Neither gender nor menstrual cycle phase influences exercise-induced lymphocyte apoptosis in untrained subjects

Linking Physical Activity to Breast Cancer via Sex Hormones, Part 1: The Effect of Physical Activity on Sex Steroid Hormones

The effect of physical activity on breast cancer risk may be partly mediated by sex steroid hormones. This review synthesized and appraised the evidence for an effect of physical activity on sex steroid hormones. Systematic searches were performed using MEDLINE (Ovid), EMBASE (Ovid), and SPORTDiscus to identify experimental studies and prospective cohort studies that examined physical activity and estrogens, progestins, and/or androgens, as well as sex hormone binding globulin (SHBG) and glucocorticoids in pre- and postmenopausal women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the GRADE system was used to appraise quality of the evidence. Twenty-eight randomized controlled trials (RCT), 81 nonrandomized interventions, and six observational studies were included. Estrogens, progesterone, and androgens mostly decreased, and SHBG increased, in response to physical activity. Effect sizes were small, and evidence quality was graded moderate or high for each outcome. Reductions in select sex steroid hormones following exercise supports the biological plausibility of the first part of the physical activity-sex hormone-breast cancer pathway. The confirmed effect of physical activity on decreasing circulating sex steroid hormones supports its causal role in preventing breast cancer.See related reviews by Lynch et al., p. 11 and Drummond et al., p. 28.

Physiological and Psychological Responses to a Maximal Swimming Exercise Test in Adolescent Elite Athletes

BACKGROUND

Continuously rising performances in elite adolescent athletes requires increasing training loads. This training overload without professional monitoring, could lead to overtraining in these adolescents.

METHODS

31 elite adolescent athletes (boys: n = 19, 16 yrs; girls: n = 12, 15 yrs) participated in a field-test which contained a unified warm-up and a 200 m maximal freestyle swimming test. Saliva samples for testosterone (T) in boys, estradiol (E) in girls and cortisol (C) in both genders were collected pre-, post- and 30 min post-exercise. Lactate levels were obtained pre- and post-exercise. Brunel Mood Scale, Perceived Stress Scale and psychosomatic symptoms questionnaires were filled out post-exercise.

RESULTS

Lactate levels differed between genders (boys: pre: 1.01 ± 0.26; post: 8.19 ± 3.24; girls: pre: 0.74 ± 0.23; post: 5.83 ± 2.48 mmol/L). C levels increased significantly in boys: pre- vs. post- (p = 0.009), pre- vs. 30 min post-exercise (p = 0.003). The T level (p = 0.0164) and T/C ratio (p = 0.0004) decreased after field test which draws attention to the possibility of overtraining. Maximal and resting heart rates did not differ between genders; however, heart rate recovery did (boys: 29.22 ± 7.4; girls: 40.58 ± 14.50 beats/min; p = 0.008).

CONCLUSIONS

Our models can be used to explain the hormonal ratio changes (37.5-89.8%). Based on the results this method can induce hormonal response in elite adolescent athletes and can be used to notice irregularities with repeated measurements.

The effect of acute running and cycling exercise on T cell apoptosis in humans: A systematic review

This review analyses the influence of acute running and cycling exercise on T lymphocyte apoptosis. We included randomized controlled trials (RCTs) and non-randomized case-control studies (NRCTs) measuring apoptosis by flow cytometry. Cochrane Library, Scopus, PubMed and Ovid were searched for running and cycling intervention studies. Risk of bias was assessed by Cochrane Collaboration's tools. We included five NRCTs and one RCT with a total of 93 participants. The RCT found a higher percentage of apoptotic T helper cells identified by upregulation of Annexin V, caspase-3 and caspase-9 under hypoxic conditions, and only one NRCT reported a higher percentage of highly differentiated apoptotic T cells immediately after exercise. Three hours after exercise, the same NRCT showed an increase in several T cell subsets such as T helper, cytotoxic T, low differentiated and regulatory T cells. The interventions were very heterogeneous by exercise protocol and external conditions. High risk of bias in NRCTs restricts accuracy of the included studies. Imprecision due to the small sample size limits further evidence. In the future, scientists should include apoptotic measures into their research design, plan RCTs, measure apoptosis at different time points post-exercise and increase sample size.

Sex-specific variation in signaling pathways and gene expression patterns in human leukocytes in response to endotoxin and exercise

Background

While exercise effects on the immune system have received increasing attention in recent years, it remains unclear to what extent gender and fluctuations in sex hormones during menstrual cycle influence immunological responses to exercise.

Methods

We investigated mRNA changes induced through exhaustive exercise (half-marathon; pre-exercise and post-exercise [30 min, 3 h, 24 h] on whole blood cultures ± lipopolysaccharide [LPS] [1 h]) with a specific focus on sex differences (men vs women in luteal phase) as an extension of our previous study.

Results

Inflammation related signaling pathways, TLRs, cytosolic DNA sensing and RIG-I like receptors were differentially activated between sexes in LPS-stimulated cultures. Genes differentially regulated between sexes included TNIP-1, TNIP-3, IL-6, HIVEP1, CXCL3, CCR3, IL-8, and CD69, revealing a bias towards less anti-inflammatory gene regulation in women compared to men. In addition, several genes relevant to brain function (KMO, DDIT4, VEGFA, IGF1R, IGF2R, and FGD4) showed differential activation between sexes. Some of these genes (e.g., KMO in women, DDIT4 in both sexes) potentially constitute neuroprotective mechanisms.

Conclusions

These data reveal that the exercise-induced change in gene expression might be gender and menstrual cycle phase dependent.

Electronic supplementary material

The online version of this article (doi:10.1186/s12974-016-0758-5) contains supplementary material, which is available to authorized users.

Caffeine affects CD8+ lymphocyte apoptosis and migration differently in naïve and familiar individuals following moderate intensity exercise

The purpose of this investigation was to determine the lymphocyte subset response to 30 min of moderate treadmill exercise during caffeine supplemented (6.0 mg.kg(-1)) and placebo conditions in caffeine-naïve and -familiar individuals. Seventeen individuals participated (caffeine-familiar = 8, caffeine-naïve = 9) completing two exercise bouts (caffeine supplemented and placebo control) 48 h apart in a counterbalanced and double-blinded fashion. Individuals were classified as follows: caffeine-naive <50 mg.d(-1) and caffeine-familiar >200 mg.d(-1) Whole blood samples were obtained at rest, 30 min after caffeine or placebo ingestion, immediately following exercise, and 1 h post exercise. Blood was used to analyze apoptosis (annexin V) and cellular migration (CX3CR1) responses in lymphocyte subsets (CD4+, CD8+, CD19+). Absolute changes from rest values were calculated and differences between conditions were determined through Chi-squared analysis with significance accepted at P <0.05. With regard to CD4+ and CD19+ lymphocytes, the interaction of caffeine and exercise did not affect naïve individuals to a greater extent immediately post exercise when compared to familiar, as similar apoptotic and migratory responses were observed (P >0.05). However, CD8+ lymphocyte cell death and migration responses were observed to be significantly greater at each sampling point in caffeine-familiar individuals (P <0.05). It is possible that chronic caffeine supplementation may prime CD8+ cell receptors for responsiveness to apoptosis and migration and the consequence of this form of immunosuppression in the post-exercise period should be determined.

Orthostatic intolerance and postural tachycardia syndrome as suspected adverse effects of vaccination against human papilloma virus

BACKGROUND

Infections with human papilloma virus (HPV) can result in cervical, oropharyngeal, anal, and penile cancer and vaccination programs have been launched in many countries as a preventive measure. We report the characteristics of a number of patients with a syndrome of orthostatic intolerance, headache, fatigue, cognitive dysfunction, and neuropathic pain starting in close relation to HPV vaccination.

METHODS

Patients were referred for orthostatic intolerance following HPV vaccination. Symptoms of autonomic dysfunction were quantified by standardised questionnaire. The diagnosis of postural orthostatic tachycardia syndrome (POTS) rested on finding a sustained heart rate increment of >30 min(-1) (>40 min(-1) in adolescents) or to levels >120 min(-1) during orthostatic challenge.

RESULTS

35 women aged 23.3 ± 7.1 years participated. Twenty-five had a high level of physical activity before vaccination and irregular periods were reported by all patients not on treatment with oral contraception. Serum bilirubin was below the lower detection limit in 17 patients. Twenty-one of the referred patients fulfilled the criteria for a diagnosis of POTS (60%, 95%CI 43-77%). All patients had orthostatic intolerance, 94% nausea, 82% chronic headache, 82% fatigue, 77% cognitive dysfunction, 72% segmental dystonia, 68% neuropathic pain.

CONCLUSIONS

In a population referred for symptoms of orthostatic intolerance and other symptoms consistent with autonomic dysfunction that began in close temporal association with a quadrivalent HPV vaccination, we identified a 60% prevalence of POTS. Further work is urgently needed to elucidate the potential for a causal link between the vaccine and circulatory abnormalities and to establish targeted treatment options for the affected patients.

Cardiovascular risk: gender differences in lifestyle behaviors and coping strategies

BACKGROUND

Although cardiovascular disease (CVD) does not occur until mid to late life for most adults, the presence of risk factors, such as high blood pressure (BP) and cholesterol, has increased dramatically in young adults.

PURPOSE

The present study examined the relationships between gender and coping strategies, lifestyle behaviors, and cardiovascular risks.

METHOD

The sample consisted of 297 (71% female) university students. Participants completed a survey to assess demographics, lifestyle behaviors, and coping strategies, and a physiological assessment including lipid and blood pressure (BP) measurements. Data collection occurred from January 2007 to May 2008.

RESULTS

Analyses revealed that age, ethnicity, greater body mass index (BMI), greater use of social support, and less frequent exercise were associated with higher cholesterol, while gender, age, greater BMI, and less frequent exercise were associated with higher systolic BP. There were two significant interactions: one between gender and avoidant coping and the other between gender and exercise on systolic BP, such that for men greater use of avoidant coping or exercise was associated with lower systolic BP.

CONCLUSION

Understanding how young adults manage their demands and cope with stress sets the stage for understanding the developmental process of CVD. Both coping strategies and lifestyle behaviors must be considered in appraising gender-related cardiovascular risk at an early age before the disease process has begun.

Three consecutive days of interval runs to exhaustion affects lymphocyte subset apoptosis and migration

This investigation assessed the lymphocyte subset response to three days of intermittent run exercise to exhaustion. Twelve healthy college-aged males (n = 8) and females (n = 4) (age = 26 ± 4 years; height = 170.2 ± 10 cm; body mass = 75 ± 18 kg) completed an exertion test (maximal running speed and VO_2max) and later performed three consecutive days of an intermittent run protocol to exhaustion (30 sec at maximal running speed and 30 sec at half of the maximal running speed). Blood was collected before exercise (PRE) and immediately following the treadmill bout (POST) each day. When the absolute change from baseline was evaluated (i. e., Δ baseline), a significant change in CD4+ and CD8+ for CX3CR1 cells was observed by completion of the third day. Significant changes in both apoptosis and migration were observed following two consecutive days in CD19+ lymphocytes, and the influence of apoptosis persisted following the third day. Given these lymphocyte responses, it is recommended that a rest day be incorporated following two consecutive days of a high-intensity intermittent run program to minimize immune cell modulations and reduce potential susceptibility.

Repeated high-intensity Wingate cycle bouts influence markers of lymphocyte migration but not apoptosis

Studies have shown significant changes in lymphocytes during continuous exercise, but little has been shown on the effect of repeated high intensity bouts. This study was designed to examine the effect of repeated intermittent bouts on lymphocyte subset cell count, apoptosis, and migration. A series of 6 Wingate anaerobic cycle tests were performed by participants (N = 8) with blood samples attained before, immediately following, and after a designated recovery period (excess postexercise oxygen consumption (EPOC)) to observe lymphocyte changes. Lymphocyte subsets (CD4+, CD4/CD45RA+, CD8+, CD8+/CD45RA+, CD19+) were assessed for apoptosis (annexin V+) and cellular migration (CX(3)CR1). Our results indicate that the CD8+ and CD8+/CD45RA+ subsets were significantly influenced by the repetitive Wingate cycling protocol such that cell counts increased with exercise, and then decreased at EPOC termination (p = 0.016). The observed postexercise decrease in CD8+ and CD8+/CD45RA+ cells was accompanied by a significant change in the CX(3)CR1 cell migration receptor (p = 0.019), but not apoptosis (p = 0.87). This indicates that with repetitive high-intensity cycling, the response in CD8+ cells following the bout is likely due to cell migration rather than cell death.

Neuroendocrine-immune interactions and responses to exercise

This article reviews the interaction between the neuroendocrine and immune systems in response to exercise stress, considering gender differences. The body's response to exercise stress is a system-wide effort coordinated by the integration between the immune and the neuroendocrine systems. Although considered distinct systems, increasing evidence supports the close communication between them. Like any stressor, the body's response to exercise triggers a systematic series of neuroendocrine and immune events directed at bringing the system back to a state of homeostasis. Physical exercise presents a unique physiological stress where the neuroendocrine and immune systems contribute to accommodating the increase in physiological demands. These systems of the body also adapt to chronic overload, or exercise training. Such adaptations alleviate the magnitude of subsequent stress or minimize the exercise challenge to within homeostatic limits. This adaptive capacity of collaborating systems resembles the acquired, or adaptive, branch of the immune system, characterized by the memory capacity of the cells involved. Specific to the adaptive immune response, once a specific antigen is encountered, memory cells, or lymphocytes, mount a response that reduces the magnitude of the immune response to subsequent encounters of the same stress. In each case, the endocrine response to physical exercise and the adaptive branch of the immune system share the ability to adapt to a stressful encounter. Moreover, each of these systemic responses to stress is influenced by gender. In both the neuroendocrine responses to exercise and the adaptive (B lymphocyte) immune response, gender differences have been attributed to the 'protective' effects of estrogens. Thus, this review will create a paradigm to explain the neuroendocrine communication with leukocytes during exercise by reviewing (i) endocrine and immune interactions; (ii) endocrine and immune systems response to physiological stress; and (iii) gender differences (and the role of estrogen) in both endocrine response to physiological stress and adaptive immune response.

Cognitive awareness of carbohydrate intake does not alter exercise-induced lymphocyte apoptosis

OBJECTIVE

The purpose of this investigation was to determine whether cognitive awareness of carbohydrate beverage consumption affects exercise-induced lymphocyte apoptosis, independent of actual carbohydrate intake.

INTRODUCTION

Carbohydrate supplementation during aerobic exercise generally protects against the immunosuppressive effects of exercise. It is not currently known whether carbohydrate consumption or simply the knowledge of carbohydrate consumption also has that effect.

METHODS

Endurance trained male and female (N = 10) athletes were randomly assigned to one of two groups based on either a correct or incorrect cognitive awareness of carbohydrate intake. In the incorrect group, the subjects were informed that they were receiving the carbohydrate beverage but actually received the placebo beverage. Participants completed a 60-min ride on a cycle ergometer at 80% VO₂peak under carbohydrate and placebo supplemented conditions. Venous blood samples were collected at rest and immediately after exercise and were used to determine the plasma glucose concentration, lymphocyte count, and extent of lymphocyte apoptosis. Cognitive awareness, either correct or incorrect, did not have an effect on any of the measured variables.

RESULTS

Carbohydrate supplementation during exercise did not have an effect on lymphocyte count or apoptotic index. Independent of drink type, exercise resulted in significant lymphocytosis and lymphocyte apoptosis (apoptotic index at rest = 6.3 ± 3% and apoptotic index following exercise = 11.6 ± 3%, P < 0.01).

CONCLUSION

Neither carbohydrate nor placebo supplementation altered the typical lymphocyte apoptotic response following exercise. While carbohydrate supplementation generally has an immune-boosting effect during exercise, it appears that this influence does not extend to the mechanisms that govern exercise-induced lymphocyte cell death.

Exercise-induced immune cell apoptosis: image-based model for morphological assessment

Methods of assessing exercise-induced lymphocyte apoptosis have produced varying results. While morphological methods generally yield a significantly greater apoptotic index compared to those employing biochemical markers, benefits and limitations are associated with each methodology. Of interest in this report is the limitation of subjectivity associated with the morphological technique. To overcome the lack of objectivity associated with the morphological method, we describe an image-based approach by which computer software assesses the characteristics associated with lymphocyte apoptosis. A stochastic controlled deformable model can be employed to detect the classic morphological apoptotic changes induced by exercise, including membrane blebbing and the formation of apoptotic bodies. We propose that an objective evaluation of multiple points in the apoptotic process through the proposed model in conjunction with current biomarker methods has the potential to advance our understanding of the exercise-induced immune cell death response to a greater degree than current methods.

Exercise-induced lymphocyte apoptosis attributable to cycle ergometer exercise in endurance-trained individuals

Exercise as a stimulus to induce lymphocyte apoptosis remains controversial. Differences may be due to participant fitness level or the methodology of assessing cell death. Another important issue is the mode of exercise used to induce physiological changes. Treadmill exercise typically induces significant apoptosis in human lymphocytes; however, the effect of cycle exercise is less clear. The 2 main purposes of this study were to assess if cycle ergometer exercise induces similar changes in apoptosis, and to further characterize the morphological method of assessing cell death. Endurance athletes (n = 10; peak oxygen consumption = 55.1 mL.kg-1.min-1) completed a 60-min ride on a cycle ergometer at approximately 80% peak oxygen consumption. Blood samples taken before (PRE) and after (POST) exercise were used to make blood films for apoptotic analysis via the morphological technique. A significant increase was observed in the apoptotic index following cycle exercise (PRE = 7.3 +/- 2%, POST = 12.9 +/- 2%; p < 0.01). On average, it took 42 +/- 9 min to read PRE sample slides, which was significantly longer than the 27 +/- 4 min needed for POST slides (p < 0.01). To our knowledge, this study is the first to report that exercise on the cycle ergometer produces changes in lymphocyte apoptosis. The values measured during this study were about 20% lower than those we have observed following treadmill running, which may be explained by differences in active muscle mass and the resultant physiological stress between the 2 exercise modes. It is likely that cycling may result in reduced immunosuppression, compared with running at the same intensity.

Normalisation of immune cell imbalance after pharmacological treatments of patients suffering from obsessive-compulsive disorder

Recent data have shown the presence of immunological alterations in adult patients suffering from obsessive-compulsive disorder (OCD). The objective of this study was to examine the possible effects of 12 months of treatment with different serotonergic drugs, such as clomipramine and selective serotonin reuptake inhibitors (SSRIs) on peripheral immunological cells of 18 OCD patients. Both the absolute number and percent of CD4+, CD8+, CD3+, CD19+ and CD56+ cells were measured in peripheral blood before and after treatment by means of a Facstar Flow Sorter apparatus. At baseline, all patients showed a significant increase of CD8+ and decrease of CD4+ lymphocytes when compared with a similar group of healthy control subjects; after the treatment, CD8+ and CD4+ cells, respectively, decreased and increased significantly, and the CD4+/CD8+ ratio increased, when compared with baseline values, in parallel with the clinical improvement. These data suggest that the alterations of immune cells reported in patients with OCD at baseline may be reverted by treatment with SRIs and should be considered a state-dependent marker, perhaps related to a condition of stress.