Exercise, stress and mucosal immunity in elite swimmers

The development of an immunoassay to measure immunoglobulin A in Asian elephant feces, saliva, urine and serum as a potential biomarker of well-being

Additional measures of well-being would be beneficial to the management of a variety of species in human care, including elephants. Immunoglobulin A (IgA) is an immune protein associated with pathogen defense, which has been demonstrated to decrease during times of stress, and increase in response to positive stimuli. This paper describes the development and validation of an enzyme immunoassay (EIA) for the quantification of Asian elephant (Elephas maximus) IgA in feces, saliva, urine, and serum. Samples were collected weekly from four females for 6 months to assess IgA and glucocorticoid (GC) concentrations, establish relationships between these two biomarkers, and determine variability in IgA within and between individuals, and across sample types. IgA was quantified in all four sample types, although urinary concentrations were low and sometimes undetectable in individual samples. Concentrations were highly variable within and between individuals, with fecal, salivary and serum IgA, and fecal, salivary and urinary GCs all differing significantly across individuals. Contrary to previous findings, IgA and GC were generally not correlated. Serum IgA was less variable within individuals, with the exception of one female that experienced a brief illness during the study. However, marked inter-individual differences were still apparent. When data from all individuals were combined, fecal IgA was significantly predicted by salivary and urinary IgA; however, this relationship did not hold when individuals were analyzed separately. Analysis of a fifth female that exhibited a more severe systemic illness demonstrated clear increases in fecal IgA and GC, suggesting these may also be useful health biomarkers. Further investigation is needed to determine what sample type is most reflective of biological state in elephants, and how IgA concentrations are associated with health and positive and negative welfare states. Based on observed variability, a longitudinal approach likely will be necessary to use IgA as a measure of well-being.

SIgA and Upper Respiratory Syndrome During a College Cross Country Season

We examined the changes in salivary immunoglobulin A (SIgA) and the incidence of upper respiratory syndrome (URS) throughout a college cross-country season as well as the acute effect of a VO _2max test on SIgA. Subjects were 22 cross country athletes (XC) (20.7±0.3 years) and 23 matched controls (C) (20.4±0.2 years). Saliva samples were collected pre and post VO2max and at four training time points (August – November). Weekly logs indicating S&S of URS from which a total symptom score (TSS) was calculated were collected. There was a significant decrease in SIgA F(1,43)=10.742, p<0.001 and the secretion rate of SIgA F(1,43)=15.617, p<0.001 for XC at time points two through four. XC was also significantly lower than controls in those two variables across those time points. The secretion rate of SIgA and URS were negatively correlated at time point four R2=0.443, F(4,22)=26.9, p=0.001. There was a significant acute post exercise decrease in the secretion rate of SIgA, pre (M=21.44, SEM=3.95) and post (M=14.5, SEM=3.0), t(1,21)=2.185, p=0.039. Prolonged training resulted in decreased mucosal SIgA.

Respiratory inflammation and infections in high-performance athletes

Upper respiratory illness is the most common reason for non-injury-related presentation to a sports medicine clinic, accounting for 35-65% of illness presentations. Recurrent or persistent respiratory illness can have a negative impact on health and performance of athletes undertaking high levels of strenuous exercise. The cause of upper respiratory symptoms (URS) in athletes can be uncertain but the majority of cases are related to common respiratory viruses, viral reactivation, allergic responses to aeroallergens and exercise-related trauma to the integrity of respiratory epithelial membranes. Bacterial respiratory infections are uncommon in athletes. Undiagnosed or inappropriately treated asthma and/or allergy are common findings in clinical assessments of elite athletes experiencing recurrent URS. High-performance athletes with recurrent episodes of URS should undergo a thorough clinical assessment to exclude underlying treatable conditions of respiratory inflammation. Identifying athletes at risk of recurrent URS is important in order to prescribe preventative clinical, training and lifestyle strategies. Monitoring secretion rates and falling concentrations of salivary IgA can identify athletes at risk of URS. Therapeutic interventions are limited by the uncertainty of the underlying cause of inflammation. Topical anti-inflammatory sprays can be beneficial for some athletes. Dietary supplementation with bovine colostrum, probiotics and selected antioxidants can reduce the incidence or severity of URS in some athletes. Preliminary studies on athletes prone to URS indicate a genetic predisposition to a pro-inflammatory response and a dysregulated anti-inflammatory cytokine response to intense exercise as a possible mechanism of respiratory inflammation. This review focuses on respiratory infections and inflammation in elite/professional athletes.

Markers of biological stress and mucosal immunity during a week leading to competition in adolescent swimmers

In this study we examined changes in the salivary concentrations of immunoglobulin A (sIgA), cortisol (sC), testosterone (sT), and testosterone-to-cortisol ratio (T/C) in 21 competitive swimmers, 11–15 years old, during a week leading to competition as compared to a control (noncompetition) week. No day-to-day changes or significant differences between weeks were observed for sIgA (47.9 ± 4.4 versus 54.9 ± 5.2 μg/mL for control versus competition week, resp.), sC (2.7 ± 0.2 versus 2.5 ± 0.2 ng/mL for control versus competition week, resp.), and T/C ratio (83.4 ± 7.0 versus 77.9 ± 7.7 for control versus competition week, resp.). In contrast, sT was significantly lower during the week of competition (154.5 ± 11.3 pg/mL) as compared to the control week (181.3 ± 11.5 pg/mL) suggesting that the swimmers were in a catabolic state, although this did not have a negative effect on their performance. In conclusion, salivary cortisol did not change between the two weeks, and thus competition stress was relatively low, and mucosal immunity was unaffected in these young athletes prior to competition.

Does exercise increase the risk of upper respiratory tract infections?

INTRODUCTION OR BACKGROUND

Heavy exercise induces marked immunodepression, which is multifactorial in origin. Evidence showing clinical significance of this immunodepression is scarce.

SOURCES OF DATA

We assessed in a systematic manner whether physical activity or intensity of exercise increase susceptibility to upper respiratory tract infections (URTI). A literature search was performed using the keywords 'upper respiratory tract infections', 'athletes', 'exercise' and 'physical activity'. We considered all studies reporting of the effect of exercise, physical activity, sport and training on susceptibility to URTI. A total of 162 publications were identified and 30 studies were eligible (4 descriptive, 18 observational and 8 interventional). The 30 studies included 8595 athletes (5471 runners, 2803 swimmers) and 1798 non-athletes.

AREAS OF AGREEMENT

Moderate activity may enhance immune function, whereas prolonged, high-intensity exercise temporarily impairs the immune competence. Athletes, when compared with lesser active individuals, experience higher rate of URTI after training and competitions. In non-athletes, increasing physical activity is associated with a decreased risk of URTI.

AREAS OF CONTROVERSY

The relationship between exercise and URTI is affected by poorly known individual determinants such as genetic factors, fitness, nutritional status or atopy. Elite athletes may have a decreased susceptibility to URTI.

GROWING POINTS AND AREAS TIMELY FOR DEVELOPING RESEARCH

The dose-response relationship between immunodepression and risk for URTI during the weeks following heavy exercise. What are the clinically relevant methods to assess exercise-induced immunodepression? Is down-regulation of immunity after intense exercise a protective response to limit inflammation? Is there a role for nutritional or pharmaceutical interventions to reduce risk of URTI?

Special feature for the Olympics: effects of exercise on the immune system: exercise effects on mucosal immunity

The present review examines the effects of exercise on mucosal immunity in recreational and elite athletes and the role of mucosal immunity in respiratory illness. Habitual exercise at an intense level can cause suppression of mucosal immune parameters, while moderate exercise may have positive effects. Saliva is the most commonly used secretion for measurement of secretory antibodies in the assessment of mucosal immune status. Salivary IgA and IgM concentrations decline immediately after a bout of intense exercise, but usually recover within 24 h. Training at an intense level over many years can result in a chronic suppression of salivary immunoglobulin levels. The degree of immune suppression and the recovery rates after exercise are associated with the intensity of exercise and the duration or volume of the training. Low levels of salivary IgM and IgA, particularly the IgA1 subclass, are associated with an increased risk of respiratory illness in athletes. Monitoring mucosal immune parameters during critical periods of training provides an assessment of the upper respiratory tract illness risk status of an individual athlete. The mechanisms underlying the mucosal immune suppression are unknown.

Salivary IgA subclasses and infection risk in elite swimmers

The concentrations of total IgA, IgA1 and IgA2 were measured in saliva collected from 25 elite swimmers in the early and late phases of a 7 month training season and compared with the number of respiratory infections during the season. The IgA1 concentrations in the early phase of the training season were significantly associated (P = 0.01) with the number of respiratory infection episodes during the training season. The lower the concentration of IgA1, the greater the number of infection episodes. Swimmers with four or more infections during the training season had significantly lower salivary IgA1 concentrations than those with less than four infection episodes (P = 0.01). The proportion of IgA1 in the saliva of the elite swimmers (80%) was higher than for normal non-exercising adults (60%). A small proportion of athletes had salivary IgA2 concentrations below the detection limit of the assay and the mean concentration of IgA2 was significantly lower than the concentrations for a normal adult population (P = 0.01). This study suggests that measurement of IgA subclasses, in particular IgA1, at the commencement of a training season may predict infection risk in elite swimmers.