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Aykut MN, Erdoğan EN, Çelik MN, Gürbüz M. An Updated View of the Effect of Probiotic Supplement on Sports Performance: A Detailed Review. Curr Nutr Rep 2024; 13:251-263. [PMID: 38470560 PMCID: PMC11133216 DOI: 10.1007/s13668-024-00527-x] [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] [Accepted: 12/29/2023] [Indexed: 03/14/2024]
Abstract
PURPOSE OF REVIEW Modulation of the host microbiota through probiotics has been shown to have beneficial effects on health in the growing body of research. Exercise increases the amount and diversity of beneficial microorganisms in the host microbiome. Although low- and moderate-intensity exercise has been shown to reduce physiological stress and improve immune function, high-intensity prolonged exercise can suppress immune function and reduce microbial diversity due to intestinal hypoperfusion. The effect of probiotic supplementation on sports performance is still being studied; however, questions remain regarding the mechanisms of action, strain used, and dose. In this review, the aim was to investigate the effects of probiotic supplements on exercise performance through modulation of gut microbiota and alleviation of GI symptoms, promotion of the immune system, bioavailability of nutrients, and aerobic metabolism. RECENT FINDINGS Probiotic supplementation may improve sports performance by reducing the adverse effects of prolonged high-intensity exercise. Although probiotics have been reported to have positive effects on sports performance, information about the microbiome and nutrition of athletes has not been considered in most current studies. This may have limited the evaluation of the effects of probiotic supplementation on sports performance.
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Affiliation(s)
- Miray Nur Aykut
- Department of Nutrition and Dietetics, Trakya University, Edirne, Turkey
| | - Esma Nur Erdoğan
- Department of Nutrition and Dietetics, Trakya University, Edirne, Turkey
| | - Menşure Nur Çelik
- Department of Nutrition and Dietetics, Ondokuz Mayıs University, Samsun, Turkey
| | - Murat Gürbüz
- Department of Nutrition and Dietetics, Trakya University, Edirne, Turkey.
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Knipping K, Kartaram SW, Teunis M, Zuithoff NPA, Buurman N, M’Rabet L, van Norren K, Witkamp R, Pieters R, Garssen J. Salivary concentrations of secretory leukocyte protease inhibitor and matrix metallopeptidase-9 following a single bout of exercise are associated with intensity and hydration status. PLoS One 2023; 18:e0291297. [PMID: 37992002 PMCID: PMC10664895 DOI: 10.1371/journal.pone.0291297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/25/2023] [Indexed: 11/24/2023] Open
Abstract
AIM To investigate the effects of exercise on salivary concentrations of inflammatory markers by analyzing a panel of 25 inflammatory markers in subjects who had participated in bicycle ergometer tests varying in workload and hydration status. METHODS Fifteen healthy young men (20-35 years) had performed 4 different exercise protocols of 1 hour duration in a randomly assigned cross-over design, preceded by a rest protocol. Individual workloads depended on participant's pre-assessed individual maximum workload (Wmax): rest (protocol 1), 70% Wmax in hydrated (protocol 2) and dehydrated (protocol 3) state, 50% Wmax (protocol 4) and intermittent 85%/55% Wmax in 2 min blocks (protocol 5). Saliva samples were collected before (T0) and immediately after exercise (T1), and at several time points after exercise (2 hours (T3), 3 hours (T4), 6 hours (T5) and 24 hours (T6)). Secretory Leukocyte Protease Inhibitor (SLPI), Matrix Metallopeptidase-9 (MMP-9) and lactoferrin was analyzed using a commercial ELISA kit, a panel of 22 cytokines and chemokines were analyzed using a commercial multiplex immunoassay. Data was analyzed using a multilevel mixed linear model, with multiple test correction. RESULTS Among a panel of 25 inflammatory markers, SLPI concentrations were significantly elevated immediately after exercise in all protocols compared to rest and higher concentrations reflected the intensity of exercise and hydration status. MMP-9 showed a significant increase in the 70% Wmax dehydrated, 50% Wmax and intermittent protocols. CONCLUSIONS Salivary concentrations of SLPI and MMP-9 seem associated with exercise intensity and hydration status and may offer non-invasive biomarkers to study (local) inflammatory responses to different exercise intensities in human studies.
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Affiliation(s)
- Karen Knipping
- Danone Nutricia Research, Utrecht, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Shirley W. Kartaram
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Marc Teunis
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Nicolaas P. A. Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Laura M’Rabet
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Klaske van Norren
- Nutritional Biology, Division Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Renger Witkamp
- Nutritional Biology, Division Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Raymond Pieters
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Institute for Risk Assessment Sciences, Immunotoxicology (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Johan Garssen
- Danone Nutricia Research, Utrecht, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Cheng L, Wang H, Han Y. Effects of caffeinated beverage ingestion on salivary antimicrobial proteins responses to acute exercise in the heat. Front Nutr 2022; 9:973003. [DOI: 10.3389/fnut.2022.973003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Caffeine is commonly used by athletes as an energy supplement, but studies on its effects on salivary antimicrobial proteins (sAMPs) in humans during exercise are rare with ambiguous findings. It is also still controversial whether hot environments affect sAMPs. Using a double-blind, randomized crossover design, we examined 12 endurance-trained male collegiate athletes who completed the following two experiments: a caffeine experiment (CAF) and a placebo experiment (PLA). The participants acutely consumed caffeine-containing (6 mg/kg body weight) sports drink (3 ml/kg body weight) or an equivalent amount of placebo sports drink and subsequently performed cycling exercise for 40 min in the heat (33 ± 0.24°C, 64 ± 2.50% relative humidity) at 50% of maximum output power, maintaining a pedal frequency of 60 rpm. Saliva was collected at 60 min pre-exercise (T–60), the start of exercise (T0), 20 min of exercise (T20), and the end of the exercise (T40), and salivary α-amylase (sAA) and lactoferrin (sLac) were tested. The rating of perceived exertion (RPE) was measured at T0–T40, while core body temperature (Tre) and heart rate (HR) were monitored continuously. Tre, HR, and RPE increased with time during the exercise (p < 0.01), with no difference in Tre and HR between the CAF and PLA (p > 0.05), but RPE was higher in the PLA than in the CAF (p < 0.05). sLac concentrations were significantly higher at T20 and T40 than at T–60 (p < 0.01) and higher at T40 than at T0 and T20 (p < 0.01), with no difference between the CAF and PLA (p > 0.05). Compared with T–60, sAA activity was significantly increased at T0, T20, and T40 (p < 0.01). sAA activity was significantly higher at T40 than at T0 and T20 (p < 0.01), at T20 than at T0 (p < 0.05), and in the CAF than in the PLA (p < 0.01). Heat stress caused by acute exercise in hot environments did not impair the sAMPs parameters of the participants. Instead, the participants showed transient increase in sAA activity and unchanged sLac concentrations. Caffeine may increase salivary markers related to immune response during exercise.
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Influence of Sports Intervention Based on K-Center Algorithm on Adolescent Obesity Metabolism and Bone Quality. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:9236369. [PMID: 34630999 PMCID: PMC8500757 DOI: 10.1155/2021/9236369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
In order to enable obese adolescents to increase muscle content, base metabolism, etc., aerobic training is used reduce body fat and then improve body components, health physique indicators, and physical fitness. This paper adopts the current situation for research and model construction through the K-center algorithm. The results show that 10 min swimming movement increased the adolescent patients' level of brain metabolism, and with no less than 15 min, the CI value rose to 41, the increase in brain metabolism in adolescents, and the rate of fat combustion effectively increased. It is guaranteed that physical health prevents the occurrence of obese syndrome diseases. Sports training can not only increase the skinny weight of the teen obese population but also reduce body fat content, which has a significant assistance to body type, is a high-cost performance, and has comprehensive training means.
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Bartolome F, Orive G, Carro E. Standardizing salivary lactoferrin measurements to obtain a robust diagnostic biomarker for Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12173. [PMID: 33969170 PMCID: PMC8088590 DOI: 10.1002/dad2.12173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/01/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
The search for new, robust, and reproducible biomarkers for Alzheimer's disease (AD) diagnosis is a challenge. We recently reported that salivary lactoferrin (Lf) could be presented as new biomarker candidate for AD, being both non-invasive and cost-effective, as well as having appropriate diagnostic performance for the clinical detection of AD subjects. Saliva is an attractive sample type for biomarker-based testing approaches for several other diseases; however, its composition may change under certain circumstances. It is therefore critical to maintain a consistent salivary handling protocol, considering possible extrinsic factors that may influence salivary Lf concentration. In this work, we analyzed salivary Lf concentration under different handling conditions and donor-dependent factors including age, inter-diurnal variations, physical activity, and pharmacological treatments. Our aim was to evaluate the influence of such conditions on salivary Lf concentration. In conclusion, we found that most of these extrinsic factors should be considered in the future when using Lf as a predictive biomarker for AD.
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Affiliation(s)
- Fernando Bartolome
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED)CordobaSpain
- Group of Neurodegenerative DiseasesHospital Universitario 12 de Octubre Research Institute (imas12)MadridSpain
| | - Gorka Orive
- Laboratory of Pharmacy and Pharmaceutical TechnologyFaculty of PharmacyUniversity of the Basque CountryVitoriaSpain
- Bioaraba, NanoBioCel Research GroupVitoria‐GasteizSpain
- Networked Center for Biomedical Research in BioengineeringBiomaterials and Nanomedicine (CIBER‐BBN)BarcelonaSpain
| | - Eva Carro
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED)CordobaSpain
- Group of Neurodegenerative DiseasesHospital Universitario 12 de Octubre Research Institute (imas12)MadridSpain
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McKenna Z, Berkemeier Q, Gorini F, Kuennen M, Naylor A, Kleint A, Gillum T. Effects of exercise in hot and humid conditions and bovine colostrum on salivary immune markers. J Therm Biol 2020; 93:102717. [PMID: 33077128 DOI: 10.1016/j.jtherbio.2020.102717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the effects of exercise in a hot and humid environment on salivary lactoferrin and lysozyme. A secondary aim was to quantify the effects of 14-day bovine colostrum (BC) supplementation on salivary lactoferrin and lysozyme at rest and following exercise in hot and humid conditions. Using a randomized, double-blind, and counterbalanced design, ten males (20 ± 2 years, VO2max 55.8 ± 3.7 mL kg-1 min-1, 11.8 ± 2.7% body fat) ran for 46 ± 7.7 min at 95% of ventilatory threshold in a 40 °C and 50% RH environment after 14-days of supplementation with either BC or placebo. Saliva was collected pre, post, 1-h, and 4-h post exercise, and was analyzed for lactoferrin and lysozyme using ELISA. There was an immediate increase in the concentration and secretion rate of lactoferrin and lysozyme (p < 0.05) with exercise, but BC had no effect (p > 0.05). Saliva flow rate was not different between conditions [(PLA: pre: 0.54 ± 0.3, post: 0.44 ± 0.3, 1-h: 0.67 ± 0.3, 4-h: 1.0 ± 0.4 mL min-1); (BC: pre: 0.58 ± 0.2, post: 0.37 ± 0.1, 1-h: 0.63 ± 0.2, 4-h: 0.83 ± 0.4 mL min-1)]. There were no differences in thermoregulatory markers (core temperature or physiological strain index) between BC and placebo trials. Interestingly, exercise-induced heat stress did not impair mucosal immune parameters, instead participants showed a transient increase in salivary lactoferrin and lysozyme. Further, 14-day BC supplementation had no effect on mucosal immunity at any time point.
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Affiliation(s)
- Zachary McKenna
- University of New Mexico, Department of Health, Exercise, and Sports Sciences, Albuquerque, NM, USA.
| | - Quint Berkemeier
- University of New Mexico, Department of Health, Exercise, and Sports Sciences, Albuquerque, NM, USA
| | - Felipe Gorini
- California Baptist University, Department of Kinesiology, Riverside, CA, USA
| | - Matthew Kuennen
- High Point University, Department of Exercise Science, High Point, NC, USA
| | - Ashley Naylor
- California Baptist University, Department of Kinesiology, Riverside, CA, USA
| | - Austin Kleint
- Western University of Health Sciences, College of Osteopathic Medicine, Lebanon, OR, USA
| | - Trevor Gillum
- California Baptist University, Department of Kinesiology, Riverside, CA, USA
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González-Sánchez M, Bartolome F, Antequera D, Puertas-Martín V, González P, Gómez-Grande A, Llamas-Velasco S, Herrero-San Martín A, Pérez-Martínez D, Villarejo-Galende A, Atienza M, Palomar-Bonet M, Cantero JL, Perry G, Orive G, Ibañez B, Bueno H, Fuster V, Carro E. Decreased salivary lactoferrin levels are specific to Alzheimer's disease. EBioMedicine 2020; 57:102834. [PMID: 32586758 PMCID: PMC7378957 DOI: 10.1016/j.ebiom.2020.102834] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Evidences of infectious pathogens in Alzheimer's disease (AD) brains may suggest a deteriorated innate immune system in AD pathophysiology. We previously demonstrated reduced salivary lactoferrin (Lf) levels, one of the major antimicrobial proteins, in AD patients. METHODS To assess the clinical utility of salivary Lf for AD diagnosis, we examine the relationship between salivary Lf and cerebral amyloid-β (Aβ) load using amyloid-Positron-Emission Tomography (PET) neuroimaging, in two different cross-sectional cohorts including patients with different neurodegenerative disorders. FINDINGS The diagnostic performance of salivary Lf in the cohort 1 had an area under the curve [AUC] of 0•95 (0•911-0•992) for the differentiation of the prodromal AD/AD group positive for amyloid-PET (PET+) versus healthy group, and 0•97 (0•924-1) versus the frontotemporal dementia (FTD) group. In the cohort 2, salivary Lf had also an excellent diagnostic performance in the health control group versus prodromal AD comparison: AUC 0•93 (0•876-0•989). Salivary Lf detected prodromal AD and AD dementia distinguishing them from FTD with over 87% sensitivity and 91% specificity. INTERPRETATION Salivary Lf seems to have a very good diagnostic performance to detect AD. Our findings support the possible utility of salivary Lf as a new non-invasive and cost-effective AD biomarker. FUNDING Instituto de Salud Carlos III (FIS15/00780, FIS18/00118), FEDER, Comunidad de Madrid (S2017/BMD-3700; NEUROMETAB-CM), and CIBERNED (PI2016/01) to E.C.; Spanish Ministry of Economy and Competitiveness (SAF2017-85310-R) to J.L.C., and (PSI2017-85311-P) to M.A.; International Centre on ageing CENIE-POCTEP (0348_CIE_6_E) to M.A.; Instituto de Salud Carlos III (PIE16/00021, PI17/01799), to H.B.
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Affiliation(s)
- Marta González-Sánchez
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain; Neurology Service Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Fernando Bartolome
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain.
| | - Desiree Antequera
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain
| | - Veronica Puertas-Martín
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain; Hospital Universitario 12 de Octubre Research Institute (imas12), Madrid, Spain
| | - Pilar González
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain; Hospital Universitario 12 de Octubre Research Institute (imas12), Madrid, Spain
| | - Adolfo Gómez-Grande
- Nuclear Medicine Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain
| | - Sara Llamas-Velasco
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain; Neurology Service Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alejandro Herrero-San Martín
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain; Neurology Service Hospital Universitario 12 de Octubre, Madrid, Spain
| | - David Pérez-Martínez
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain; Neurology Service Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alberto Villarejo-Galende
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain; Neurology Service Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain, CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Spain
| | - Miriam Palomar-Bonet
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain, CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Spain
| | - Jose Luis Cantero
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain, CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Spain
| | - George Perry
- Department of Biology and Neurosciences Institute, University of Texas at San Antonio, San Antonio, TX, USA
| | - Gorka Orive
- Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of the Basque Country, Vitoria, Spain; Networked Center for Biomedical Research in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - Borja Ibañez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, CIBER de Enfermedades Cardiovasculares, Madrid, Spain; IIS-Fundacion Jiménez Díaz Hospital, Madrid, Spain
| | - Hector Bueno
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, CIBER de Enfermedades Cardiovasculares, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Hospital Universitario 12 de Octubre Research Institute (imas12), Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Eva Carro
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain; Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain.
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Upper respiratory tract symptoms and salivary immunoglobulin A of elite female gymnasts: a full year longitudinal field study. Biol Sport 2020; 37:285-293. [PMID: 32879551 PMCID: PMC7433336 DOI: 10.5114/biolsport.2020.95639] [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: 01/09/2020] [Revised: 03/28/2020] [Accepted: 05/17/2020] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to determine the frequency of upper respiratory tract symptoms (URS) in elite female gymnasts during a training season. In addition, we aimed to observe the extent to which salivary immunoglobulin A (sIgA) is associated with URS in these athletes, including potential effects of the season and timing of sample collection. Over one year, 18 elite female gymnasts completed URS and fatigue questionnaires weekly and provided 1 mL of saliva after a minimum 36 h of rest (morning or afternoon) to measure relative sIgA concentration (= mean absolute sIgA value of the week divided by the mean absolute sIgA value of the weeks without URS). Mean weekly URS and mean relative sIgA values per gymnast correlated negatively (r = -0.606, P = 0.022). Most URS were noted in the most fatigued gymnasts (7.4 ± 10.1 vs. 2.5 ± 5.6 (P < 0.001) for ‘normal’ and 2.1 ± 3.7 (P = 0.001) for ‘better than normal’ rested). In spring, relative sIgA was higher compared to autumn (112 ± 55 vs. 89 ± 41%, P < 0.001) and winter (92 ± 35%, P = 0.001), while during summer, relative sIgA appeared higher compared to autumn (110 ± 55 vs. 89 ± 41%, P = 0.016). The interaction effect with timing of sample collection showed higher relative sIgA values in morning samples in spring and summer compared to afternoon samples, with the inverse observed in autumn and winter (F = 3.565, P = 0.014). During a gymnastics season, lower relative sIgA values were linked to higher susceptibility to URS in elite gymnasts. However, relative sIgA values were influenced by season and timing of sample collection and thus should be considered when interpreting sIgA data.
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Grande AJ, Keogh J, Silva V, Scott AM. Exercise versus no exercise for the occurrence, severity, and duration of acute respiratory infections. Cochrane Database Syst Rev 2020; 4:CD010596. [PMID: 32246780 PMCID: PMC7127736 DOI: 10.1002/14651858.cd010596.pub3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Acute respiratory infections (ARIs) last for less than 30 days and are the most common acute diseases affecting people. Exercise has been shown to improve health generally, but it is uncertain whether exercise may be effective in reducing the occurrence, severity, and duration of ARIs. This is an update of our review published in 2015. OBJECTIVES To evaluate the effectiveness of exercise for altering the occurrence, severity, or duration of acute respiratory infections. SEARCH METHODS We searched CENTRAL (2020, Issue 2), MEDLINE (1948 to March week 1, 2020), Embase (1974 to 05 March 2020), CINAHL (1981 to 05 March 2020), LILACS (1982 to 05 March 2020), SPORTDiscus (1985 to 05 March 2020), PEDro (searched 05 March 2020), OTseeker (searched 05 March 2020), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (searched 05 March 2020). SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs (method of allocation that is not truly random, e.g. based on date of birth, medical record number) of exercise for ARIs in the general population. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from the included trials using a standard form. One review author entered data, which a second review author checked. We contacted trial authors to request missing data. There were sufficient differences in the populations trialed and in the nature of the interventions to use the random-effects model (which makes fewer assumptions than the fixed-effect model) in the analysis. MAIN RESULTS We included three new trials for this update (473 participants) for a total of 14 trials involving 1377 adults, published between 1990 and 2018. Nine trials were conducted in the USA, and one each in Brazil, Canada, Portugal, Spain, and Turkey. Sample sizes ranged from 16 to 419 participants, aged from 18 to 85 years. The proportion of female participants ranged from 52% to 100%. Follow-up duration ranged from 1 to 36 weeks (median = 12 weeks). Moderate-intensity aerobic exercise (walking, bicycling, treadmill, or a combination) was evaluated in 11 trials, and was most commonly prescribed at least three times a week for 30 to 45 minutes. There was no difference between exercise and no exercise in the number of ARI episodes per person per year (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.77 to 1.30; 4 trials; 514 participants; low-certainty evidence); proportion of participants who experienced at least one ARI over the study period (RR 0.88, 95% CI 0.72 to 1.08; 5 trials; 520 participants; low-certainty evidence); and the number of symptom days per episode of illness (mean difference (MD) -0.44 day, 95% CI -2.33 to 1.46; 6 trials; 557 participants; low-certainty evidence). Exercise reduced the severity of ARI symptoms measured on the Wisconsin Upper Respiratory Symptom Survey (WURSS-24) (MD -103.57, 95% CI -198.28 to -8.87; 2 trials; 373 participants; moderate-certainty evidence) and the number of symptom days during follow-up period (MD -2.24 days, 95% CI -3.50 to -0.98; 4 trials; 483 participants; low-certainty evidence). Excercise did not have a significant effect on laboratory parameters (blood lymphocytes, salivary secretory immunoglobulin, and neutrophils), quality of life outcomes, cost-effectiveness, and exercise-related injuries. There was no difference in participant dropout between the intervention and control groups. Overall, the certainty of the evidence was low, downgraded mainly due to limitations in study design and implementation, imprecision, and inconsistency. Seven trials were funded by public agencies; five trials did not report funding; and two trials were funded by private companies. AUTHORS' CONCLUSIONS Exercise did not reduce the number of ARI episodes, proportion of participants experiencing at least one ARI during the study, or the number of symptom days per episode of illness. However, exercise reduced the severity of ARI symptoms (two studies) and the number of symptom days during the study follow-up period (four studies). Small study size, risk of bias, and heterogeneity in the populations studied contributed to the uncertainty of the findings. Larger trials that are designed to avoid risk of bias associated with participant selection, blinding of outcomes assessors, and with adequate reporting of all outcomes proposed for measurement in trials, would help to provide more robust evidence.
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Affiliation(s)
- Antonio Jose Grande
- Universidade Estadual de Mato Grosso do SulLaboratory of Evidence‐Based PracticeAv. Dom Antônio Barbosa, 4155Vila Santo AmaroCampo GrandeMato Grosso do SulBrazil79115‐898
| | - Justin Keogh
- Bond UniversityFaculty of Health Sciences and Medicine14 University DriveGold CoastQueenslandAustralia4229
| | - Valter Silva
- Centro Universitário Tiradentes (UNIT/AL)Postgraduate Program on Society, Technology and Public Policies (SOTEPP); Department of MedicineAv. Comendador Gustavo Paiva, 5017Cruz das AlmasMaceióALBrazil57038‐000
| | - Anna M Scott
- Bond UniversityCentre for Research in Evidence‐Based Practice (CREBP)14 University DriveGold CoastQueenslandAustralia4229
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Hanstock HG, Edwards JP, Walsh NP. Tear Lactoferrin and Lysozyme as Clinically Relevant Biomarkers of Mucosal Immune Competence. Front Immunol 2019; 10:1178. [PMID: 31231369 PMCID: PMC6558391 DOI: 10.3389/fimmu.2019.01178] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/09/2019] [Indexed: 01/01/2023] Open
Abstract
Tears have attracted interest as a minimally-invasive biological fluid from which to assess biomarkers. Lactoferrin (Lf) and lysozyme (Lys) are abundant in the tear fluid and have antimicrobial properties. Since the eye is a portal for infection transmission, assessment of immune status at the ocular surface may be clinically relevant. Therefore, the aim of this series of studies was to investigate the tear fluid antimicrobial proteins (AMPs) Lf and Lys as biomarkers of mucosal immune status. To be considered biomarkers of interest, we would expect tear AMPs to respond to stressors known to perturb immunity but be robust to confounding variables, and to be lower in participants with heightened risk or incidence of illness. We investigated the relationship between tear AMPs and upper respiratory tract infection (URTI; study 1) as well as the response of tear AMPs to prolonged treadmill exercise (study 2) and dehydration (study 3). Study 1 was a prospective cohort study conducted during the common cold season whereas studies 2 and 3 used repeated-measures crossover designs. In study 1, tear Lys concentration (C) as well as tear AMP secretion rates (SRs) were lower in individuals who reported pathogen-confirmed URTI (n = 9) throughout the observation period than in healthy, pathogen-free controls (n = 17; Lys-C, P = 0.002, d = 0.85; Lys-SR, P < 0.001, d = 1.00; Lf-SR, P = 0.018, d = 0.66). Tear AMP secretion rates were also lower in contact lens wearers. In study 2, tear AMP SRs were 42-49% lower at 30 min-1 h post-exercise vs. pre-exercise (P < 0.001, d = 0.80-0.93). Finally, in study 3, tear AMPs were not influenced by dehydration, although tear AMP concentrations (but not secretion rates) displayed diurnal variation. We conclude that Lf and Lys have potential as biomarkers of mucosal immune competence; in particular, whether these markers are lower in infection-prone individuals warrants further investigation.
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Affiliation(s)
- Helen G Hanstock
- Extremes Research Group, School of Sport, Health and Exercise Sciences, College of Health and Human Sciences, Bangor University, Bangor, United Kingdom.,Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Jason P Edwards
- Extremes Research Group, School of Sport, Health and Exercise Sciences, College of Health and Human Sciences, Bangor University, Bangor, United Kingdom
| | - Neil P Walsh
- Extremes Research Group, School of Sport, Health and Exercise Sciences, College of Health and Human Sciences, Bangor University, Bangor, United Kingdom
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11
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Keaney LC, Kilding AE, Merien F, Dulson DK. Keeping Athletes Healthy at the 2020 Tokyo Summer Games: Considerations and Illness Prevention Strategies. Front Physiol 2019; 10:426. [PMID: 31057419 PMCID: PMC6479135 DOI: 10.3389/fphys.2019.00426] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/27/2019] [Indexed: 12/23/2022] Open
Abstract
Keeping athletes healthy will be important for optimal athletic performance at the 2020 Tokyo Summer Olympic and Paralympic Games. Athletes will be exposed to several stressors during the preparatory and competition phases of the Summer Games that have the potential to depress immunity and increase illness risk. This mini-review provides an overview on effective and practical stressor-specific illness prevention strategies that can be implemented to maintain and protect the health of Olympic and Paralympic athletes.
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Affiliation(s)
- Lauren C Keaney
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Fabrice Merien
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,AUT Roche Diagnostics Laboratory, Auckland University of Technology, Auckland, New Zealand
| | - Deborah K Dulson
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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12
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Salivary immunity and lower respiratory tract infections in non-elite marathon runners. PLoS One 2018; 13:e0206059. [PMID: 30462646 PMCID: PMC6248899 DOI: 10.1371/journal.pone.0206059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/06/2018] [Indexed: 01/19/2023] Open
Abstract
Rationale Respiratory infections are common after strenuous exercise, when salivary immunity may be altered. We aim to investigate changes in salivary immunity after a marathon and its relationship with lower respiratory tract infections (LRTI) in healthy non-elite marathon runners. Methods Forty seven healthy marathon runners (28 males and 19 females) who completed the 42.195 km of the 2016 Barcelona marathon were studied. Saliva and blood samples were collected the day before the marathon and two days after the end of the race. Salivary IgA, antimicrobial proteins (lactoferrin, lysozyme) and chemokines (Groα, Groβ, MCP-1) were determined using ELISA kits in saliva supernatant. Blood biochemistry and haemogram were analyzed in all participants. The presence of LRTI was considered in those runners who reported infectious lower respiratory tract symptoms during a minimum of 3 consecutive days in the 2 weeks after the race. Results Eight participants (17%) presented a LRTI during the 2 weeks of follow-up. Higher lysozyme levels were detected after the race in runners with LRTI when compared with those without infection. A decrease in salivary lysozyme, Groα and Groβ levels after the race were observed in those runners who did not develop a LRTI when compared to basal levels. Salivary Groα levels correlated with basophil blood counts, and salivary lysozyme levels correlated with leukocyte blood counts. Conclusions LRTI are common after a marathon race in non-elite healthy runners. Changes in salivary antimicrobial proteins and chemokines are related to the presence of LRTI and correlate with systemic defense cells, which suggest an important role of salivary immunity in the development of LRTI in non-elite marathon runners.
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Williams NC, Killer SC, Svendsen IS, Jones AW. Immune nutrition and exercise: Narrative review and practical recommendations. Eur J Sport Sci 2018; 19:49-61. [PMID: 29975589 DOI: 10.1080/17461391.2018.1490458] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Evidence suggests that periods of heavy intense training can result in impaired immune cell function, and whether this leaves elite athletes at greater risk of infections and upper respiratory symptoms (URS) is still debated. There is some evidence that episodes of URS do cluster around important periods of competition and intense periods of training. Since reducing URS, primarily from an infectious origin, may have implications for performance, a large amount of research has focused on nutritional strategies to improve immune function at rest and in response to exercise. Although there is some convincing evidence that meeting requirements of high intakes in carbohydrate and protein and avoiding deficiencies in nutrients such as vitamin D and antioxidants is integral for optimal immune health, well-powered randomised controlled trials reporting improvements in URS beyond such intakes are lacking. Consequently, there is a need to first understand whether the nutritional practices adopted by elite athletes increases their risk of URS. Second, promising evidence in support of efficacy and mechanisms of immune-enhancing nutritional supplements (probiotics, bovine colostrum) on URS needs to be followed up with more randomised controlled trials in elite athletes with sufficient participant numbers and rigorous procedures with clinically relevant outcome measures of immunity.
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Affiliation(s)
- Neil C Williams
- a Exercise and Health Research Group, Department of Sport Science, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Sophie C Killer
- b British Athletics, English Institute of Sport, National Performance Institute, Loughborough University , Loughborough , UK
| | | | - Arwel Wyn Jones
- d Lincoln Institute for Health, University of Lincoln , Lincoln , UK
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14
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Lindsay A, Costello JT. Realising the Potential of Urine and Saliva as Diagnostic Tools in Sport and Exercise Medicine. Sports Med 2018; 47:11-31. [PMID: 27294353 DOI: 10.1007/s40279-016-0558-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Accurate monitoring of homeostatic perturbations following various psychophysiological stressors is essential in sports and exercise medicine. Various biomarkers are routinely used as monitoring tools in both clinical and elite sport settings. Blood collection and muscle biopsies, both invasive in nature, are considered the gold standard for the analysis of these biomarkers in exercise science. Exploring non-invasive methods of collecting and analysing biomarkers that are capable of providing accurate information regarding exercise-induced physiological and psychological stress is of obvious practical importance. This review describes the potential benefits, and the limitations, of using saliva and urine to ascertain biomarkers capable of identifying important stressors that are routinely encountered before, during, or after intense or unaccustomed exercise, competition, over-training, and inappropriate recovery. In particular, we focus on urinary and saliva biomarkers that have previously been used to monitor muscle damage, inflammation, cardiovascular stress, oxidative stress, hydration status, and brain distress. Evidence is provided from a range of empirical studies suggesting that urine and saliva are both capable of identifying various stressors. Although additional research regarding the efficacy of using urine and/or saliva to indicate the severity of exercise-induced psychophysiological stress is required, it is likely that these non-invasive biomarkers will represent "the future" in sports and exercise medicine.
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Affiliation(s)
- Angus Lindsay
- Program in Physical Therapy and Rehabilitation Sciences, School of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Joseph T Costello
- Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Spinnaker Building, Cambridge Road, Portsmouth, PO1 2ER, UK
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15
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Campbell JP, Turner JE. Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan. Front Immunol 2018; 9:648. [PMID: 29713319 PMCID: PMC5911985 DOI: 10.3389/fimmu.2018.00648] [Citation(s) in RCA: 350] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 03/15/2018] [Indexed: 12/17/2022] Open
Abstract
Epidemiological evidence indicates that regular physical activity and/or frequent structured exercise reduces the incidence of many chronic diseases in older age, including communicable diseases such as viral and bacterial infections, as well as non-communicable diseases such as cancer and chronic inflammatory disorders. Despite the apparent health benefits achieved by leading an active lifestyle, which imply that regular physical activity and frequent exercise enhance immune competency and regulation, the effect of a single bout of exercise on immune function remains a controversial topic. Indeed, to this day, it is perceived by many that a vigorous bout of exercise can temporarily suppress immune function. In the first part of this review, we deconstruct the key pillars which lay the foundation to this theory-referred to as the "open window" hypothesis-and highlight that: (i) limited reliable evidence exists to support the claim that vigorous exercise heightens risk of opportunistic infections; (ii) purported changes to mucosal immunity, namely salivary IgA levels, after exercise do not signpost a period of immune suppression; and (iii) the dramatic reductions to lymphocyte numbers and function 1-2 h after exercise reflects a transient and time-dependent redistribution of immune cells to peripheral tissues, resulting in a heightened state of immune surveillance and immune regulation, as opposed to immune suppression. In the second part of this review, we provide evidence that frequent exercise enhances-rather than suppresses-immune competency, and highlight key findings from human vaccination studies which show heightened responses to bacterial and viral antigens following bouts of exercise. Finally, in the third part of this review, we highlight that regular physical activity and frequent exercise might limit or delay aging of the immune system, providing further evidence that exercise is beneficial for immunological health. In summary, the over-arching aim of this review is to rebalance opinion over the perceived relationships between exercise and immune function. We emphasize that it is a misconception to label any form of acute exercise as immunosuppressive, and, instead, exercise most likely improves immune competency across the lifespan.
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Affiliation(s)
- John P Campbell
- Department for Health, University of Bath, Bath, United Kingdom
| | - James E Turner
- Department for Health, University of Bath, Bath, United Kingdom
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16
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Hanstock HG, Walsh NP, Edwards JP, Fortes MB, Cosby SL, Nugent A, Curran T, Coyle PV, Ward MD, Yong XHA. Tear Fluid SIgA as a Noninvasive Biomarker of Mucosal Immunity and Common Cold Risk. Med Sci Sports Exerc 2017; 48:569-77. [PMID: 26496418 DOI: 10.1249/mss.0000000000000801] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Research has not convincingly demonstrated the utility of saliva secretory immunoglobulin-A (SIgA) as a biomarker of upper respiratory tract infection (URTI) risk, and disagreement exists about the influence of heavy exercise ("open-window theory") and dehydration on saliva SIgA. Prompted by the search for viable alternatives, we compared the utility of tear and saliva SIgA to predict URTI prospectively (study 1) and assessed the influence of exercise (study 2) and dehydration (study 3) using a repeated-measures crossover design. METHODS In study 1, 40 subjects were recruited during the common-cold season. Subjects provided tear and saliva samples weekly and recorded upper respiratory symptoms (URS) daily for 3 wk. Real-time PCR confirmed common-cold pathogens in 9 of 11 subjects reporting URS (82%). Predictive utility of tear and saliva SIgA was explored by comparing healthy samples with those collected during the week before URS. In study 2, 13 subjects performed a 2-h run at 65% V˙O2peak. In study 3, 13 subjects performed exercise heat stress to 3% body mass loss followed by overnight fluid restriction. RESULTS Tear SIgA concentration and secretion rate were 48% and 51% lower, respectively, during URTI and 34% and 46% lower the week before URS (P < 0.05), but saliva SIgA remained unchanged. The risk of URS the following week increased ninefold (95% confidence interval, 1.7-48) when the tear SIgA secretion rate was <5.5 μg·min(-1) and sixfold (95% confidence interval, 1.2-29) when the tear SIgA secretion rate decreased >30%. Tear SIgA secretion rate >5.5 μg·min(-1) or no decrease of >30% predicted subjects free of URS in >80% of cases. Tear SIgA concentration decreased after exercise (-57%, P < 0.05) in line with the "open-window theory" but was unaffected by dehydration. Saliva flow rate decreased and saliva SIgA concentration increased after exercise and during dehydration (P < 0.05). CONCLUSIONS Tear SIgA has utility as a noninvasive biomarker of mucosal immunity and common-cold risk.
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Affiliation(s)
- Helen G Hanstock
- 1College of Health and Behavioural Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM; 2Centre for Infection and Immunity, Queen's University Belfast, Northern Ireland, UNITED KINGDOM; and 3Regional Virus Laboratory, Royal Victoria Hospital, Belfast, UNITED KINGDOM
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Walsh NP, Oliver SJ. Exercise, immune function and respiratory infection: An update on the influence of training and environmental stress. Immunol Cell Biol 2015; 94:132-9. [PMID: 26563736 DOI: 10.1038/icb.2015.99] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/05/2015] [Accepted: 11/09/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Neil P Walsh
- Extremes Research Group, Bangor University Bangor UK
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