Chronic treatment with the glucocorticoid receptor antagonist RU486 inhibits diabetes-induced enhancement of experimental periodontitis

BACKGROUND AND OBJECTIVE

Chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity and excessive glucocorticoid hormone release have been associated with diabetes, altered immune responses and increased susceptibility to periodontitis. In the present study we tested the impact of streptozotocin (STZ)-induced diabetes on ligature-induced periodontitis and the effect of subsequent treatment with the glucocorticoid receptor (GR) antagonist, RU486.

MATERIAL AND METHODS

A single dose of STZ [45 mg/kg, intraperitoneally (i.p.)] or vehicle was given 10 d before induction of ligature-induced periodontitis and implantation subcutaneously of a drug pellet containing the GR antagonist, RU486, or a placebo pellet. Periodontitis was assessed when the ligatures had been in place for 21 d. Two hours before decapitation all rats received gram-negative bacterial lipopolysaccharide (LPS) (150 μg/kg, i.p.) to induce a robust immune and stress response.

RESULTS

Compared with control rats, STZ-treated rats developed significantly more periodontal bone loss, and RU486 treatment of STZ -treated rats significantly inhibited this effect. STZ-treated rats also showed significantly higher levels of the HPA axis-derived hormone, corticosterone, as well as of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF-α), but lower levels of the anti-inflammatory cytokines interleukin-10 (IL-10) and transforming growth factor-1beta (TGF-1β) after LPS stimulation. GR blockade had no statistically significant effects on these measurements in diabetic rats, but tended to enhance the levels of TNF-α and TGF-1β, and reduce the levels of IL-10 and blood glucose.

CONCLUSION

In diabetic subjects, excessive GR activation as a result of chronic high levels of glucocorticoid hormones may alter immune-system responses in a manner that may increase the susceptibility to periodontitis.

Oral treatment with complement factor C5a receptor (CD88) antagonists inhibits experimental periodontitis in rats

BACKGROUND AND OBJECTIVE

The complement activation product 5a (C5a) is a potent mediator of the innate immune response to infection, and may thus also importantly determine the development of periodontitis. The present study was designed to explore the effect of several novel, potent and orally active C5a receptor (CD88) antagonists (C5aRAs) on the development of ligature-induced periodontitis in an animal model.

MATERIAL AND METHODS

Three different cyclic peptide C5aRAs, termed PMX205, PMX218 and PMX273, were investigated. Four groups of Wistar rats (n = 10 in each group) were used. Starting 3 d before induction of experimental periodontitis, rats either received one of the C5aRas (1-2 mg/kg) in the drinking water or received drinking water only. Periodontitis was assessed when the ligatures had been in place for 14 d.

RESULTS

Compared with control rats, PMX205- and PMX218-treated rats had significantly reduced periodontal bone loss.

CONCLUSION

The findings suggest that complement activation, and particularly C5a generation, may play a significant role in the development and progression of periodontitis. Blockade of the major C5a receptor, CD88, with specific inhibitors such as PMX205, may offer novel treatment options for periodontitis.

Severe gunshot injuries in a porcine model: impact on central markers of innate immunity

BACKGROUND

the mechanisms behind lipopolysaccharide (LPS) tolerance remain obscure. LPS signals through Toll-like receptor 4 (TLR4) and severe trauma/haemorrhage may influence binding and signalling through this receptor, e.g. by changing membrane expression or by releasing endogenous ligands like High Mobility Group Box 1 (HMGB1). The aim of this study was to examine these relations further in a porcine model with standardized trauma.

METHODS

nine anaesthetized pigs sustained one gunshot through the femur and one pistol shot through the upper abdomen. Blood was sampled before and 90 min after shooting. The samples were stimulated for 4 h with LPS 10 ng/ml or an equivalent amount of normal saline. The leucocyte response was evaluated by measuring the tumour necrosis factor-α (TNF-α) and CXC ligand 8 (CXCL8) in the supernatant. Flow cytometry was used to measure the surface expression of TLR4 on CD14+ monocytes. HMGB1 concentrations were measured in the plasma.

RESULTS

trauma and treatment caused a significant decline in the LPS-stimulated concentrations of TNF-α [4.53 ± 0.24 pg/ml (ln) at 0 min, 3.54 ± 0.35 pg/ml (ln) at 90 min, P=0.026], but did not modify the release of CXCL8. Monocyte TLR4 expression was unchanged. Plasma HMGB1 increased significantly [<0.92 vs. 3.02 ± 0.19 ng/ml (ln), P<0.001]. The concentrations of TNF-α and CXCL8 did not correlate with TLR4 expression or HMGB1 concentrations.

CONCLUSION

the results suggest that trauma-induced LPS tolerance is not primarily regulated by TLR4 expression on circulating CD14+ monocytes or by the release of HMGB1 from damaged tissues.

Capacity of glycine to modulate early inflammatory disturbances after serious gunshot injuries in the pig

OBJECTIVE

Perturbation of immune homeostasis is an important determinant for organ dysfunction following multiple injuries. The aim of this study was to investigate the ability of glycine to influence the immediate post-traumatic inflammatory environment and altered reactivity of circulating leucocytes.

MATERIAL AND METHODS

Twenty pigs were subjected to two standardized gunshots to the abdomen and thigh. Treatment was started immediately. The animals were randomized to receive either glycine 180 mg/kg i.v. over 30 min (n=10) or normal saline (n=10). Blood samples were drawn at baseline and 75 min after injury. In a follow-up study 12 pigs were exposed to an identical trauma. Blood was drawn at the same time-points and stimulated with lipopolysaccharide (LPS) or LPS plus glycine for 2 h in an ex vivo whole blood model.

RESULTS

Selected physiologic variables and organ injury did not differ between groups 75 min after trauma. Reactive oxygen species decreased to 82.7+/-5.5 % of baseline (p<0.05) in the glycine group (unaltered in the controls). Liver glutathione concentrations decreased in parallel in both groups. In vivo production of TNF-alpha and IL-1-beta increased to the same extent regardless of treatment. Trauma induced a strong LPS tolerance. In whole blood challenged with LPS, glycine inhibited cytokine synthesis, but only in samples drawn at baseline.

CONCLUSIONS

Post-traumatic infusion of glycine only modestly influenced the early post-traumatic inflammatory environment. Our ex vivo results confirm previous reports on the anti-inflammatory potential of glycine, but restricted to pre-trauma conditions.

Early time course of altered leukocyte response to lipopolysaccharide and peptidoglycan in porcine gunshot injury

BACKGROUND

Penetrating injuries are frequently combined with polybacterial soiling. Clearance of the microorganisms depends on the ability to activate immune responses, but post-traumatic hyporeactivity of immune cells is almost universal. The aim of this study was to map the early time course of this altered leukocyte reactivity, and to compare the reactions to subsequent Gram-positive or Gram-negative challenges.

METHODS

Twelve juvenile pigs sustained two standardized rounds, one through the right femur and one through the left upper abdomen. First aid treatment and acute surgery were started immediately. Blood samples were drawn before trauma and after 10, 30, 60, and 90 min, and thereafter stimulated in ex vivo whole blood for 3 h with lipopolysaccharide (LPS, 10 ng/ml), peptidoglycan (PepG, 1 microg/ml), or an equivalent amount of normal saline. The leukocyte response was evaluated by measurement of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-8, and IL-10 in the supernatant.

RESULTS

In the post-traumatic in vivo serum, the concentration of TNF-alpha increased steadily (significant after 60 min). A reduced ex vivo reaction to LPS was evident after 10 min, and was statistically significant after 30 min. The lowest levels were reached after 90 min. The ex vivo synthesis of TNF-alpha after stimulation with PepG remained unaltered. A similar development was seen for IL-6. IL-1 beta levels did not change, while IL-8 increased significantly only after 60 and 90 min.

CONCLUSIONS

Trauma almost instantaneously reprogrammed circulating leukocytes. As measured with TNF-alpha, a profound hyporeactivity to LPS, but not to PepG, was induced. In addition, no global down-regulation of leukocyte function was found after stimulation with LPS.

Glycine--an important neurotransmitter and cytoprotective agent

BACKGROUND

Glycine, the simplest of the amino acids, is an essential component of important biological molecules, a key substance in many metabolic reactions, the major inhibitory neurotransmitter in the spinal cord and brain stem, and an anti-inflammatory, cytoprotective, and immune modulating substance.

MATERIAL AND METHODS

Based on available literature, we discuss some of the important biological properties of glycine. In addition, we describe some clinical disorders where glycine plays a central role, either as an essential structural element, or through its metabolism or receptors.

RESULTS

The past few years have witnessed a broadening of glycine research. The traditional prime interest in aspects related to its role as an inhibitory neurotransmitter in the central nervous system has been expanded to equally emphasize other organs and tissues. With the demonstration of glycine-gated chloride channels on neurons in the central nervous system, on most leukocytes, and subsequently on other cells as well, a unifying mechanism of action accounting for many of the widespread effects of glycine has been found.

CONCLUSIONS

Glycine is a simple, easily available, and inexpensive substance with few and innocuous side-effects. The diversity of biological activities is well documented in the literature. Despite this, glycine has only gained a modest place in clinical medicine.

Response of circulating immune cells to major gunshot injury, haemorrhage, and acute surgery

PURPOSE

The purpose of this study was to use an established porcine model to investigate the effects on immune function of severe gunshot injury.

METHODS

Twelve pigs sustained two standardised rounds, one through right femur and one through left upper abdomen. First aid treatment and acute surgery was started immediately. Blood samples were drawn before shooting and after 75 min. Circulating neutrophils were isolated and reactive oxygen species (ROS) measured. Serum levels of tumour necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), IL-6, and IL-10 were determined at 0, 75 min, as well as 2h after incubation with 1 microg/ml endotoxin in an ex vivo whole blood model.

RESULTS

TNF-alpha, IL-1beta, and IL-6 significantly increased at 75 min. ROS in circulating granulocytes tended to increase (NS). Incubation with endotoxin led to a more than 100-fold increase of TNF-alpha pre-trauma, compared to a three-fold increase post-trauma (p<0.0001 between groups). A similar pattern was obtained for IL-1beta, and IL-6. IL-10 was below detection in all samples. The granulocytes maintained their ability to react to the protein kinase C activator phorbol myristate acetate (PMA) after trauma.

CONCLUSION

Severe gunshot injury and peritraumatic stress rapidly activate circulating immune cells, but reduce their capacity to react to a subsequent challenge to endotoxin.

Modest protection of early hydrocortisone treatment in a rat model of volume-controlled haemorrhage

BACKGROUND

Major insults may trigger generalized inflammatory responses that contribute to progressive multiple organ dysfunction. The present study was performed to test the potential of early hydrocortisone treatment to influence these responses as well as organ function following an episode of rapid and profound blood loss.

METHODS

In isoflurane anaesthesia, 35 spontaneously breathing male Sprague-Dawley rats were bled 2.5 ml 100 g-1 body weight over 10 min. Immediately following withdrawal of blood, one group (n = 17) was given 2 mg of hydrocortisone, and the other (n = 18) had the same amount of normal saline. Seventy-five minutes after initiation of bleeding, two-thirds of the blood was retransfused, together with a new injection of hydrocortisone or saline. Thereafter the rats were observed for 2 h. Key mediators of systemic inflammation and plasma markers of organ function and integrity were measured. Internal organs were weighed and scored for visible pathology. Leukocyte infiltration of the liver was counted in a light microscope.

RESULTS

Hydrocortisone reduced the plasma levels of IL-6 (P < 0.05); non-significant reductions of TNF-alpha (P = 0.12) and IL-10 (P = 0.44) were noted. The synthesis of reactive oxygen species in peritoneal cells was unaffected. Relative organ weights and organ injury scores tended to be reduced, but only wet organ weight for the lungs reached statistical significance. Leukocyte infiltration of the liver was equal in both groups. Plasma levels of ALT, AST, alpha-GST and creatinine did not differ significantly between groups. Two of the hydrocortisone treated rats died compared with four controls.

CONCLUSION

Early treatment with hydrocortisone had a limited organ protective effect in this model of controlled haemorrhagic shock. Although a general tendency for better outcome in the hydrocortisone group was noted, clear-cut and significant advantages of the treatment were not obtained.

Chemiluminescence response of granulocytes from elite athletes during recovery from one or two intense bouts of exercise

In this study nine elite athletes each participated in three different 24- h trials, as follows: (1) complete bed rest (REST), (2) one bout of exercise at 1515 hours (ONE-EX), (3) two exercise bouts, one at 1100 hours and one at 1515 hours (TWO-EX-3 h), and (4) two exercise bouts, one at 0800 hours and one at 1515 hours (TWO-EX-6 h). Exercise was performed on a cycle ergometer with 10 min of warm-up and then 65 min at an exercise intensity of 75% of maximum oxygen uptake (VO(2max)). The polymorphonuclear neutrophil (PMN) counts increased consistently in response to exercise, and more in trial TWO-EX-3 h than in the two other exercise trials (P < 0.01). The respiratory burst of PMN was measured as chemiluminescence (CL), obtained with phorbol myristate (PMA) and serum-opsonised zymosan (SOZ) as stimulators. Exercise triggered the CL response for a defined number of PMN, significantly above baseline (REST) values (P < 0.05) for ONE-EX and TWO-EX-3 h, but not for TWO-EX-6 h. The strongest response was observed for TWO-EX-3 h, but the difference between exercise procedures was not significant. However, as a novel approach, a comparison was made using total oxidative potentials per litre of blood, as obtained by combining CL values and PMN numbers. TWO-EX-3 h yielded significantly higher values than the other experimental treatments. Thus, by this measure the total oxidative potential of PMN x l(-1) blood remains at a higher level with short intervals between exercise bouts (i.e. 3 h instead of 6 h), possibly due to a combined effect of cell number increase and the priming state of PMN. This may suggest that for intensive training twice a day, a recovery phase of 5-6 h is preferable. The elevation in cell number is best explained by a combined effect of catecholamines and cortisol. Growth hormone is one probable candidate as a stimulator of CL, but other molecular participants that respond to exercise may exert roles as either stimulators or inhibitors of CL.

Hypothalamic-pituitary-adrenal axis activation by experimental periodontal disease in rats

Organisms respond to inflammatory conditions by mounting a co-ordinated complex series of adaptive responses involving the immune, nervous and endocrine systems that are aimed at restoring the homeostatic balance. We have recently shown in a rat model that inappropriate hypothalamic-pituitary-adrenal (HPA) axis regulation and a subsequent inability to mount a suitable glucocorticoid response to gingival inflammation may influence susceptibility to periodontal disease. This study was designed to investigate whether ligature- and bacterial lipopolysaccharide (LPS)-induced inflammation in the gingival connective tissues may activate this physiological axis, and to further explore the significance of HPA regulation in periodontal disease. Experimental periodontal disease was induced in major histocompatibility complex (MHC)-identical but HPA low (LEW) and high (F344) responding rat strains. We tested (1) whether ongoing periodontal disease activates the HPA axis as measured by corticosterone levels, and (2) whether genetic differences in HPA regulation modulate periodontal disease progression. In the F344 strain. the periodontal tissue destruction was more severe. This observation was associated with a significant increase of corticosterone levels in F344 rats only. Addition of LPS at the gingival inflammatory site led to a further increase of corticosterone levels and disease severity in F344 rats. These findings illustrate a positive feedback loop between the HPA axis and periodontal disease: the disease activates the HPA axis, and a genetically determined high HPA responsivity further increases disease susceptibility.

Moderate hypothermia blunts the inflammatory response and reduces organ injury after acute haemorrhage

BACKGROUND

Reduced body temperature is a common companion to trauma/haemorrhage. Several clinical studies have identified hypothermia as an independent risk variable predisposing to increased morbidity and mortality. At the same time it is known that most enzymatic reactions are downregulated at temperatures below 37 degrees C. Theoretically this should restrain the inflammatory response and protect the host from remote organ injury. The study was performed to test this hypothesis.

METHODS

Twenty-six male Sprague Dawley rats were used for the experiments. Volume controlled haemorrhagic shock was induced by withdrawal of 2.5 ml blood/100 g body weight over 10 min. Half of the animals (n=13) were then cooled to 32.5-33 degrees C, the other half (n=13) were kept normothermic (37.5+/-0.5 degrees C). Seventy-five minutes after initiation of bleeding, two-thirds of the blood was retransfused. Thereafter the rats were observed for 2 h. Key substances of systemic inflammation were determined (plasma values of TNF-alpha, IL-6, IL-10, and corticosterone; reactive oxygen species in peritoneal phagocytes), plasma markers of organ function and integrity (AST, ALT, alphaGST, creatinine, urea), and survival.

RESULTS

Hypothermia reduced the release of IL-6 (P<0.01). The reductions of plasma levels of TNFalpha (P=0.07) and IL-10 (P=0.09) were less clear-cut. The release of reactive oxygen species diminished (P<0.01). Organ injury was ameliorated, as reflected by decreased levels of AST (P<0.01), alphaGST (P<0.01), and creatinine (P<0.01). Both groups experienced an almost identical increase of plasma corticosterone. None of the hypothermic rats died, compared to two normothermic.

CONCLUSION

Moderate hypothermia had an organ protective effect in this model of controlled haemorrhagic shock. This coincided with a significant reduction of the proximal cytokine IL-6 and reactive oxygen species, which conceivably influenced the outcome.

No effect of seasonal variation in training load on immuno-endocrine responses to acute exhaustive exercise

This study was designed to examine the relationship between seasonal changes in training and competition load, and changes in leukocyte subsets, stress hormones, and interleukin-6 (IL-6) in response to a standardised bout of endurance exercise. In addition, changes in mood states were monitored. Ten male, international Nordic skiers, age 20-29, maximal oxygen uptake 70-82 ml x kg(-1) x min(-1) performed the same incremental treadmill tests to exhaustion at the same time of day (+/-1 h), during the competitive season (in-season HI test) and the recovery season (off-season LO test). The subject filled out a training and competition log (TC score) for three weeks prior to each test and a 65-item Profile of Mood State (POMS) test on arrival at the laboratory. Venous blood for haematological, hormonal, and IL-6 analysis was drawn before and at 0, 15, 30, 60, 120 and 240 min after the test. TC score was more than twice as high during the competitive season (16.0 +/- 3.9) compared to the off-season period (7.0 +/- 4.4). An ANOVA procedure for repeated measures showed no difference in exercise induced changes in concentrations of neutrocytes, lymphocytes, epinephrine, ACTH or cortisol between the in-season HI and off-season LO tests; however, norepinephrine and the IL-6 concentrations were elevated at the in-season HI test compared to the off-season LO test. There were no significant differences in POMS global mood score or sub-scores between the in-season HI and the off-season LO tests. Thus, in a group of elite Nordic skiers, we conclude that a doubling of the training and competition load during the winter season does not alter the leukocyte and stress hormone responses to an incremental exercise test to exhaustion.

Glucocorticoid receptor antagonist RU 486 treatment reduces periodontitis in Fischer 344 rats

Inappropriate hypothalamic pituitary adrenal (HPA) axis regulation of immune responses to bacterial challenges has been found to play an important role in infections and inflammatory disease susceptibility and progression. In the present study we investigated the tissue effects of experimental periodontitis in Fischer 344 rats, which were subcutaneously (s.c.) injected with 20 mg/kg of the glucocorticoid receptor antagonist and active antiglucocorticoid agent RU 486 every second day over a period of 14 d. Periodontitis was induced by placing a bacterial plaque retentive silk ligature in the gingival sulcus around the neck of maxillary right 2nd molar teeth 1 d after the first injection in 10 RU 486-treated and 10 vehicle (1,2-propanediol)-treated control animals. The contralateral maxillary left 2nd molars served as internal control teeth for naturally occurring periodontitis. Disease progression was evaluated radiographically and histometrically. The average level of corticosterone in blood at sacrifice was significantly lower in the RU 486-treated animals as compared to controls. The experimental animals also developed significantly less periodontal breakdown at both experimental and control teeth compared to the vehicle-treated control animals. The results support our recent findings showing that HPA hyper-reactivity, either genetically determined or experimentally induced, stimulates periodontal disease susceptibility. These findings suggest that central nervous regulation of inflammatory responses to dental plaque microorganisms in the gums may modulate periodontal disease susceptibility and progression.

Effects of hypothalamic-pituitary-adrenal axis reactivity on periodontal tissue destruction in rats

The aim of this study was to test the hypothesis of an association between hypothalamic-pituitary-adrenal (HPA) axis reactivity and progression of periodontal disease. Histocompatible Lewis and Fischer 344 rats respond to stressful stimuli with low and high HPA axis reactivity, respectively. Experimental periodontitis was induced by tying a silk ligature around the neck of maxillary 2nd right molar teeth in 10 Lewis and 10 Fischer 344 rats with contralateral non-manipulated teeth as controls. Twenty non-manipulated animals were included. Also, experimental periodontitis was induced in 10 adrenalectomized Wistar rats and in 10 sham-operated rats. Furthermore, corticosterone pellets were subcutaneously implanted in 9 Lewis rats, while placebo pellets were implanted in 8 animals. Disease progression was evaluated histometrically and radiographically. The low-responding Lewis rats developed significantly less periodontal breakdown than did the high-responding Fischer 344 rats. Administration of corticosterone increased the disease development. while adrenalectomy reduced the disease severity. Our findings demonstrate the importance of genetic factors in the development of periodontal disease, and suggest that HPA axis hyper-activation is one mechanism by which periodontal disease susceptibility may be increased.

Intestinal IgA- and IgM-producing cells are not decreased in marathon runners

Alterations in duodenal immunoglobulin (Ig-)producing cells after excessive physical stress (marathon running) were studied by immunohistochemistry in 11 well-trained male adults, both shortly after running (race time, approximately 3.00 h) and later on after a "resting period" of 8-12 weeks with normal training (7-20 h/week). The ratios of IgA-, IgM- and IgG-producing cells were similar in the two biopsy specimens and virtually identical to those in eight normal duodenal controls (medians 77.6% IgA, 18.6% IgM, and 2.5% IgG). However, in the first sample the total number of positive cells per intestinal length unit was increased in five for IgA and in seven for IgM, while it was decreased in eight for IgG compared with the second biopsy. Also, the IgA cell number tended to be slightly increased immediately after the race (median 128 cells/unit) compared with that in normal controls (median 111 cells/unit); the same tendency was found for all Ig classes considered together. This apparent change was not explained by a thickening of the mucosa. Our study showed that marathon runners seem to maintain or even enhance their intestinal IgA and IgM-production, in contrast to the IgA decrease reported for other compartments such as salivary secretions and peripheral blood. The tendency to slightly increased intestinal IgA and IgM immunocyte populations in some runners might reflect a stress-induced hormonal influence on the homing of primed B cells to the mucosa, or perhaps an immune response to elevated influx of stimulatory luminal antigens.

Granulocyte chemiluminescence response to serum opsonized zymosan particles ex vivo during long-term strenuous exercise, energy and sleep deprivation in humans

The chemiluminescence response of granulocytes to serum opsonized zymosan particles (SOZ) ex vivo was investigated during two ranger training courses lasting 7 days with continuous moderate physical activities corresponding to about 32% of maximal oxygen uptake or 35000 kJ.24 h-1, with energy deficiency (energy supply 0-4000 kJ.24 h-1), and less than 3-h sleep during the 7 days. Significant granulocytosis in combination with a lymphopenia in peripheral blood was observed during the whole course. A priming of the granulocytes for accentuated chemiluminescence response to SOZ was observed during the first days of the course with a maximal increase on day 3 in course A (+35% of control response) and on day 1 in course B (+12%). Thereafter, reduced responses to SOZ compared to control values (-28% and -21% in course A and B) were observed. In course A, a group (n = 8) receiving 5000 kJ.24 h-1 of additional energy, showed a more pronounced priming (maximum +57% versus +21% of control response) during the first days. In course B, all the cadets had 3 h of organised rest/sleep on day 5, and a second priming of the chemiluminescence response was observed on the subsequent 2 days. These data indicated that moderate, continuous, predominantly aerobic physical activities for 1-3 days around the clock primed the production of reactive oxygen species in granulocytes. This priming may be beneficial for, for example, host defence against micro-organisms, but may also contribute to inflammatory damage to normal tissues such as muscle, tendons and joints during exercise. However, when the moderate exercise continued for several more days, a down-modulation of the granulocyte response was observed. The findings of this study further support the possibility that moderate physical activity stimulates immunity, while more extreme duration of the same activities may result in a down-modulation of non-specific (and specific) immunity.

The effect of strenuous exercise, calorie deficiency and sleep deprivation on white blood cells, plasma immunoglobulins and cytokines

Moderate exercise appears to stimulate the immune system, but there is good evidence that intense exercise can cause immune deficiency. In the present study the authors examined the effect of continuous physical exercise (35% of VO2 max), calorie deficiency and sleep deprivation on the immune system of young men participating in a 5-7 days military training course. There was a two-three fold increase of neutrophils from day 1, the values remained high and decreased slightly at the end of the course. Monocyte counts also increased with a pattern similar to that of neutrophils. Eosinophils decreased to 30% of control and lymphocyte numbers decreased by 30-40%. All the major subgroups (CD4 T cells, CD8 T cells, B cells, NK cells) were reduced. Neutrophil function, as tested by measuring chemotaxis, was significantly stimulated during the first days of the course, in particular in the group with the lowest calorie intake. The mitogenic response of lymphocytes to PHA and Con A was variable, ranging from stimulation during one course to no effect in another course. Serum levels of immunoglobulins decreased significantly during the course. IgG was reduced by 6-7%, IgA by 10-20% and IgM by 20-35%. The authors found no changes of interleukin 1, 2 and 4 during the course, but a (12-20%) reduction (P less than 0.01) of interleukin 6, and an increase (P less than 0.01) of granulocyte-macrophage colony stimulating factor. Altogether the results from the ranger course present a mixed-up picture. The non-specific phagocyte-related immunity was enhanced. On the other hand, the data indicate that even a moderate physical activity, around the clock, caused significant suppression of a number of parameters reflecting the status of the specific, lymphocyte-related immunity. It is noteworthy, however, that there was no significantly increased infection rate during the course or in the first 4-5 weeks thereafter.

Effect of in vivo corticosterone and acute food deprivation on rat resident peritoneal cell chemiluminescence after activation ex vivo

Adrenoglucocorticoid regulation of rat peritoneal monocyte/macrophage function was studied by exposing rats to corticosterone (CS) in the drinking water, and to fast (48 h). Production of reactive oxygen metabolites was measured by luminol amplified chemiluminescence (CL) in preparations of peritoneal cells activated by serum treated zymosan (STZ). Administration of CS which led to an increase in plasma CS from 31 (controls) to 46 ng mL-1, reduced CL (per cell) by 31%. Fast, which did not change plasma CS or ACTH, also had an inhibitory effect on CL (-25%), while the combination of CS administration and fast strongly inhibited the CL (-89%), indicating that plasma CS and fast reduced CL in a synergistic way. Similar effects on cell number were observed: CS-administration, fast and the combination reduced macrophage numbers (-13, -19.7 and -55%), while no significant effect was observed on the number of monocytes. The effect of adrenalectomy (adx) was studied in another series of experiments; adx induced no significant change in peritoneal leucocyte number or composition, while cells from adx animals had significantly higher chemiluminescence reaction than cells from sham operated animals. CS substitution in adx animals reduced CL by 30% while sham operated animals had 49% lower CL in adx. The data from adx animals also suggest that endogenous levels of CS are inhibitory for CL, but the results are not conclusive for the effect of very low doses of CS since other mechanisms than elimination of CS could prime the chemiluminescence reaction after adx. In conclusion, a moderate elevation of CS after systemic administration in vivo reduced the total number of mononuclear phagocytes in rat peritoneum, reduced the relative number of macrophages compared with monocytes, and suppressed the function of monocytes/macrophages by reducing the production of reactive oxygen molecules in activated cells. Furthermore, the effect of corticosterone was also dependent on the physiological situation, since the effects of fast and corticosterone were synergistic.

Atrial natriuretic peptide in plasma after prolonged physical strain, energy deficiency and sleep deprivation

Plasma concentrations of atrial natriuretic peptide (ANP) were investigated daily in 16 male cadets during a 6-day military training course with continuous heavy physical activities, sleep and energy deficiency (course I). At the end of another similar course (course II) 15 cadets were studied during 30-min cycle exercise at 50% maximal oxygen uptake with and without glucose infusion. A small, but not significant increase was found in the plasma concentrations of ANP during course I from 9.6 (SEM 1.1) pmol.l-1 in the control experiment to 11.1 (SEM 0.5) pmol.l-1 on day 5. During course II a small but significant increase was found from 7.8 (SEM 0.5) pmol.l-1 in the control experiment to 9.1 (SEM 0.5) pmol.l-1 at the end of the course. Plasma osmolality and chloride concentration decreased during the course. During the exercise test a significant increase was seen in ANP concentration from 8.2 (SEM 0.8) to 13.1 (SEM 2.0) pmol.l-1 in the control experiment and from 9.4 (SEM 0.7) to 13.5 (SEM 1.2) pmol.l-1 during the course. This response was attenuated by glucose infusion, an effect which may have been due to an exercise induced increase in plasma chloride concentration being abolished. In contrast, the potassium concentration response to exercise was increased during the course but unaffected by glucose infusion. In conclusion, the large increases in endogenous plasma catecholamine concentration shown to take place during previous courses were not reflected in the plasma concentrations of ANP, indicating only a moderate cardiac stress or no cardiac work overload during such courses.

Adrenaline stimulated cyclic adenosine monophosphate response in leucocytes is reduced after prolonged physical activity combined with sleep and energy deprivation

The mechanism for adrenergic desensitisation during physical stress was studied by measuring [125I] cyanopindolol ([125I]CYP) binding sites and the adrenaline stimulated cyclic adenosine monophosphate (cAMP) responses in peripheral blood leucocytes from ten male cadets during a 5-day military training course. The cadets had physical activities around the clock corresponding to a daily energy consumption of about 40,000 kJ but with an intake of only 2,000 kJ, and only 1-3 h of sleep in the 5 days. During the course, the maximal cAMP response to adrenaline stimulation was reduced to about 45% in granulocytes and to 52% in mononuclear cells, and the half maximal response was obtained only at 5-10 times higher adrenaline concentrations than in the control experiment. The binding sites for [125I]-CYP in mononuclear cells increased during the course. However, [125I]-CYP measured not only surface receptors but also intracellular receptors and might even have represented other binding sites. In conclusion, this study showed that decreased cAMP response to adrenergic stimulation would seem to be one of the mechanisms behind adrenergic desensitisation during stress.

The effect of glucose on the plasma concentration of somatostatin during caloric deficiency in man

Somatostatin produced in the D-cells of the stomach and the pancreas plays an important role in the carbohydrate metabolism and has been suggested to be involved in the disturbed glucose homeostasis during starvation. We investigated two groups of subjects during severe caloric deficiency. Nine healthy subjects (mean age, 32 years) fasted for 4 days, and the plasma concentration of somatostatin increased greatly, from 11.0 +/- 1.3 pM to 21.7 +/- 2.3 pM (p = 0.001). Intravenous infusion of 50 g glucose after a 60-h fast and oral loading of 50 g glucose after an 80-h fast normalized temporarily the plasma concentration within 45 min and 60 min, respectively. In another group of 12 subjects (mean age, 34 years), who participated in a 90-km cross-country ski race lasting 4.45-6.50 h and who were suspected of being in severely catabolic metabolic state, the plasma concentration of somatostatin increased from 6.1 +/- 0.8 pM to 26.9 +/- 4.7 pM (p < 0.001). Post-race oral feeding of 100 g glucose in seven of the subjects normalized the plasma concentration within 30 min, but the concentration remained increased in the five subjects who had no post-race caloric supply. The results indicate a close relationship between somatostatin and glucose during caloric deficiency in man.

[Overtraining among elite athletes--causes, diagnosis and treatment]

Overtraining is an imbalance between training and recovery. We review the pathogenesis of overtraining, with emphasis on the neuroendocrinal changes which occur in response to acute overtraining. At present, no sensitive and specific tests are available to allow early diagnosis of overtraining. The diagnosis is based on medical history, clinical evaluation and exercise testing. The treatment is rest, and may take weeks to months.

The hypothalamo-pituitary regulation of androgen secretion in young men after prolonged physical stress combined with energy and sleep deprivation

During a five days' military training course for male cadets with hard physical activity day and night and almost no sleep or food, a decrease was found in LH, FSH, PRL and TSH. A decrease was also found in testosterone, dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone and 17 alpha-OH progesterone, whereas dehydroepiandrosterone-sulfate increased twofold. The LH and FSH responses to GnRH intravenously were increased at the end of the course. This demonstrates enhanced pituitary reserves of gonadotropin, or, alternatively, increased sensitivity to GnRH stimulation and may be due to decreased hypothalamic secretion of GnRH during the course. The decreased DHT and testosterone levels were almost normalized after HCG stimulation, indicating a gonadotropin regulated decrease in testosterone secretion during the course. In spite of fairly weak correlation between the alteration in gonadotropins and androgens it is concluded that there is a major regulation of testicular androgen secretion during prolonged stress by the hypothalamo-pituitary axis.

Androgenic hormones during prolonged physical stress, sleep, and energy deficiency

Androgenic hormones were investigated during two separate 5-day military endurance training courses, with physical activities around the clock corresponding to a daily energy consumption of about 40,000 kilojoules, but with an intake of only 2,000 kilojoules. Altogether, the cadets slept for 1-3 h in the 5 days. Eleven male cadets participated in course I, and 10 in course II. Plasma levels of testosterone, free testosterone, dehydroepiandrosterone, 17 alpha-hydroxyprogesterone, and androstenedione decreased by 60-80% during the course. In contrast, plasma cortisol, aldosterone, progesterone, and dehydroepiandrosterone sulfate increased. LH, FSH, and ACTH decreased to about 50-80% of precourse levels. Weak correlations between plasma levels of hypophyseal and levels of adrenal and testicular hormones indicate a multifactorial regulation. In conclusion, both adrenal and testicular androgens decrease during prolonged physical strain combined with energy and sleep deficiency.

Changes in the gastrointestinal mucosa after long-distance running

Two groups of long-distance runners were investigated for the effect of marathon running on the gastrointestinal mucosa. In one group gastric erosions with bleeding were found in five of nine subjects, mostly localized to the corpus region. The relative gastric blood flow measured by endoscopic laser Doppler flowmetry was slightly decreased in the cardia region (from 7.0 to 5.8; p less than 0.05) but unchanged in the other parts of the stomach, including the erosive lesions. In another group (n = 8) all the subjects showed a substantial increase in the urinary excretion of 51Cr-labeled ethylenediaminetetraacetic acid after oral intake, which indicates an increase in the intestinal permeability. There is reason to suggest that long-distance running affects the integrity of the gastric and the intestinal mucosa.

Alterations in the morning plasma levels of hormones and the endocrine responses to bicycle exercise during prolonged strain. The significance of energy and sleep deprivation

The relative significance of physical exercise, energy and sleep deprivation for the morning levels of hormones and the endocrine response to short-term bicycle exercise were investigated in 24 male cadets during a 5-day military training course. Significant increases in the morning levels of noradrenaline, adrenaline, and dopamine, and a decrease in PRL were ascribed mainly to physical strain. Cortisol and hGH increased, whereas insulin and glucose decreased mainly due to energy deficiency. Pulse rate after the bicycle test was unchanged and similar in all groups in spite of increased catecholamine responses. The increased catecholamine response was mainly due to physical strain. The cortisol response to the bicycle test was increased in all groups, and energy deficiency caused slower postexercise recovery. The incremental hGH response to the exercise test was unchanged in the energy-deficient subjects but abolished in the well-fed subjects. The results suggest that the endocrine responses during long-lasting exhausting strain were mainly due to physical exertion and energy deficiency, whereas sleep deprivation did not play any major role.

Strenuous prolonged exercise elevates resting metabolic rate and causes reduced mechanical efficiency

Resting O2 consumption, net mechanical efficiency during cycling exercise and excess postexercise O2 consumption (EPOC) was measured in 15 army cadets after 3 or 4 days of continuous simulated combat exercises (estimated energy demand: 40 MJ day-1), no organized sleep and virtually no food intake (stress experiment). They exercised for 30 minutes at a work load corresponding to about 50% of maximal O2 uptake. An identical test using the same absolute work load was repeated when the cadets were completely recovered from the combat course (control experiment). Resting O2 consumption increased by 15% from 279 +/- 7 ml min-1 (control) to 320 +/- 8 ml min-1 (stress, P less than 0.001). Mechanical efficiency decreased from 24.6 +/- 0.4% (control) to 20.9 +/- 0.2% (stress, P less than 0.001). EPOC1h increased from 0.58 +/- 0.41 l (control) to 2.24 +/- 0.2% (stress, P less than 0.05). Glucose infusion during exercise (0.20 g kg-1 body weight) had no effect on mechanical efficiency or EPOC. About 1/5 of the increase in exercise O2 uptake can be explained by a substrate shift from carbohydrates to fat, as evidenced by a reduction in R-value during exercise from 0.90 +/- 0.012 (control) to 0.80 +/- 0.010 (stress). Hence, after severe physical stress combined with sleep deprivation and food restriction, O2 uptake is increased both at rest and during submaximal exercise.

Transcutaneous nerve stimulation in patients with coronary arterial disease: haemodynamic and biochemical effects

Low-frequency transcutaneous nerve stimulation (TNS) is known to produce widespread and prolonged vasodilation in skin and muscles. In the present study the effects of low-frequency TNS on coronary and systemic haemodynamics, myocardial blood flow, myocardial oxygen consumption, myocardial free fatty acid and lactate uptake were measured at rest in 16 normotensive patients, with coronary heart disease, undergoing diagnostic cardiac catheterization. In addition, vasoactive intestinal polypeptides (VIP) and noradrenaline were measured in the coronary sinus and the aorta. The study was randomized and double-blind, with half of the patients serving as placebo controls. A stimulation period of 20 min caused a significant lowering of mean femoral arterial pressure and systemic vascular resistance measured at 15 and 30 min after the start of TNS (P less than 0.01). There was no significant change in the other parameters mentioned. The hypotonic effect is considered to be due to increased peripheral microcirculation resulting from sympatho-inhibition.

Reduced systolic blood pressure elevations during maximum exercise at simulated altitudes

Ten healthy female subjects performed maximum exercise on a bicycle in an altitude chamber during normoxia and hypobaric hypoxia simulating altitudes of 2,450, 3,700 and 4,600 m. The increases in systolic blood pressure responses were reduced with the degree of hypobaric hypoxia, whereas heart rate and diastolic pressure responses were unchanged. The increases in blood levels of aldosterone, plasma renin activity, adrenaline, noradrenaline, neuropeptide-Y and vasoactive intestinal peptide were similar at the different simulated altitudes. Angiotensin-converting enzyme and vasoactive intestinal peptide levels were not affected by hypoxia or maximum exercise. The present results suggest that the decreases in systolic blood pressure responses during hypobaric hypoxia could not be explained by altered responses of the measured vasoactive substances from the renin-angiotensin, gastrointestinal, and autonomic nervous systems.

Effect of VIP on the respiratory burst in human monocytes ex vivo during prolonged strain and energy deficiency

VIP-stimulated cyclic AMP production and VIP effect on the production of reactive oxygen compounds in human monocytes activated by serum opsonized zymosan (respiratory burst) were studied during a ranger training course lasting for five days with almost continuous physical activity, and deficiency of sleep and energy. Respiratory burst was inhibited and cyclic AMP production was stimulated by VIP on all days. Maximum cyclic AMP production stimulated by VIP (0.1 microM) on the day of control was 148.6% of basal, and 255.3%, 213.8%, 218.9% and 198.7% on Days 1, 2, 3 and 5. Maximum inhibition was observed 20 min after addition of the peptide on the day of control, after 5 min on Days 1, 2 and 3, and after 10 min on Day 5. Inhibition at the 5-min time point was 33.1% on the day of control, and 34.7%, 53.6%, 53.3% and 36.2% on the different days during the training course. The observed increment in VIP effect adds to prior reported data about increased VIP secretion during the training course, and may indicate enhanced physiological significance of VIP during stress.

Adrenaline-mediated glycogenolysis in different skeletal muscle fibre types in the anaesthetized rat

The effect of adrenaline infusion on glycogen breakdown in different muscle fibres types in resting extensor digitorum longus (EDL) and soleus was investigated with histochemical methods. During adrenaline infusion the glycogen content in type IIB and type IIA fibres in EDL, as measured in PAS-stained sections, decreased 24.5% and 11.5% respectively. The glycogen content in type I fibres in EDL and in type I, type IIA and T-fibres in soleus did not change during adrenaline infusion. The present study shows that adrenaline infusion has different effects on glycogen breakdown in the different fibre types in EDL and a different effect on type IIA fibres in EDL and soleus. So far, the reason for these differences is unknown.

Erosive prepyloric changes--a manifestation of stress?

To study the relationship between stress and the endoscopic diagnosis of erosive prepyloric changes (EPC), upper gastrointestinal endoscopy was performed twice in 19 cadets from the Military Academy, once in a 'non-stressed' situation and once after exposure to a standardized stress model. Five biopsy specimens per examination were obtained from the prepyloric mucosa, and the features of acute and chronic inflammation, erosion, and campylobacter-like structures (CLS) were evaluated. The endoscopy showed a significant (p less than 0.001) aggravation of EPC after stress. The histologic examination showed an increase of acute inflammation (p less than 0.05) and a higher density of CLS (p less than 0.01) after stress, as compared with the findings under non-stressed conditions. No association was observed between CLS and EPC. The study sheds new light on the pathogenesis of EPC, as it shows that EPC is aggravated during stress.

Elevated VIP and endotoxin plasma levels in human gram-negative septic shock

Vasoactive intestinal polypeptide (VIP) and endotoxin (lipopolysaccharides, LPS) were measured in plasma samples from 11 patients with bacteriologically verified meningococcal disease. Five patients suffered fulminant septicaemia, developed severe septic shock, and 2 died due to circulatory collapse. Initially, all 5 had levels of VIP above 4 pM and plasma endotoxin above 200 ng/liter. Five patients were diagnosed as meningitis and 1 as having meningococcaemia, all with a normal circulatory state. None of these 6 patients had initially levels of VIP above 2.5 pM or endotoxin levels above 25 ng/liter (P less than 0.001). A correlation existed between plasma endotoxin and VIP levels (r = 0.735, P = 0.01). Sequentially collected samples from 3 patients showed rapidly declining VIP levels after initiation of antibiotic and fluid treatment. These results are in agreement with previous animal experiments, suggesting that endotoxin directly or indirectly stimulates the VIP-ergic nervous system in the initial phase of gram-negative septic shock in man.

The influence of prolonged physical stress on gastric juice components in healthy man

Eight healthy men were exposed to 5 days of continuous heavy exercise combined with caloric deficiency and sleep deprivation. Immediately after the stress period the fasting and postprandial intragastric bile acid concentration, pepsin concentration, and gastric juice acidity were measured. Compared with a control experiment performed 8 weeks later, the results from the stress period showed a sevenfold increase in the fasting concentration of intragastic bile acids (from 35 mumol/l to 256 mumol/l; p less than 0.02), there was a tendency towards an increase in the fasting intragastric pepsin concentration, and there was an increase (p less than 0.05) in the intragastric pH level throughout the 3rd postprandial hour. It appears that physical stress induces changes in the intragastric milieu that might dispose for mucosal lesions.

Receptors for vasoactive intestinal peptide (VIP) on human mononuclear leucocytes are upregulated during prolonged strain and energy deficiency

VIP receptors on blood mononuclear leucocytes and plasma VIP concentrations were studied during a ranger training course lasting for five days with almost continuous physical activity, and energy deficiency. The maximum binding capacity (Bmax) for the high affinity receptor increased (p less than 0.0005) from 0.71 (SEM = 0.11, N = 10) fmol/million cells to a maximum of 7.33 (SEM = 1.0) fmol/million cells on Day 4. There was no significant change in the dissociation constant (Kd) for the high affinity receptor, and no effect on Kd nor Bmax for the low affinity VIP receptor was detected. Plasma VIP concentration increased (p less than 0.0005) from 8.8 pmol/l (SEM = 0.6) to a maximum of 23.4 (SEM = 1.9) on the second day of the course. However, the highest plasma concentrations were about one order of magnitude lower than the dissociation constant (Kd) for the high affinity VIP receptor on the mononuclear leucocytes. These data indicate that heterologous upregulation of the high affinity VIP receptor on mononuclear blood cells takes place during combined strenuous physical exercise, and calorie deficiency.

Binding and degradation of vasoactive intestinal peptide in prolactin-producing cultured rat pituitary tumour cells (GH4C1)

Vasoactive intestinal peptide (VIP) stimulates prolactin (PRL) secretion from cultured rat pituitary cells (GH cells) (Bjøro et al. 1984). This study demonstrates the presence of specific receptors for 125I-VIP on the GH4C1 cells. Specific binding was rapid and biphasic giving a transient plateau lasting from 7 to 30 min. Thereafter specific binding declined to about one-third after 90 min. This coincided with enhanced degradation of 125I-VIP. The degradation was mainly cell-mediated and only partly receptor dependent. Trichloroacetic acid precipitation and absorption chromatography indicated that the degradation products were either 125I- and/or small labelled peptide fragments. Bioassay, RIA and rebinding studies also demonstrated degradation of VIP. Pretreatment of GH4C1 cells with trypsin decreased the rate of degradation of 125I-VIP, but also reduced the amount of specific binding. Scatchard analysis of binding data indicated the existence of two independent classes of receptors, one with Kd = 2.2 nM and Bmax = 15 fmol per 10(6) cells and another with Kd = 180 nM and Bmax = 550 fmol per 10(6) cells. The IC50 for VIP, PHI and secretin were 4, 5 and 500 nM, respectively. We conclude that the high affinity receptor is the most probable mediator of VIP on PRL secretion. The effect of VIP and PHI on PRL secretion in GH4C1 cells is mediated through one common receptor.

Comparison of VIP and beta 2-adrenoceptor-induced relaxations in the circular and longitudinal smooth muscle layers of the rat portal vein

The relative importance of VIP in reduction of vascular tone was studied in circular and longitudinal preparations of the VIP-innervated rat portal vein. Exogenous VIP inhibited the methoxamine-evoked contractures in the atropine-blocked preparations with a lower potency in the inner, circular (pD2 = 6.4 +/- 0.5, n = 6) than in the outer, longitudinal layer (pD2 = 7.7 +/- 0.1, n = 6). VIP was also a less efficient relaxant (intrinsic activity (alpha) = 0.60 +/- 0.16, n = 6) of the inner than of the outer layer (alpha = 1.00). The selective (salbutamol) and the non-selective (isoproterenol) beta 2-agonists completely relaxed the methoxamine contractures in both layers and the potency (isoproterenol) was higher in the inner (pD2 = 6.39 +/- 0.32, n = 6) than in the outer layer (pD2 = 5.67 +/- 0.34, n = 6). Plasma from the portal-mesenteric vein of anaesthetized, fasting rats contained 0.036 nM VIP (median, n = 17), that is, several orders of magnitude lower than the range of VIP concentrations relaxing the methoxamine contracted vein preparations via VIP receptors of the apamin-blockable category. The results support the hypothesis that alpha 1-adrenoceptor-induced contractions in the circular layer are predominately relaxed via beta 2-adrenoceptors while relaxation of the outer layer may occur via VIP receptors, probably activated by local release of the neuropeptide.

The plasma vasoactive intestinal peptide (VIP) response to exercise is increased after prolonged strain, sleep and energy deficiency and extinguished by glucose infusion

The VIP response to a 30 minute bicycle exercise test with a workload of 50% of VO2 max was investigated in young men before and after 5 days of continuous physical activities, almost total sleep deprivation and limited amounts of food. It was shown that plasma VIP increased during physical exercise lasting for more than 20 minutes with a workload of more than 50% of VO2 max. A further increase took place in the early recovery period to a maximum level 5-10 minutes after the exercise. This response to exercise is even stronger after prolonged strain. Glucose infusion during the exercise almost abolished the increase of plasma VIP.

Biochemical plasticity in the superior colliculus of adult rats after chronic visual cortex ablation

We have measured the changes of several neurochemical parameters in the adult rat superior colliculus (SC) 1.5-4 months after unilateral visual cortex ablation. High-affinity uptake of D-[3H]Asp was increased by 22.5% and glutamate decarboxylase by 10% in the ipsilateral SC. This may be largely attributed to reactive synaptogenesis of intrinsic glutamatergic and GABAergic neurons, respectively. The noradrenaline content was increased by about 60 and 25% in the ipsi- and contralateral SCs, respectively. The latter probably reflects sprouting of noradrenergic fibres from the locus coeruleus.

Increase in plasma vasoactive intestinal polypeptide (VIP) in muscular exercise in humans

We have previously shown that plasma vasoactive intestinal polypeptide (VIP) is increased in normal subjects by low-frequency transcutaneous nerve stimulation. The latter may also increase short-term physical performance in athletes (running, swimming and ergometer cycling). The present study examines whether the plasma VIP level is similarly increased in short-term ergometer exercise in seven healthy volunteers. A group of four patients with angina pectoris were included, since a lowered concentration of VIP is found in diseased heart tissue. In the group of healthy subjects, ergometer exercises with progressive increases in workload until exhaustion, lasting from 16 to 32 min (mean 26 min) and with a corresponding maximum energy output of 1500 to 5100 W (mean 3560 W), resulted in an increase in plasma VIP concentration from a pre-stimulatory level of 3.3 pmol . l-1 to 5.3, 5.2 and 5.6 pmol . l-1, measured 3, 10 and 20 min respectively, following termination of the exercise, i.e. a maximal 70% increase. In the patients with angina pectoris there was no significant VIP increase (cycling time 7-15 min, work performed 400-1350 W). Possible triggering mechanisms for VIP release and its source are discussed.

Binding of vasoactive intestinal polypeptide (VIP) by human blood monocytes: demonstration of specific binding sites

Vasoactive intestinal polypeptide (VIP) interaction with a 94% pure preparation of monocytes isolated from human peripheral blood was studied by direct binding technique using 3-[125I]tyrosyl-VIP as a tracer ligand. Scatchard analysis of binding data was compatible with two classes of binding sites, one with Kd = 0.25 nM and maximal binding capacity of 16 fmol/10(6) cells, and another one with Kd = 25 nM and maximal binding capacity of 180 fmol/10(6) cells. The binding was time-, temperature-, and pH-dependent and was saturable, reversible, and specific. This study has demonstrated that human monocytes have high affinity/low capacity as well as low affinity/high capacity binding sites for VIP. No specific VIP binding was found in pure preparations of human granulocytes, platelets or erythrocytes.

Plasma renin activity and serum aldosterone during prolonged physical strain. The significance of sleep and energy deprivation

Plasma renin activity (PRA), serum aldosterone and the serum and urinary levels of sodium and potassium have been investigated in 24 young men participating in a 5-day military training course with heavy continuous physical exercise, energy and sleep deprivation. The subjects were divided into three groups. Group 1 did not get any extra sleep or food, group 2 were compensated for the energy deficiency, and group 3 slept 3 h each night. The basic diet given to all the subjects was about 5,000 kJ and 2 g NaCl X 24 h-1 X cadet-1. The high calorie diet contained approximately 25,000-35,000 kJ and 20 g of NaCl X 24 h-1 X cadet-1. The study showed that serum aldosterone and PRA were extremely activated during such prolonged physical strain combined with lack of food and salt, whereas sleep deprivation did not seem to have any large influence. Only small variations were found in the serum levels of sodium and potassium and the urinary level of potassium during the course, whereas a decrease was seen in urinary sodium concentration. The fairly good correlations between the decrease in urinary sodium levels and the increase in PRA (r = 0.7) and further between PRA and serum aldosterone (r = 0.8) during the course indicate that there is a causal connection between the decrease in urinary sodium excretion and the increase in PRA and serum aldosterone.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of physical stress on gastric secretion and pancreatic polypeptide levels in man

Twelve healthy subjects were exposed to a 4-day period of hard physical exercise, calorie supply deficiency, and severe sleep deprivation. The basal acid output (BAO), the sham-feeding-induced acid output (MAOsh), and the pentagastrin-stimulated acid output (MAOpg) were measured immediately after this stress period and in a control experiment performed several weeks later. The stress induced a threefold increase in the median BAO and an increase (p less than 0.05) in the MAOsh, which, however, was not significantly elevated when basal-subtracted. MAOpg was unchanged. In contrast to acid, pepsin output was not influenced by stress. The human pancreatic polypeptide (hPP) level in serum increased twofold after the stress. The integrated hPP response induced by modified sham feeding was higher (p = 0.02) after the stress than in the control experiment. The results show that physical stress has separate influence on the gastric secretion of acid and pepsin.

The thyroid function in young men during prolonged exercise and the effect of energy and sleep deprivation

Thyroid function has been investigated in 24 young military cadets participating in a 5 d ranger training course with heavy physical exercise, calorie deficiency and deprivation of sleep. The cadets were divided into three groups, each differing in the amount of sleep and food consumption. The serum levels of thyroid hormones (T4, FT4, T3, rT3) and TBG showed a biphasic pattern during the course. Initially there was an increased secretion concomitant with an increased deiodination of T4 to T3 and rT3 mainly due to physical exercise. When the activities lasted for several days without sufficient food supply the thyroid secretion decreased simultaneously with an alteration of the peripheral conversion of T4 to rT3 instead of T3. A significant correlation was found between the changes in total and free thyroxine (r = 0.9) and between the increase in rT3 and decrease in T3 (r = 0.6). TSH decreased during the first day of activities and remained low throughout the course. The TSH response to TRH stimulation was greatly reduced during the course due to physical exercise and calorie deficiency. The present investigation demonstrates that the thyroid function is strongly affected by prolonged physical exercise and a negative energy balance, whereas sleep deprivation does not have any significant influence. The results indicate that the alteration observed is not regulated just by the hypothalamo-pituitary-thyroid-axis alone.

Increase in the ratio of serum levels of apolipoproteins A-I and A-II during prolonged physical strain and calorie deficiency

Effects of four days of intense physical activity on serum concentrations of total triglycerides, total cholesterol and apolipoproteins A-I, A-II, and B were studied in 35 well-trained young men. Serum total triglyceride levels decreased to 70% of baseline levels after 24 h, and fell further to 50% of baseline levels after 4 days. Serum levels of total cholesterol fell steadily to about 80% of baseline levels on the 4th day. Apo-B levels fell to 85% of baseline levels after 24 h, and remained at that level. Apo A-I fell to about 90%, and apo A-II to about 80% of baseline levels, causing a significant increase in the ratio of apo A-I to apo A-II. The intraindividual changes in apo B were positively correlated to changes in cholesterol during the first day (r = 0.60). The changes in apo A-I and apo A-II had no significant correlation with changes in total cholesterol or triglycerides, or with one another, suggesting that apo A-I and apo A-II are metabolized independently during conditions of hard physical exercise.

Physiological responses and effects on meat quality in reindeer (Rangifer tarandus) transported on lorries

Reindeer transported on lorries to the slaughterhouse showed strongly elevated plasma noradrenaline, adrenaline and Cortisol values. Plasma creatine kinase and aspartate aminotransferase activity measurements gave no evidence of muscle damage, but by cooking ammonia-like and another taint were observed in the meat from about 25 % of the transported reindeer. A control group consisting of reindeer slaughtered from the gathering corral also showed a high prevalence of these meat taints. Plasma and meat urea values were elevated in the transported reindeer, but there was no correlation between the meat urea values and the intensities of ammonia-like taint. The character of the other observed taint was not defined.

Responses of vasoactive intestinal polypeptide, secretin, and human pancreatic polypeptide to glucose during fasting

The plasma concentrations of vasoactive intestinal polypeptide (VIP) and secretin and the serum concentration of human pancreatic polypeptide (hPP) were measured in nine healthy subjects during a 4-day fast. The fast induced a considerable increase in the concentrations of VIP and secretin but only a small increase in the concentration of hPP. The intravenous infusion of 50 g glucose and the oral ingestion of 50 g glucose temporarily suppressed the high concentrations of VIP and secretin. Conversely, hPP responded with a slight decrease in blood concentration after the intravenous infusion and with a modest increase after the oral ingestion. The study shows that glucose suppresses the high blood concentrations of VIP and secretin during starvation independent of the route of glucose administration. In addition, the results indicate that the blood concentration of hPP is not directly related to the blood glucose concentration during prolonged fasting.

Failure to influence the VIP level in the cerebrospinal fluid by transcutaneous nerve stimulation in humans

Low-frequency transcutaneous nerve stimulation (TNS) is known to produce a prolonged and widespread cutaneous vasodilatation. This is associated with a moderate but significant increase of 30-35% in the concentration of the vasoactive intestinal polypeptide (VIP) in the cubital vein plasma. A possible source of this increased plasma VIP following TNS is the central nervous system. This possibility is tested in the present experiment. The concentration of VIP in the cerebrospinal fluid (CSF) was determined by radioimmunoassay in 9 patients with no organic disease of the central nervous system, before and at various intervals (15, 30 and 45 min) after the onset of TNS. No significant change in the VIP level of the cerebrospinal fluid was encountered, although the stimulation evoked rises in finger temperature indicating effectiveness of the stimulation. It is concluded that the stimulation-induced increase in plasma VIP is due to release of VIP outside the brain.

Plasma concentration of vasoactive intestinal polypeptide during prolonged physical exercise, calorie supply deficiency, and sleep deprivation

Twenty-four military cadets went through a 5-day period of heavy physical exercise (35% of max O2 uptake), severe calorie supply deficiency (about 36,000 kJ/24 h), and sleep deprivation (2 h of sleep as a total during 5 days). Some cadets compensated for the caloric deficiency, whereas others partly compensated for the sleep deprivation. Fasting and meal- and glucose-induced changes in the plasma concentration of vasoactive intestinal polypeptide (VIP) were measured on separate days during the course and 8 h after the course was finished (day 6). Fasting plasma concentration of VIP increased two- to five-fold during the course, with the highest increase on day 2. The calorie-compensated subjects showed a smaller increase than those who did not receive any calorie or sleep compensation. Intake of a meal or glucose solution lowered the VIP concentration in plasma within 30-60 min to the concentrations found in the control experiments performed several weeks after the course. The results indicate a role of VIP as 'a polypeptide of substrate need'.