity exercise and 12 of them also after a bout of high-intensity interval training.

RESULTS

Higher self-reported MVPA level predicted greater opioid release after high-intensity interval training, and both V̇O2peak and MVPA level were associated with a larger decrease in cerebral MOR binding after aerobic exercise in the ventral striatum, orbitofrontal cortex, and insula. That is, more trained individuals showed greater opioid release acutely after exercise in brain regions especially relevant for reward and cognitive processing. Fitness was not associated with MOR availability.

CONCLUSIONS

We conclude that regular exercise training and higher aerobic fitness may induce neuroadaptation within the MOR system, which might contribute to improved emotional and behavioral responses associated with long-term exercise.

HPA axis responses to acute exercise differ in smokers and non-smokers

Physical exercise has been proposed as an adjunct in addiction treatment, including tobacco cigarette smoking. The physiological and biochemical mechanisms that could be affected by physical exercise in smokers and that could help quit smoking have not been investigated yet.

OBJECTIVE

To investigate whether the effects of acute exercise on smoking behavior and HPA axis activation in smokers are intensity-dependent.

METHODS

Healthy, non-systematically exercising individuals [25 smokers (age: 33±1.4 years) and 10 non-smokers (age: 34±2.1 years)] underwent three trials [moderate intensity (MI), high intensity (HI) exercise, control (C)] in a counterbalanced order, after an overnight fast and smoking abstinence, separated by at least six days. MI involved cycling at 50-60% of Heart Rate Reserve (HRR) for 30 min, HI involved cycling at 65-75% HRR for 30 min, while in C participants rested for 30 min. Time till the first cigarette following each trial was recorded. Smoking urge was evaluated and blood samples, [analyzed for β-endorphin (β-E), adrenocorticotropic hormone (ACTH), cortisol and catecholamines], were obtained prior to and immediately after each trial.

RESULTS

β-E, ACTH, catecholamines and cortisol responses to exercise were intensity-dependent and differed in smokers and non-smokers. Resting β-E levels were 2-2.5 times lower in smokers compared to non-smokers. HI resulted in increased β-E levels in both groups, with smokers exhibiting similar levels to that observed in non-smokers. Although smoking urge did not change post-exercise in smokers, time till first cigarette increased following both MI (64.6%) and HI (77.9%) compared to C.

CONCLUSIONS

HPA axis activation in response to exercise may differ between smokers and non-smokers. Smokers have lower resting levels of β-E compared to non-smokers and, since HI exercise increases β-E to similar levels to those of non-smokers and delays smoking, this may be used as an adjunct in smoking cessation.

The Associations among Psychological Distress, Coping Style, and Health Habits in Japanese Nursing Students: A Cross-Sectional Study

Background: Nursing students in many countries have been reported to experience high levels of stress and psychological distress. Health habits could potentially mediate the association between coping styles and psychological status. The purpose of this study was to evaluate the mediation effect of health habits in the relationship between stress coping styles and psychological distress in Japanese nursing students. Methods: A total of 181 nursing students completed anonymous self-reported questionnaires comprised of the General Health Questionnaire-12 (GHQ-12), the Brief Coping Orientation questionnaire, and an additional questionnaire on health behavior. A mediation analysis using path analysis with bootstrapping was used for data analysis. Results: Multivariate linear regression analysis showed that psychological distress was significantly and positively associated with “Avoidance coping” (β = 0.39, p < 0.001), and was negatively associated with “Active coping” (β = −0.30, p < 0.001), “exercise habit” (β = −0.25, p = 0.001), and “sleeping” (β = −0.24, p = 0.002). In the path model, “Active coping” and “Avoidance coping” had significant or marginally significant associations with “exercise habits” (active: β = 0.19, p = 0.008, avoidance: β = −0.12, p = 0.088), and psychological distress (active: β = −0.25, p < 0.001, avoidance: β = 0.363, p < 0.001). However, these coping style variables did not have a significant association with “sleep”. In general, the size of the correlations was below 0.4. Conclusions: Exercise habits mediated the relationship between coping styles and psychological distress to a greater extent than sleep. The present study suggests the possibility that complex interactions between health habits and coping styles may influence the psychological status of nursing students.

Bi-stability in type 2 diabetes mellitus multi-organ signalling network

Type 2 diabetes mellitus (T2DM) is believed to be irreversible although no component of the pathophysiology is irreversible. We show here with a network model that the apparent irreversibility is contributed by the structure of the network of inter-organ signalling. A network model comprising all known inter-organ signals in T2DM showed bi-stability with one insulin sensitive and one insulin resistant attractor. The bi-stability was made robust by multiple positive feedback loops suggesting an evolved allostatic system rather than a homeostatic system. In the absence of the complete network, impaired insulin signalling alone failed to give a stable insulin resistant or hyperglycemic state. The model made a number of correlational predictions many of which were validated by empirical data. The current treatment practice targeting obesity, insulin resistance, beta cell function and normalization of plasma glucose failed to reverse T2DM in the model. However certain behavioural and neuro-endocrine interventions ensured a reversal. These results suggest novel prevention and treatment approaches which need to be tested empirically.

Role of exercise in the treatment of alcohol use disorders

Excessive alcohol use can cause harmful effects on the human body, which are associated with serious health problems, and it can also lead to the development of alcohol use disorders (AUDs). There is certain evidence that physical exercise positively affects excessive alcohol use and the associated problems by leading to reduced alcohol intake. A literature search was conducted using the databases PubMed, Medline and Web of Science. The search terms used as keywords were: Addiction, abuse, alcohol use disorders, exercise training, β-endorphin, opioids, brain, ethanol and alcohol. The current study presents the studies that reported on the use of exercise in the treatment of AUDs between 1970 and 2015. The potential psychological and physiological mechanisms that contribute to the action of exercise were also reviewed, highlighting the role of β-endorphin and the hypothalamic-pituitary-adrenal axis in AUDs and the possible association among physical activity, the endogenous opioid system and the desire for alcohol. Only 11 studies were identified that refer to the effect of exercise on alcohol consumption and/or the associated outcomes. Six of those studies concluded that exercise may have a positive impact towards alcohol consumption, abstinence rates or the urge to drink. One of those studies also indicated that a bout of exercise affects the endogenous opioids, which may be associated with the urge to drink. Another 3 studies indicated that responses to acute exercise in individuals with AUDs are different compared to those in healthy ones. Generally, despite limited research data and often contradictory results, there is certain early promising evidence for the role of exercise as an adjunctive tool in the treatment of AUDs. Physiological and biochemical parameters that would confirm that exercise is safe for individuals with AUDs should be examined in future studies.

Exercise reinforcement, stress, and β-endorphins: an initial examination of exercise in anabolic-androgenic steroid dependence

BACKGROUND

Anabolic-androgenic steroids (AASs) are abused primarily in the context of intense exercise and for the purposes of increasing muscle mass as opposed to drug-induced euphoria. AASs also modulate the HPA axis and may increase the reinforcing value of exercise through changes to stress hormone and endorphin release. To test this hypothesis, 26 adult males drawn from a larger study on AAS use completed a progressive ratio task designed to examine the reinforcing value of exercise relative to financial reinforcer.

METHOD

Sixteen experienced and current users (8 on-cycle, 8 off-cycle) and 10 controls matched on quantity×frequency of exercise, age, and education abstained from exercise for 24 h prior to testing and provided 24-h cortisol, plasma cortisol, ACTH, β-endorphin samples, and measures of mood, compulsive exercise, and body image.

RESULTS

Between group differences indicated that on-cycle AAS users had the highest β-endorphin levels, lowest cortisol levels, higher ACTH levels than controls. Conversely, off-cycle AAS users had the highest cortisol and ACTH levels, but the lowest β-endorphin levels. Exercise value was positively correlated with β-endorphin and symptoms of AAS dependence.

CONCLUSION

The HPA response to AASs may explain why AASs are reinforcing in humans and exercise may play a key role in the development of AAS dependence.

Magnitude of exercise-induced β-endorphin response is associated with subsequent development of altered hypoglycemia counterregulation

CONTEXT

β-Endorphin release in response to recurrent hypoglycemia is implicated in the pathogenesis of hypoglycemia-associated autonomic failure.

OBJECTIVE

We hypothesized that exercise-induced β-endorphin release will also result in the deterioration of subsequent hypoglycemia counterregulation and that the counterregulatory response will negatively correlate with the degree of antecedent β-endorphin elevation.

DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS

Sixteen healthy subjects (six females, aged 26 ± 4.3 yr, body mass index 26.1 ± 5.6 kg/m(2)) were studied with three experimental paradigms on 2 consecutive days. Day 1 consisted of one of the following: 1) two 90-min hyperinsulinemic hypoglycemic clamps (3.3 mmol/liter); 2) two 90-min hyperinsulinemic euglycemic clamps while subjects exercised at 60% maximal oxygen uptake; or 3) two 90-min hyperinsulinemic euglycemic clamps (control). Day 2 followed with hyperinsulinemic (396 ± 7 pmol/liter) stepped hypoglycemic clamps (5.0, 4.4, 3.9, and 3.3 mmol/liter plasma glucose steps).

MAIN OUTCOME MEASURES

Day 2 hypoglycemia counterregulatory hormonal response and glucose turnover ([3-(3)H]-glucose) as indicators of recovery from hypoglycemia.

RESULTS

There was a significant inverse correlation between plasma β-endorphin levels during exercise and catecholamine release during subsequent hypoglycemia. Subjects with an exercise-induced rise in β-endorphin levels to above 25 pg/ml (n = 7) exhibited markedly reduced levels of plasma epinephrine and norepinephrine compared with control (2495 ± 306 vs. 4810 ± 617 pmol/liter and 1.9 ± 0.3 vs. 2.9 ± 0.4 nmol/liter, respectively, P < 0.01 for both). The rate of endogenous glucose production recovery in this group was also much lower than in controls (42 vs. 89%, P < 0.01).

CONCLUSIONS

The physiological increase in β-endorphin levels during exercise is associated with the attenuation of counterregulation during subsequent hypoglycemia.

Advocating neuroimaging studies of transmitter release in human physical exercise challenges studies

This perspective attempts to outline the emerging role of positron emission tomography (PET) ligand activation studies in human exercise research. By focusing on the endorphinergic system and its acclaimed role for exercise-induced antinociception and mood enhancement, we like to emphasize the unique potential of ligand PET applied to human athletes for uncovering the neurochemistry of exercise-induced psychophysiological phenomena. Compared with conventional approaches, in particular quantification of plasma beta-endorphin levels under exercise challenges, which are reviewed in this article, studying opioidergic effects directly in the central nervous system (CNS) with PET and relating opioidergic binding changes to neuropsychological assessments, provides a more refined and promising experimental strategy. Although a vast literature dating back to the 1980s of the last century has been able to reproducibly demonstrate peripheral increases of beta-endorphin levels after various exercise challenges, so far, these studies have failed to establish robust links between peripheral beta-endorphin levels and centrally mediated behavioral effects, ie, modulation of mood and/or pain perception. As the quantitative relation between endorphins in the peripheral blood and the CNS remains unknown, the question arises, to what extent conventional blood-based methods can inform researchers about central neurotransmitter effects. As previous studies using receptor blocking approaches have also revealed equivocal results regarding exercise effects on pain and mood processing, it is expected that PET and other functional neuroimaging applications in athletes may in future help uncover some of the hitherto unknown links between neurotransmission and psychophysiological effects related to physical exercise.

Endogenous opioid peptide responses to opioid and anti-inflammatory medications following eccentric exercise-induced muscle damage

To determine the effects of Vicoprofen, Ibuprofen, and a placebo on the responses of endogenous opioid peptides following eccentric exercise-induced muscle damage 36 healthy men (age: 22.8 years; height: 178.8+/-6.2cm; body mass: 78.9+/-13.7kg; body fat: 15.8+/-6.5%) volunteered to participate in the study. Each participant was evaluated for pain 24h post and randomly assigned to an experimental group: VIC (Vicoprofen), IBU (Ibuprofen), or P (placebo). Medication was given four times daily (i.e., VIC (hydrocodone bitartrate 7.5mg with Ibuprofen 200mg) and IBU 200mg). Blood was obtained at rest and at 0, 24, 48, 72, 96 and 120h following the eccentric exercise damage protocol. No significant changes for B-END were observed in the resting values over the recovery period among any of the treatment conditions. Conversely for plasma P-F, VIC and IBU had significantly (P<0.05) higher plasma concentrations of P-F above placebo at 24, 48, 72, and 96 and 120h with VIC higher than IBU and placebo conditions at 48, 72, 96, and 120h. Significant resting elevations were observed for P-F from pre-exercise at 48, 72, 96, and 120h for VIC; at 72 and 96h for IBU and no changes in the placebo treatment. Less tissue damage (MRI analyses), improved physical function as well as reduced pain was observed for the VIC condition over IBU and placebo. These data indicate that exogenous medications appear to be differentially stimulating the peripheral (adrenal medulla) opioid neuroendocrine responses as measured by plasma concentrations.

Physical exercise in epilepsy: what kind of stressor is it?

Stress has been considered the most frequently self-reported precipitant of seizures in people with epilepsy. The literature documents that physical stress, that is, physical exercise, can have beneficial effects in people with epilepsy. In view of evidence indicating that sensitivity to stress is reduced after a physical exercise program, physical activity could be a potential candidate for stress reduction in people with epilepsy. This review considers how physical exercise could contribute to reduce seizure susceptibility and, hence, seizure frequency. Possible mechanisms by which exercise can be beneficial for people with epilepsy are highlighted. Hypothalamic-pituitary-adrenal axis adaptation, neurotransmitter system modulation, and metabolic and neuroendocrine changes may interfere with seizure susceptibility. The psychological stress of different sports activities is an important concern that must also be taken into account. Overall, among stress reduction therapies for the treatment of seizures, exercise might be a potential candidate.

An unusual complication: prolonged myopathy due to an alternative medical therapy with heat and massage

A 66-year-old male presented with swelling of the neck and arms, which was limiting his daily activities. Serum muscle enzymes were increased. A detailed history revealed that the patient received 10 cycles of infrared heat and massage therapy approximately 1 month before his first visit to the outpatient clinic. The swelling of the extremities began on day 11 of therapy, and the pain became unbearable. He was followed up with analgesics. There was a significant decrease in the muscle enzymes and a subjective improvement of 60-70% one month after discharge. Alternative therapies may have serious complications, and patients usually do not report them unless asked specifically.

Níveis de beta-endorfina em resposta ao exercício e no sobretreinamento

O sobretreinamento (ST) é um fenômeno esportivo complexo e multifatorial; e atualmente não existe nenhum marcador independente que possa diagnosticá-lo. Interessantemente, alguns sintomas do ST apresentam relação com os efeitos da b-endorfina (b-end1-31). Alguns de seus efeitos são importantes para o treinamento, como analgesia, maior tolerância ao lactato e euforia do exercício. Esses efeitos podem ser revertidos por destreinamento ou por ST, ocasionando diminuição no desempenho, redução da tolerância à carga e depressão. O exercício físico é o principal estímulo da b-end1-31, pois sua secreção é volume/intensidade dependente, tanto para exercícios aeróbios quanto anaeróbios. No entanto, o treinamento excessivo pode diminuir suas concentrações, alterando assim seus efeitos benéficos para o treinamento. Portanto, a b-end1-31 poderia ser utilizada como um marcador adicional de ST, principalmente porque seus efeitos apresentam extensa relação com os sintomas do ST.

Efeitos dos exercícios físicos sobre o edema inflamatório agudo em ratos Wistar

Os exercícios físicos têm sido associados a importantes e variados benefícios à saúde, como aqueles relacionados a função imune específica e não-específica, destacando-se, nesta última, o processo inflamatório. Contudo, dependendo do tipo, intensidade, freqüência e duração, os exercícios também podem causar certos prejuízos ao organismo. De fato, estudo prévio mostrou que a hipernocicepção de origem inflamatória, em ratos, foi influenciada pelo protocolo de exercícios físicos realizados em esteira ergométrica. Assim, este trabalho teve como objetivo estudar os efeitos dos exercícios físicos de baixa e alta intensidade sobre a resposta inflamatória aguda. Para isso, foram utilizados ratos machos, adultos, da linhagem Wistar, os quais foram submetidos (grupo treinado) ou não (grupo não treinado) a exercícios em esteira ergométrica. A inflamação aguda foi induzida pela injeção de carragenina-0,5% no coxim da pata posterior esquerda dos ratos, sendo o volume de edema inflamatório agudo mensurado por meio de pletismografia, antes e após 1, 2, 3, 4, 6, 8 e 24 horas da indução do processo inflamatório. A análise estatística dos resultados mostrou aumento significante no volume de edema inflamatório nos momentos H1, H2 e H3 (P<0,01) e nos momentos H4 e H6 (P<0,05) nos animais treinados em baixa intensidade. Entretanto, não ocorreram alterações estatisticamente significantes no volume de edema inflamatório agudo em nenhum dos momentos avaliados (P>0,05) nos animais do grupo treinado em alta intensidade em relação aos não treinados. Concluiu-se, então, que os exercícios físicos de baixa intensidade, em esteira ergométrica, aumentaram o volume de edema inflamatório agudo em ratos, provavelmente ocasionado pelo aumento na síntese e secreção de prostaglandinas e/ou aumento nos níveis plasmáticos das citocinas IL-1, IL-6 e TNF-alfa entre outros fatores. Tal fato não foi observado com os exercícios de alta intensidade, mostrando assim, a influência da intensidade, freqüência e duração dos exercícios sobre este parâmetro inflamatório.

The effect of physical therapy on beta-endorphin levels

Beta-endorphin (betaE) is an important reliever of pain. Various stressors and certain modalities of physiotherapy are potent inducers of the release of endogenous betaE to the blood stream. Most forms of exercise also increase blood betaE level, especially when exercise intensity involves reaching the anaerobic threshold and is associated with the elevation of serum lactate level. Age, gender, and mental activity during exercise also may influence betaE levels. Publications on the potential stimulating effect of manual therapy and massage on betaE release are controversial. Sauna, mud bath, and thermal water increase betaE levels through conveying heat to the tissues. The majority of the techniques for electrical stimulation have a similar effect, which is exerted both centrally and--to a lesser extent--peripherally. However, the parameters of electrotherapy have not yet been standardised. The efficacy of analgesia and the improvement of general well-being do not necessarily correlate with betaE level. Although in addition to blood, increased brain and cerebrospinal fluid betaE levels are also associated with pain, the majority of studies have concerned blood betaE levels. In general, various modalities of physical therapy might influence endorphin levels in the serum or in the cerebrospinal fluid--this is usually manifested by elevation with potential mitigation of pain. However, a causal relationship between the elevation of blood, cerebrospinal fluid or brain betaE levels and the onset of the analgesic action cannot be demonstrated with certainty.

Hormonal responses to opioid receptor blockade: during rest and exercise in cold and hot environments

Opioid receptors appear to modulate a variety of physiological and metabolic homeostatic responses to stressors such as exercise and thermally extreme environments. To more accurately determine the role of the naloxone (NAL) sensitive opioid receptor system during rest and exercise, subjects were subjected to concomitant environmental thermal stress. Fifteen untrained men rested or performed low intensity (60% VO2peak) or high intensity (80% VO2peak) exercise on a cycle ergometer for 60 min in an environmental chamber during cold (0 degrees C) hot (35 degrees C) air exposure while receiving an infusion of normal saline (SAL) or NAL (0.1 mg kg(-1)). Plasma adrenocorticotropin hormone (ACTH), immunoreactive beta-endorphin (IBE), cortisol and growth hormone were measured at baseline and every 15 min while in the chamber. Time to exhaustion was significantly reduced during high intensity exercise in the heat (P<0.0001). NAL significantly (P=0.0004) reduced the time to exhaustion (38.3+/-2.1 min) during high intensity exercise in the heat compared to SAL (49.4+/-2.1 min). ACTH and IBE increased during hot conditions and cold attenuated this response. Plasma concentrations of IBE, ACTH, and growth hormone increased significantly with NAL during high intensity exercise in the heat compared to SAL. Cold attenuated the response of ACTH, IBE and cortisol to NAL. NAL administration exaggerates plasma hormone concentration during high intensity exercise in the heat, but not cold. These results support a regulatory effect of the opioid receptor system on physiological responses during exercise in thermally stressful environments. Future research should be directed to more clearly defining the effect of environmental temperature on the mechanism of hypothalamic-pituitary-adrenal hormonal release during exercise and hot environmental temperatures.

Splanchnic blood flow and hepatic glucose production in exercising humans: role of renin-angiotensin system

The study examined the implication of the renin-angiotensin system (RAS) in regulation of splanchnic blood flow and glucose production in exercising humans. Subjects cycled for 40 min at 50% maximal O(2) consumption (VO(2 max)) followed by 30 min at 70% VO(2 max) either with [angiotensin-converting enzyme (ACE) blockade] or without (control) administration of the ACE inhibitor enalapril (10 mg iv). Splanchnic blood flow was estimated by indocyanine green, and splanchnic substrate exchange was determined by the arteriohepatic venous difference. Exercise led to an approximately 20-fold increase (P < 0.001) in ANG II levels in the control group (5.4 +/- 1.0 to 102.0 +/- 25.1 pg/ml), whereas this response was blunted during ACE blockade (8.1 +/- 1.2 to 13.2 +/- 2.4 pg/ml) and in response to an orthostatic challenge performed postexercise. Apart from lactate and cortisol, which were higher in the ACE-blockade group vs. the control group, hormones, metabolites, VO(2), and RER followed the same pattern of changes in ACE-blockade and control groups during exercise. Splanchnic blood flow (at rest: 1.67 +/- 0.12, ACE blockade; 1.59 +/- 0.18 l/min, control) decreased during moderate exercise (0.78 +/- 0.07, ACE blockade; 0.74 +/- 0.14 l/min, control), whereas splanchnic glucose production (at rest: 0.50 +/- 0.06, ACE blockade; 0.68 +/- 0.10 mmol/min, control) increased during moderate exercise (1.97 +/- 0.29, ACE blockade; 1.91 +/- 0.41 mmol/min, control). Refuting a major role of the RAS for these responses, no differences in the pattern of change of splanchnic blood flow and splanchnic glucose production were observed during ACE blockade compared with controls. This study demonstrates that the normal increase in ANG II levels observed during prolonged exercise in humans does not play a major role in the regulation of splanchnic blood flow and glucose production.

Influence of fitness on the integrated neuroendocrine response to aerobic exercise until exhaustion

A group of trained and sedentary men performed an incremental graded exercise-test to exhaustion in order to assess the organic response of the two main stress-activated systems: the sympathetic nervous system with its endocrine component (the adrenal medulla), and the hypothalamic-pituitary-adrenal (HPA) axis. Maximal plasma concentrations of ACTH, cortisol and endogenous opioids (beta-endorphins) were obtained at the end of the exercise-test in the trained group. Thus ACTH increased from basal value of 21.25 +/- 2.5 pg/ml to 88.78 +/- 11.8 pg/ml at the end of the exercise (p<0.01); cortisol, from 16.56 microg/dl +/- 4.94 microg/dl to 23.80 +/- 4.57 microg/dl in min 15 of the recovery period (p<0.001); and beta-endorphin from 21.80 +/- 8.33 pmol/ml to 64.36 +/- 9.8 pmol/ml in min 3 of the recovery period (p<0.05). Catecholamine levels were increased from initial values at the end of the effort test in both control and trained groups. Control subjects exhibited a higher responsiveness compared to trained and showed superior intrinsic stimulation of the sympathetic nervous system. These results reveal a different response according to fitness in a physical stress situation.

Special feature for the Olympics: effects of exercise on the immune system: neuropeptides and their interaction with exercise and immune function

It is known today that the immune system is influenced by various types of psychological and physiological stressors, including physical activity. It is well known that physical activity can influence neuropeptide levels both in the central nervous system as well as in peripheral blood. The reported changes of immune function in response to exercise have been suggested to be partly regulated by the activation of different neuropeptides and the identification of receptors for neuropeptides and steroid hormones on cells of the immune system has created a new dimension in this endocrine-immune interaction. It has also been shown that immune cells are capable of producing neuropeptides, creating a bidirectional link between the nervous and immune systems. The most common neuropeptides mentioned in this context are the endogenous opioids. The activation of endogenous opioid peptides in response to physical exercise is well known in the literature, as well as the immunomodulation mediated by opioid peptides. The role of endogenous opioids in the exercise-induced modulation of immune function is less clear. The present paper will also discuss the role of other neuroendocrine factors, such as substance P, neuropeptide Y and vasoactive intestinal peptide, and pituitary hormones, including growth hormone, prolactin and adrenocorticotrophin, in exercise and their possible effects on immune function.

Special feature for the Olympics: effects of exercise on the immune system: neuropeptides and their interaction with exercise and immune function

It is known today that the immune system is influenced by various types of psychological and physiological stressors, including physical activity. It is well known that physical activity can influence neuropeptide levels both in the central nervous system as well as in peripheral blood. The reported changes of immune function in response to exercise have been suggested to be partly regulated by the activation of different neuropeptides and the identification of receptors for neuropeptides and steroid hormones on cells of the immune system has created a new dimension in this endocrine-immune interaction. It has also been shown that immune cells are capable of producing neuropeptides, creating a bidirectional link between the nervous and immune systems. The most common neuropeptides mentioned in this context are the endogenous opioids. The activation of endogenous opioid peptides in response to physical exercise is well known in the literature, as well as the immunomodulation mediated by opioid peptides. The role of endogenous opioids in the exercise-induced modulation of immune function is less clear. The present paper will also discuss the role of other neuroendocrine factors, such as substance P, neuropeptide Y and vasoactive intestinal peptide, and pituitary hormones, including growth hormone, prolactin and adrenocorticotrophin, in exercise and their possible effects on immune function.

Beta-endorphin (1-31) in the plasma of male volunteers undergoing physical exercise

beta-Endorphin is an opioid peptide representing the C-terminal 31 amino acid residue fragment of proopiomelanocortin (POMC). The release of beta-endorphin from the pituitary into the cardiovascular compartment under physical or emotional stress has been frequently reported. However, besides beta-endorphin (1-31), nine acetylated or non-acetylated beta-endorphin analogues exist - in addition to N-terminally elongated beta-endorphin derivatives such as beta-lipotropin (beta-LPH). Since conventional radioimmunoassays (RIAs) and even commercially available two site-RIAs pick up at least some of those beta-endorphin derivatives, only "beta-endorphin immunoreactive materials" and not authentic beta-endorphin have been determined in those studies. We have developed a highly specific two site-RIA for beta-endorphin (1-31), which does not cross-react with all beta-endorphin derivatives known to occur as yet. Using this RIA as well as further assays for determination of beta-endorphin (1-31), beta-endorphin immunoreactive material (IRM), ACTH and Cortisol in the plasma of 14 volunteers upon intensive physical exercise, we found authentic beta-endorphin only in about 50% of the plasma samples, representing therein only a minor portion of the beta-endorphin IRM.

Chronic running-wheel activity decreases sensitivity to morphine-induced analgesia in male and female rats

The effects of exercise on morphine-induced analgesia were examined in male and female Long-Evans rats. In Experiment 1, 10 male rats were housed in standard laboratory cages, and 10 in activity wheels for 20 days prior to nociceptive testing. Pain thresholds were assessed using a tail-flick (TF) procedure. Morphine sulfate was administered using a cumulative dosing procedure (2.5, 5.0, 7.5, 10.0, 12.5, and 15.0 mg/kg). TF latencies were measured immediately prior to and 30 min following each injection. In Experiment 2, morphine-induced analgesia was examined in females in an identical manner to that of Experiment 1. Additionally, to determine if the attenuation of morphine-induced analgesia was permanent or reversible, after the initial test nociceptive test, previously active female rats were placed in standard cages, and previously inactive females placed in running wheels for 17 days prior to a second nociceptive test. Baseline TF latencies were significantly shorter in active male rats than in inactive animals. Additionally, both active male and female rats displayed decreased morphine-induced analgesia relative to inactive controls. Moreover, females that had been inactive and then were permitted to run showed a suppression in morphine-induced analgesia relative to presently inactive rats, and to their own nociceptive responses when sedentary. In contrast, morphine-induced analgesia in initially active females who were housed in standard cages during part 2 of Experiment 2 was enhanced relative to their first nociceptive test and to presently active rats. Experiment 3 examined the effects of short-term (24 h) running on antinociception. Baseline TF latencies were shorter in active rats than inactive rats. However, no differences in morphine-induced analgesia were observed as a function of short-term exposure to exercise. Experiment 4 investigated whether differences in body weight contributed to the differences in morphine-induced analgesia between chronically active and inactive animals. %MPEs did not vary among male rats maintained at 100, 85, or 77% of their free-feeding body weight. These results indicate that chronic activity can decrease morphine's analgesic properties. These effects may be due to crosstolerance between endogenous opioid peptides released during exercise and exogenous opioids.

Physical exercise and vasomotor symptoms in postmenopausal women

BACKGROUND

The mechanisms causing postmenopausal vasomotor symptoms are unknown, but changes in hypothalamic beta-endorphins have been suggested to be involved. beta-endorphin production may be increased by regular physical exercise.

OBJECTIVE

To assess if physically active women suffered from vasomotor symptoms to a lower extent than sedentary women.

MATERIAL AND METHODS

All women (n = 1323) in the ages ranging from 55-56 years in the community of Linköping Sweden, were included. In a questionnaire these women were asked about their physical exercise habits and their complaints from vasomotor symptoms. Only those 793 women who had reached a natural menopause were grouped into sedentary, moderately or highly active women, based on a physical activity score.

RESULTS

Only 5% of highly physically active women experienced severe hot flushes as compared with 14-16% of women who had little or no weekly exercise (P < 0.05; relative risk 0.26; CI 95%: 0.10-0.71). This was not explained by differences in body mass index, smoking habits or use of hormone replacement therapy. Women who used hormone replacement therapy were more physically active than non-users (P < 0.05).

CONCLUSION

Fewer physically active women had severe vasomotor symptoms compared with sedentary women. This may be due to a selection bias but also to the fact that physical exercise on a regular basis affects neurotransmitters which regulate central thermoregulation.

Activity wheel running blunts increased plasma adrenocorticotrophin (ACTH) after footshock and cage-switch stress

We examined whether chronic circadian physical activity attenuates hypothalamic-pituitary-adrenal hormone responses after footshock with or without cage-switch stress. Young (45 g) male Fischer 344 rats were randomly assigned to individual suspended home cages (HC) or cages with activity wheels (AW) (12 h:12 h light-dark photoperiod). After 6 weeks, each animal from a pair matched on mass (HC and AW) and average weekly running distance (AW) was randomly assigned to controllable or uncontrollable footshock on 2 days separated by 24 h. Half the animals were returned to the HC after the first day of shock, and half were switched to a new shoebox cage. One animal of each pair could end the shock for both rats by performing an FR-2 lever press. The yoked animal could not control the shock. After shock on Day 2, trunk blood was collected after decapitation. Plasma adrenocorticotrophin (ACTH), corticosterone, and prolactin were determined by radioimmunoassay. ANOVA for a 2 Group (AW vs. sedentary) x 2 Test (controllable vs. uncontrollable shock) x 2 Condition (HC vs. cage-switch) design indicated a Group x Test x Condition effect [F(1, 48) = 5.07, p = 0.03] and a Test main effect [F(1, 47) = 6.93, p = 0.01] for ACTH. ACTH was higher for sedentary animals after uncontrollable footshock under cage-switch conditions and higher after uncontrollable versus controllable footshock when averaged across groups and cage conditions. No effects were found for corticosterone or prolactin. Our results extend to activity wheel running prior findings of a cross-stressor attenuation in plasma [ACTH] in response to cage-switch after treadmill exercise training, though the cross-stressor effect was additive with footshock. Consistent with our prior reports, the cross-stressor effect of wheel running was not apparent after footshock administered under home-cage conditions.

Beta-endorphin response to exercise. An update

beta-Endorphin, a 31-amino-acid peptide, is primarily synthesised in the anterior pituitary gland and cleaved from pro-opiomelanocortin, its larger precursor molecule. beta-Endorphin can be released into the circulation from the pituitary gland or can project into areas of the brain through nerve fibres. Exercise of sufficient intensity and duration has been demonstrated to increase circulating beta-endorphin levels. Previous reviews have presented the background of opioids and exercise and discussed the changes in beta-endorphin levels in response to aerobic and anaerobic exercise. The present review is to update the response of beta-endorphin to exercise. This review suggests that exercise-induced beta-endorphin alterations are related to type of exercise and special populations tested, and may differ in individuals with health problems. Additionally, some of the possible mechanisms which may induce beta-endorphin changes in the circulation include analgesia, lactate or base excess, and metabolic factors. Based on the type of exercise, different mechanisms may be involved in the regulation of beta-endorphin release during exercise.

Glucose homeostasis during exercise in humans with a liver or kidney transplant

To investigate the role of liver nerve activity on hepatic glucose production during exercise, liver-transplant subjects (LTX, n = 7, 25-62 yr, 4-18 mo postoperative) cycled for 40 min, 20 min at 52 +/- 3% (SE) maximal O2 consumption (VO2max) and 20 min at 83 +/- 1% VO2max, respectively. Kidney-transplant (KTX) and healthy control subjects (C) matched for sex and age exercised at the same %VO2max as LTX. VO2max was lower in both LTX (1.59 +/- 0.12 l/min) and KTX (1.59 +/- 0.07) than in C (2.60 +/- 0.26). At rest plasma renin and insulin were higher and plasma adrenocorticotropic hormone and cortisol lower in transplant corticosteroid-treated subjects compared with C. In LTX, hepatic glucose production (Ra) increased from 11.9 +/- 0.9 (rest) to 17.6 +/- 1.8 and 25.5 +/- 1.8 mumol.min-1.kg-1 at 52 and 82% VO2max, respectively. Peripheral glucose uptake was similar to Ra, and glucose remained at basal postabsorptive levels. During exercise the Ra increase as well as norepinephrine, insulin, and growth hormone responses were similar in LTX compared with both KTX and C. The increase in epinephrine was smaller in LTX than in C, the only group showing an increase in cortisol. The increase in plasma renin activity during exercise was attenuated in KTX compared with LTX and C. During exercise blood lactate rose more and plasma glycerol and free fatty acid levels were lower in LTX and KTX compared with C.(ABSTRACT TRUNCATED AT 250 WORDS)

Beta-endorphin and the immune system--possible role in autoimmune diseases

The immune system and the neuroendocrine system are closely interconnected having such means of bidirectional communication and regulation. In this review, a hypothesis is put forward regarding the possible role of beta-endorphins in the pathogenesis of autoimmune diseases: It is suggested that the increased cytokine production in immunoinflammatory disorders induces production of beta-endorphins from the pituitary and the lymphocytes; the enhanced level of beta-endorphin causes inhibition of human T helper cell function, which potentially down-regulate the antibody production. Also the beta-endorphin-induced enhancement of the natural killer cell activity may suppress the B cell function. In addition, beta-endorphin also exerts a direct inhibitory effect on the antibody production. Thus, in autoimmune disorders the enhanced cytokine level may via stimulation of the production of beta-endorphins exert a negative feed back on the antibody production and potentially so on the production of autoantibodies.

Plasma endorphin species during dynamic exercise in humans

beta-Endorphin is metabolized to gamma- and alpha-endorphin. In order to evaluate endorphin metabolism during exercise, radioimmunoassay blood levels of alpha-, beta- and gamma-endorphins were recorded during exercise for 2 h on a cycling ergometer in 12 endurance-trained and 11 untrained male subjects. In untrained subjects, mild exercise (49 +/- 4% VO2max, mean +/- SD) did not show an increase in plasma beta-endorphin, while the levels of its metabolites rose. No changes were noted in the endurance-trained subjects. More intensive exercise (66 +/- 6% VO2max in untrained and 57 +/- 7% VO2max in trained subjects) resulted in an increase in beta-endorphin concentration in association with elevation of the alpha-endorphin level. While before and during exercise the beta-endorphin levels did not differ significantly between athletes and untrained subjects, the levels of gamma- and alpha-endorphins, as well as the molar ratios alpha/beta and gamma/beta, were significantly higher in untrained subjects. In conclusion, blood levels of beta-endorphin metabolites in the resting state and during exercise are dependent on previous training. In untrained subjects, mild exercise may result in accumulation of gamma- and alpha-endorphins in blood without a concomitant change in beta-endorphin level.

Resistance exercise decreases beta-endorphin immunoreactivity

Previous research investigating the response of plasma beta-endorphins (beta-EP) to resistance exercise has resulted in equivocal findings. To examine further the effects of resistance exercise on beta-EP immunoreactivity, 10 male and 10 female college-age students participated in a series of controlled isotonic resistance exercises. The session consisted of three sets of eight repetitions at 80% of one repetition maximum (1-RM) for each of the following exercises: (1) bench press; (2) lateral pull-downs; (3) seated arm curls; and (4) military press. Blood plasma was sampled both before and after the lifting routine and beta-endorphin levels were determined by radioimmunoassay. A Students t test for paired samples indicated that mean(s.e.) plasma beta-endorphin levels after exercise (10.5(1.3) pg beta-EP ml-1) were significantly decreased as compared with pre-exercise (control) levels (16.5(1.2), P < 0.05). While the mechanism(s) contributing to the decrease in immunoreactivity is unclear, it may be the result of the synergistic effect of beta-EP clearance during rest intervals and changes in psychological states between sampling.

Plasma beta-endorphin immunoreactivity: response to resistance exercise

Previous research investigating the response of plasma beta-endorphins (beta-EP) to resistance exercise has resulted in equivocal findings. To further examine the effects of resistance exercise on beta-endorphin immunoreactivity, six resistance-trained athletes participated in a three-set series of eight repetitions of isotonic exercise. All exercises were performed at 80% maximal effort. Blood was sampled from the group by venepuncture, both prior to and following the exercise bout, and beta-endorphin concentration was determined by radioimmunoassay. The results indicated that mean (+/- S.E.) plasma levels of beta-endorphins following exercise (18.04 +/- 3.4 pg beta-EP ml-1) were not significantly changed from pre-exercise (control) levels (19.59 +/- 2.4 pg beta-EP ml-1), although there was considerable inter-individual variability. Our results support previous research which has reported no significant changes in beta-endorphin immunoreactivity following resistance exercise, as well as reported findings of considerable variability in the beta-endorphin response to exercise.

Steroid and pituitary hormone responses to rowing: relative significance of exercise intensity and duration and performance level

To analyse the relative significance of exercise intensity and duration as well as performance capacity, hormone changes were recorded in 16 male rowers in two experiments separated by a year. The test exercises consisted of 7-min (at the supramaximal intensity) and 40-min rowing (at the level of the anaerobic threshold) on a rowing apparatus. In addition, somatotropin and cortisol responses were estimated in rowing for 8 x 2000 m in 14 rowers of national class. All three tests caused significant increases in somatotropin and cortisol concentrations in the blood. Follitropin concentrations were elevated in the 7-min exercise test in the second experiment and in the 40-min exercise test in both experiments. Lutropin and progesterone concentrations increased during the more prolonged exercise in the first experiment. No common change was found in testosterone concentrations. Cortisol and somatotropin response to the 40-min rowing test at anaerobic threshold were more pronounced than to the 7-min exercise test at supramaximal intensity. When the rowers achieved a national class level of performance (the second experiment) the hormone responses to 7-min supramaximal exercise were increased. During the 8 x 2000-m rowing test cortisol but not somatotropin concentration increased to an extremely high level in the rowers of national class. It is concluded that in strenuous exercise cortisol and somatotropin responses were triggered by the exercise intensity threshold. The exact magnitude of the response would seem to have depended on additional stimuli caused by exercise duration and on possibility of mobilizing hormone reserves.

Beta-endorphins and mood states during resistance exercise

Research examining the relationship between beta-endorphin immunoreactivity and affect has resulted in equivocal findings. To examine this relationship further, 10 male and 10 female college-age students participated in a controlled free-weight exercise session. Blood plasma samples were procured both prior to and following the exercise bout and beta-endorphin levels were determined by immunoassay. Analysis indicated that plasma beta-endorphin levels following exercise were significantly decreased from pre-exercise levels. Pearson correlations showed no significant relationship between pre- or postexercise plasma beta-endorphins and either total mood disturbance or Profile of Mood States subscores. The data support previous failure of resistance exercise to produce an increase in beta-endorphin immunoreactivity as well as the lack of a significant relationship between affect and the beta-endorphin response to exercise.

Beta-endorphin and adrenocorticotropic hormone production during marathon and incremental exercise

To evaluate the increases in concentration of beta-endorphin and adrenocorticotropic hormone (ACTH) 16 healthy athletes, well-trained for endurance exercise, volunteered for an exhausting incremental graded treadmill exercise and a marathon run. Maximum oxygen uptake was determined during the treadmill exercise. Venous blood samples were drawn before and after exercise, and at 30, 60 and 120 min during the recovery phase. For the marathon race venous blood was collected before, after 1 and 2 h of running and at the end, as well as at 0.5, 1, 2 and 24 h during the recovery phase. Lactate concentration, heart rate and perceived exertion were also determined at all points of blood collection. Both types of exercise led to significant increases in concentration of beta-endorphin and ACTH of similar magnitude, with beta-endorphin tending to be higher after the marathon run. The decrease of both was slower during the recovery from the marathon than after the incremental test. Concentrations of both hormones increased exponentially during the marathon run. Positive correlations between beta-endorphin and ACTH concentrations were determined at the end of both runs. It was found that incremental exhausting and prolonged exhausting endurance exercise such as marathon running induced an increase of similar magnitude in both beta-endorphin and ACTH concentration.

Stimulation by voluntary exercise of adrenal glucocorticoid secretion in mature female hamsters

The possibility that habitual voluntary running induces a chronic change in adrenal glucocorticoid synthesis and secretion was examined in freely running mature female hamsters, in whom this behavior accelerates growth, reduces body fat levels, and elevates core temperature. Hamsters were free to run on horizontal discs or in vertical wheels between 32 and 80 days, in 14L:10D or in 10L:14D photoperiods, and at the end of this period, corticosterone and cortisol steroidogenesis and serial plasma corticosterone concentrations during day and night were used as measures of the chronic stimulation of adrenal cortical activity. Habitual voluntary running significantly increased steroidogenesis of both glucocorticoids and plasma corticosterone concentrations and alone accounted for all the variance in enhanced synthesis and secretion of corticosterone. Acute exercise and/or the nocturnal phase of circadian period enhanced the chronic stimulatory effects of exercise on cortisol. Despite its voluntary and apparently stress-free nature, running induces chronic increases in basal glucocorticoid secretion in mature female hamsters. Putative oversecretion of corticotropin releasing factor in freely running hamsters could account for increased steroidogenesis, acceleration of growth, reduced body fat levels, and core temperature elevation.

Plasma beta-endorphin and adrenocorticotrophin in young horses in training

A controlled period of submaximal exercise on a treadmill was used as a standardised stress test in 6 young horses to monitor the effects of training. Circulating plasma concentrations of immunoreactive beta-endorphin (IR beta-EP) were measured before, during and after the exercise period. The stress test was conducted on 3 occasions during an intensive training program lasting 14 weeks. In week 3 a marked increase in plasma IR beta-EP (P = 0.003) was demonstrated as a result of training, but by the last exercise test performed in week 9 no significant increase in plasma IR beta-EP concentrations could be detected. During the training period the basal concentrations of plasma IR beta-EP significantly decreased (P = 0.0059). Plasma adrenocorticotrophin (ACTH) did not increase during exercise, although there was a trend of decreasing basal plasma ACTH by the end of the training period. It was concluded that a standardised work test acted as a mild stress to unfit horses, but as the horses' fitness increased the hormonal response to exercise diminished. Basal plasma beta-EP concentrations were decreased with increasing fitness.

The effect of chronic exercise on the pituitary-adrenocortical response in conscious rats

1. This study was designed to investigate the effect of chronic exercise on exercise-induced changes in plasma concentrations of adrenocorticotrophic hormone (ACTH) and corticosterone in rats. Corticotrophin releasing factor (CRF) and ACTH were injected I.V. in order to assess the responsiveness of the pituitary and adrenal glands after chronic exercise. 2. The concentrations of ACTH and corticosterone in the plasma increased significantly after acute exercise in both the control and the exercised groups but both responses were significantly smaller in the exercised group. 3. The ACTH response to I.V. CRF was also significantly smaller in the exercised rats. However, both groups of animals showed similar increases in plasma corticosterone levels after the administration of exogenous ACTH. 4. The ACTH response to CRF attenuated by repeated administration of CRF. 5. These results suggest that attenuated ACTH and corticosterone responses to acute exercise after chronic exercise result from reduced responsiveness of the pituitary gland to CRF.

Hormonal, metabolic, and cardiovascular responses to static exercise in humans: influence of epidural anesthesia

To determine the role of reflex neural mechanisms for hormonal, metabolic, heart rate (HR), and blood pressure (MABP) changes during static exercise, seven health young males performed 10-min periods of two-legged static knee extension both during control and during epidural anesthesia. Comparisons were made at identical absolute (29 Nm) and relative [15% maximal voluntary contraction (MVC)] force. Afferent nerve blockade was verified by hypesthesia below T10-T12 and attenuated postexercise ischemic pressor response. Leg strength was reduced to 67 +/- 5% of control. At same relative force, increases in MABP and HR occurred more rapidly without than with epidural anesthesia (P less than 0.05). This difference was diminished during identical absolute force. Changes in plasma concentrations of catecholamines followed the pattern of HR and MABP responses, with differences between epidural and control experiments being most pronounced early in the work period. Plasma beta-endorphin was elevated only after control exercise. No response at 15% MVC was found for growth hormone, adrenocorticotropic hormone, insulin, glucagon, cortisol, glycerol, free fatty acids, or glucose (P greater than 0.05). In conclusion, during static exercise with large muscle groups and moderate relative force, modest changes in plasma hormones and metabolites take place. Furthermore, afferent nervous feedback from contracting muscles is important in regulation of blood pressure, heart rate, and catecholamine responses during static exercise in humans.

Effects of diving experience on submersion-induced increases in plasma levels of beta-endorphin in scuba divers

The submersion of eight male scuba divers in a state of neutral buoyancy for 20 min resulted in a significant increase (mean, 20%) in plasma beta-endorphin immunoreactivity (beta-EIR), and all subjects reported post-submersion feelings of well-being, relaxation or euphoria. The increase in beta-EIR was negatively correlated with age (r = -0.727) and diving experience (r = -0.860), and positively correlated with the amount of air usage during submersion (r = 0.863). Thus, diving experience appears to influence many of the nonsubjective parameters measured.