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Burtscher J, Pasha Q, Chanana N, Millet GP, Burtscher M, Strasser B. Immune consequences of exercise in hypoxia: A narrative review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:297-310. [PMID: 37734549 PMCID: PMC11116970 DOI: 10.1016/j.jshs.2023.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
Immune outcomes are key mediators of many health benefits of exercise and are determined by exercise type, dose (frequency/duration, intensity), and individual characteristics. Similarly, reduced availability of ambient oxygen (hypoxia) modulates immune functions depending on the hypoxic dose and the individual capacity to respond to hypoxia. How combined exercise and hypoxia (e.g., high-altitude training) sculpts immune responses is not well understood, although such combinations are becoming increasingly popular. Therefore, in this paper, we summarize the impact on immune responses of exercise and of hypoxia, both independently and together, with a focus on specialized cells in the innate and adaptive immune system. We review the regulation of the immune system by tissue oxygen levels and the overlapping and distinct immune responses related to exercise and hypoxia, then we discuss how they may be modulated by nutritional strategies. Mitochondrial, antioxidant, and anti-inflammatory mechanisms underlie many of the adaptations that can lead to improved cellular metabolism, resilience, and overall immune functions by regulating the survival, differentiation, activation, and migration of immune cells. This review shows that exercise and hypoxia can impair or complement/synergize with each other while regulating immune system functions. Appropriate acclimatization, training, and nutritional strategies can be used to avoid risks and tap into the synergistic potentials of the poorly studied immune consequences of exercising in a hypoxic state.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Qadar Pasha
- Institute of Hypoxia Research, New Delhi 110067, India
| | - Neha Chanana
- Department of Biochemistry, Jamia Hamdard, New Delhi 110062, India
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne 1015, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck 6020, Austria.
| | - Barbara Strasser
- Faculty of Medicine, Sigmund Freud Private University, Vienna 1020, Austria; Ludwig Boltzmann Institute for Rehabilitation Research, Vienna 1100, Austria
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2
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Lu TL, He CS, Suzuki K, Lu CC, Wang CY, Fang SH. Concurrent Ingestion of Alkaline Water and L-Glutamine Enhanced Salivary α-Amylase Activity and Testosterone Concentration in Boxing Athletes. Nutrients 2024; 16:454. [PMID: 38337738 PMCID: PMC10857026 DOI: 10.3390/nu16030454] [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: 12/13/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
Athletes often take sport supplements to reduce fatigue and immune disturbances during or after training. This study evaluated the acute effects of concurrent ingestion of alkaline water and L-glutamine on the salivary immunity and hormone responses of boxers after training. Twelve male boxing athletes were recruited in this study. During regular training, the participants were randomly divided into three groups and asked to consume 400 mL of alkaline water (Group A), 0.15 g/kg body weight of L-glutamine with 400 mL of water (Group G), and 0.15 g/kg of L-glutamine with 400 mL of alkaline water (Group A+G) at the same time each day for three consecutive weeks. Before and immediately after the training, saliva, heart rates, and the rate of perceived exertion were investigated. The activity of α-amylase and concentrations of lactoferrin, immunoglobulin A (IgA), testosterone, and cortisol in saliva were measured. The results showed that the ratio of α-amylase activity/total protein (TP) significantly increased after training in Group A+G but not in Group A or G, whereas the ratios of lactoferrin/TP and IgA/TP were unaffected in all three groups. The concentrations of salivary testosterone after training increased significantly in Group A+G but not in Group A or G, whereas the salivary cortisol concentrations were unaltered in all groups. In conclusion, concurrent ingestion of 400 mL of alkaline water and 0.15 g/kg of L-glutamine before training enhanced the salivary α-amylase activity and testosterone concentration of boxers, which would be beneficial for post-exercise recovery.
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Affiliation(s)
- Tung-Lin Lu
- Institute of Athletics, National Taiwan University of Sport, Taichung 404401, Taiwan; (T.-L.L.); (C.-C.L.)
| | - Cheng-Shiun He
- Department of Athletic Sports, National Chung Cheng University, Minxiong 621301, Taiwan;
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan;
| | - Chi-Cheng Lu
- Institute of Athletics, National Taiwan University of Sport, Taichung 404401, Taiwan; (T.-L.L.); (C.-C.L.)
| | - Chung-Yuan Wang
- Department of Combat Sports, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Shih-Hua Fang
- Institute of Athletics, National Taiwan University of Sport, Taichung 404401, Taiwan; (T.-L.L.); (C.-C.L.)
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Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future. Sports Med 2022; 52:25-67. [PMID: 36214993 PMCID: PMC9734240 DOI: 10.1007/s40279-022-01756-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
The ketone bodies acetoacetate (AcAc) and β-hydroxybutyrate (βHB) have pleiotropic effects in multiple organs including brain, heart, and skeletal muscle by serving as an alternative substrate for energy provision, and by modulating inflammation, oxidative stress, catabolic processes, and gene expression. Of particular relevance to athletes are the metabolic actions of ketone bodies to alter substrate utilisation through attenuating glucose utilisation in peripheral tissues, anti-lipolytic effects on adipose tissue, and attenuation of proteolysis in skeletal muscle. There has been long-standing interest in the development of ingestible forms of ketone bodies that has recently resulted in the commercial availability of exogenous ketone supplements (EKS). These supplements in the form of ketone salts and ketone esters, in addition to ketogenic compounds such as 1,3-butanediol and medium chain triglycerides, facilitate an acute transient increase in circulating AcAc and βHB concentrations, which has been termed 'acute nutritional ketosis' or 'intermittent exogenous ketosis'. Some studies have suggested beneficial effects of EKS to endurance performance, recovery, and overreaching, although many studies have failed to observe benefits of acute nutritional ketosis on performance or recovery. The present review explores the rationale and historical development of EKS, the mechanistic basis for their proposed effects, both positive and negative, and evidence to date for their effects on exercise performance and recovery outcomes before concluding with a discussion of methodological considerations and future directions in this field.
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Slavish DC, Szabo YZ. What moderates salivary markers of inflammation reactivity to stress? A descriptive report and meta-regression. Stress 2021; 24:710-722. [PMID: 33759687 PMCID: PMC8460706 DOI: 10.1080/10253890.2021.1887848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 02/04/2021] [Indexed: 02/07/2023] Open
Abstract
As the assessment of salivary markers of inflammation gains popularity in stress research, understanding factors that influence these markers' reactivity to stress is important. A recent meta-analysis synthesized literature on changes in salivary markers of inflammation in response to acute stressors in adults. As a supplement to this, we present pre-registered moderator analyses of salivary markers of inflammation responses to acute stress. Analyses included data from 27 studies (35 unique study samples). Outcomes were Cohen's d effect sizes for salivary biomarkers interleukin-1 beta (IL-1β), IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), from pre- to post-stress. Moderators included: college education levels of the study sample; percent of the study sample that identified as African-American; body mass index (BMI); use of a resting baseline saliva sample; and use of a social evaluative stressor. Descriptive results on saliva sample timing were also examined. Biomarkers peaked 0-60 minutes after the end of the stressor. Before removing influential outliers, no moderators of salivary inflammation reactivity emerged, though not all moderators could be tested due to missing data. After removing one influential outlier study, higher study sample average BMI was associated with greater salivary IL-1β reactivity to stress (b = 0.41, p=.007). For every 1-unit increase in study sample average BMI, effect sizes for IL-1β increased by 0.41 units. These findings suggest BMI may be important to examine when assessing salivary markers of inflammation in response to stress. As this field expands, it is important to replicate these results and consider the role of other moderators of salivary markers of inflammation reactivity to stress.
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Affiliation(s)
- Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Yvette Z. Szabo
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA
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Paris HL, Sinai EC, Shei RJ, Keller AM, Mickleborough TD. The influence of carbohydrate ingestion on peripheral and central fatigue during exercise in hypoxia: A narrative review. Eur J Sport Sci 2021; 21:1423-1435. [PMID: 33106121 PMCID: PMC8140067 DOI: 10.1080/17461391.2020.1842512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hypoxia impairs aerobic performance by accelerating fatiguing processes. These processes may originate from sites either distal (peripheral) or proximal (central) to the neuromuscular junction, though these are not mutually exclusive. Peripheral mechanisms include decrements in muscle glycogen or fluctuations in intramuscular metabolites, whereas central responses commonly refer to reductions in central motor drive elicited by alterations in blood glucose and neurotransmitter concentrations as well as arterial hypoxemia. Hypoxia may accelerate both peripheral and central pathways of fatigue, with the level of hypoxia strongly dictating the degree and primary locus of impairment. As more people journey to hypoxic settings for work and recreation, developing strategies to improve work capacity in these environments becomes increasingly relevant. Given that sea level performance improves with nutritional interventions such as carbohydrate (CHO) ingestion, a similar strategy may prove effective in delaying fatigue in hypoxia, particularly considering how the metabolic pathways enhanced with CHO supplementation overlap the fatiguing pathways upregulated in hypoxia. Many questions regarding the relationship between CHO, hypoxia, and fatigue remain unanswered, including specifics on when to ingest, what to ingest, and how varying altitudes influence supplementation effectiveness. Therefore, the purpose of this narrative review is to examine the peripheral and central mechanisms contributing to fatigue during aerobic exercise at varying degrees of hypoxia and to assess the role of CHO ingestion in attenuating fatigue onset.
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Affiliation(s)
- Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, USA
| | - Erin C Sinai
- Department of Sports Medicine, Pepperdine University, Malibu, CA, USA
| | - Ren-Jay Shei
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, and Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
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Szabo YZ, Slavish DC. Measuring salivary markers of inflammation in health research: A review of methodological considerations and best practices. Psychoneuroendocrinology 2021; 124:105069. [PMID: 33316694 PMCID: PMC8412951 DOI: 10.1016/j.psyneuen.2020.105069] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022]
Abstract
There is an increasing interest in using saliva to measure inflammatory biomarkers. Compared to blood, saliva is non-invasive, requires a lower biosafety classification, and requires less specialized personnel to collect. As the assessment of inflammation in saliva becomes more popular in psychoneuroimmunology research, the development of gold-standard methodological practices is paramount. This paper reviews different considerations for designing studies to assess salivary measures of inflammation. We review saliva collection procedures, sample storage and processing considerations, assay techniques, flow rate, correspondence with blood-based markers, and potential demographic and health moderators of levels of salivary markers of inflammation. Together, this review highlights critical gaps for future research, including calls for standardization of study protocols, transparent reporting of results, assessing predictive validity of markers of salivary inflammation for disease, and the need for assessment of participants' oral and general health status. Although additional work is needed to elucidate gold standards for study design, measurement, and analysis, salivary markers of inflammation may be a useful tool for understanding oral and peripheral inflammation dynamics non-invasively.
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Affiliation(s)
- Yvette Z. Szabo
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA, Corresponding Authors: Yvette Z. Szabo, 4800 Memorial Drive (151C), Waco, Texas 76711 (254) 297-3179;
| | - Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
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7
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Paixão V, Almeida EB, Amaral JB, Roseira T, Monteiro FR, Foster R, Sperandio A, Rossi M, Amirato GR, Santos CAF, Pires RS, Leal FB, Durigon EL, Oliveira DBL, Vieira RP, Vaisberg M, Santos JMB, Bachi ALL. Elderly Subjects Supplemented with L-Glutamine Shows an Improvement of Mucosal Immunity in the Upper Airways in Response to Influenza Virus Vaccination. Vaccines (Basel) 2021; 9:vaccines9020107. [PMID: 33572639 PMCID: PMC7911866 DOI: 10.3390/vaccines9020107] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although glutamine is able to improve the immune response, its action in the upper airway immunity against the influenza virus vaccine remains unclear. Therefore, we aimed to evaluate the L-glutamine supplementation effect on the mucosal immune/inflammatory response of elderly subjects vaccinated against the influenza virus. METHODS Saliva sampling from 83 physically active elderly volunteers were collected pre- and 30 days after influenza virus vaccination and supplementation with L-glutamine (Gln, n = 42) or placebo (PL, n = 41). RESULTS Gln group showed higher salivary levels of interleukin (IL)-17, total secretory immunoglobulin A (SIgA), and specific-SIgA post-vaccination than values found pre-vaccination and in the PL group post-vaccination. Whereas higher salivary levels of IL-6 and IL-10 were observed post-vaccination in the Gln group, IL-37 levels were lower post-vaccination in both groups than the values pre-vaccination. Tumor necrosis factor (TNF)-α levels were unchanged. Positive correlations between IL-6 and IL-10 were found in all volunteer groups pre- and post-vaccination and also between IL-17 and IL-6 or IL-10 in the Gln group post-vaccination. A negative correlation between IL-37 and IL-10 was found pre- and post-vaccination in the PL group. CONCLUSION Gln supplementation was able to modulate salivary cytokine profile and increase SIgA levels, both total and specific to the influenza virus vaccine, in physically active elderly subjects.
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Affiliation(s)
- Vitória Paixão
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Ewin B. Almeida
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Jonatas B. Amaral
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Tamaris Roseira
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | - Fernanda R. Monteiro
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | - Roberta Foster
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Method Faculty of São Paulo (FAMESP), São Paulo 04046-200, Brazil;
| | | | - Marcelo Rossi
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Gislene R. Amirato
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Carlos A. F. Santos
- Department of Medicine, Geriatry, Paulista School of Medicine (EPM), São Paulo 04023-062, Brazil;
| | - Renier S. Pires
- Post-Graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo 04743-030, Brazil;
| | - Fabyano B. Leal
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
| | - Edison L. Durigon
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
- Scientific Platform Pasteur, University of São Paulo (USP), São Paulo 05508-060, Brazil
| | - Danielle B. L. Oliveira
- Institute of Biomedical Science, University of São Paulo (USP), São Paulo 05508-060, Brazil; (F.B.L.); (E.L.D.); (D.B.L.O.)
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Rodolfo P. Vieira
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São Paulo 12245-520, Brazil;
- Post-Graduation Program in Bioengineering and Biomedical Engineering, Universidade Brasil, São Paulo 15600-000, Brazil
- Post-Graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos 11015-020, Brazil
| | - Mauro Vaisberg
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
| | - Juliana M. B. Santos
- Post-Graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos 11015-020, Brazil
- Correspondence:
| | - André L. L. Bachi
- Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo 04021-001, Brazil; (V.P.); (E.B.A.); (J.B.A.); (T.R.); (F.R.M.); (R.F.); (M.R.); (G.R.A.); (M.V.); (A.L.L.B.)
- Post-Graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo 04743-030, Brazil;
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São Paulo 12245-520, Brazil;
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Santos JAR, Fernandes RJ, Zacca R. Multi-Micronutrient Supplementation and Immunoglobulin Response in Well-Fed Firefighters. Sports Med Int Open 2020; 5:E1-E7. [PMID: 33376770 PMCID: PMC7758155 DOI: 10.1055/a-1296-1486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
Intensive physical training programs can affect the immune system. This study aims to verify the multi-micronutrient supplementation effects on serum immunoglobulins levels prior to and after a five-week physical training program. Twenty-four male recruit firefighters were randomly allocated into supplemented (with Prisfar Ever-Fit Plus over 35 consecutive days) and placebo groups (n=12 each). Serum immunoglobulins G, A, and M were assessed. Supplementation effect was detected for immunoglobulin G (eta-squared, η 2 : 0.09; p =0.035; power: 0.56), A (η 2 : 0.24; p =0.001; power: 0.95), and M (η 2 : 0.09; p =0.036; power: 0.56). Although immunoglobulin A was different between groups at baseline (mean difference: 42.58; 95%CI: 7.00 to 78.16 mg/dL; p =0.021; d =2.48), within-group (before vs . after five weeks) showed no differences for both supplemented and control groups. In addition, even if immunoglobulin G and M were similar at baseline, immunoglobulin G decreased (mean diff.: 46.4; 95%CI: 6.7 to 86.1 mg/dL; p =0.03; d =0.74) and immunoglobulin M increased (mean diff.: -10.7; 95%CI: -15.8 to -5.5 mg/dL; p =0.001; d =-1.33) in the control group. Although mean values remained within the reference values, changes observed for immunoglobulin G and M may reflect some immune protection for firefighters engaged in recruit training.
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Affiliation(s)
- José Augusto Rodrigues Santos
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Ricardo J Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP‑UP), University of Porto, Porto, Portugal
| | - Rodrigo Zacca
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP‑UP), University of Porto, Porto, Portugal.,Ministry of Education, CAPES Foundation, Brazilia, Brazil
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9
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Caris AV, Thomatieli-Santos RV. Carbohydrate and Glutamine Supplementation Attenuates the Increase in Rating of Perceived Exertion during Intense Exercise in Hypoxia Similar to 4200 m. Nutrients 2020; 12:nu12123797. [PMID: 33322280 PMCID: PMC7763460 DOI: 10.3390/nu12123797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/16/2022] Open
Abstract
The rating of perceived exertion (RPE) indicates the feeling of fatigue. However, hypoxia worsens the condition and can worsen RPE. We evaluated whether carbohydrate and glutamine supplementation alters RPE and physiological markers in running at 70% peak oxygen uptake until exhaustion in a simulated altitude of 4500 m. Nine volunteers underwent three running tests at 70% peak oxygen uptake until exhaustion: (1) hypoxia and placebo, (2) hypoxia and 8% maltodextrin, and (3) hypoxia after six days of glutamine supplementation (20 g/day) and 8% maltodextrin. The exercise and supplementation were randomized and double-blinded. Lactate, heart rate, haemoglobin O2 saturation (SpO2%), and RPE (6-20 scale) were analyzed at the 15th and 30th min. The level of significance was set at p ≤ 0.05. SpO2% decreased at the 15th and 30th minutes compared to resting in placebo, carbohydrate, and glutamine supplementation. RPE increased at the 30th minute compared to the 15th minute in placebo and carbohydrate supplementation; however, there was no difference in the glutamine supplementation condition. Heart rate and lactate increased after the 15th and 30th minutes compared to resting, similar to the three conditions studied. We conclude that previous supplementation with glutamine and carbohydrate during intense exercise in hypoxia similar to 4500 m can attenuate the increase in RPE by the increase in glycemia and can be a useful strategy for people who exercise in these conditions.
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Affiliation(s)
- Aline V. Caris
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, Brazil;
| | - Ronaldo V. Thomatieli-Santos
- Department of Bioscience, Universidade Federal de São Paulo, São Paulo 11015-020, Brazil
- Correspondence: ; Tel.: +55-11-5572-0177
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10
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The Possible Importance of Glutamine Supplementation to Mood and Cognition in Hypoxia from High Altitude. Nutrients 2020; 12:nu12123627. [PMID: 33255790 PMCID: PMC7760805 DOI: 10.3390/nu12123627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
Hypoxia induced by low O2 pressure is responsible for several physiological and behavioral alterations. Changes in physiological systems are frequent, including inflammation and psychobiological declines such as mood and cognition worsening, resulting in increased reaction time, difficulty solving problems, reduced memory and concentration. The paper discusses the possible relationship between glutamine supplementation and worsening cognition mediated by inflammation induced by high altitude hypoxia. The paper is a narrative literature review conducted to verify the effects of glutamine supplementation on psychobiological aspects. We searched MEDLINE/PubMed and Web of Science databases and gray literature by Google Scholar for English articles. Mechanistic pathways mediated by glutamine suggest potential positive effects of its supplementation on mood and cognition, mainly its potential effect on inflammation. However, clinical studies are scarce, making any conclusions impossible. Although glutamine plays an important role and seems to mitigate inflammation, clinical studies should test this hypothesis, which will contribute to a better mood and cognition state for several people who suffer from problems mediated by hypoxia.
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11
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Shi Y, Dong B, Dong Q, Zhao Z, Yu Y. Effect of Preoperative Oral Carbohydrate Administration on Patients Undergoing Cesarean Section with Epidural Anesthesia: A Pilot Study. J Perianesth Nurs 2020; 36:30-35. [PMID: 33239219 DOI: 10.1016/j.jopan.2020.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of preoperative oral carbohydrate administration on patients undergoing Cesarean section with epidural anesthesia. DESIGN Randomized controlled clinical study. METHODS A total of 75 patients undergoing Cesarean section (American Society of Anesthesiologists physical status grade I-II) were randomized to preparation with a carbohydrate drink (CHO group), flavored water (placebo group), or to the fasting group. The CHO and placebo groups were double-blinded and given 300 mL of the drink 2 hours before surgery. Visual analog scores of the patient were assessed to evaluate thirst, hunger, and anxiety level, and the gastric antral cross-sectional areas were recorded by ultrasonography during the operative period. Insulin resistance was calculated on the basis of the blood glucose and insulin levels assessed before administration and after surgery. FINDINGS The CHO and placebo groups did not show an increase in gastric fluid volumes in terms of gastric antral cross-sectional area, and there were no adverse events. The visual analog scale scores at preoperative baseline were not different between groups . During the preoperative waiting period, preparation with CHO reduced not only thirst and anxiety more efficiently than water (placebo) but also hunger (P < .05), whereas water did not. No difference was observed in insulin resistance between groups before intake of the drink. Compared with the preoperative levels, insulin resistance showed a statistically significant increase in all groups (P < .05); however, the increase was significantly higher in the fasting and placebo groups than in the CHO group (P < .05). CONCLUSIONS Preoperative administration of CHO decreases postoperative insulin resistance and enhances pregnant women's comfort, leading to a reduced sense of thirst, hunger, and anxiety during the preoperative period for Cesarean section.
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Affiliation(s)
- Yuan Shi
- Department of Anesthesiology, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, PR China
| | - Beibei Dong
- Department of Anesthesiology, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, PR China
| | - Qingyun Dong
- Department of Emergency, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, PR China
| | - Zhili Zhao
- Department of Anesthesiology, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, PR China
| | - Yonghao Yu
- Department of Anesthesiology, Tianjin Institute of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin, PR China.
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Szabo YZ, Slavish DC, Graham-Engeland JE. The effect of acute stress on salivary markers of inflammation: A systematic review and meta-analysis. Brain Behav Immun 2020; 88:887-900. [PMID: 32371089 PMCID: PMC7478864 DOI: 10.1016/j.bbi.2020.04.078] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress. METHOD The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [dav]). RESULTS Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, dav = 0.27), IL-10 (k = 11, dav = 0.34), TNF-α (k = 10, dav = 0.57), and IFN-γ (k = 6, dav = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, dav = 0.16) and IL-8 (k = 7, dav = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations. CONCLUSIONS This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.
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Affiliation(s)
- Yvette Z. Szabo
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Texas A&M College of Medicine, Bryan, TX, USA,Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA
| | - Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
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13
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Hill GW, Gillum TL, Lee BJ, Romano PA, Schall ZJ, Hamilton AM, Kuennen MR. Prolonged treadmill running in normobaric hypoxia causes gastrointestinal barrier permeability and elevates circulating levels of pro- and anti-inflammatory cytokines. Appl Physiol Nutr Metab 2020; 45:376-386. [DOI: 10.1139/apnm-2019-0378] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the impact of treadmill running in normobaric hypoxia on gastrointestinal barrier permeability and the systemic inflammatory response. Ten recreationally active participants completed two 1-h bouts of matched-workload treadmill exercise (65% normoxic maximal oxygen consumption) in counterbalanced order. One bout was performed in normoxia (NORM: fraction of inspired oxygen (FIO2) = 20.9%) and the other in normobaric hypoxia (HYP: FIO2 = 13.5%). Minute ventilation, respiratory rate (RR), tidal volume (VT), oxygen consumption, carbon dioxide production, respiratory exchange ratio (RER), and heart rate (HR) were measured with a metabolic cart. Peripheral oxygen saturation (SpO2) was measured with pulse oximetry. Absolute tissue saturation (StO2) was measured with near-infrared spectroscopy. Fatty acid-binding protein (I-FABP) and circulating cytokine concentrations (interleukin (IL)-1Ra, IL-6, IL-10) were assayed from plasma samples that were collected pre-exercise, postexercise, 1 h-postexercise, and 4 h-postexercise. Data were analyzed with 2-way (condition × time) repeated-measures ANOVAs. Newman–Keuls post hoc tests were run where appropriate (p < 0.05). As compared with NORM, 1 h of treadmill exercise in HYP caused greater (p < 0.05) changes in minute ventilation (+30%), RR (+16%), VT (+10%), carbon dioxide production (+18%), RER (+16%), HR (+4%), SpO2 (–16%), and StO2 (–10%). Gut barrier permeability and circulating cytokine concentrations were also greater (p < 0.05) following HYP exercise, where I-FABP was shown increased at postexercise (+68%) and IL-1Ra at 1 h-postexercise (+266%). I-FABP and IL-1Ra did not change (p > 0.05) following NORM exercise. IL-6 and IL-10 increased with exercise in both study conditions but were increased more (p < 0.05) following HYP at postexercise (+705% and +127%, respectively) and 1 h-postexercise (+400% and +128%, respectively). Novelty Normobaric hypoxia caused significant desaturation and increased most cardiopulmonary responses by 10%–30%. Significant gut barrier permeability and increased pro- and anti-inflammatory cytokine concentrations could promote an “open window” in the hours following HYP exercise.
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Affiliation(s)
- Garrett W. Hill
- Department of Exercise Science, High Point University, High Point, NC 27268, USA
| | - Trevor L. Gillum
- Department of Kinesiology, California Baptist University, Riverside, CA 92504, USA
| | - Ben J. Lee
- Occupational Performance Research Group, University of Chichester, Chichester, PO19 6PE, UK
| | - Phebe A. Romano
- Department of Exercise Science, High Point University, High Point, NC 27268, USA
| | - Zach J. Schall
- Department of Exercise Science, High Point University, High Point, NC 27268, USA
| | - Ally M. Hamilton
- Department of Exercise Science, High Point University, High Point, NC 27268, USA
| | - Matthew R. Kuennen
- Department of Exercise Science, High Point University, High Point, NC 27268, USA
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14
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Caris AV, Tavares-Silva E, Thomatieli-Santos RV. Effects of carbohydrate and glutamine supplementation on cytokine production by monocytes after exercise in hypoxia: A crossover, randomized, double-blind pilot study. Nutrition 2019; 70:110592. [PMID: 31743809 DOI: 10.1016/j.nut.2019.110592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/24/2019] [Accepted: 08/25/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the combined effects of carbohydrate (CHO) and glutamine (Gln) supplementation on cytokine production by monocytes after exercise until exhaustion performed in hypoxia. METHODS Fifteen physically active men underwent three exercises until exhaustion with an intensity of 70% maximal oxygen intake at a simulated height of 4500 m under the following supplementation: placebo, CHO (maltodextrin 8%/200 mL for 20 min), and CHO + Gln (Gln 20 g/d for 6 d and maltodextrin 8%/200 mL for 20 min) during exercise and for 2 h of recovery. Analysis of variance for repeated measures followed by the Tukey's post hoc test was realized and P < 0.05 was considered statistically significant. RESULTS Oxygen saturation of arterial blood (SaO2%) decreased in the three trials compared with baseline. Two hours post-exercise, the SaO2% was high in CHO + Gln condition compared with placebo. Two hours after exercise, interleukin (IL)-1β decreased compared with post-exercise in placebo and was lower compared with baseline in the CHO + Gln condition. Tumor necrosis factor-α decreased 2 h after exercise compared with baseline and pre-exercise in the CHO + Gln condition. No changes were observed in myeloperoxidase or IL-6 production. Two hours after exercise, Gln decreased compared with baseline and post-exercise in placebo and decreased 2 h after exercise in relation to post-exercise in the CHO condition. Gln increased post-exercise compared with pre-exercise in the CHO + Gln condition. Although erythropoietin did not change in this condition, it was high post-exercise and 2 h after exercise in the placebo condition compared with baseline and 2 h after exercise compared with baseline and pre-exercise in the CHO condition. CONCLUSIONS Gln supplementation for 6 d before exercise, associated with CHO supplementation during exercise, was able to revert Gln reduction after exercise and after 2 h of recovery and may have contributed to reducing tumor necrosis factor-α production, suggesting a possible anti-inflammatory effect of supplementation.
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Affiliation(s)
- Aline V Caris
- Universidade Federal de São Paulo, Campus São Paulo, Brazil
| | | | - Ronaldo V Thomatieli-Santos
- Universidade Federal de São Paulo, Campus Baixada Santista, Brazil; Postgraduate program in Psychobiology, Universidade Federal de São Paulo, Campus São Paulo, Brazil.
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15
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Feng L, Jin F. Screening of differentially methylated genes in breast cancer and risk model construction based on TCGA database. Oncol Lett 2018; 16:6407-6416. [PMID: 30405777 PMCID: PMC6202521 DOI: 10.3892/ol.2018.9457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/10/2018] [Indexed: 12/12/2022] Open
Abstract
Differentially methylated genes in breast cancer were screened out and a prognostic risk model of breast cancer was constructed. RNA-seq data and methylation data for breast cancer-related level 3 were downloaded from The Cancer Genome Atlas (TCGA), and MethylMix R package was used to screen out differentially methylated genes in cancer tissues and normal tissues. DAVID was used to analyze the GO enrichment of differentially methylated genes, ConsensusPathDB to analyze the PATHWAY pathways of differentially methylated genes, the single factor, multivariate Cox analysis and Akaike Information Criterion (AIC) to construct the prognostic risk model of breast cancer, and the ROC curve to judge the clinical application value of the risk model. Two hundred and fifty-seven differentially methylated genes were successfully screened out in cancer tissues and normal tissues; 39 related to GO enrichments and 19 related to PATHWAY pathways were found; the best prognostic risk model was obtained, risk score = QRFP (degree of methylation) × (−3.657) + S100A16 × (−3.378) + TDRD1 × (−4.001) + SMO × (3.548); it was determined from each sample that the median value of the risk score was 0.936; using it as the cut-off value, the five-year survival rate in high-risk group of patients was 72.4% (95% CI, 62.7–83.6%), and that in low-risk group of patients was 86.6% (95% CI, 78.6–95.3%). The difference in the survival rate between the high-risk and low-risk groups was significant (P<0.001). The AUC of ROC curve was 0.791, so the model had a good clinical application value. This study successfully found multiple breast cancer-related methylation genes, the relationship between them and the course and prognosis of breast cancer was analyzed. Moreover, a prognostic risk model was constructed, which facilitated the expansion of the current study on the role of methylation in the occurrence and development of breast cancer.
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Affiliation(s)
- Liang Feng
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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Khanna K, Mishra KP, Ganju L, Kumar B, Singh SB. High-Altitude-Induced alterations in Gut-Immune Axis: A review. Int Rev Immunol 2017; 37:119-126. [PMID: 29231767 DOI: 10.1080/08830185.2017.1407763] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
High-altitude sojourn above 8000 ft is increasing day by day either for pilgrimage, mountaineering, holidaying or for strategic reasons. In India, soldiers are deployed to these high mountains for their duty or pilgrims visit to the holy places, which are located at very high altitude. A large population also resides permanently in high altitude regions. Every year thousands of pilgrims visit Holy cave of Shri Amarnath ji, which is above 15 000 ft. The poor acclimatization to high altitude may cause alteration in immunity. The low oxygen partial pressure may cause alterations in gut microbiota, which may cause changes in gut immunity. Effect of high altitude on gut-associated mucosal system is new area of research. Many studies have been carried out to understand the physiology and immunology behind the high-altitude-induced gut problems. Few interventions have also been discovered to circumvent the problems caused due to high-altitude conditions. In this review, we have discussed the effects of high-altitude-induced changes in gut immunity particularly peyer's patches, NK cells and inflammatory cytokines, secretary immunoglobulins and gut microbiota. The published articles from PubMed and Google scholar from year 1975 to 2017 on high-altitude hypoxia and gut immunity are cited in this review.
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Affiliation(s)
- Kunjan Khanna
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - K P Mishra
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Lilly Ganju
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Bhuvnesh Kumar
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
| | - Shashi Bala Singh
- a Immunomodulation Division , Defence Institute of Physiology and Allied Sciences (DIPAS), DRDO , Delhi , India
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