Immunological changes in response to exercise: influence of age, puberty, and gender

Acute Effects of Kickboxing K1 Matches on Hematological Parameters of Kickboxers

While there is clear evidence in the literature that the hematological parameters in athletes of different sports are affected by exercise and varying loads, to our knowledge, there are limited studies on the real impact of kickboxing matches on kickboxers' hematological parameters. In this context, this cross-sectional study was conducted to examine the acute changes in the hematological parameters of kickboxers following K1 matches. With the participation of 10 kickboxing K1 athletes, the hematological parameters, including the WBC, Plt, Neut, Lymph, Mono, RBC, Hgb, Hct, CK, La, and glucose levels, were examined before and after matches. Paired sample t-tests were used to compare the pre-test and post-test hematological parameters of the participants. The findings indicated statistically significant differences in the post-match WBC, Plt, Neut, Lymph, CK, La, and glucose levels, while no statistically significant differences were observed in the RBC, Hct, Hgb, and CK levels (p < 0.05). These results not only emphasize the complexity of physiological changes in athletes, but also show consistency with various findings in the literature, while contradicting some. Therefore, it is highlighted that further research is needed to understand the effects of K1 matches on hematological parameters.

Effect of 2 weeks rest-pause on oxidative stress and inflammation in female basketball players

Intense exercise leads to increased production of free radicals, resulting in an inflammatory response in athletes. For this reason, it was decided to investigate whether a single intensive exercise until exhaustion applied after a 2-week rest period would result in a violation of the pro-oxidant-antioxidant balance. Twenty-seven trained female basketball players (age: 16.55 ± 0.96 years, body mass: 66.40 ± 13.68 kg, height: 173.45 ± 5.14 cm) were enrolled to the study following the application of inclusion and exclusion criteria. Study was conducted at the end of the competitive training phase. Participants underwent incremental treadmill exercise, with blood samples collected before the test, immediately post-exercise, and after a 3-h restitution period. Total antioxidant capacity (TAC) levels increased significantly after exercise and remained unchanged after 3 h. Concentration of interleukin-10 (IL-10) and creatine kinase (CK) significantly increased after exercise and then decreased. Concentration of interleukin-2 (IL-2) was significantly reduced immediately and 3 h after exercise, while interleukin-13 (IL-13), interleukin-1α (IL-1α), and tryptophan (TRP) decreased 3 h after exercise. No significant changes were observed in other biochemical parameters. Obtained results show an increased antioxidant capacity which reduced oxidative stress and inflammation in response to intense exercise indicating that rested athletes have a high adaptation and elevated tolerance to effort.

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

CONTEXT

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

EVIDENCE ACQUISITION

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

STUDY DESIGN

Narrative review.

LEVEL OF EVIDENCE

Level 5.

RESULTS

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

CONCLUSION

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

STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT)

Evidence B level 3.

Systemic inflammatory proteins in offspring following maternal probiotic supplementation for atopic dermatitis prevention

BACKGROUND

Maternal probiotic supplementation has a promising effect on atopic dermatitis (AD) prevention in infancy. In the randomised controlled study, Probiotics in the Prevention of Allergy among Children in Trondheim (ProPACT), maternal probiotics reduced the cumulative incidence of AD in their offspring by 40% at 2 years of age. However, our understanding on how probiotics prevented AD is still limited, and the role of inflammatory proteins in infants following maternal probiotic supplementation is unclear. We hypothesised that maternal probiotics lowered pro-inflammatory proteins and increased anti-inflammatory proteins in their 2-year-old children as a mechanism of AD prevention. We aimed to explore this hypothesis and the association between these proteins and the presence of AD, severity of AD, and the degree of preventive effect of probiotics.

METHODS

Plasma samples were collected from 2-year-old children (n = 202) during the ProPACT study, a randomised placebo-controlled trial of maternal probiotic supplementation. These samples were analysed for 92 inflammatory proteins using a multiplex proximity extension assay. Associations between inflammatory proteins and the presence and severity of AD, and the degree of preventive effect, was estimated individually using regression analysis and then collectively using unsupervised cluster analysis.

RESULTS

Several proteins were observed to differ between the groups. The probiotic group had lower CCL11 and IL-17C, while children with AD had higher IL-17C, MCP-4, uPA, and CD6. Cytokine CCL20 and IL-18 had moderate correlation (r = 0.35 and r = 0.46) with the severity of AD. The cluster analysis revealed that children in the cluster of samples with the highest value of immune checkpoint receptors and inflammatory suppressor enzymes showed the greatest AD preventive effect from probiotics.

CONCLUSIONS

The proteins associated with both maternal probiotic supplementation and the presence and severity of AD warrant attention because of their potential biological relevance. Cluster analysis may provide a new insight when considering which subgroups benefit from probiotic supplementation. Larger studies are needed to confirm the results.

TRIAL REGISTRATION NUMBER

The study was retrospectively registered at ClinicalTrials.gov (NCT00159523) on 12nd September 2005.

A Single Bout of Fatiguing Aerobic Exercise Induces Similar Pronounced Immunological Responses in Both Sexes

Introduction: Physical exercise can acutely and chronically modulate immunological responses. Women and men have different innate and adaptive immune responses, and in this sense, these two groups may also have different acute immunological responses induced by exercise. In addition, it is essential to understand further whether the effects of physical exercise on the immune system responses depend on sex because limited scientific evidence on this topic is available. This information may allow athletes and coaches to improve the training process, mainly to understand if the physiological impact of given training stimuli in women is similar to that in men.

Objective: The present study aimed to investigate the acute effects of continuous submaximal exercise until fatigue on physiological and immunological parameters in amateur female and male runners.

Methods: This study included 18 female and 15 male volunteers. Each participant visited the laboratory on four consecutive days. The first visit consisted of medical history taking and explaining the study design. On the second visit, the participants were subjected to an incremental test to determine their maximal rate of oxygen consumption (VO_2max) that was required to prescribe the intensity of the submaximal exercise protocol. On the third visit, the fatiguing exercise protocol was performed at 77%–80% of the VO_2max. During this submaximal exercise, the heart rate, rating of perceived exertion (RPE), and blood lactate were recorded. Blood samples were collected before, immediately after, and 1 h after the fatiguing protocol to analyze the plasma levels of cytokines and creatine kinase (CK) and to count leukocytes. Finally, on the fourth visit, the participants underwent physical evaluations to measure their body composition using dual-energy X-ray absorptiometry (DXA) imaging.

Results: The average ages of the female and male groups were 34.2 ± 3.7 and 30.5 ± 4.3 years old, respectively. The female group ran 57 ± 27 min, while the male group ran 52 ± 15 min before fatiguing. In the female group, when comparing before and after the submaximal exercise, marked increases were observed in the following variables: heart rate (from 68.5 to 180.4 bpm), RPE (from 3.6 to 8.2), lactate (from 2.1 to 4.49 mmol/L), and CK (from 89.5 to 126.3 U/L). In addition, the female group showed an increased number of total leukocytes (from 7222.3 to 11162.9 × 10⁶/μl), neutrophils (from 4,403 to 6,480 × 10⁶/μl), and lymphocytes (from 2,342 ± to 3,562 × 10⁶/μl) from pre- to post-submaximal exercise. In the male group, similar elevations in psychophysiological variables were observed, as evidenced by comparing the heart rate (from 52.8 to 184.1 bpm), RPE (from 0.0 to 8.9), lactate (from 2.7 to 7.2 mmol/L), and CK (from 106.2 to 165 U/L) before and after the submaximal exercise. The male group also showed an augmented number of total leukocytes (from 6,245 to 8,050 × 10⁶/μl), neutrophils (from 3,335 to 4,128 × 10⁶/), and lymphocytes (from 2,191 to 3,212 × 10⁶/μl) when comparing pre- and post-submaximal exercise. There were no differences in the changes between women and men for these parameters.

Conclusion: The aerobically fatiguing exercise protocol induced pronounced changes in the heart rate, plasma levels of lactate and CK, total leukocyte count, especially the number of neutrophils and lymphocytes, in both sexes. The fatiguing exercise protocol also changed the plasma levels of IL-6 and IL-10 in the female and male groups. Under the present conditions, the physiological changes induced by fatiguing submaximal exercise, including the immunological changes, were not influenced by sex. This study shows that the same aerobic physical exercise can alter immunological parameters in women and men, and this response is similar between sexes.

Lipid profile and C-reactive protein changes to elastic-band resistance training in young healthy men

Resistance bands are a device for resistance training routine or rehabilitation program and come in various sizes, lengths, and strengths. The purpose of this study was to investigate the effect of elastic resistance training (ERT) on lipid profiles and C-reactive protein (CRP) changes in young and healthy men. Twenty untrained young and healthy men voluntarily participated in the study and were randomly assigned to the ERT (n=10) and control group (n=10). The ERT group performed three non-consecutive sessions per week for eight weeks. Blood was sampled before training and this was repeated after 72 h of the interval of the last session of ERT. The concentration of CRP and lipid profiles, including changes of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC), were measured. Also, changes in body fat percentage (BF%) were measured. It was observed that CRP was not significantly affected by ERT (P>0.05). Also, TC and TG did not change significantly due to ERT (P>0.05). However, ERT increased the HDL-C concentration (P=0.001) and significantly decreased LDL-C (P=0.033). It is concluded that although the elastic resistance training failed to improve CRP; however, with a positive impact on some of the lipid profiles and health indices, it can be a useful, simple and low-cost exercise training in health promotion.

Electrochemical sensing: A prognostic tool in the fight against COVID-19

The COVID-19 pandemic has devastated the world, despite all efforts in infection control and treatment/vaccine development. Hospitals are currently overcrowded, with health statuses of patients often being hard to gauge. Therefore, methods for determining infection severity need to be developed so that high-risk patients can be prioritized, resources can be efficiently distributed, and fatalities can be prevented. Electrochemical prognostic biosensing of various biomarkers may hold promise in solving these problems as they are low-cost and provide timely results. Therefore, we have reviewed the literature and extracted the most promising biomarkers along with their most favourable electrochemical sensors. The biomarkers discussed in this paper are C-reactive protein (CRP), interleukins (ILs), tumour necrosis factor alpha (TNFα), interferons (IFNs), glutamate, breath pH, lymphocytes, platelets, neutrophils and D-dimer. Metabolic syndrome is also discussed as comorbidity for COVID-19 patients, as it increases infection severity and raises chances of becoming infected. Cannabinoids, especially cannabidiol (CBD), are discussed as a potential adjunct therapy for COVID-19 as their medicinal properties may be desirable in minimizing the neurodegenerative or severe inflammatory damage caused by severe COVID-19 infection. Currently, hospitals are struggling to provide adequate care; thus, point-of-care electrochemical sensor development needs to be prioritized to provide an approximate prognosis for hospital patients. During and following the immediate aftermath of the pandemic, electrochemical sensors can also be integrated into wearable and portable devices to help patients monitor recovery while returning to their daily lives. Beyond the COVID-19 pandemic, these sensors will also prove useful for monitoring inflammation-based diseases such as cancer and cardiovascular disease.

The role of BMI on cognition following acute physical activity in preadolescent children

BACKGROUND

There is an increasing prevalence of physical inactivity during childhood, concurrent with a rise in obesity rates, which is associated with a variety of health problems. However, the extent to which increased body mass index (BMI) influences acute physical activity (PA) benefits on cognition in childhood remains unknown. The aim of this study was to examine whether BMI influences the effects of acute PA on inhibitory control task performance.

METHODS

In a sample of 116 children pooled from four prior studies (ages 8-11; 51 females), demographic measures of age, sex, IQ, socioeconomic status, and aerobic fitness were considered along with BMI. Children participated in a counterbalanced, randomized crossover study, whereby they completed two different interventions; 20 minutes of treadmill walking (60-70% heart rate max) and restful reading (non-exercise control). Following each intervention, children performed a modified flanker task that manipulates inhibitory control demands. Correlations were conducted to determine the influence of demographic variables, fitness, and BMI on inhibitory control following each intervention. Subsequent hierarchical regression analyses were performed with significant demographic factors in the first step, aerobic fitness in the second step when significant, and BMI in the final step.

RESULTS

Analyses indicated that children exhibited improved task performance (p's ≤ 0.001) and decreased interference (p = 0.04) following the walking intervention compared to the restful reading control condition, indicating greater benefits following acute PA across task condition, with selectively greater benefits for the task condition requiring greater inhibitory control. Regression analyses revealed that greater BMI was related to decreased performance following acute PA (p = 0.001); an association not observed following restful reading (p's ≥ 0.11). These results suggest that BMI negatively influences the effect of acute exercise on performance.

CONCLUSION

Confirming previous studies, these findings indicate beneficial effects of acute PA on a flanker task that modulates inhibitory control requirements, but the effects are significantly greater for task conditions requiring greater amounts of inhibitory control. Further, these beneficial effects of PA appear to be blunted in children with higher BMI. These findings suggest that the acute benefits of PA on cognition may not be fully realized in children with higher BMI.

Expert's Choice: 2018's Most Exciting Research in the Field of Pediatric Exercise Science

This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.

Cytokine, glycemic, and insulinemic responses to an acute bout of games-based activity in adolescents

An acute bout of endurance exercise in adults stimulates a same‐day anti‐inflammatory response which may affect low‐grade chronic inflammation and insulin resistance and benefit cardio‐metabolic health. The anti‐inflammatory responses to intermittent games‐based exercise and to exercise in young people beyond 2 hours post‐exercise are unknown. Thus, the purpose of the present study is to examine the anti‐inflammatory, glycemic and insulinemic response to games‐based activity in adolescents. Following ethical approval and familiarization, 39 adolescents (12.3 ± 0.7 years) completed an exercise (E) and rested (R) trial in a counterbalanced, randomized crossover design. Following a standardized breakfast, participants completed 1‐hour games‐based activity. Capillary blood samples were taken at baseline, immediately and 1 hour post‐exercise, and 30, 60 and 120 minutes following a standardized lunch. A final blood sample was taken the next morning. Data were analyzed using repeated measures ANOVA. IL‐6 concentration was higher on day one of the exercise trial (E:3.4 ± 0.4, R:2.7 ± 0.4 pg/mL; P = 0.006), as was the anti‐inflammatory IL‐6:TNF‐α ratio (E:5.53 ± 0.93, R:3.75 ± 0.45; P = 0.027). Levels of the anti‐inflammatory cytokine IL‐10 increased on day two of the exercise trial (E:2.11 ± 0.23, R:1.66 ± 0.16 pg/mL; P = 0.032). Insulin sensitivity was enhanced on the exercise trial with a reduction in iAUC following the standardized lunch (E:2310 ± 834, R:3122 ± 1443 mU/L × 120 minutes; P < 0.001). Games‐based activity stimulated an anti‐inflammatory response up to 24 hours post‐exercise and improved insulin sensitivity in response to a standardized meal in healthy adolescents. These novel findings suggest that games‐based activity is an ecologically valid mode of exercise to elicit beneficial effects on cardio‐metabolic risk factors in young people.

Immunological Modulation in Long-Term Karate Practitioners

Karate is a Japanese martial arts system with potential physical and psychological benefits. However, karate has been scarcely investigated from a psychobiological perspective, and its effects on the immune system remain virtually unknown. We designed the present study with the aim of analyzing the effects of karate practice on immunological parameters. 27 healthy male volunteer subjects participated in the study, 15 in the experimental group and 12 in the control. Experimental subjects were all karate players who had practiced this martial art for a minimum of three years attending regular lessons at a karate training center, in the evening, two to three days per week. Blood samples for the quantification of immunological parameters (total leukocytes, neutrophils, monocytes, eosinophils, basophils, lymphocytes, IgG, IgA, and IgM) were taken in both groups. A t-test for independent groups was performed in each dependent variable; a value of p<0.05 was considered to be significant. Karate practitioners exhibited a significantly higher number of total leukocytes (p<0.02), monocytes (p<0.01), and lymphocytes (p<0.01), a higher percentage of monocytes (p<0.01), and greater serum concentrations of IgG (p<0.02) and IgM (p<0.01). Our findings show that long-term karate practice is related to a broad modulation of immune parameters, including total and specific leukocyte counts, as well as immunoglobulin concentrations. This peculiar immunomodulatory profile, apart from its psychobiological relevance, may have noteworthy clinical implications.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Timing and pattern of postexercise protein ingestion affects whole-body protein balance in healthy children: a randomized trial

The dose and timing of postexercise protein ingestion can influence whole-body protein balance (WBPB) in adults, although comparable data from children are scarce. This study investigated how protein intake (both amount and distribution) postexercise can affect WBPB in physically active children. Thirty-five children (26 males; 9-13 years old) underwent a 5-day adaptation diet, maintaining a protein intake of 0.95 g·kg^-1·day^-1. Participants consumed [¹⁵N]glycine (2 mg·kg^-1) before performing 3 × 20 min of variable-intensity cycling, and whole-body protein kinetics were assessed over 6 and 24 h of recovery. Fifteen grams of protein was distributed across 2 isoenergetic carbohydrate-containing beverages (15 and 240 min postexercise) containing reciprocal amounts of protein (i.e., 0 + 15 g, 5 + 10 g, 10 + 5 g, and 15 + 0 g for Groups A-D, respectively). Over the 6 h that included the exercise bout and consumption of the first beverage at 15 min postexercise, WBPB (i.e., synthesis - breakdown) demonstrated a linear increase of 0.647 g·kg^-1·day^-1 per 1 g protein intake (P < 0.001). Over 24 h, robust regression revealed that WBPB was best modeled by a parabola (P < 0.05), suggesting that a maximum in WBPB was achieved between groups B and C. In conclusion, despite a dose response early in recovery, a periodized protein intake with multiple smaller doses after physical activity may be more beneficial than a single bolus dose in promoting daily WBPB in healthy active children.

Influence of Age and Other Factors on Cytokine Expression Profiles in Healthy Children-A Systematic Review

Cytokines have attracted much attention as diagnostic biomarkers for infectious and inflammatory diseases in recent years. However, understanding of maturation and normal age-associated values is limited. This review summarizes evidence on the influence of age and other factors on expression profiles of soluble and intracellular cytokines in healthy children. IFN-γ, IL-6, IL-10, and TNF-α are the most frequently investigated cytokines, of which an age-associated increase was shown consistently for IFN-γ and TNF-α. An age-associated decrease of IL-13 was seen in resource-limited settings. For other cytokines, including IL-1RA, IL-2, and IL-10, uni- or bimodal curves have been described, and results were influenced by study setting. To conclude, despite limited current understanding of the development of cytokine expression, age clearly influences expression profiles in healthy children. Dynamics of cytokine expression in childhood need to be considered when these are measured in diagnostic assays or as biomarkers. In addition, cytokine-targeting agents may require adjustment for normal values when used in children.

Exercise and Immune Function in Children

Exercise immunology is one of the fastest growing disciplines of the past 2 decades. Unfortunately, the number of investigations devoted to the pediatric population remains low, and our understanding of the interaction between acute and chronic exercise and the immune system in youth is relatively deficient. In general, healthy children experience smaller overall perturbations to the immune system in response to an acute bout of exercise as compared with adults, and they demonstrate a faster recovery of the immune system following exercise. There is only limited evidence to suggest that moderate to high levels of habitual physical activity are associated with a reduction in the incidence of infection and illness in youth. Special consideration should be made for the young athlete training and competing during an illness or infection. Some of the unique exercise responses of the immune system in children may have important clinical relevance, but much more work is required in this area.

Immune cell changes in response to a swimming training session during a 24-h recovery period

Understanding the impact of training sessions on the immune response is crucial for the adequate periodization of training, to prevent both a negative influence on health and a performance impairment of the athlete. This study evaluated acute systemic immune cell changes in response to an actual swimming session, during a 24-h recovery period, controlling for sex, menstrual cycle phases, maturity, and age group. Competitive swimmers (30 females, 15 ± 1.3 years old; and 35 males, 16.5 ± 2.1 years old) performed a high-intensity training session. Blood samples were collected before, immediately after, 2 h after, and 24 h after exercise. Standard procedures for the assessment of leukogram by automated counting (Coulter LH 750, Beckman) and lymphocytes subsets by flow cytometry (FACS Calibur BD, Biosciences) were used. Subjects were grouped according to competitive age groups and pubertal Tanner stages. Menstrual cycle phase was monitored. The training session induced neutrophilia, lymphopenia, and a low eosinophil count, lasting for at least 2 h, independent of sex and maturity. At 24 h postexercise, the acquired immunity of juniors (15-17 years old), expressed by total lymphocytes and total T lymphocytes (CD3(+)), was not fully recovered. This should be accounted for when planning a weekly training program. The observed lymphopenia suggests a lower immune surveillance at the end of the session that may depress the immunity of athletes, highlighting the need for extra care when athletes are exposed to aggressive environmental agents such as swimming pools.

Cold applications for recovery in adolescent athletes: a systematic review and meta analysis

Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e.g. heats/finals). In recent years, a lot of emphasis has been put on recovery modalities. In particular, emphasis has been placed on the need to reduce the delayed onset of muscle soreness (DOMS) typically evident following training and competitive activities inducing a certain degree of muscle damage. One of the most used recovery modalities consists of cold-water immersion and/or ice/cold applications to muscles affected by DOMS. While the scientific literature has provided a rationale for such modalities to reduce pain in athletes and recreationally active adults, it is doubtful if this rationale is appropriate to aid training with adolescent athletes. In particular, since these methods have been suggested to potentially impair the muscle remodeling process leading to muscle hypertrophy. While this debate is still active in the literature, many coaches adopt such practices in youth populations, simply transferring what they see in elite sportspeople directly; without questioning the rationale, safety or effectiveness as well as the potential for such activity to reduce the adaptive potential of skeletal muscle remodeling in adolescent athletes. The aim of this review was to assess the current knowledge base on the use of ice/cold applications for recovery purposes in adolescent athletes in order to provide useful guidelines for sports scientists, medical practitioners, physiotherapists and coaches working with such populations as well as developing research questions for further research activities in this area. Based on the current evidence, it seems clear that evidence for acute benefits of such interventions are scarce and more work is needed to ascertain the physiological implications on a pre or peri-pubertal population.

Acute effects of high- and low-intensity exercise bouts on leukocyte counts

BACKGROUND/OBJECTIVE

It is widely accepted that physical exercise may bring about changes in the immune system. Even acute bouts of exercise can alter the number and function of leukocytes, but the degree of white blood cell trafficking depends on the intensity and duration of exercise. The aim of this study was to analyze the acute and short-term effects of exercise intensity on leukocyte counts and leukocyte subsets.

METHODS

Nine physically healthy, active young males (21.0 ± 1.9 years) underwent three experimental trials: high exercise intensity [80% peak oxygen consumption (VO2peak)], low exercise intensity (40% VO2peak), and the control condition (no exercise). Blood samples were collected prior to exercise, immediately after exercise, and 2 hours after exercise. Two-way analysis of variance for repeated measures was used to evaluate differences between the trials and the time-points, and to compare times within trials.

RESULTS

There was a greater increase in the leukocyte count after high-intensity exercise, compared to the control condition (p < 0.01) and low-intensity exercise (p < 0.01). This effect was still present 2 hours after passive recovery (p < 0.01).

CONCLUSION

When the same participants were submitted to different exercise intensities, the acute and short-term effects of exercise on white blood cells were intensity-dependent immediately after exercise (i.e., lymphocytosis and monocytosis) and 2 hours after passive recovery (i.e., neutrophilia).

Postexercise protein ingestion increases whole body net protein balance in healthy children

Postexercise protein ingestion increases whole body and muscle protein anabolism in adults. No study has specifically investigated the combined effects of exercise and protein ingestion on protein metabolism in healthy, physically active children. Under 24-h dietary control, 13 (seven males, six females) active children (∼ 11 yr old; 39.3 ± 5.9 kg) consumed an oral dose of [(15)N]glycine prior to performing a bout of exercise. Immediately after exercise, participants consumed isoenergetic mixed macronutrient beverages containing a variable amount of protein [0, 0.75, and 1.5 g/100 ml for control (CON), low protein (LP), and high protein (HP), respectively] according to fluid losses. Whole body nitrogen turnover (Q), protein synthesis (S), protein breakdown (B), and protein balance (WBPB) were measured throughout exercise and the early acute recovery period (9 h combined) as well as over 24 h. Postexercise protein intake from the beverage was ∼ 0.18 and ∼ 0.32 g/kg body mass for LP and HP, respectively. Q, S, and B were significantly greater (main effect time, all P < 0.001) over 9 h compared with 24 h with no differences between conditions. WBPB was also greater over 9 h compared with 24 h in all conditions (main effect time, P < 0.001). Over 9 h, WBPB was greater in HP (P < 0.05) than LP and CON with a trend (P = 0.075) toward LP being greater than CON. WBPB was positive over 9 h for all conditions but only over 24 h for HP. Postexercise protein ingestion acutely increases net protein balance in healthy children early in recovery in a dose-dependent manner with larger protein intakes (∼ 0.32 g/kg) required to sustain a net anabolic environment over an entire 24 h period.

Effects of exercise on leukocytosis and blood hemostasis in 800 healthy young females and males

AIM: To investigate the effects of exercise on healthy individuals of both genders.

METHODS: This study lasted 6 years and involved about 800 healthy people. Individuals were divided into females and males and further sub-divided into two groups; in the first group individuals run (or skied in the winter time) and then rested for 3 h, whereas individuals in the second group intensely cycled for 5 min. The status of health was determined by measuring the sedimentation rate and the intensity of exercises by measuring the heart rate. Blood samples were collected before and after exercise.

RESULTS: We observed that in the first group a significant increase of the total white blood cells, segmented neutrophils, band neutrophils, eosinophils and to a lesser extent lymphocytes but not monocytes in the blood circulation. However, all cell types were increased in the circulation after 5 min intense exercise. No differences in the pattern of cell increase were observed among the genders. Activated partial thromboplastin time (APTT) and D-dimer were also measured in the blood of individuals who cycled intensely for 5 min to determine the coagulation and fibrinolytic activities in the blood. APTT is reduced and D-dimer values significantly increased after intense exercise. However, APTT was statistically lower in males than females, whereas no differences in the D-dimer values were observed among the genders.

CONCLUSION: Our results indicate that exercise whether leisure or strenuous affects leukocytosis and hemostasis in both genders. A major advantage of this study is the high numbers of individuals involved and the inclusion of both females and males values.

Exercise-induced immunodepression in endurance athletes and nutritional intervention with carbohydrate, protein and fat-what is possible, what is not?

Heavily exercising endurance athletes experience extreme physiologic stress, which is associated with temporary immunodepression and higher risk of infection, particularly upper respiratory tract infections (URTI). The aim of this review is to provide a critical up-to-date review of existing evidence on the immunomodulatory potential of selected macronutrients and to evaluate their efficacy. The results of 66 placebo-controlled and/or crossover trials were compared and analysed. Among macronutrients, the most effective approach to maintain immune function in athletes is to consume ≥6% carbohydrate during prolonged exercise. Because inadequate nutrition affects almost all aspects of the immune system, a well-balanced diet is also important. Evidence of beneficial effects from other macronutrients is scarce and results are often inconsistent. Using a single nutrient may not be as effective as a mixture of several nutritional supplements. Due to limited research evidence, with the exception of carbohydrate, no explicit recommendations to reduce post-exercise URTI symptoms with single macronutrients can be derived.

Oxidative stress, inflammation, and muscle soreness in an 894-km relay trail run

We describe the effects of multi-day relay trail running on muscle soreness and damage, and systemic immune, inflammatory, and oxidative responses. 16 male and 4 female athletes ran 894 km in 47 stages over 95 h, with mean (SD) 6.4 (1.0) stages per athlete and 19.0 (1.7) km per stage. We observed post-pre run increases in serum creatine kinase (qualified effect size extremely large, p = 0.002), IL-6 (extremely large, p < 0.001), urinary 8-isoprostane/creatinine (extremely large, p = 0.04), TNF-α (large, p = 0.002), leukocyte count (very large, p < 0.0001) and neutrophil fraction (very large, p < 0.001); and reductions in hemoglobin (moderate, p < 0.001), hematocrit (moderate, p < 0.001), and lymphocyte fraction (trivial, p < 0.001). An increase in ORAC total antioxidant capacity (TAC, small, p = 0.3) and decrease in urinary 8-OHdG/creatinine (small, p = 0.1) were not statistically significant. During the run, muscle soreness was most frequent in the quadriceps. The threshold for muscle pain (pain-pressure algometry) in the vastus lateralis and gastrocnemius was lower post-run (small, p = 0.04 and 0.03). Average running speed was correlated with algometer pain and leukocyte count (large, r = 0.52), and TAC was correlated with IL-6 (very large, r = 0.76) and 8-isoprostane/creatinine (very large, r = -0.72). Multi-day stage-racing increases inflammation, lipid peroxidation, muscle damage and soreness without oxidative DNA damage. High TAC is associated with reduced exercise-induced lipid peroxidation, but is not related to immune response or muscle damage.

Altered inflammatory, oxidative, and metabolic responses to exercise in pediatric obesity and type 1 diabetes

Obesity (Ob) and type 1 diabetes (T1DM) are associated with increased inflammation and oxidative stress, which are major pathogenetic pathways toward higher cardiovascular risks. Although long-term exercise protects against systemic inflammation and oxidation, acute exercise actually exerts pro-inflammatory and oxidative effects, prompting the necessity for better defining these molecular processes in at-risk patients; in particular, very little is known regarding obese and T1DM children. We therefore examined key inflammatory and oxidative stress variables during exercise in 138 peripubertal children (47 Ob, 12.7 ± 0.4 yr, 22 F, BMI% 97.6 ± 0.2; 49 T1DM, 13.9 ± 0.2 yr, 20 F, body mass index% [BMI] 63.0 ± 3.6; 42 healthy, CL, 13.5 ± 0.5 yr, 24 F, BMI% 57.0 ± 3.6), who performed 10 bouts of 2-min cycling ~80% VO(2max) , separated by 1-min rest intervals. Blood samples were drawn at baseline and peak exercise. Ob displayed elevated baseline interleukin-6 (IL-6, 2.1 ± 0.2 pg/mL, p < 0.005) vs. CL (1.5 ± 0.3), whereas T1DM displayed the greatest maximum exercise-induced change in IL-6 (1.2 ± 0.3) than in both Ob (0.7 ± 0.1, p < 0.001) and CL (0.6 ± 0.1, p < 0.0167). Myeloperoxidase (MPO) was elevated in T1DM (143 ± 30 ng/mL, p < 0.0167) vs. CL (89 ± 10) and Ob (76 ± 6), whereas increases in exercise only occurred in Ob and CL. Disparate baseline and exercise responses were also observed for 8-hydroxy-2'-deoxyguanosine, glutathione, and F(2) -isoprostane. This data show distinct patterns of dysregulation in baseline and adaptive immunologic and oxidative responses to exercise in Ob and T1DM. A full understanding of these alterations is required so that developing exercise regimens aimed at maximizing health benefits for specific dysmetabolic states can be achieved based on complete scientific characterization rather than empirical implementation.

Effects of resistance training on the inflammatory response

Resistance training (RT) is associated with reduced risk of low grade inflammation related diseases, such as cardiovascular disease and type 2 diabetes. The majority of the data studying cytokines and exercise comes from endurance exercise. In contrast, evidence establishing a relationship between RT and inflammation is more limited. This review focuses on the cytokine responses both following an acute bout, and after chronic RT. In addition, the effect of RT on low grade systemic inflammation such as individuals at risk for type 2 diabetes is reviewed. Cytokines are secreted proteins that influence the survival, proliferation, and differentiation of immune cells and other organ systems. Cytokines function as intracellular signals and almost all cells in the body either secrete them or have cytokine receptors. Thus, understanding cytokine role in a specific physiological situation such as a bout of RT can be exceedingly complex. The overall effect of long term RT appears to ameliorate inflammation, but the specific effects on the inflammatory cytokine, tumor necrosis factor alpha are not clear, requiring further research. Furthermore, it is critical to differentiate between chronically and acute Interleukin-6 levels and its sources. The intensity of the RT and the characteristics of the training protocol may exert singular cytokine responses and as a result different adaptations to exercise. More research is needed in the area of RT in healthy populations, specifically sorting out gender and age RT acute responses. More importantly, studies are needed in obese individuals who are at high risk of developing low grade systemic inflammatory related diseases. Assuring adherence to the RT program is essential to get the benefits after overcoming the first acute RT responses. Hence RT could be an effective way to prevent, and delay low grade systemic inflammatory related diseases.

Relationship between stress hormones and immune response during high-altitude exposure in women

We previously confirmed that high altitude (HA) exposure can modify the number and function of immune cells, leading to a disruption in the homeostatic regulation of T helper1 (Th1)/T helper2 (Th2) immune responses. Our aim was to evaluate possible relationships between the stress response and immunological parameters during HA exposure. Thirteen healthy women spent 21 days at 5050 m. Before (SL1), the first and the 21st day at HA (HA1 and HA2, respectively), and the day after returning at sea level (SL2), we collected blood samples for immunologic parameters, and 24-h urine samples for norepinephrine, epinephrine, and cortisol. Norepinephrine and cortisol significantly increased (p<0.01) at HA1 and HA2 compared to SL1, while epinephrine did not change. At HA1, CD3+ T-cell fell significantly (p<0.001) with respect to SL1, owing to a significant (p<0.001) CD4+ T-cell reduction, while CD16+ and CD56+ increased (p<0.001) at HA2 compared to SL1. The expression of interferon-gamma (IFN-gamma) decreased (p<0.0005) at HA1 and HA2 with respect to SL1. At HA1 different lymphocyte subset (CD3+, CD4+, CD19+) were well correlated with epinephrine (p<0.05), whereas in analyzing the combined data (SL1-HA1-HA2-SL2), CD3+ (r=-0.310), CD4+ (r=-0.332), CD16+ (r=0.404), and CD56+ (r=0.373) demonstrated moderate but significant correlations (p<0.05) with norepinephrine. Moreover, norepinephrine levels were inversely correlated (r=-0.591; p<0.001) with IFN-gamma expression, a typical Th1 cytokine. We suggest that the sympatho-adrenal axis may have a role on the immunologic adaptations observed during HA exposure, and specifically on the observed impairment of the Th1/Th2 immune balance.

Relation between adiposity and disease risk factors in Mexican American children

OBJECTIVE

Excess adiposity is associated with systemic low-grade inflammation, which has been implicated in the pathophysiology of various diseases. The purpose of this study was to examine the relation between measures of adiposity and disease risk factors in Mexican American children participating in a weight loss intervention.

SUBJECTS AND METHODS

Boys and girls (N=170; 13.3+/-0.1 year) volunteered for additional testing from a larger study that demonstrated significant reduction in standardized body mass index. Insulin, C-reactive protein, soluble cluster of differentiation 14, glucose, and cholesterol profile were assessed.

RESULTS

Linear mixed models regression showed that changes in adiposity (standardized body mass index and triceps skinfold) were significantly related with changes in total cholesterol (P=0.01), triglycerides (P<0.001), C-reactive protein (P<0.001), insulin (P<0.001), Homeostasis model assessment of insulin resistance (P<0.001), and high-density lipoprotein (P<0.001).

CONCLUSIONS

The relation between measures of adiposity and disease risk factors was stable over time in children participating in an exercise/weight loss intervention. Also, our findings indicate that reducing adiposity results in an improvement of blood disease risk factors in Mexican American children.

Adjunctive use of lithium carbonate for the management of neutropenia in clozapine-treated children

OBJECTIVE

Clozapine, a dibenzodiazepine antipsychotic, is the most effective medication for treatment-resistant schizophrenia. However, its use has been limited by the high risk of neutropenia. In children, the rate of neutropenia is higher when compared to adults. We decided to explore the use of lithium to manage neutropenia in childhood-onset schizophrenia (COS) through a systematic audit of COS cases.

METHODS

Medical records were reviewed for patients with COS who had been treated with the combination of clozapine and lithium carbonate.

RESULTS

Seven patients were found to have been treated with both clozapine and lithium. After initiation of lithium, ANC increased significantly in six out of seven subjects by 29 to 106% with a mean of 66%. In addition, six out of seven subjects continued using both clozapine and lithium for over 2 years (range: 2.0-7.2 years) and do not have immediate plans for discontinuation of either medications.

CONCLUSIONS

Our study bolsters support for the use of lithium in the management of neutropenia in children treated with clozapine. Although the coadministration of lithium and clozapine appears effective in the management of neutropenia, it is not without its risks and clinicians must be diligent in their joint use of these medications.

Exercise leukocyte profiles in healthy, type 1 diabetic, overweight, and asthmatic children

Leukocytosis contributes to exercise-induced immune modulation, which is a mechanism of cardiovascular protection. However, this process is poorly defined in children. We therefore measured leukocytes in 45 healthy, 18 overweight, 16 type 1 diabetic, and 8 asthmatic children at pre, end-, and 30-min postexercise (30-min intermittent or 6-min continuous). In all groups, total leukocytes, neutrophils, lymphocytes, and monocytes increased at end-exercise, but returned to baseline by 30-min postexercise, including neutrophils, previously reported to remain elevated for at least some exercise formats. This highly preserved pattern indicates the importance of the adaptive response to physical stress across multiple health conditions.

Comparison of metabolic substrates between exercise and cold exposure in skaters

To test the effect of a cold condition on metabolic substrate and possible development of muscle injuries, short track skaters (n=9) and inline skaters (n=10) took rest and submaximal cycled (65% V(.)O2max) in cold (ambient temperature: 5+/-1 degrees C, relative humidity: 41+/-8%) and warm conditions (ambient temperature: 21+/-1 degrees C, relative humidity: 35+/-5%), for 60 min, each. Blood glucose (BG), triglyceride (TG), free fatty acid (FFA), and total cholesterol (TC) were determined to investigate the effect on energy metabolism. To estimate possible muscle injury in the cold condition, creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin (Mb) were also measured. TG and FFA levels were increased during exercise in the cold condition, but were unaffected by the difference of skaters. Of the myocellular enzymes, CK was significantly higher during the transition from submaximal exercise to recovery phase in a short track skater compared with inline skater group, indicating a higher physical strain. Additionally, the level of Mb in the inline skater group significantly elevated during recovery phase in the cold compared with in the warm condition. It is concluded that exercise caused stress that was dependent on the ambient temperature. Therefore, exercise in the cold condition altered the circulating level of energy substrate and increased muscle injuries.

Effect of cold acclimation on antioxidant status in cold acclimated skaters

We investigated whether cold acclimation leads to increased activity of the antioxidant defense enzymes and muscle injury. Comparisons were between short track skaters (n=6) and inline skaters (n=6) during rest and at submaximal cycling (65% VO2max) in cold (ambient temperature: 5+/-1 degrees C, relative humidity: 41+/-8%) and warm conditions (ambient temperature: 21+/-1 degrees C, relative humidity: 35+/-5%), during 60 min, respectively, and during the recovery phase. Erythrocyte superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHpx), reduced glutathione (GSH), thiobarbituric substance acid (TBARS), serum creatine kinase (CK), lactate dehydrogenase (LDH), plasma myoglobin (Mb) and cortisol were determined. Activities of CAT and GSHpx and the level of GSH and TBARS in erythrocyte and the level of LDH in serum were elevated in cold acclimated subjects. We suggested that the compensatory increase in antioxidative defense enzymes resulting from long-term cold exposure may reflect the elevated reactive oxygen species (ROS) production and muscle injury at this environment acclimation.

A pediatric perspective on inflammation and oxidative stress in response to exercise

Dr. Oded Bar-Or was a giant in the area of pediatric exercise science and made numerous contributions to the health of children around the world. He also had a significant impact on a relatively new area of pediatric exercise science — pediatric exercise immunology. Under his supervision, some aspects of the immunobiology of exercise have been unravelled from a pediatric perspective. In general, healthy children experience less inflammatory stress in response to standardized exercise, while demonstrating an exercise-induced elevation in the anabolic cytokine IL-8. Mechanisms for the maturity- and age-dependent changes in cytokine responses to exercise are unknown, but may involve oxidative stress. Studies of oxidative stress and exercise in children are scant, but preliminary data suggests that, like the inflammatory cytokine response to exercise, children may experience less oxidative stress in response to intense exercise. We propose that the links between exercise, inflammatory and oxidative stress, and growth factors will be important to understand in the context of how exercise contributes to optimal growth and development during childhood. This understanding will be particularly relevant for childhood diseases that restrict growth.

Energy substrate utilization during prolonged exercise with and without carbohydrate intake in preadolescent and adolescent girls

Little information is available on energy metabolism during exercise in girls, particularly the contribution of exogenous carbohydrate (CHOexo). The purpose of this study was to determine substrate utilization during exercise with and without CHOexo intake in healthy girls. Twelve-yr-old preadolescent (YG; n = 12) and 14-yr-old adolescent (OG; n = 10) girls consumed flavored water (WT) or 13C-enriched 6% CHO (CT) while cycling for 60 min at ∼70% maximal aerobic power (V̇o2max). Substrate utilization was calculated for the final 15 min of exercise. CHOexo decreased fat oxidation by ∼50% in YG but not in OG ( P < 0.001) and decreased endogenous CHO oxidation by ∼15% in OG but not in YG ( P = 0.006). Endogenous CHO oxidation was lower in YG than in OG regardless of trial ( P ≤ 0.01), whereas fat oxidation was higher in YG only during WT ( P < 0.001). CHOexo oxidation rate was similar between YG and OG (7.1 ± 0.5 and 6.8 ± 0.4 mg·kg−1·min−1, respectively, P = 0.67), contributing ∼19% to total energy expenditure. Serum estradiol levels in all girls correlated with fat ( r = −0.50 to −0.59, P = 0.03 to 0.005) and endogenous CHO oxidation ( r = 0.50 to 0.63, P = 0.03 to 0.005) but not with CHOexo oxidation ( r = −0.09, P = 0.71). We conclude that CHOexo influences endogenous substrate utilization in an age-dependent manner in healthy girls but that total CHOexo oxidation during exercise is not different between YG and OG. Our results also point to potential sex-related differences in energy substrate utilization even during childhood.

Evidence of sex-based differences in natural killer cell responses to exercise and carbohydrate intake in children

Distinct natural killer (NK) cell subsets (CD56bright and CD56dim) are mobilized with exercise and these cells may serve adaptive functions. We determined the distribution of NK cell subsets in response to exercise and carbohydrate (CHO) intake in young girls and compared these responses with previous findings in young boys of the same age. Twelve girls (12 years old) cycled for 60 min at 70% VO2max while drinking 6% CHO or flavoured water. Blood was collected at rest, during (30 and 60 min) and following (30 and 60 min) exercise to identify NK cells as CD3-CD56bright or CD3-CD56dim. CD69 expression on total CD3-CD56+ cells was also determined. A trend (P=0.07) was found for a trial x time interaction in CD56dim cell counts, with values lower with CHO than with water. CHO intake did not influence CD56bright responses (P>or=0.39). The CD56bright:CD56dim ratio increased during recovery from exercise (P<0.001), compared to rest, with no effect of CHO intake (P=0.48). CD69 expression was not different between exercise or recovery and rest. Like young boys, girls experience an elevated CD56bright:CD56dim ratio during recovery from exercise and CHO intake attenuates the exercise-induced CD56dim but not CD56bright cell response. Unlike young boys, girls do not experience a CHO-induced increase in the CD56bright:CD56dim ratio during recovery and CD69 expression does not increase on CD3-CD56+ cells during recovery. We conclude that even in young children sex-based differences exist in the NK cell response to exercise and CHO intake.

Lymphocyte expression of CD95 at rest and in response to acute exercise in healthy children and adolescents

CD95 is essential in regulating the immune system, and its reduced expression has been associated with anthracycline resistance in some childhood leukemias. We determined whether an acute bout of exercise would influence the mixed lymphocyte expression of CD95 in healthy children and adolescents. Fifty healthy pediatric subjects (female n=25) cycled for 60 min @ 70% V O(2max). Blood was collected before, during, and after exercise to determine CD95 expression on T (CD3(+)CD19(-)) and B (CD3(-)CD19(+)) cells using flow cytometry. At rest, the percentage of CD95(hi) T cells was 29% higher in girls versus boys (p<0.001). The percentage of CD95(hi) T cells and the median fluorescence intensity (MFI) of CD95(hi) were higher during recovery versus rest (p<0.0001). The percentage of CD95(lo) T cells was lower during recovery versus rest, whereas the MFI of CD95(lo) was higher during exercise versus rest. The CD95(hi) T cell count increased during exercise, but only in 14-yr-old girls, whereas CD95(lo) T cell counts increased similarly in all groups. CD95(+) B cells were relatively unresponsive to exercise. We conclude that lymphocyte expression of CD95 is influenced by acute exercise in healthy children and adolescents. Exercise-induced alterations in CD95 expression may have clinical implications for some pediatric conditions.

The effect of brief exercise on circulating CD34+ stem cells in early and late pubertal boys

We tested the hypothesis that exercise could stimulate CD34+ peripheral blood hematopoietic stem cells (PBSC) in children. Fourteen early pubertal boys (EP, age 10.3 +/- 0.3 y) and 13 late pubertal boys (LP, age 16.5 +/- 0.4 y) performed 20 min of moderate-to-vigorous cycle ergometer exercise. Blood was drawn before and after exercise. Cells were stained for surface CD34+. Plasma granulocyte colony stimulating factor (G-CSF), Fms-like tyrosine kinase-3 (FLT-3), and stromal cell-derived factor-1 (SDF-1) were measured using ELISA. Exercise substantially increased PBSC (in EP from 112 +/- 21 to 182 +/- 30 cells/microL, p=0.0007; in LP from 63 +/- 8 to 152 +/- 21, p=0.0008), and to a smaller extent FLT-3 (in EP from 98 +/- 5 to 110 +/- 6 pg/mL, p<0.0001; in LP from 73 +/- 6 to 92 +/- 6, p<0.0001) and G-CSF (in EP from 26 +/- 4 to 29 +/- 4 pg/mL, p<0.0001; in LP from 14 +/- 1 to 18 +/- 1, p<0.0001). Baseline levels of PBSC, FLT-3, and G-CSF were significantly higher in EP. Exercise increased SDF-1 alpha only in LP, and the FLT-3 increase was greater in LP than EP. Brief exercise affects PBSC and PBSC mediators in children.

Influence of age and pubertal status on substrate utilization during exercise with and without carbohydrate intake in healthy boys

Substrate utilization during exercise is known to differ between children and adults, but whether these differences are related to pubertal status is unclear. The objective of this study was to investigate the effects of pubertal status on endogenous (CHOendo) and orally ingested exogenous (CHOexo) carbohydrate and fat oxidation rates during exercise. Twenty boys at the same chronological age (12 y) were divided into three pubertal groups (pre-pubertal, PP: n = 7; early-pubertal, EP: n = 7; mid- to late-pubertal, M-LP: n = 6) and consumed either a placebo or13C-enriched 6% CHO drink while cycling for 60 min at ~70% of their maximal aerobic power (VO2 max). Another group of 14-year-old boys (pubertal, n = 9) completed all procedures. Substrate utilization was calculated for the final 15 min of exercise using indirect calorimetry and stable isotope methodology. CHOexodecreased fat (p < 0.001) and increased total CHO (p < 0.001) oxidation, irrespective of group. Fat oxidation was higher (p = 0.01) in younger boys than in older boys, but similar (p ≥ 0.33) among PP, EP, and M-LP boys. CHOexocontributed to ~30% of energy expenditure (EE) in PP and EP, but to only 24% in M-LP (p = 0.02), which was identical to the older boys (24%). CHOexooxidation rate as a percentage of EE was inversely related to testosterone levels (r = −0.51, p = 0.005, n = 29). It was concluded that reliance on CHOexoduring exercise is particularly sensitive to pubertal status, with the highest oxidation rates observed in pre- and early-pubertal boys, independent of chronological age.

Measurement of cytokines in sweat patches and plasma in healthy women: validation in a controlled study

Cytokines have been detected by ELISA in a variety of body fluids. Recycling immunoaffinity chromatography (RIC) coupled with laser-induced fluorescence detection is a highly sensitive and specific method, which allows simultaneous measurements of many analytes in small volumes of biological fluids. This method has been applied to plasma, cervical secretions and other body fluids, but has not previously been applied to sweat. The aim of this study was to validate the RIC methodology in sweat for measurements of IL-1alpha, IL-1beta, IL-6, TNF-alpha, IL-8 and TGF-beta. Two sweat patches were applied for 24 h on the torso, and blood was collected at one time point during this period in nine healthy women. Cytokines were measured in paired samples of plasma and sweat. Cytokines were detected in sweat in similar concentrations to plasma. Linear regression analysis confirmed that sweat levels of these cytokines accounted for a large percentages of variance in plasma levels: IL-1alpha (R2 = 0.70, p = 0.005), IL-1beta (R2 = 0.79, p = 0.003), IL-6 (R2 = 0.52, p = 0.03), TNF-alpha (R2 = 0.95, p < 0.0001), IL-8 (R2 = 0.81, p = 0.001) and TGF-beta (R2 = 0.94, p = 0.0003). These findings indicate that cytokine levels measured in sweat are informative of circulating levels and that sweat patches combined with RIC represents a viable non-invasive method to measure cytokines in ambulatory settings over time. This method is unobtrusive and requires minimal active compliance on the part of the subjects being studied, without pain or stress. This approach can open a new generation of studies to address the effects of environmental factors on immune responses in a wide range of different settings.