Leukocytosis, muscle damage and increased lymphocyte proliferative response after an adventure sprint race

Effects of Ultratrail Running on Neuromuscular Function, Muscle Damage and Hydration Status. Differences According to Training Level

The status of trail running races has exponentially grown in recent years. The present study aimed to: (a) evaluate the acute response of ultratrail racing in terms of neuromuscular function, muscle damage and hydration status; (b) analyze if responses could differ according to training levels. Twenty runners participated in the present study. The participants were divided into amateur training level (n = 10; 43.30 ± 4.52 years) or high level competitors (n = 10; 41.40 ± 6.18). Neuromuscular response (squat jump, countermovement jump and Abalakov jump), muscle damage (alanine aminotransferase, bilirubin, creatine kinase and leukocytes) and hydration status (sodium and creatinine) were evaluated before and after the Guara Somontano Ultratrail Race (108 km distance, with an accumulated slope of 5800 m). The height and power achieved by vertical jumps were lower after the race (p < 0.001). The post-race muscle damage and creatinine parameters increased in both groups (p < 0.001). The high-level group obtained lower percentages of change in squat jump and countermovement jump than the amateur-level group (p < 0.05). However, the increase in creatinine was greater for the high-level group (p < 0.05). Ultratrail racing reduces neuromuscular function and increases muscle damage. High-level runners showed less neuromuscular fatigue compared to amateur ones.

Probiotic supplementation in marathonists and its impact on lymphocyte population and function after a marathon: a randomized placebo-controlled double-blind study

Probiotic supplementation arises as playing an immune-stimulatory role. High-intensity and -volume exercise can inhibit immune cell function, which threatens athletic performance and recovery. We hypothesized that 30 days of probiotic supplementation could stabilize the immune system of athletes preventing immune suppression after a marathon race. Twenty-seven male marathonists were double-blinded randomly into probiotic (Bifidobacterium-animalis-subsp.-Lactis (10 × 10⁹) and Lactobacillus-Acidophilus (10 × 10⁹) + 5 g of maltodextrin) and placebo (5 g of maltodextrin) group. They received 30 sachets and supplemented 1 portion/day during 30 days before the race. Blood were collected 30 days before (rest), 1 day before (pre), 1 h after (post) and 5 days after the race (recovery). Both chronic and acute exercise modulated a different T lymphocyte population (CD3⁺CD4⁻CD8⁻ T-cells), increasing pre-race, decreasing post and returning to rest values at the recovery. The total number of CD8 T cell and the memory subsets statistically decreased only in the placebo group post-race. Pro-inflammatory cytokine production by stimulated lymphocytes decreased in the probiotic group after the supplementation period. 30 days of probiotic supplementation maintained CD8 T cell and effector memory cell population and played an immunomodulatory role in stimulated lymphocytes. Both, training and marathon modulated a non-classical lymphocyte population regardless of probiotic supplementation.

Changes in immunological parameters in ultramarathon runners depending on the duration of the load

BACKGROUND

In recent decades, there has been an increasing interest in long-distance running, not only to the classic marathon distances but also to an ultramarathon -100 km, 250 km, and multi-day races. One of the most reactive body systems in conditions of prolonged muscular loads is the immune system. The work aimed to investigate the changes in immunological parameters in runners for extra-long distances of various durations.

METHODS

We examined 73 male athletes specializing in long-distance and ultra-long-distance running. The design of the survey included the study of immunological status during the marathon race, 100 km run, and six-day run. We studied the dynamics of leukocyte formula; subpopulations of lymphocytes; fractions of immunoglobulins: IgA, IgM, IgG; phagocytic activity.

RESULTS

During the marathon run, athletes' immunological changes are manifested by the development of neutrophilic leukocytosis with a decrease in the phagocytic activity of neutrophils. There was a sharp increase in the NLR and decrease in the LMR. A 100-km race caused a decrease in the absolute and relative number of T-lymphocytes. NLR increased almost ten times, and LMR, on the contrary, decreased nearly five times. On the first day of the 6-days run, there is a sharp increase in NLR and a decrease in LMR, after which there is a relative stabilization of both indicators.

CONCLUSIONS

Changes in immunological parameters during jogging are closely related to the duration of the load. The most pronounced changes are observed on the part of neutrophils and lymphocytes.

Does melamine exposure during infancy cause rhabdomyolysis?

We investigated the possible toxic effects of melamine on muscle tissue in rats using biochemical, hematological and histopathological methods. We used three groups of female albino Wistar rats. The first group was given 0.1 ml saline. The second and third groups were given 50 and 75 mg/kg melamine dissolved in 0.1 ml saline, respectively, daily for 21 days. On day 45, all rats were sacrificed, and whole blood and plasma were analyzed for hematologic and biochemical characteristics. Muscle samples were stained with hematoxylin and eosin for histopathological investigation. Other sections were immunostained for matrix metalloproteinase-9 (MMP-9) and type IV collagen. We found a significant increase in the lymphocytosis-compliant leukocyte number in the 75 mg/kg melamine group compared to the other groups. We also found significant decreases in the hemoglobin levels and hematocrit values in the 75 mg/kg compared to the other groups. We found that the 75 mg/kg melamine group exhibited a significant increase in plasma aspartate aminotransferase (AST) activity compared to the other groups. Changes in plasma creatine kinase and lactate dehydrogenase activity were not statistically significant. Plasma AST activity and mean corpuscular hemoglobin levels were correlated with the lymphocyte:neutrophil ratio. We found mononuclear cell infiltration at the periphery of muscle bundles and in the connective tissue bundles in the melamine treated group. We found MMP-9 expression in muscle cell membranes and type IV collagen expression in degenerative connective tissue fibers. Whole blood, plasma and muscle tissue analysis indicated that the 75 mg/kg melamine group exhibited rhabdomyolysis that was associated with lymphocytosis and anemia. The underlying mechanisms by which melamine causes rhabdomyolytic effects remain unclear.

Beneficial Effect of Ubiquinol on Hematological and Inflammatory Signaling during Exercise

Strenuous exercise (any activity that expends six metabolic equivalents per minute or more causing sensations of fatigue and exhaustion to occur, inducing deleterious effects, affecting negatively different cells), induces muscle damage and hematological changes associated with high production of pro-inflammatory mediators related to muscle damage and sports anemia. The objective of this study was to determine whether short-term oral ubiquinol supplementation can prevent accumulation of inflammatory mediators and hematological impairment associated to strenuous exercise. For this purpose, 100 healthy and well-trained firemen were classified in two groups: Ubiquinol (experimental group), and placebo group (control). The protocol was two identical strenuous exercise tests with rest period between tests of 24 h. Blood samples were collected before supplementation (basal value) (T1), after supplementation (T2), after first physical exercise test (T3), after 24 h of rest (T4), and after second physical exercise test (T5). Hematological parameters, pro- and anti-inflammatory cytokines and growth factors were measured. Red blood cells (RBC), hematocrit, hemoglobin, VEGF, NO, EGF, IL-1ra, and IL-10 increased in the ubiquinol group while IL-1, IL-8, and MCP-1 decreased. Ubiquinol supplementation during high intensity exercise could modulate inflammatory signaling, expression of pro-inflammatory, and increasing some anti-inflammatory cytokines. During exercise, RBC, hemoglobin, hematocrit, VEGF, and EGF increased in ubiquinol group, revealing a possible pro-angiogenic effect, improving oxygen supply and exerting a possible protective effect on other physiological alterations.

Effect of Acute and Chronic Aerobic Exercise on Immunological Markers: A Systematic Review

Introduction: The effects of aerobic exercise on the immune system are not yet fully defined in the scientific literature. This fact demonstrates the need to investigate its influence on existing immunological markers by classifying and quantifying their acute and chronic effects. Objective: To investigate the effects of acute and chronic aerobic exercise on inflammatory markers of healthy adults. Methods: This study is a systematic review according to PRISMA recommendations. The following databases were searched: MEDLINE (via PubMed), Science Direct, Scopus, Web of Science, SciELO, Bireme and Cochrane Library, and article references. The last search was performed in March 2019. We included randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) investigating the acute and chronic effects of aerobic exercise on immune markers in healthy male and female adults aged 20 to 45 years, without restrictions in language or year of publication. Two authors independently analyzed the studies by reading the titles, abstracts, and full texts. Risk of Study bias was analyzed using Cochrane's Risk of Bias Tool. Outcomes: We included 15 studies in this systematic review, 13 of which were acute intervention and 2 were chronic, with 296 participants, 196 men and 100 women all being healthy individuals. It was observed that the acute intervention promotes changes in most immunological markers, while the chronic intervention interferes with a smaller proportion, this being in lymphocyte subpopulations. In the evaluation of quality, it was found that most studies did not present a high risk of bias in the evaluated aspects, but an unclear related risk of bias was observed, requiring a more careful analysis. Conclusion: Thus, it can be concluded that the evidence indicates that acute and chronic interventions may modify most immune markers, but aspects such as gender, contraceptive pill use in women, physical capacity of the investigated individuals, environment, and type and intensity of the exercises may interfere with these markers as well as the data analysis. Therefore, this review suggests that further research is needed to contribute to the confirmation and estimation of results.

CD4+ T cell activation and associated susceptibility to HIV-1 infection in vitro increased following acute resistance exercise in human subjects

Early studies in exercise immunology suggested acute bouts of exercise had an immunosuppressive effect in human subjects. However, recent data, show acute bouts of combined aerobic and resistance training increase both lymphocyte activation and proliferation. We quantified resistance exercise-induced changes in the activation state of CD4+ T lymphocytes via surface protein expression and using a medically relevant model of infection (HIV-1). Using a randomized cross-over design, 10 untrained subjects completed a control and exercise session. The control session consisted of 30-min seated rest while the exercise session entailed 3 sets × 10 repetitions of back squat, leg press, and leg extensions at 70% 1-RM with 2-min rest between each set. Venous blood samples were obtained pre/post each session. CD4+ T lymphocytes were isolated from whole blood by negative selection. Expression of activation markers (CD69 & CD25) in both nonstimulated and stimulated (costimulation through CD3+ CD28) cells were assessed by flow cytometry. Resistance exercised-induced effects on intracellular activation was further evaluated via in vitro infection with HIV-1. Nonstimulated CD4+ T lymphocytes obtained postexercise exhibited elevated CD25 expression following 24 h in culture. Enhanced HIV-1 replication was observed in cells obtained postexercise. Our results demonstrate that an acute bout of resistance exercise increases the activation state of CD4+ T lymphocytes and results in a greater susceptibility to HIV-1 infection in vitro. These findings offer further evidence that exercise induces activation of T lymphocytes and provides a foundation for the use of medically relevant pathogens as indirect measures of intracellular activation.

DAILY HEMATOLOGIC ASSESSMENT DURING A 230-KM MULTISTAGE ULTRAMARATHON

ABSTRACT Introduction: The popularity of ultra-endurance events is increasing worldwide. However, information about hematological parameters during repeated bouts of long-duration running, such as stages during a multi-stage ultramarathon (MSUM) is scarce. Objective: The purpose of the study was to monitor daily hematologic assessment in a 230-km multistage ultramarathon (MSUM) in hot environmental conditions. Methods: Eleven male and three female (n = 14) ultra-endurance runners entered this MSUM, which was conducted over five stages, covering a total distance of 230 km in hot ambient conditions. Peripheral blood samples were collected before and after each stage to determine leukocyte and erythrocytes parameters. Results: Multilevel modelling considering all measurement points showed an increase for whole blood leukocyte and granulocyte counts at five stages of the MSUM and for monocytes until Stage 3 of the race. For erythrocyte parameters, decreases across stages were observed in hemoglobin concentration and hematocrit responses when computing/considering all measurement points. Conclusions: The results indicate that MSUM in a hot environment leads to a greater impact on leukocyte population responses and platelet variation in the initial stages of the race. We suggest that athletes may have a decrease in immune function in the early stages of the MSUM, probably with some transient risk of infectious. Nevertheless, a physiological adaptation to physical exertion and heat mitigates these changes in the subsequent stages of MSUM. Level of Evidence III; Case-control study.

Lifelong training improves anti-inflammatory environment and maintains the number of regulatory T cells in masters athletes

PURPOSE

The purpose of this study was to quantify and characterize peripheral blood regulatory T cells (Tregs), as well as the IL-10 plasma concentration, in Masters athletes at rest and after an acute exhaustive exercise test.

METHODS

Eighteen Masters athletes (self-reported training: 24.6 ± 1.83 years; 10.27 ± 0.24 months and 5.45 ± 0.42 h/week per each month trained) and an age-matched control group of ten subjects (that never took part in regular physical training) volunteered for this study. All subjects performed an incremental test to exhaustion on a cycle ergometer. Blood samples were obtained before (Pre), 10 min into recovery (Post), and 1 h after the test (1 h).

RESULTS

Absolute numbers of Tregs were similar in both groups at rest. Acute exercise induced a significant increase in absolute numbers of Tregs at Post (0.049 ± 0.021 to 0.056 ± 0.024 × 10⁹/L, P = 0.029 for Masters; 0.048 ± 0.017 to 0.058 ± 0.020 × 10⁹/L, P = 0.037 for control) in both groups. Treg mRNA expression for FoxP3, IL-10, and TGF-β in sorted Tregs was similar throughout the trials in both groups. Masters athletes showed a higher percentage of subjects expressing the FoxP3 (100% for Masters vs. 78% for Controls, P = 0.038) and TGF-β (89% for Masters vs. 56% for Controls, P = 0.002) after exercise and a higher plasma IL-10 concentration (15.390 ± 7.032 for Masters vs. 2.411 ± 1.117 for control P = 0.001, ES = 2.57) at all timepoints. KLRG1 expression in Tregs was unchanged.

CONCLUSION

Our findings showed that Masters athletes have elevated anti-inflammatory markers and maintain the number of Tregs, and may be an adaptive response to lifelong training.

Protective effect of Curcuma longa L. extract on CCl4-induced acute hepatic stress

BACKGROUND

The Curcuma longa L. (CLL) rhizome has long been used to treat patients with hepatic dysfunction. CLL is a member of the ginger family of spices that are widely used in China, India, and Japan, and is a common spice, coloring, flavoring, and traditional medicine. This study was performed to evaluate the hepatoprotective activity of CLL extract and its active component curcumin in an acute carbon tetrachloride (CCl4)-induced liver stress model.

METHODS

Acute hepatic stress was induced by a single intraperitoneal injection of CCl4 (0.1 ml/kg body weight) in rats. CLL extract was administered once a day for 3 days at three dose levels (100, 200, and 300 mg/kg/day) and curcumin was administered once a day at the 200 mg/kg/day. We performed alanine transaminase (ALT) and aspartate transaminase (AST). activity analysis and also measured total lipid, triglyceride, and cholesterol levels, and lipid peroxidation.

RESULTS

At 100 g CLL, the curcuminoid components curcumin (901.63 ± 5.37 mg/100 g), bis-demethoxycurcumin (108.28 ± 2.89 mg/100 g), and demethoxycurcumin (234.85 ± 1.85 mg/100 g) were quantified through high liquid chromatography analysis. In CCl4-treated rats, serum AST and ALT levels increased 2.1- and 1.2-fold compared with the control. AST but not ALT elevation induced by CCl4 was significantly alleviated in CLL- and curcumin-treated rats. Peroxidation of membrane lipids in the liver was significantly prevented by CLL (100, 200, and 300 mg/kg/day) on tissue lipid peroxidation assay and immunostaining with anti-4HNE antibody. We found that CLL extract and curcumin exhibited significant protection against liver injury by improving hepatic superoxide dismutase (p < 0.05) and glutathione peroxidase activity, and glutathione content in the CCl4-treated group (p < 0.05), leading to a reduced lipid peroxidase level.

CONCLUSION

Our data suggested that CLL extract and curcumin protect the liver from acute CCl4-induced injury in a rodent model by suppressing hepatic oxidative stress. Therefore, CLL extract and curcumin are potential therapeutic antioxidant agents against acute hepatotoxicity.

Greater muscle damage in athletes with ACTN3 R577X (RS1815739) gene polymorphism after an ultra-endurance race: a pilot study

In this study, we aimed to investigate the influence of ACTN3 R577X gene polymorphism on muscle damage responses in athletes competing in an ultra-endurance race. Twenty moderate to well-trained ultra-runners who had entered in an official 37.1 km adventure race (22.1 km mountain biking, 10.9 km trekking, 4.1 km water trekking, 30 m rope course, and orienteering) volunteered for the study. Blood samples were collected for genotyping and analysis of muscle protein levels before and after the race. Percentage changes (pre- to post-race) of serum myoglobin [XX = 5,377% vs. RX/RR = 1,666%; P = 0.005, effect size (ES) = 1.73], creatine kinase (XX = 836.5% vs. RX/RR = 455%; P = 0.04, ES = 1.29), lactate dehydrogenase (XX = 82% vs. RX/RR = 65%; P = 0.002, ES = 1.61), and aspartate aminotransferase (XX = 148% vs. RX/RR = 75%; P = 0.02, ES = 1.77) were significantly greater for XX than RX/RR genotypes. ES analysis confirmed a large magnitude of muscle damage in XX genotype ultra-runners. Therefore, athletes with the ACTN3 577XX genotype experienced more muscle damage after an adventure race. This suggests that ultra-runners with alpha-actinin-3 deficiency may be more susceptible to rhabdomyolysis and associated health complications during ultra-endurance competitions.

Leukocyte Populations are Associated with Heart Rate Variability After a Triathlon

The purpose of this study was to analyze cellular immune components and their association with heart rate variability in triathlon athletes. Twelve athletes were included (age 36.41 ± 5.57 years, body mass 81.84 ± 10.97 kg) and blood samples were taken one week before, immediately, at 2 and 48 hours, and one week after competition. Total lymphocytes and their subpopulations, neutrophils, basophils, eosinophils and monocytes were analyzed. At the same time, heart rate variability was recorded for 30 minutes using Polar Team2®. A significant difference between lymphocyte subpopulations and heart rate variability was found in the different study periods. A positive correlation was found between total lymphocytes and rMSSD (r = .736, p <0.05), CD3+ and rMSSD (r = .785, p <0.05), and CD4+ and rMSSD (r = .795, p < 0.05) at the end of the competition. After one week of competition, a negative correlation was found between eosinophils and MRR, SDNN, pNN50, and rMSSD (p <0.01); and basophils and MRR, SDNN, pNN50, and rMSSD (p <0.01); while a positive correlation was found between CD19+ (B cells) and pNN50 (r = .678, p <0.05). Our results suggest that it is possible to predict the effect of training with regard to the athlete's performance.

Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults

BACKGROUND

Influenza is an infectious virus affecting both humans and animals. In humans, symptoms present as fever, cough, sore throat, runny nose, headache, muscle and joint pain, and malaise. The epidemiological profile of influenza is influenced by multiple factors, including transmissibility of the virus and the susceptibility of the population. Annually, influenza is estimated to infect 5% to 10% of adults, with higher rates in winter seasons in countries with seasonal variation. Exercise could be an intervention to enhance immune response and limit influenza incidence and its related complications.

OBJECTIVES

To assess the efficacy and safety of short and long-term exercise prior to influenza vaccination in enhancing influenza prevention in adults.

SEARCH METHODS

We searched CENTRAL (2015, Issue 11), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 3 November 2015), Embase (1974 to 3 November 2015), CINAHL (1981 to 3 November 2015), LILACS (Latin American and Caribbean Health Sciences, 1982 to 3 November 2015), PEDro (1980 to 3 November 2015), SPORTDiscus (1985 to 3 November 2015), the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (November 2015).

SELECTION CRITERIA

Randomised controlled trials (RCTs) of short- and long-term exercise prior to influenza vaccination for the general adult population were eligible for inclusion.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted and checked data from the included trials using a standard form. We used the random-effects model due to differences in the type, duration, intensity and frequency of exercise in the analysis.

MAIN RESULTS

We included six trials published between 2007 and 2014 that randomised 599 adult participants. Study size ranged from 46 to 158 participants. Participants were aged between 18 years and 80 years; we could not derive gender proportions, as participants' sex was not reported in all studies. One study was available in abstract form only.We did not find a significant difference in outcomes between people who exercised and those who did not exercise before receiving influenza vaccination.Pre-vaccination exercises included endurance activities such as walking or using a treadmill, and resistance activities included biceps curls and lateral raises. Five of the studies provided one session of exercise between 25 and 50 minutes. In five studies, exercise was undertaken on the same day as the vaccination. One study provided exercise over a period of eight weeks before vaccination, with one 2½ hour supervised session, plus daily home exercise practice of 45 minutes. Exercise intensity ranged from 55% to 85% of maximal heart rate. Control group participants undertook a range of activities, including quiet rest, sitting, reading, meditation or unspecified activity.One study reported numbers of people who contracted influenza; no significant difference was reported between exercise and no-exercise participants. None of the included studies reported complications related to influenza illness. Only one study, which we assessed as providing low-quality evidence, reported numbers of people who experienced adverse events. This study reported no significant difference in outcomes between people who exercised and those who did not. No studies reported numbers of working days or days lost related to influenza illness. Only two studies reported participant-centred outcomes.Overall, study quality was unclear; we assessed five of the six included studies to have at least four unclear 'Risk of bias' domains (allocation concealment, blinding of outcome assessment, selective reporting and other bias). Insufficient reporting in four studies about selective reporting did not provide enough information to enable judgement; only two studies were included in trials registers.

AUTHORS' CONCLUSIONS

From the available evidence, we found that exercising before influenza vaccination is neither beneficial nor harmful. However, study data were limited and of low quality. Small sample sizes, study design limitations, exercise types, and focus on biochemical rather than participant-centred outcomes strongly influenced our findings.

Acute bouts of exercise induce a suppressive effect on lymphocyte proliferation in human subjects: A meta-analysis

OBJECTIVE

Lymphocyte proliferative responses are commonly used to assess immune function in clinical settings, yet it is unclear how proliferative capacity is altered by exercise. This analysis aims to quantitatively assess the proliferative response of lymphocytes following an acute bout of exercise.

METHODS

Electronic databases were searched for articles containing the keywords "exercise" OR "acute" OR "aerobic" OR "resistance training" OR "immune function" AND "proliferation" AND "lymphocyte." Initial results yielded 517 articles of which 117 were reviewed in full. Twenty-four articles met the inclusion criteria. Calculated standardized mean difference (SMD) and corresponding standard errors (SE) were integrated using random-effect models.

RESULTS

Analyses uncovered evidence for suppression of proliferative capacity following acute exercise in general (SMD=-0.18, 95% CI: -0.21, -0.16) with long duration, high intensity exercise exhibiting a moderate suppressive effect (SMD=-0.55, 95% CI: -0.86, -0.24). Discordant proliferative responses for long duration, high intensity exercise in competitive versus non-competitive settings were identified with enhanced proliferation (SMD=0.46, 95% CI: 0.03, 0.89) observed following competitive events and a large suppressive effect detected for similar activities outside of a competitive environment (SMD: -1.28, 95% CI: -1.61, -0.96) (p=0.02).

CONCLUSION

Evidence suggests lymphocyte proliferation is suppressed following acute bouts of exercise, with exercise lasting longer than one hour having a greater magnitude of effect regardless of exercise intensity. Variations in observed effect sizes across intensity, duration, and competitive environment further highlight our need to acknowledge the impact of study designs in advancing our understanding of exercise immunology.