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Xinliang Z, Achkasov EE, Gavrikov LK, Yuchen L, Zhang C, Dudnik EN, Rumyantseva O, Beeraka NM, Glazachev OS. Assessing the importance and safety of hypoxia conditioning for patients with occupational pulmonary diseases: A recent clinical perspective. Biomed Pharmacother 2024; 178:117275. [PMID: 39126774 DOI: 10.1016/j.biopha.2024.117275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024] Open
Abstract
Occupational pulmonary diseases (OPDs) pose a significant global health challenge, contributing to high mortality rates. This review delves into the pathophysiology of hypoxia and the safety of intermittent hypoxic conditioning (IHC) in OPD patients. By examining sources such as PubMed, Relemed, NLM, Scopus, and Google Scholar, the review evaluates the efficacy of IHC in clinical outcomes for OPD patients. It highlights the complexities of cardiovascular and respiratory regulation dysfunctions in OPDs, focusing on respiratory control abnormalities and the impact of intermittent hypoxic exposures. Key areas include the physiological effects of hypoxia, the role of hypoxia-inducible factor-1 alpha (HIF-1α) in occupational lung diseases, and the links between brain ischemia, stroke, and OPDs. The review also explores the interaction between intermittent hypoxic exposures, mitochondrial energetics, and lung physiology. The potential of IHE to improve clinical manifestations and underlying pathophysiology in OPD patients is thoroughly examined. This comprehensive analysis aims to benefit molecular pathologists, pulmonologists, clinicians, and physicians by enhancing understanding of IHE's clinical benefits, from research to patient care, and improving clinical outcomes for OPD patients.
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Affiliation(s)
- Zhang Xinliang
- Chair of Sports Medicine and Rehabilitation, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia; Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Eugeny E Achkasov
- Chair of Sports Medicine and Rehabilitation, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Leonid K Gavrikov
- Volgograd State Medical University, 1, Pavshikh Bortsov Sq., Volgograd 400131, Russia.
| | - Li Yuchen
- Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Chen Zhang
- Chair of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia
| | - Elena N Dudnik
- Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
| | - Olga Rumyantseva
- Izmerov Research Institute of Occupational Health, 31 Budeynniy Avenye, Moscow 105275, Russia.
| | - Narasimha M Beeraka
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, R4-168, Indianapolis, IN 46202, USA; Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia; Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Chiyyedu, Anantapuramu, Andhra Pradesh 515721, India.
| | - Oleg S Glazachev
- Co-Chair of Normal Physiology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia.
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Janssen Daalen JM, Koopman WJH, Saris CGJ, Meinders MJ, Thijssen DHJ, Bloem BR. The Hypoxia Response Pathway: A Potential Intervention Target in Parkinson's Disease? Mov Disord 2024; 39:273-293. [PMID: 38140810 DOI: 10.1002/mds.29688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder for which only symptomatic treatments are available. Both preclinical and clinical studies suggest that moderate hypoxia induces evolutionarily conserved adaptive mechanisms that enhance neuronal viability and survival. Therefore, targeting the hypoxia response pathway might provide neuroprotection by ameliorating the deleterious effects of mitochondrial dysfunction and oxidative stress, which underlie neurodegeneration in PD. Here, we review experimental studies regarding the link between PD pathophysiology and neurophysiological adaptations to hypoxia. We highlight the mechanistic differences between the rescuing effects of chronic hypoxia in neurodegeneration and short-term moderate hypoxia to improve neuronal resilience, termed "hypoxic conditioning". Moreover, we interpret these preclinical observations regarding the pharmacological targeting of the hypoxia response pathway. Finally, we discuss controversies with respect to the differential effects of hypoxia response pathway activation across the PD spectrum, as well as intervention dosing in hypoxic conditioning and potential harmful effects of such interventions. We recommend that initial clinical studies in PD should focus on the safety, physiological responses, and mechanisms of hypoxic conditioning, as well as on repurposing of existing pharmacological compounds. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jules M Janssen Daalen
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands, Nijmegen, The Netherlands
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Werner J H Koopman
- Department of Pediatrics, Amalia Children's Hospital, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Mitochondrial Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Christiaan G J Saris
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Radboud Center for Mitochondrial Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjan J Meinders
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands, Nijmegen, The Netherlands
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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Tessema B, Sack U, König B, Serebrovska Z, Egorov E. Effects of Intermittent Hypoxia in Training Regimes and in Obstructive Sleep Apnea on Aging Biomarkers and Age-Related Diseases: A Systematic Review. Front Aging Neurosci 2022; 14:878278. [PMID: 35677200 PMCID: PMC9168371 DOI: 10.3389/fnagi.2022.878278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Several studies have assessed the effects of intermittent hypoxia-normoxia training (IHNT), intermittent hypoxia-hyperoxia training (IHHT), and obstructive sleep apnea (OSA) on aging and age-related diseases in humans; however, the results remain contradictory. Therefore, this review aims to systematically summarize the available studies on the effects of IHNT, IHHT, and OSA on aging and age-related diseases. Relevant studies were searched from PubMed, Google Scholar, Cochrane Library databases, and through manual searching from reference lists of eligible studies. A total of 38 eligible studies were included in this systematic review. IHHT and IHNT provide positive effects on several age-related parameters including quality of life, cognitive and physical functions, plasma level of glucose and cholesterol/LDL, systolic blood pressure, red blood cells, and inflammation. Moreover, moderate intermittent hypoxia induces telomerase reverse transcriptase (TERT) activity and telomere stabilization, delays induction of senescence-associated markers expression and senescence-associated β-galactosidase, upregulates pluripotent marker (Oct4), activates a metabolic shift, and raises resistance to pro-apoptotic stimuli. On the contrary, intermittent hypoxia in OSA causes hypertension, metabolic syndrome, vascular function impairment, quality of life and cognitive scores reduction, advanced brain aging, increase in insulin resistance, plasma hydrogen peroxide, GSH, IL-6, hsCRP, leptin, and leukocyte telomere shortening. Thus, it can be speculated that the main factor that determines the direction of the intermittent hypoxia action is the intensity and duration of exposure. There is no direct study to prove that IHNT/IHHT actually increases life expectancy in humans. Therefore, further study is needed to investigate the actual effect of IHNT/IHHT on aging in humans.Systematic Review Registrationwww.crd.york.ac.uk/prospero, identifier CRD42022298499.
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Affiliation(s)
- Belay Tessema
- Institute of Clinical Immunology, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Belay Tessema, ,
| | - Ulrich Sack
- Institute of Clinical Immunology, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Brigitte König
- Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Zoya Serebrovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Egor Egorov
- IPAM Institute for Preventive and Anti-Aging Medicine, Berlin, Germany
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Effects of Resistance Training in Hypobaric vs. Normobaric Hypoxia on Circulating Ions and Hormones. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063436. [PMID: 35329124 PMCID: PMC8949299 DOI: 10.3390/ijerph19063436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Abstract
Hypobaric hypoxia (HH) seems to lead to different responses compared to normobaric hypoxia (NH) during physical conditioning. The aim of the study was to analyze the hormonal and circulating ion responses after performing high-intensity resistance training with different inter-set rest under HH and NH condition. Sixteen male volunteers were randomly divided into two training groups. Each group completed two counterbalanced resistance training sessions (three sets × ten repetitions, remaining two repetitions in reserve), with both one- and two-minute inter-set rest, under HH and NH. Blood samples were obtained to determine hormones and circulating ions (Ca2+, Pi, and HCO3−) at baseline and after training sessions (5, 10, and 30 min). Resistance training with one-minute rest caused greater hormonal stress than with two-minute rest in cortisol and growth hormone, although the hypoxic environmental condition did not cause any significant alterations in these hormones. The short inter-set rest also caused greater alterations in HCO3− and Pi than the longer rest. Additionally, higher levels of Ca2+ and Pi, and lower levels of HCO3−, were observed after training in HH compared to NH. Metabolic and physiological responses after resistance training are mediated by inter-set rest intervals and hypoxic environmental condition. According to the alterations observed in the circulating ions, HH could cause greater muscular fatigue and metabolic stress than NH.
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Nguyen TH, Conotte S, Belayew A, Declèves AE, Legrand A, Tassin A. Hypoxia and Hypoxia-Inducible Factor Signaling in Muscular Dystrophies: Cause and Consequences. Int J Mol Sci 2021; 22:7220. [PMID: 34281273 PMCID: PMC8269128 DOI: 10.3390/ijms22137220] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022] Open
Abstract
Muscular dystrophies (MDs) are a group of inherited degenerative muscle disorders characterized by a progressive skeletal muscle wasting. Respiratory impairments and subsequent hypoxemia are encountered in a significant subgroup of patients in almost all MD forms. In response to hypoxic stress, compensatory mechanisms are activated especially through Hypoxia-Inducible Factor 1 α (HIF-1α). In healthy muscle, hypoxia and HIF-1α activation are known to affect oxidative stress balance and metabolism. Recent evidence has also highlighted HIF-1α as a regulator of myogenesis and satellite cell function. However, the impact of HIF-1α pathway modifications in MDs remains to be investigated. Multifactorial pathological mechanisms could lead to HIF-1α activation in patient skeletal muscles. In addition to the genetic defect per se, respiratory failure or blood vessel alterations could modify hypoxia response pathways. Here, we will discuss the current knowledge about the hypoxia response pathway alterations in MDs and address whether such changes could influence MD pathophysiology.
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Affiliation(s)
- Thuy-Hang Nguyen
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Stephanie Conotte
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Alexandra Belayew
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Anne-Emilie Declèves
- Department of Metabolic and Molecular Biochemistry, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium;
| | - Alexandre Legrand
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
| | - Alexandra Tassin
- Laboratory of Respiratory Physiology, Pathophysiology and Rehabilitation, Research Institute for Health Sciences and Technology, University of Mons, 7000 Mons, Belgium; (T.-H.N.); (S.C.); (A.B.); (A.L.)
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Raberin A, Nader E, Lopez Ayerbe J, Alfonsi G, Mucci P, Rytz CL, Pialoux V, Durand F. Pro-Oxidant/Antioxidant Balance during a Prolonged Exposure to Moderate Altitude in Athletes Exhibiting Exercise-Induced Hypoxemia at Sea-Level. Life (Basel) 2021; 11:life11030228. [PMID: 33799611 PMCID: PMC8001482 DOI: 10.3390/life11030228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/16/2022] Open
Abstract
This study examined to what extent athletes exhibiting exercise-induced hypoxemia (EIH) possess an altered redox status at rest, in response to exercise at sea level (SL) and during moderate altitude exposure. EIH was defined as a fall in arterial O2 saturation of at least 4% during exercise. Nine endurance athletes with EIH and ten without (NEIH) performed a maximal incremental test under three conditions: SL, one (H1) and five (H2) days after arrival to 2400 m. Gas exchange and peripheral capillary oxygen saturation (SpO2) were continuously monitored. Blood was sampled before exercise and after exercise cessation. Advanced oxidation protein products (AOPP), catalase, ferric-reducing antioxidant power, glutathione peroxidase, superoxide dismutase (SOD) and nitric oxide metabolites (NOx) were measured in plasma by spectrophotometry. EIH athletes had higher AOPP and NOx concentrations at pre- and post-exercise stages compared to NEIH at SL, H2 but not at H1. Only the EIH group experienced increased SOD activity between pre- and post-exercise exercise at SL and H2 but not at H1. EIH athletes had exacerbated oxidative stress compared to the NEIH athletes at SL and H2. These differences were blunted at H1. Oxidative stress did not alter the EIH groups’ aerobic performance and could lead to higher minute ventilation at H2. These results suggest that higher oxidative stress response EIH athletes could be involved in improved aerobic muscle functionality and a greater ventilatory acclimatization during prolonged hypoxia.
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Affiliation(s)
- Antoine Raberin
- Laboratoire Européen Performance Santé Altitude (LEPSA), EA 4604, Université de Perpignan Via Domitia, 66120 Font Romeu, France;
- Correspondence: ; Tel.: +33-6-8217-3800
| | - Elie Nader
- Team « Vascular Biology and Red Blood Cell », Univ Lyon, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA 7424, Université Claude Bernard Lyon 1, 69000 Lyon, France; (E.N.); (G.A.)
- Laboratoire d’Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, 75000 Paris, France
| | | | - Gauthier Alfonsi
- Team « Vascular Biology and Red Blood Cell », Univ Lyon, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA 7424, Université Claude Bernard Lyon 1, 69000 Lyon, France; (E.N.); (G.A.)
| | - Patrick Mucci
- ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Univ. Lille, Univ. Artois, Univ. Littoral Côte d’Opale, 59000 Lille, France;
| | - Chantal L. Rytz
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AL T2P 2M5, Canada;
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AL T2P 2M5, Canada
| | - Vincent Pialoux
- Team « Atherosclerosis, Thrombosis and Physical Activity », Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Univ Lyon, Université Claude Bernard Lyon 1, 69000 Lyon, France;
- Institut Universitaire de France, 75000 Paris, France
| | - Fabienne Durand
- Laboratoire Européen Performance Santé Altitude (LEPSA), EA 4604, Université de Perpignan Via Domitia, 66120 Font Romeu, France;
- IMAGES ESPACE-DEV, UMR228, Université de Perpignan Via Domitia, 66000 Perpignan, France
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Rathor R, Agrawal A, Kumar R, Suryakumar G, Singh SN. Ursolic acid ameliorates hypobaric hypoxia-induced skeletal muscle protein loss via upregulating Akt pathway: An experimental study using rat model. IUBMB Life 2021; 73:375-389. [PMID: 33368975 DOI: 10.1002/iub.2435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022]
Abstract
Hypobaric hypoxic stress leads to oxidative stress, inflammation, and disturbance in protein turnover rate. Aggregately, this imbalance in redox homeostasis is responsible for skeletal muscle protein loss and a decline in physical performance. Hence, an urgent medical need is required to ameliorate skeletal muscle protein loss. The present study investigated the efficacy of ursolic acid (UA), a pentacyclic triterpene acid to ameliorate hypobaric hypoxia (HH)-induced muscle protein loss. UA is a naturally occurring pentacyclic triterpene acid present in several edible herbs and fruits such as apples. It contains skeletal muscle hypertrophy activity; still its potential against HH-induced muscle protein loss is unexplored. To address this issue, an in vivo study was planned to examine the beneficial effect of UA supplementation on HH-induced skeletal muscle loss. Male Sprague Dawley rats were exposed to HH with and without UA supplementation (20 mg/kg; oral) for 3 continuous days. The results described the beneficial role of UA as supplementation of UA with HH exposure attenuated reactive oxygen species production and oxidative protein damage, which indicate the potent antioxidant activity. Furthermore, UA supplementation enhanced Akt, pAkt, and p70S6kinase activity (Akt pathway) and lowered the pro-inflammatory cytokines in HH exposed rats. UA has potent antioxidant and anti-inflammatory activity, and it enhanced the protein content via upregulation of Akt pathway-related proteins against HH exposure. These three biological activities of UA make it a novel candidate for amelioration of HH-induced skeletal muscle damage and protein loss.
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Affiliation(s)
- Richa Rathor
- Cellular Biochemistry Division, DRDO Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Akanksha Agrawal
- Cellular Biochemistry Division, DRDO Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Ravi Kumar
- Cellular Biochemistry Division, DRDO Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Geetha Suryakumar
- Cellular Biochemistry Division, DRDO Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Som Nath Singh
- Cellular Biochemistry Division, DRDO Defence Institute of Physiology and Allied Sciences, Delhi, India
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Biuomy AR, Oraby FSH, Khalifa EA, El-Sherif HA, Hussein J, Abdel-Latif Y. Hypoxia-induced oxidative stress in high altitude population: impact of coenzyme Q10 supplementation. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:621-626. [PMID: 34592077 DOI: 10.1515/jcim-2020-0077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/22/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of coenzyme Q10 (CoQ10) supplementation on oxidative stress engendered from hypoxia in population live at high altitude. METHODS This is an intervention study in which 50 females of volunteers population-36 of them who live at high altitude compared with the placebo group (14 from the total population that live at sea level). Blood samples were collected in -anticoagulant tubes from control and high altitude before and after CoQ10 supplementation (150 mg/day for 2, 4 and 8 weeks). Plasma was separated and used for the determination of malondialdehyde (MDA), nitric oxide (NOx), total antioxidant capacity (TAC), paraoxonase (PON1) by spectrophotometer, CoQ10 and vitamin E by high performance liquid chromatography (HPLC). RESULTS Our results appeared that TAC, PON1, vitamin E and CoQ10 concentrations were significantly decreased in population at high altitude at base line compared to placebo group population at sea level. Whereas, administration of CoQ10 attenuated all measured parameters especially after eight weeks of administration. CONCLUSION We concluded that coenzyme Q10 supplement at a dose of 150 mg/day has a powerful effect in oxidative stress parameters and increased antioxidant parameters included vitamin E in population with hypoxia after 4 and 8 weeks. So that supplementation positively affects oxidative stress and is recommended CoQ10 supplementation in population who live at high altitude.
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Affiliation(s)
- Ayman R Biuomy
- Pharmacology Department, Faculty of Medicine, Taif University, Taif, Saudi Arabia
- Pharmacology Department, National Research Centre, Giza, Egypt
| | - Fatma S H Oraby
- Biochemistry Department, Faculty of Medicine, Taif University, Taif, Saudi Arabia
- Medical Biochemistry Department, National Research Centre, Giza, Egypt
| | - Eman A Khalifa
- Parasitology Department, Faculty of Medicine, Taif University, Taif, Saudi Arabia
- Parasitology Department, Tanta University, Tanta, Egypt
| | - Hanaa A El-Sherif
- Medical Biochemistry Department, National Research Centre, Giza, Egypt
| | - Jihan Hussein
- Medical Biochemistry Department, National Research Centre, Giza, Egypt
| | - Yasmin Abdel-Latif
- Medical Biochemistry Department, National Research Centre, Giza, Egypt
- Faculty of Biotechnology, October University for Modern Sciences and Arts, 6th October, Giza, Egypt
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Role of Gender and Physical Activity Level on Cardiovascular Risk Factors and Biomarkers of Oxidative Stress in the Elderly. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1315471. [PMID: 32655757 PMCID: PMC7321518 DOI: 10.1155/2020/1315471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 01/14/2023]
Abstract
Background Cardiovascular diseases remain as the leading cause of morbidity and mortality in industrialized countries. Ageing and gender strongly modulate the risk to develop cardiovascular diseases but very few studies have investigated the impact of gender on cardiovascular diseases in the elderly, which represents a growing population. The purpose of this study was to test the impact of gender and physical activity level on several biochemical and clinical markers of cardiovascular risk in elderly individuals. Methods Elderly individuals (318 women (75.8 ± 1.2 years-old) and 227 men (75.8 ± 1.1 years-old)) were recruited. Physical activity was measured by a questionnaire. Metabolic syndrome was defined using the National Cholesterol Education Program Expert Panel's definition. Polysomnography and digital tonometry were used to detect obstructive sleep apnea and assess vascular reactivity, respectively. Blood was sampled to measure several oxidative stress markers and adhesion molecules. Results The frequency of cardiovascular diseases was significantly higher in men (16.4%) than in women (6.1%) (p < 0.001). Body mass index (25.0 ± 4.3 vs. 25.8 ± 3.13 kg.m−2) and glycaemia (94.9 ± 16.5 vs. 101.5 ± 22.6 mg.dL−1) were lower, and High Density Lipoprotein (HDL) (74.6 ± 17.8 vs. 65.0 ± 17.2 mg.dL−1) was higher in women compared to men (p < 0.05). Oxidative stress was lower in women than in men (uric acid: 52.05 ± 13.78 vs. 59.84 ± 13.58, advanced oxidation protein products: 223 ± 94 vs. 246 ± 101 μmol.L−1, malondialdehyde: 22.44 ± 6.81 vs. 23.88 ± 9.74 nmol.L−1). Physical activity was not associated with lower cardiovascular risk factors in both genders. Multivariate analyses showed an independent effect of gender on acid uric (β = 0.182; p = 0.020), advanced oxidation protein products (β = 0.257; p < 0.001), and HDL concentration (β = −0.182; p = 0.026). Conclusion These findings suggest that biochemical cardiovascular risk factors are lower in women than men which could explain the lower cardiovascular disease proportion observed in women in the elderly.
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Nutrition and Altitude: Strategies to Enhance Adaptation, Improve Performance and Maintain Health: A Narrative Review. Sports Med 2020; 49:169-184. [PMID: 31691928 PMCID: PMC6901429 DOI: 10.1007/s40279-019-01159-w] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Training at low to moderate altitudes (~ 1600-2400 m) is a common approach used by endurance athletes to provide a distinctive environmental stressor to augment training stimulus in the anticipation of increasing subsequent altitude- and sea-level-based performance. Despite some scientific progress being made on the impact of various nutrition-related changes in physiology and associated interventions at mountaineering altitudes (> 3000 m), the impact of nutrition and/or supplements on further optimization of these hypoxic adaptations at low-moderate altitudes is only an emerging topic. Within this narrative review we have highlighted six major themes involving nutrition: altered energy availability, iron, carbohydrate, hydration, antioxidant requirements and various performance supplements. Of these issues, emerging data suggest that particular attention be given to the potential risk for poor energy availability and increased iron requirements at the altitudes typical of elite athlete training (~ 1600-2400 m) to interfere with optimal adaptations. Furthermore, the safest way to address the possible increase in oxidative stress associated with altitude exposure is via the consumption of antioxidant-rich foods rather than high-dose antioxidant supplements. Meanwhile, many other important questions regarding nutrition and altitude training remain to be answered. At the elite level of sport where the differences between winning and losing are incredibly small, the strategic use of nutritional interventions to enhance the adaptations to altitude training provides an important consideration in the search for optimal performance.
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Thirupathi A, Pinho RA, Chang YZ. Physical exercise: An inducer of positive oxidative stress in skeletal muscle aging. Life Sci 2020; 252:117630. [PMID: 32294473 DOI: 10.1016/j.lfs.2020.117630] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/12/2022]
Abstract
Oxidative stress is the core of most pathological situations, and its attribution toward disease conversion is not yet well established. The adaptive capacity of a cell can overcome ROS-induced pathology. However, when a cell fails to extend its maximum adaptive capacity against oxidative stress, it could lead a cell to misbehave or defunct from its normal functions. Any type of physical activity can increase the cells' maximum adaptive capacity, but aging can limit this. However, whether aging is the initiating point of reducing cells' adaptive capacity against oxidative stress or oxidative stress can induce the aging process is a mystery, and it could be the key to solving several uncured diseases. Paradoxically, minimum ROS is needed for cellular homeostasis. Nevertheless, finding factors that can limit or nullify the production of ROS for cellular homeostasis is a million-dollar question. Regular physical exercise is considered to be one of the factors that can limit the production of ROS and increase the ROS-induced benefits in the cells through inducing minimum oxidative stress and increasing maximum adapting capacity against oxidative stress-induced damages. The type and intensity of exercise that can produce such positive effects in the cells remain unclear. Therefore, this review discusses how physical exercise can help to produce minimal positive oxidative stress in preventing skeletal muscle aging.
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Affiliation(s)
- Anand Thirupathi
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei Province 050024, China.
| | - Ricardo A Pinho
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Yan-Zhong Chang
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei Province 050024, China
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Millet GP, Debevec T. CrossTalk proposal: Barometric pressure, independent of , is the forgotten parameter in altitude physiology and mountain medicine. J Physiol 2020; 598:893-896. [DOI: 10.1113/jp278673] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Tadej Debevec
- Faculty of SportUniversity of Ljubljana Ljubljana Slovenia
- Department of AutomationBiocybernetics and RoboticsJozef Stefan Institute Ljubljana Slovenia
- School of Life sciencesFaculty of Medicine and Health SciencesNottingham University Nottingham UK
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Serebrovska TV, Grib ON, Portnichenko VI, Serebrovska ZO, Egorov E, Shatylo VB. Intermittent Hypoxia/Hyperoxia Versus Intermittent Hypoxia/Normoxia: Comparative Study in Prediabetes. High Alt Med Biol 2019; 20:383-391. [DOI: 10.1089/ham.2019.0053] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Oksana N. Grib
- D.F. Chebotarev State Institute of Gerontology, Kiev, Ukraine
| | | | | | - Egor Egorov
- CellAir Construction GmbH, Stuttgart, Germany
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Park HY, Park W, Lim K. Living High-Training Low for 21 Days Enhances Exercise Economy, Hemodynamic Function, and Exercise Performance of Competitive Runners. J Sports Sci Med 2019; 18:427-437. [PMID: 31427864 PMCID: PMC6683611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/16/2019] [Indexed: 06/10/2023]
Abstract
Living high-training low (LHTL) is performed by competitive athletes expecting to improve their performance in competitions at sea level. However, the beneficial effects of LHTL remain controversial. We sought to investigate whether 21 days of LHTL performed at a 3,000 m simulated altitude (fraction of inspired oxygen [FIO2]=14.5%) and at sea level can improve hematological parameters, exercise economy and metabolism, hemodynamic function, and exercise performance compared with living low-training low (LLTL) among competitive athletes. All participants (age = 23.5 ± 2.1 years, maximal oxygen consumption [VO2max] = 55.6 ± 2.5 mL·kg-1·min-1, 3,000 m time trial performance=583.7 ± 22.9 seconds) were randomly assigned to undergo LHTL (n = 12) or LLTL (n = 12) and evaluated before and after the 21 days of intervention. During the 21-day intervention period, the weekly routine for all athletes included 6-day training and 1-day rest. The daily training programs consisted of >4 hours of various exercise programs (i.e., jogging, high-speed running, interval running, and 3,000 m or 5,000-m time trial). The LHTL group resided in a simulated environmental chamber (FIO2 = 14.5%) for >12 hours per day and the LLTL group at sea level under comfortable conditions. The hematological parameters showed no significant interaction. However, LHTL yielded more improved exercise economy, metabolic parameters (oxygen consumption=-152.7 vs 32.4 mL·kg-1·30min-1, η2 = 0.457, p = 0.000; tissue oxygenation index=6.18 vs .66%, η2 = 0.250, p = 0.013), and hemodynamic function (heart rate = -234.5 vs -49.7 beats·30min-1, η2 = 0.172, p = 0.044; stroke volume = 136.4 vs -120.5 mL/30 min, η2 = 0.191, p = 0.033) during 30 minutes of submaximal cycle ergometer exercise corresponding to 80% maximal heart rate before training than did LLTL. Regarding exercise performance, LHTL also yielded more improved VO2max (5.40 vs 2.35 mL·kg-1·min-1, η2 = 0.527, p = 0.000) and 3,000 m time trial performance (-34.0 vs -19.5 seconds, η2 = 0.527, p = 0.000) than did LLTL. These results indicate that compared with LLTL, LHTL can have favorable effects on exercise performance by improving exercise economy and hemodynamic function in competitive runners.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, Seoul, Republic of Korea
| | - Wonil Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute, Konkuk University, Seoul, Republic of Korea
- Department of Physical Education, Konkuk University, Seoul, Republic of Korea
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Three weeks of intermittent hypoxic training affect antioxidant enzyme activity and increases lipid peroxidation in cyclists. MONATSHEFTE FUR CHEMIE 2019. [DOI: 10.1007/s00706-019-02451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Koivisto AE, Olsen T, Paur I, Paulsen G, Bastani NE, Garthe I, Raastad T, Matthews J, Blomhoff R, Bøhn SK. Effects of antioxidant-rich foods on altitude-induced oxidative stress and inflammation in elite endurance athletes: A randomized controlled trial. PLoS One 2019; 14:e0217895. [PMID: 31194785 PMCID: PMC6563980 DOI: 10.1371/journal.pone.0217895] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/17/2019] [Indexed: 12/27/2022] Open
Abstract
Background Various altitude training regimes, systematically used to improve oxygen carrying capacity and sports performance, have been associated with increased oxidative stress and inflammation. We investigated whether increased intake of common antioxidant-rich foods attenuates these processes. Methods In a randomized controlled trial, 31 elite endurance athletes (23 ± 5 years), ingested antioxidant-rich foods (n = 16), (> doubling their usual intake), or eucaloric control foods (n = 15) during a 3-week altitude training camp (2320 m). Fasting blood and urine samples were collected 7 days pre-altitude, after 5 and 18 days at altitude, and 7 days post-altitude. Change over time was compared between the groups using mixed models for antioxidant capacity [uric acid-free (ferric reducing ability of plasma (FRAP)], oxidative stress (8-epi-PGF2α) and inflammatory biomarkers (IFNγ, IL1α, IL1RA, IL1β, IL2, IL5, IL6, IL7, IL10, IL12p70, IL13, IL17, TNFα, MCP-1 and micro-CRP). The cytokine response to a stress-test (VO2max ramp test or 100 m swimming) was assessed at pre- and post-altitude. Results FRAP increased more in the antioxidant compared to the control group (p = 0.034). IL13 decreased in the antioxidant group, while increasing in the controls (p = 0.006). A similar trend was seen for IL6 (p = 0.062). A larger decrease in micro-CRP was detected in the antioxidant group compared to controls (β: -0.62, p = 0.02). We found no group differences for the remaining cytokines. 8-epi-PGF2α increased significantly in the whole population (p = 0.033), regardless group allocation. The stress response was significantly larger post-altitude compared with pre-altitude for IL1β, IL6, IL7, IL13, IL12p70 and TNFα, but we found no group differences. Conclusions Increased intake of antioxidant-rich foods elevated the antioxidant capacity and attenuated some of the altitude-induced systemic inflammatory biomarkers in elite athletes. The antioxidant intervention had no impact on the altitude-induced oxidative stress or changes in acute cytokine responses to exercise stress-tests.
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Affiliation(s)
- Anu Elisa Koivisto
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ingvild Paur
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Gøran Paulsen
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Ina Garthe
- Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jason Matthews
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Siv Kjølsrud Bøhn
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway
- * E-mail:
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Molano Franco D, Nieto Estrada VH, Gonzalez Garay AG, Martí‐Carvajal AJ, Arevalo‐Rodriguez I. Interventions for preventing high altitude illness: Part 3. Miscellaneous and non-pharmacological interventions. Cochrane Database Syst Rev 2019; 4:CD013315. [PMID: 31012483 PMCID: PMC6477878 DOI: 10.1002/14651858.cd013315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND High altitude illness (HAI) is a term used to describe a group of mainly cerebral and pulmonary syndromes that can occur during travel to elevations above 2500 metres (˜ 8200 feet). Acute mountain sickness (AMS), high altitude cerebral oedema (HACE), and high altitude pulmonary oedema (HAPE) are reported as potential medical problems associated with high altitude ascent. In this, the third of a series of three reviews about preventive strategies for HAI, we assessed the effectiveness of miscellaneous and non-pharmacological interventions. OBJECTIVES To assess the clinical effectiveness and adverse events of miscellaneous and non-pharmacological interventions for preventing acute HAI in people who are at risk of developing high altitude illness in any setting. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) in January 2019. We adapted the MEDLINE strategy for searching the other databases. We used a combination of thesaurus-based and free-text search terms. We scanned the reference lists and citations of included trials and any relevant systematic reviews that we identified for further references to additional trials. SELECTION CRITERIA We included randomized controlled trials conducted in any setting where non-pharmacological and miscellaneous interventions were employed to prevent acute HAI, including preacclimatization measures and the administration of non-pharmacological supplements. We included trials involving participants who are at risk of developing high altitude illness (AMS or HACE, or HAPE, or both). We included participants with, and without, a history of high altitude illness. We applied no age or gender restrictions. We included trials where the relevant intervention was administered before the beginning of ascent. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures employed by Cochrane. MAIN RESULTS We included 20 studies (1406 participants, 21 references) in this review. Thirty studies (14 ongoing, and 16 pending classification (awaiting)) will be considered in future versions of this suite of three reviews as appropriate. We report the results for the primary outcome of this review (risk of AMS) by each group of assessed interventions.Group 1. Preacclimatization and other measures based on pressureUse of simulated altitude or remote ischaemic preconditioning (RIPC) might not improve the risk of AMS on subsequent exposure to altitude, but this effect is uncertain (simulated altitude: risk ratio (RR) 1.18, 95% confidence interval (CI) 0.82 to 1.71; I² = 0%; 3 trials, 140 participants; low-quality evidence. RIPC: RR 3.0, 95% CI 0.69 to 13.12; 1 trial, 40 participants; low-quality evidence). We found evidence of improvement of this risk using positive end-expiratory pressure (PEEP), but this information was derived from a cross-over trial with a limited number of participants (OR 3.67, 95% CI 1.38 to 9.76; 1 trial, 8 participants; low-quality evidence). We found scarcity of evidence about the risk of adverse events for these interventions.Group 2. Supplements and vitaminsSupplementation of antioxidants, medroxyprogesterone, iron or Rhodiola crenulata might not improve the risk of AMS on exposure to high altitude, but this effect is uncertain (antioxidants: RR 0.58, 95% CI 0.32 to 1.03; 1 trial, 18 participants; low-quality evidence. Medroxyprogesterone: RR 0.71, 95% CI 0.48 to 1.05; I² = 0%; 2 trials, 32 participants; low-quality evidence. Iron: RR 0.65, 95% CI 0.38 to 1.11; I² = 0%; 2 trials, 65 participants; low-quality evidence. R crenulata: RR 1.00, 95% CI 0.78 to 1.29; 1 trial, 125 participants; low-quality evidence). We found evidence of improvement of this risk with the administration of erythropoietin, but this information was extracted from a trial with issues related to risk of bias and imprecision (RR 0.41, 95% CI 0.20 to 0.84; 1 trial, 39 participants; very low-quality evidence). Regarding administration of ginkgo biloba, we did not perform a pooled estimation of RR for AMS due to considerable heterogeneity between the included studies (I² = 65%). RR estimates from the individual studies were conflicting (from 0.05 to 1.03; low-quality evidence). We found scarcity of evidence about the risk of adverse events for these interventions.Group 3. Other comparisonsWe found heterogeneous evidence regarding the risk of AMS when ginkgo biloba was compared with acetazolamide (I² = 63%). RR estimates from the individual studies were conflicting (estimations from 0.11 (95% CI 0.01 to 1.86) to 2.97 (95% CI 1.70 to 5.21); low-quality evidence). We found evidence of improvement when ginkgo biloba was administered along with acetazolamide, but this information was derived from a single trial with issues associated to risk of bias (compared to ginkgo biloba alone: RR 0.43, 95% CI 0.26 to 0.71; 1 trial, 311 participants; low-quality evidence). Administration of medroxyprogesterone plus acetazolamide did not improve the risk of AMS when compared to administration of medroxyprogesterone or acetazolamide alone (RR 1.33, 95% CI 0.50 to 3.55; 1 trial, 12 participants; low-quality evidence). We found scarcity of evidence about the risk of adverse events for these interventions. AUTHORS' CONCLUSIONS This Cochrane Review is the final in a series of three providing relevant information to clinicians, and other interested parties, on how to prevent high altitude illness. The assessment of non-pharmacological and miscellaneous interventions suggests that there is heterogeneous and even contradictory evidence related to the effectiveness of these prophylactic strategies. Safety of these interventions remains as an unclear issue due to lack of assessment. Overall, the evidence is limited due to its quality (low to very low), the relative paucity of that evidence and the number of studies pending classification for the three reviews belonging to this series (30 studies either awaiting classification or ongoing). Additional studies, especially those comparing with pharmacological alternatives (such as acetazolamide) are required, in order to establish or refute the strategies evaluated in this review.
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Affiliation(s)
- Daniel Molano Franco
- Fundacion Universitaria de Ciencias de la Salud, Hospital de San JoséDepartment of Critical CareCarrera 19 # 8‐32BogotaBogotaColombia11001
| | - Víctor H Nieto Estrada
- Los Cobos Medical Centre. Grupo Investigacion GRIBOSDepartment of Critical CareBogotaBogotaColombia
| | | | | | - Ingrid Arevalo‐Rodriguez
- Hospital Universitario Ramón y Cajal (IRYCIS), CIBER Epidemiology and Public Health (CIBERESP)Clinical Biostatistics UnitCtra. Colmenar Km. 9,100MadridSpain28034
- Cochrane Associate Centre of MadridMadridSpain
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica EquinoccialCochrane EcuadorQuitoEcuador
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Mourot L, Millet GP. Is Maximal Heart Rate Decrease Similar Between Normobaric Versus Hypobaric Hypoxia in Trained and Untrained Subjects? High Alt Med Biol 2018; 20:94-98. [PMID: 30489174 DOI: 10.1089/ham.2018.0104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We compared the decrease in maximal heart rate (HRmax) from normoxia to normobaric (NH) and hypobaric (HH) hypoxia, respectively, in trained and untrained subjects (n = 187). HRmax data in normoxia and NH (n = 55) or HH (n = 26) were collected from 81 publications. No study directly compared HRmax in NH and HH. Concomitant arterial oxygen saturation (SaO2) and HRmax data were found in 60 studies. Overall, the results showed that the higher the desaturation, the greater the decrease in HRmax. Since desaturation appeared to be slightly higher during HH versus NH and was higher in trained than in untrained subjects, the decrease in HRmax tended (p = 0.07) to be higher in trained subjects in HH than in NH (e.g., -12.7 bpm vs. -8.6 bpm at 4000 m), whereas in untrained subjects the difference was negligible (-9.9 bpm vs. -8.3 bpm). To conclude, when compared with normoxia, the decrease in HRmax was slightly higher in HH than in NH in trained subjects. However, this result has to be confirmed and from a practical point of view, one may question the significance of this difference as well as the relevance of using different HR values for prescribing training intensity during exercise performed in NH or in HH.
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Affiliation(s)
- Laurent Mourot
- 1 EA 3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation Platform, University of Franche-Comté, Besançon, France.,2 Tomsk Polytechnic University, Tomsk, Russia
| | - Grégoire P Millet
- 3 Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Switzerland
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Shaw S, Ghosh D, Kumar U, Panjwani U, Kumar B. Impact of high altitude on key determinants of female reproductive health: a review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:2045-2055. [PMID: 30218203 DOI: 10.1007/s00484-018-1609-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 06/08/2023]
Abstract
Imperishable research work was done on females visiting high-altitude (HA) areas for recreational activities or job purposes as well as on female HA natives. Hypoxia at HA is an unavoidable condition that affects the determinants of female reproductive functions like, the age of menarche and menopause, whole reproductive span, hormone synthesis, and fertility. This review will emphasize whether HA hypoxia is a threat to women: residents or visitors by analyzing these proximate determinants. Delayed menarcheal and advanced menopausal age was found to shorten the reproductive span in some HA populations, whereas in some cases, menstrual cycle was also reported to be irregular. In addition, the completed fertility rate (CFR) was increased when people migrated to lower altitude. Altered stress hormones and reproductive hormones were observed in sea-level females exposed to HA. Oxidative stress (OS) at HA was also reviewed to explain the probable reasons for the observed changes in these determinants because disturbed redox homeostasis may be a connecting link, affecting the reproductive functions. In conclusion, HA hypoxia plays a crucial role on various determinants of female reproductive health and this review will be helpful for more precise study along with the probable underlying mechanisms responsible for the changes in female reproductive functions at HA.
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Affiliation(s)
- Snigdha Shaw
- High Altitude Physiology Department, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Dishari Ghosh
- High Altitude Physiology Department, Defence Institute of Physiology and Allied Sciences, Delhi, India.
| | - Utkarsha Kumar
- High Altitude Physiology Department, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Usha Panjwani
- High Altitude Physiology Department, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Bhuvnesh Kumar
- High Altitude Physiology Department, Defence Institute of Physiology and Allied Sciences, Delhi, India
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DiPasquale DM. Moving the Debate Forward: Are Normobaric and Hypobaric Hypoxia Interchangeable in the Study of Altitude? Curr Sports Med Rep 2018; 16:68-70. [PMID: 28282350 DOI: 10.1249/jsr.0000000000000337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Dana M DiPasquale
- Biomedical Department, Navy Experimental Diving Unit, Panama City, FL
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León-López J, Calderón-Soto C, Pérez-Sánchez M, Feriche B, Iglesias X, Chaverri D, Rodríguez FA. Oxidative stress in elite athletes training at moderate altitude and at sea level. Eur J Sport Sci 2018; 18:832-841. [PMID: 29575975 DOI: 10.1080/17461391.2018.1453550] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Using a controlled parallel group longitudinal trial design, we investigated the effects of different training interventions on the prooxidant/antioxidant status of elite athletes: living and training at moderate altitude for 3 (Hi-Hi3) and 4 weeks (Hi-Hi), and for 4 weeks too, living high and training high and low (Hi-HiLo) and living and training at sea level (Lo-Lo). From 61 swimmers, 54 completed the study. Nitrites, carbonyls, and lipid peroxidation (LPO) levels were assessed in plasma. Enzymatic antioxidants glutathione peroxidase (GPx) and glutathione reductase (GRd), and non-enzymatic antioxidants total glutathione (GST), reduced glutathione (GSH) and oxidized glutathione (GSSG) were analysed in the erythrocyte fraction. At the end of the intervention, nitrites levels were similar in all altitude groups but higher than in the Lo-Lo controls (P = .02). Hi-HiLo had greater GPx activity than Hi-Hi and Hi-Hi3 during most of the intervention (P ≤ .001). GRd activity was higher in Lo-Lo than in Hi-Hi at the end of the training camp (P ≤ .001). All groups showed increased levels of LPO, except Lo-Lo, and carbonyls at the end of the study (P ≤ .001). Training at altitude for 3 or 4 weeks drives oxidative stress leading to cellular damage mainly by worsening the antioxidant capacities. The GSSG/GSH ratio appears to be related to perceived exertion and fatigue. The stronger antioxidant defence showed by the Hi-HiLo group suggests an inverse relationship between redox alterations and performance. Further studies are required to investigate the role of oxidative stress in acclimatization, performance, and health.
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Affiliation(s)
- Josefa León-López
- a San Cecilio University Hospital , University of Granada , Granada , Spain
| | | | - Matías Pérez-Sánchez
- c Virgen de las Nieves University Hospital , University of Granada , Granada , Spain
| | - Belén Feriche
- d Faculty of Sports Sciences , University of Granada , Granada , Spain
| | - Xavier Iglesias
- e INEFC-Barcelona Sport Sciences Research Group, National Institute of Physical Education of Catalonia (INEFC) , University of Barcelona , Barcelona , Spain
| | - Diego Chaverri
- e INEFC-Barcelona Sport Sciences Research Group, National Institute of Physical Education of Catalonia (INEFC) , University of Barcelona , Barcelona , Spain
| | - Ferran A Rodríguez
- e INEFC-Barcelona Sport Sciences Research Group, National Institute of Physical Education of Catalonia (INEFC) , University of Barcelona , Barcelona , Spain
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Gonzalez Garay AG, Molano Franco D, Nieto Estrada VH, Martí‐Carvajal AJ, Arevalo‐Rodriguez I. Interventions for preventing high altitude illness: Part 2. Less commonly-used drugs. Cochrane Database Syst Rev 2018; 3:CD012983. [PMID: 29529715 PMCID: PMC6494375 DOI: 10.1002/14651858.cd012983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND High altitude illness (HAI) is a term used to describe a group of mainly cerebral and pulmonary syndromes that can occur during travel to elevations above 2500 metres (˜ 8200 feet). Acute mountain sickness (AMS), high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE) are reported as potential medical problems associated with high altitude ascent. In this second review, in a series of three about preventive strategies for HAI, we assessed the effectiveness of five of the less commonly used classes of pharmacological interventions. OBJECTIVES To assess the clinical effectiveness and adverse events of five of the less commonly used pharmacological interventions for preventing acute HAI in participants who are at risk of developing high altitude illness in any setting. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) in May 2017. We adapted the MEDLINE strategy for searching the other databases. We used a combination of thesaurus-based and free-text search terms. We scanned the reference lists and citations of included trials and any relevant systematic reviews that we identified for further references to additional trials. SELECTION CRITERIA We included randomized controlled trials conducted in any setting where one of five classes of drugs was employed to prevent acute HAI: selective 5-hydroxytryptamine(1) receptor agonists; N-methyl-D-aspartate (NMDA) antagonist; endothelin-1 antagonist; anticonvulsant drugs; and spironolactone. We included trials involving participants who are at risk of developing high altitude illness (AMS or HACE, or HAPE, or both). We included participants with and without a history of high altitude illness. We applied no age or gender restrictions. We included trials where the relevant medication was administered before the beginning of ascent. We excluded trials using these drugs during ascent or after ascent. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures employed by Cochrane. MAIN RESULTS We included eight studies (334 participants, 9 references) in this review. Twelve studies are ongoing and will be considered in future versions of this review as appropriate. We have been unable to obtain full-text versions of a further 12 studies and have designated them as 'awaiting classification'. Four studies were at a low risk of bias for randomization; two at a low risk of bias for allocation concealment. Four studies were at a low risk of bias for blinding of participants and personnel. We considered three studies at a low risk of bias for blinding of outcome assessors. We considered most studies at a high risk of selective reporting bias.We report results for the following four main comparisons.Sumatriptan versus placebo (1 parallel study; 102 participants)Data on sumatriptan showed a reduction of the risk of AMS when compared with a placebo (risk ratio (RR) = 0.43, CI 95% 0.21 to 0.84; 1 study, 102 participants; low quality of evidence). The one included study did not report events of HAPE, HACE or adverse events related to administrations of sumatriptan.Magnesium citrate versus placebo (1 parallel study; 70 participants)The estimated RR for AMS, comparing magnesium citrate tablets versus placebo, was 1.09 (95% CI 0.55 to 2.13; 1 study; 70 participants; low quality of evidence). In addition, the estimated RR for loose stools was 3.25 (95% CI 1.17 to 8.99; 1 study; 70 participants; low quality of evidence). The one included study did not report events of HAPE or HACE.Spironolactone versus placebo (2 parallel studies; 205 participants)Pooled estimation of RR for AMS was not performed due to considerable heterogeneity between the included studies (I² = 72%). RR from individual studies was 0.40 (95% CI 0.12 to 1.31) and 1.44 (95% CI 0.79 to 2.01; very low quality of evidence). No events of HAPE or HACE were reported. Adverse events were not evaluated.Acetazolamide versus spironolactone (1 parallel study; 232 participants)Data on acetazolamide compared with spironolactone showed a reduction of the risk of AMS with the administration of acetazolamide (RR = 0.36, 95% CI 0.18 to 0.70; 232 participants; low quality of evidence). No events of HAPE or HACE were reported. Adverse events were not evaluated. AUTHORS' CONCLUSIONS This Cochrane Review is the second in a series of three providing relevant information to clinicians and other interested parties on how to prevent high altitude illness. The assessment of five of the less commonly used classes of drugs suggests that there is a scarcity of evidence related to these interventions. Clinical benefits and harms related to potential interventions such as sumatriptan are still unclear. Overall, the evidence is limited due to the low number of studies identified (for most of the comparison only one study was identified); limitations in the quality of the evidence (moderate to low); and the number of studies pending classification (24 studies awaiting classification or ongoing). We lack the large and methodologically sound studies required to establish or refute the efficacy and safety of most of the pharmacological agents evaluated in this review.
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Affiliation(s)
- Alejandro G Gonzalez Garay
- National Institute of PediatricsMethodology Research UnitInsurgentes Sur 3700 ‐ CCol. Insurgentes Cuicuilco, CoyoacanMexico CityDistrito FederalMexico04530
| | - Daniel Molano Franco
- Fundacion Universitaria de Ciencias de la Salud, Hospital de San JoséDepartment of Critical CareCarrera 19 # 8‐32BogotaBogotaColombia11001
| | - Víctor H Nieto Estrada
- Fundacion Universitaria Sanitas, Colombia ClinicDepartment of Critical CareCarrera 19 # 8‐32BogotaBogotaColombia11001
| | | | - Ingrid Arevalo‐Rodriguez
- Universidad Tecnológica EquinoccialCochrane Ecuador. Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud Eugenio EspejoAv. Mariscal Sucre s/n y Av. Mariana de JesúsQuitoEcuador
- Hospital Universitario Ramon y Cajal (IRYCIS)Clinical Biostatistics UnitMadridSpain
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23
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Nieto Estrada VH, Molano Franco D, Medina RD, Gonzalez Garay AG, Martí‐Carvajal AJ, Arevalo‐Rodriguez I. Interventions for preventing high altitude illness: Part 1. Commonly-used classes of drugs. Cochrane Database Syst Rev 2017; 6:CD009761. [PMID: 28653390 PMCID: PMC6481751 DOI: 10.1002/14651858.cd009761.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND High altitude illness (HAI) is a term used to describe a group of cerebral and pulmonary syndromes that can occur during travel to elevations above 2500 metres (8202 feet). Acute hypoxia, acute mountain sickness (AMS), high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE) are reported as potential medical problems associated with high altitude. In this review, the first in a series of three about preventive strategies for HAI, we assess the effectiveness of six of the most recommended classes of pharmacological interventions. OBJECTIVES To assess the clinical effectiveness and adverse events of commonly-used pharmacological interventions for preventing acute HAI. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), LILACS and trial registries in January 2017. We adapted the MEDLINE strategy for searching the other databases. We used a combination of thesaurus-based and free-text terms to search. SELECTION CRITERIA We included randomized-controlled and cross-over trials conducted in any setting where commonly-used classes of drugs were used to prevent acute HAI. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as expected by Cochrane. MAIN RESULTS We included 64 studies (78 references) and 4547 participants in this review, and classified 12 additional studies as ongoing. A further 12 studies await classification, as we were unable to obtain the full texts. Most of the studies were conducted in high altitude mountain areas, while the rest used low pressure (hypobaric) chambers to simulate altitude exposure. Twenty-four trials provided the intervention between three and five days prior to the ascent, and 23 trials, between one and two days beforehand. Most of the included studies reached a final altitude of between 4001 and 5000 metres above sea level. Risks of bias were unclear for several domains, and a considerable number of studies did not report adverse events of the evaluated interventions. We found 26 comparisons, 15 of them comparing commonly-used drugs versus placebo. We report results for the three most important comparisons: Acetazolamide versus placebo (28 parallel studies; 2345 participants)The risk of AMS was reduced with acetazolamide (risk ratio (RR) 0.47, 95% confidence interval (CI) 0.39 to 0.56; I2 = 0%; 16 studies; 2301 participants; moderate quality of evidence). No events of HAPE were reported and only one event of HACE (RR 0.32, 95% CI 0.01 to 7.48; 6 parallel studies; 1126 participants; moderate quality of evidence). Few studies reported side effects for this comparison, and they showed an increase in the risk of paraesthesia with the intake of acetazolamide (RR 5.53, 95% CI 2.81 to 10.88, I2 = 60%; 5 studies, 789 participants; low quality of evidence). Budenoside versus placebo (2 parallel studies; 132 participants)Data on budenoside showed a reduction in the incidence of AMS compared with placebo (RR 0.37, 95% CI 0.23 to 0.61; I2 = 0%; 2 studies, 132 participants; low quality of evidence). Studies included did not report events of HAPE or HACE, and they did not find side effects (low quality of evidence). Dexamethasone versus placebo (7 parallel studies; 205 participants)For dexamethasone, the data did not show benefits at any dosage (RR 0.60, 95% CI 0.36 to 1.00; I2 = 39%; 4 trials, 176 participants; low quality of evidence). Included studies did not report events of HAPE or HACE, and we rated the evidence about adverse events as of very low quality. AUTHORS' CONCLUSIONS Our assessment of the most commonly-used pharmacological interventions suggests that acetazolamide is an effective pharmacological agent to prevent acute HAI in dosages of 250 to 750 mg/day. This information is based on evidence of moderate quality. Acetazolamide is associated with an increased risk of paraesthesia, although there are few reports about other adverse events from the available evidence. The clinical benefits and harms of other pharmacological interventions such as ibuprofen, budenoside and dexamethasone are unclear. Large multicentre studies are needed for most of the pharmacological agents evaluated in this review, to evaluate their effectiveness and safety.
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Affiliation(s)
- Víctor H Nieto Estrada
- Fundacion Universitaria Sanitas, Colombia ClinicDepartment of Critical CareCarrera 19 # 8‐32BogotaBogotaColombia11001
| | - Daniel Molano Franco
- Fundacion Universitaria de Ciencias de la Salud, Hospital de San JoséDepartment of Critical CareCarrera 19 # 8‐32BogotaBogotaColombia11001
| | - Roger David Medina
- Fundación Universitaria de Ciencias de la SaludDivision of ResearchCarrera 19 # 8‐32Bogotá D.C.Colombia
| | - Alejandro G Gonzalez Garay
- National Institute of PediatricsMethodology Research UnitInsurgentes Sur 3700 ‐ CCol. Insurgentes Cuicuilco, CoyoacanMexico CityDistrito FederalMexico04530
| | | | - Ingrid Arevalo‐Rodriguez
- Universidad Tecnológica EquinoccialCochrane Ecuador. Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud Eugenio EspejoAv. Mariscal Sucre s/n y Av. Mariana de JesúsQuitoEcuador
- Hospital Universitario Ramon y Cajal (IRYCIS)Clinical Biostatistics UnitMadridSpain
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24
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Esteve-Lanao J, Moreno-Pérez D, Cardona CA, Larumbe-Zabala E, Muñoz I, Sellés S, Cejuela R. Is Marathon Training Harder than the Ironman Training? An ECO-method Comparison. Front Physiol 2017; 8:298. [PMID: 28611674 PMCID: PMC5447032 DOI: 10.3389/fphys.2017.00298] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/24/2017] [Indexed: 11/13/2022] Open
Abstract
Purpose: To compare the absolute and relative training load of the Marathon (42k) and the Ironman (IM) training in recreational trained athletes. Methods: Fifteen Marathoners and Fifteen Triathletes participated in the study. Their performance level was the same relative to the sex's absolute winner at the race. No differences were presented neither in age, nor in body weight, height, BMI, running VO2max max, or endurance training experience (p > 0.05). They all trained systematically for their respective event (IM or 42k). Daily training load was recorded in a training log, and the last 16 weeks were compared. Before this, gas exchange and lactate metabolic tests were conducted in order to set individual training zones. The Objective Load Scale (ECOs) training load quantification method was applied. Differences between IM and 42k athletes' outcomes were assessed using Student's test and significance level was set at p < 0.05. Results: As expected, Competition Time was significantly different (IM 11 h 45 min ± 1 h 54 min vs. 42k 3 h 6 min ± 28 min, p < 0.001). Similarly, Training Weekly Avg Time (IM 12.9 h ± 2.6 vs. 42k 5.2 ± 0.9), and Average Weekly ECOs (IM 834 ± 171 vs. 42k 526 ± 118) were significantly higher in IM (p < 0.001). However, the Ratio between Training Load and Training Time was superior for 42k runners when comparing ECOs (IM 65.8 ± 11.8 vs. 42k 99.3 ± 6.8) (p < 0.001). Finally, all ratios between training time or load vs. Competition Time were superior for 42k (p < 0.001) (Training Time/Race Time: IM 1.1 ± 0.3 vs. 42k 1.7 ± 0.5), (ECOs Training Load/Race Time: IM 1.2 ± 0.3 vs. 42k 2.9 ± 1.0). Conclusions: In spite of IM athletes' superior training time and total or weekly training load, when comparing the ratios between training load and training time, and training time or training load vs. competition time, the preparation of a 42k showed to be harder.
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Affiliation(s)
| | - Diego Moreno-Pérez
- All In Your Mind TMMadrid, España.,Fundamentos de los Deportes, Universidad Europea de MadridMadrid, España
| | - Claudia A Cardona
- All In Your Mind TMMadrid, España.,Departamento de Fisioterapia, Universidad del Valle de MéxicoMérida, Mexico
| | | | - Iker Muñoz
- Ciencias de la Salud, Universidad Europea del AtlánticoSantander, España
| | - Sergio Sellés
- Departmental Section of Physical Education and Sports, University of AlicanteAlicante, Spain
| | - Roberto Cejuela
- All In Your Mind TMMadrid, España.,Departmental Section of Physical Education and Sports, University of AlicanteAlicante, Spain
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25
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Debevec T, Millet GP, Pialoux V. Hypoxia-Induced Oxidative Stress Modulation with Physical Activity. Front Physiol 2017; 8:84. [PMID: 28243207 PMCID: PMC5303750 DOI: 10.3389/fphys.2017.00084] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/30/2017] [Indexed: 12/17/2022] Open
Abstract
Increased oxidative stress, defined as an imbalance between prooxidants and antioxidants, resulting in molecular damage and disruption of redox signaling, is associated with numerous pathophysiological processes and known to exacerbate chronic diseases. Prolonged systemic hypoxia, induced either by exposure to terrestrial altitude or a reduction in ambient O2 availability is known to elicit oxidative stress and thereby alter redox balance in healthy humans. The redox balance modulation is also highly dependent on the level of physical activity. For example, both high-intensity exercise and inactivity, representing the two ends of the physical activity spectrum, are known to promote oxidative stress. Numerous to-date studies indicate that hypoxia and exercise can exert additive influence upon redox balance alterations. However, recent evidence suggests that moderate physical activity can attenuate altitude/hypoxia-induced oxidative stress during long-term hypoxic exposure. The purpose of this review is to summarize recent findings on hypoxia-related oxidative stress modulation by different activity levels during prolonged hypoxic exposures and examine the potential mechanisms underlying the observed redox balance changes. The paper also explores the applicability of moderate activity as a strategy for attenuating hypoxia-related oxidative stress. Moreover, the potential of such moderate intensity activities used to counteract inactivity-related oxidative stress, often encountered in pathological, elderly and obese populations is also discussed. Finally, future research directions for investigating interactive effects of altitude/hypoxia and exercise on oxidative stress are proposed.
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Affiliation(s)
- Tadej Debevec
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan InstituteLjubljana, Slovenia
| | - Grégoire P. Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland
| | - Vincent Pialoux
- Laboratoire Interuniversitaire de Biologie de la Motricité EA 7424, Univ Lyon, Université Claude Bernard Lyon 1Villeurbanne, France
- Institut Universitaire de FranceParis, France
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26
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Heinzer R, Saugy JJ, Rupp T, Tobback N, Faiss R, Bourdillon N, Rubio JH, Millet GP. Comparison of Sleep Disorders between Real and Simulated 3,450-m Altitude. Sleep 2016; 39:1517-23. [PMID: 27166242 DOI: 10.5665/sleep.6010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/12/2016] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES Hypoxia is known to generate sleep-disordered breathing but there is a debate about the pathophysiological responses to two different types of hypoxic exposure: normobaric hypoxia (NH) and hypobaric hypoxia (HH), which have never been directly compared. Our aim was to compare sleep disorders induced by these two types of altitude. METHODS Subjects were exposed to 26 h of simulated (NH) or real altitude (HH) corresponding to 3,450 m and a control condition (NN) in a randomized order. The sleep assessments were performed with nocturnal polysomnography (PSG) and questionnaires. Thirteen healthy trained males subjects volunteered for this study (mean ± SD; age 34 ± 9 y, body weight 76.2 ± 6.8 kg, height 179.7 ± 4.2 cm). RESULTS Mean nocturnal oxygen saturation was further decreased during HH than in NH (81.2 ± 3.1 versus 83.6 ± 1.9%; P < 0.01) when compared to NN (95.5 ± 0.9%; P < 0.001). Heart rate was higher in HH than in NH (61 ± 10 versus 55 ± 6 bpm; P < 0.05) and NN (48 ± 5 bpm; P < 0.001). Total sleep time was longer in HH than in NH (351 ± 63 versus 317 ± 65 min, P < 0.05), and both were shorter compared to NN (388 ± 50 min, P < 0.05). Breathing frequency did not differ between conditions. Apnea-hypopnea index was higher in HH than in NH (20.5 [15.8-57.4] versus 11.4 [5.0-65.4]; P < 0.01) and NN (8.2 [3.9-8.8]; P < 0.001). Subjective sleep quality was similar between hypoxic conditions but lower than in NN. CONCLUSIONS Our results suggest that HH has a greater effect on nocturnal breathing and sleep structure than NH. In HH, we observed more periodic breathing, which might arise from the lower saturation due to hypobaria, but needs to be confirmed.
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Affiliation(s)
- Raphaël Heinzer
- Center for Investigation and Research in Sleep, CHUV, Lausanne, Switzerland
| | - Jonas J Saugy
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland.,Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Thomas Rupp
- Savoie Mont Blanc University, Exercise Physiology Laboratory, Chambery, France
| | - Nadia Tobback
- Center for Investigation and Research in Sleep, CHUV, Lausanne, Switzerland
| | - Raphael Faiss
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland.,Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Nicolas Bourdillon
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland.,Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - José Haba Rubio
- Center for Investigation and Research in Sleep, CHUV, Lausanne, Switzerland
| | - Grégoire P Millet
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Switzerland.,Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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27
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Saugy JJ, Schmitt L, Fallet S, Faiss R, Vesin JM, Bertschi M, Heinzer R, Millet GP. Sleep Disordered Breathing During Live High-Train Low in Normobaric Versus Hypobaric Hypoxia. High Alt Med Biol 2016; 17:233-238. [PMID: 27410774 DOI: 10.1089/ham.2016.0049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Saugy, Jonas J., Laurent Schmitt, Sibylle Fallet, Raphael Faiss, Jean-Marc Vesin, Mattia Bertschi, Raphaël Heinzer, and Grégoire P. Millet. Sleep disordered breathing during live high-train low in normobaric versus hypobaric hypoxia. High Alt Med Biol. 17:233-238, 2016.-The present study aimed to compare sleep disordered breathing during live high-train low (LHTL) altitude camp using normobaric hypoxia (NH) and hypobaric hypoxia (HH). Sixteen highly trained triathletes completed two 18-day LHTL camps in a crossover designed study. They trained at 1100-1200 m while they slept either in NH at a simulated altitude of 2250 m or in HH. Breathing frequency and oxygen saturation (SpO2) were recorded continuously during all nights and oxygen desaturation index (ODI 3%) calculated. Breathing frequency was lower for NH than HH during the camps (14.6 ± 3.1 breath × min-1 vs. 17.2 ± 3.4 breath × min-1, p < 0.001). SpO2 was lower for HH than NH (90.8 ± 0.3 vs. 91.9 ± 0.2, p < 0.001) and ODI 3% was higher for HH than NH (15.1 ± 3.5 vs. 9.9 ± 1.6, p < 0.001). Sleep in moderate HH is more altered than in NH during a LHTL camp.
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Affiliation(s)
- Jonas J Saugy
- 1 Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne , Switzerland .,2 Department of Physiology, Faculty of Biology and Medicine, University of Lausanne , Switzerland
| | - Laurent Schmitt
- 3 National School of Mountain Sports/National Ski-Nordic Centre , Prémanon, France
| | - Sibylle Fallet
- 4 Institute of Electrical Engineering, Swiss Federal Institute of Technology , Lausanne, Switzerland
| | - Raphael Faiss
- 1 Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne , Switzerland
| | - Jean-Marc Vesin
- 4 Institute of Electrical Engineering, Swiss Federal Institute of Technology , Lausanne, Switzerland
| | - Mattia Bertschi
- 5 Swiss Center for Electronics and Microtechnology , CSEM, Neuchâtel, Switzerland
| | - Raphaël Heinzer
- 6 Center for Investigation and Research in Sleep , CHUV, Lausanne, Switzerland
| | - Grégoire P Millet
- 1 Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne , Switzerland .,2 Department of Physiology, Faculty of Biology and Medicine, University of Lausanne , Switzerland
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28
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Debevec T, Pialoux V, Ehrström S, Ribon A, Eiken O, Mekjavic IB, Millet GP. FemHab: The effects of bed rest and hypoxia on oxidative stress in healthy women. J Appl Physiol (1985) 2016; 120:930-8. [PMID: 26796757 DOI: 10.1152/japplphysiol.00919.2015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/15/2016] [Indexed: 12/17/2022] Open
Abstract
Independently, both inactivity and hypoxia augment oxidative stress. This study, part of the FemHab project, investigated the combined effects of bed rest-induced unloading and hypoxic exposure on oxidative stress and antioxidant status. Healthy, eumenorrheic women were randomly assigned to the following three 10-day experimental interventions: normoxic bed rest (NBR;n= 11; PiO2 = 133 mmHg), normobaric hypoxic bed rest (HBR;n= 12; PiO2 = 90 mmHg), and ambulatory hypoxic confinement (HAMB;n= 8: PiO2 = 90 mmHg). Plasma samples, obtained before (Pre), during (D2, D6), immediately after (Post) and 24 h after (Post+1) each intervention, were analyzed for oxidative stress markers [advanced oxidation protein products (AOPP), malondialdehyde (MDA), and nitrotyrosine], antioxidant status [superoxide dismutase (SOD), catalase, ferric-reducing antioxidant power (FRAP), glutathione peroxidase (GPX), and uric acid (UA)], NO metabolism end-products (NOx), and nitrites. Compared with baseline, AOPP increased in NBR and HBR on D2 (+14%; +12%;P< 0.05), D6 (+19%; +15%;P< 0.05), and Post (+22%; +21%;P< 0.05), respectively. MDA increased at Post+1 in NBR (+116%;P< 0.01) and D2 in HBR (+114%;P< 0.01) and HAMB (+95%;P< 0.05). Nitrotyrosine decreased (-45%;P< 0.05) and nitrites increased (+46%;P< 0.05) at Post+1 in HAMB only. Whereas SOD was higher at D6 (+82%) and Post+1 (+67%) in HAMB only, the catalase activity increased on D6 (128%) and Post (146%) in HBR and HAMB, respectively (P< 0.05). GPX was only reduced on D6 (-20%;P< 0.01) and Post (-18%;P< 0.05) in HBR. No differences were observed in FRAP and NOx. UA was higher at Post in HBR compared with HAMB (P< 0.05). These data indicate that exposure to combined inactivity and hypoxia impairs prooxidant/antioxidant balance in healthy women. Moreover, habitual activity levels, as opposed to inactivity, seem to blunt hypoxia-related oxidative stress via antioxidant system upregulation.
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Affiliation(s)
- Tadej Debevec
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia;
| | - Vincent Pialoux
- Center of Research and Innovation on Sports, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Sabine Ehrström
- Center of Research and Innovation on Sports, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Alexandra Ribon
- Center of Research and Innovation on Sports, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Ola Eiken
- Department of Environmental Physiology, Swedish Aerospace Physiology Centre, Royal Institute of Technology, Stockholm, Sweden
| | - Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Grégoire P Millet
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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