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Carneiro A, Viana-Gomes D, Macedo-da-Silva J, Lima GHO, Mitri S, Alves SR, Kolliari-Turner A, Zanoteli E, Neto FRDA, Palmisano G, Pesquero JB, Moreira JC, Pereira MD. Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis. Neuromuscul Disord 2021; 31:583-595. [PMID: 34193371 DOI: 10.1016/j.nmd.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
Exertional rhabdomyolysis may occur when an individual is subjected to strenuous physical exercise. It is occasionally associated with myoglobinuria (i.e. "cola-colored" urine) alongside muscle pain and weakness. The pathophysiology of exertional rhabdomyolysis involves striated muscle damage and the release of cellular components into extracellular fluid and bloodstream. This can cause acute renal failure, electrolyte abnormalities, arrhythmias and potentially death. Exertional rhabdomyolysis is observed in high-performance athletes who are subjected to intense, repetitive and/or prolonged exercise but is also observed in untrained individuals and highly trained or elite groups of military personnel. Several risk factors have been reported to increase the likelihood of the condition in athletes, including: viral infection, drug and alcohol abuse, exercise in intensely hot and humid environments, genetic polymorphisms (e.g. sickle cell trait and McArdle disease) and epigenetic modifications. This article reviews several of these risk factors and proposes screening protocols to identify individual susceptibility to exertional rhabdomyolysis as well as the relevance of proteomics for the evaluation of potential biomarkers of muscle damage.
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Affiliation(s)
- Andréia Carneiro
- Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Brazil; Departamento de Química, Diretoria de Sistemas de Armas da Marinha, Marinha do Brazil, Brazil; Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil.
| | - Diego Viana-Gomes
- Departamento de Corridas, Universidade Federal do Rio de Janeiro, Escola de Educação Física, Brazil
| | - Janaina Macedo-da-Silva
- Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil
| | - Giscard Humberto Oliveira Lima
- Departamento de Biofísica, Universidade Federal de São Paulo, Brazil; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | - Simone Mitri
- Centro de Ecologia Humana e Saúde do Trabalhador, Fundação Oswaldo Cruz, Brazil
| | | | | | - Edmar Zanoteli
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | | | - Giuseppe Palmisano
- Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil
| | - João Bosco Pesquero
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | | | - Marcos Dias Pereira
- Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Brazil.
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Rocha AWDO, Nascimento WMD, Oliveira CMDC, Pereira Neto JM, Nascimento OVD, Santos JOLD, Viera ÉP, Brunetta HS, Pontes IDM, Astolfi Filho S. FREQUENCY OF GENE ACE I POLYMORPHISM I-D IN ATHLETES OF DIFFERENT SPORTS. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202602218862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: The angiotensin-converting enzyme I-D (ACE) polymorphism gene is one of the most widely investigated genetic variations in sports science. Apparently, allele I is related to endurance sports, while allele D is related to power-strength activities. Nevertheless, studies have presented controversial results when it comes as to its occurrence in a variety of sports. Objective: This study aims to evaluate the frequency of gene ACE polymorphism I-D in professional athletes of collective or individual sports. Methods: Five mL blood were collected from 189 subjects divided into two groups: athletes (AG, n=127, wrestling, taekwondo, soccer, futsal and handball) and non-athletes (NAG, n=62). The athletes group was subdivided by group modalities, into: collective and individual. Both groups were further subdivided into male and female. Thus, we have the groups FAC= collective female, FAI= individual female, MAC= collective male, and MAI= individual male. The statistical analysis was carried out by frequency test, and the Hardy- Weinberg equilibrium by the x² test. Results: The results for the AG group indicated the following frequencies: DD=7%, ID=44% and II=49%. Allele frequency: D=29% and I=71%. For the NAG, the results were: DD=6.5%, ID=45.2% and II=48%. Allele frequency: D=29% and I=71%. The AG genotypic and allele frequencies did not differ statistically from those of the NAG (p= 0.982 and p= 0.984, respectively). However, we noticed that the genotypes II and ID frequencies were significantly higher than those of the DD. Conclusion: It can be concluded that the genotypic and allelic I-D frequencies of the ACE gene do not seem to influence performance in either group or individual sports. ACTN3 genotype frequencies did not vary significantly between male and female control subjects, and overall, there was no significant deviation from Hardy-Weinberg (H-W) equilibrium. Level of evidence I; Diagnostic studies–Investigating diagnostic test.
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