The acute response of the immune system to tennis drills in adolescent athletes

Complement System Deficiencies in Elite Athletes

BACKGROUND

Although regular physical activity improves immune competency and reduces the prevalence of inflammatory diseases, strenuous training in elite athletes is associated with an increased susceptibility to infectious complications. Therefore, the objective of our study was to assess the routinely examined parameters of the complement system in elite athletes. The study was carried out in a cohort of elite athletes (n = 134) and healthy control subjects (n = 110). In all subjects, besides a routine laboratory check-up, serum concentrations of the C3 and C4 complement components, mannose-binding lectin (MBL), as well as activation of all three complement pathways were determined.

RESULTS

Compared to healthy controls, lower C3 and C4 complement component concentrations were observed in elite athletes (0.96 ± 0.1 vs. 1.08 ± 0.2 mg/L, and 0.18 ± 0.1 vs. 0.25 ± 0.1 mg/L, respectively, p < 0.05); with much higher frequency rates of C3 and C4 deficiencies in athletes (31.3 vs. 14.5%, and 6 vs. 0%, p < 0.05). Simultaneously, athletes had much higher frequency rates of deficiencies of activation of classical and alternative complement pathways; while, deficiency of activation of the lectin pathway was similar in both cohorts.

CONCLUSIONS

We confirmed a high frequency of defects in the complement system in elite athletes. Lower concentrations of C3 and C4 complement components, with high frequencies of deficiencies of the classical and alternative complement activation pathways were the most prevalent disorder of the complement system in elite athletes. Further studies are needed to uncover the functional impacts of these observations upon the susceptibility to infectious diseases.

Effects of branched-chain amino acids on immune status of young racing horses

High-intensity exercise and competition are associated with depressed immune function. Young horses, which participate in high-intensity exercise and competitions, are at increased risk for the development of infectious disease due to depression of immune function. The effects of branched-chain amino acid (BCAA) supplementation on the immune status of young racing horses were evaluated, determining whether BCAA might help to avoid or reduce immune suppression during exercise and competitions. Twenty horses (10 male and 10 female) were treated with BCAA supplementation; another twenty untreated horses (10 male and 10 female) constituted control group. Peripheral blood was collected from each animal and evaluated for lymphocyte subsets, phagocytosis analysis of monocytes and granulocytes, lymphocyte proliferative response, and expression of cytokine-encoding messenger ribonucleic acids (mRNAs). The numbers of CD4⁺, CD8⁺, and major histocompatibility complex (MHC) class II⁺ cells in females of the treated group were significantly higher than those in females of the control group. The lymphocyte proliferative response in female of the treated group also was significantly higher than that in females of the control group. In addition, expression of mRNAs encoding interleukin-1β (IL-1β) and interferon-γ (IFN-γ) in females of the treated group was significantly higher than that in females of the control group. There were no significant differences between males of the treated and control groups. The results of this study indicated the positive effects of BCAA supplementation in counteracting immunosuppression in young female racing horses during and following high-intensity exercise.

The design of a volleyball training drill: definition of parameters and assessment of drills’ contents

ABSTRACT The aim of this work was to define a model of volleyball drills’ structure. A set of parameters has been designed and tested for: i) pertinence and accuracy; ii) criteria reliability; iii) practical application. Expert judges evaluated model’s pertinence, accuracy and criteria reliability. A sample of 50 drills was assessed for drills’ analysis. The model demonstrated pertinence and accuracy, with complete agreement among experts. Criteria were reliable (Kappa test results > 0.8). Analysis indicated significant differences in the frequency of model’s parameters (graph topology), for instance among attributes (basic complex - 30%) with manifold drills (46,7%) in the technical domain (100%). The model contributes with theoretical support for a coach’s key task of designing practice contents.

Monitoring Salivary Immunoglobulin A Responses to Official and Simulated Matches In Elite Young Soccer Players

The purpose of the present study was to examine SIgA responses (concentration [SIgAabs] and a secretion rate [SIgArate]) to official and simulated competitive matches in young soccer players. The sample was composed of 26 male soccer players (age 15.6 ± 1.1 yrs, stature 177.0 ± 6.1 cm, body mass 70.5 ± 5.7 kg). Four soccer matches (two simulated matches [SM] and two official matches [OM]) were conducted. The matches consisted of two halves of 35 min with a 10 min rest interval. Each assessed player participated in only one SM and one OM. All matches were performed in the same week, during the competitive season, and at the same time of the day (9:00 am), separated by 48 h. Saliva samples were collected before and after every match. The session rating of perceived exertion was reported 30 min after each match in order to determine the internal training load (ITL). A significant decrease in SIgAabs and SIgArate after OM was observed when compared to the pre-match value. In addition, the SIgArate was higher at pre-OM when compared to pre-SM. A higher ITL for OM was observed compared to SM. The current findings indicate that OM may lead to a decrease in the main mucosal immunity function parameter of young soccer players that could increase the risk of URTI. Coaches should be aware of it in order to plan appropriate training loads and recovery procedures to avoid or minimize the likelihood of upper respiratory tract infection occurrences.

Exercise and Immune Function in Children

Exercise immunology is one of the fastest growing disciplines of the past 2 decades. Unfortunately, the number of investigations devoted to the pediatric population remains low, and our understanding of the interaction between acute and chronic exercise and the immune system in youth is relatively deficient. In general, healthy children experience smaller overall perturbations to the immune system in response to an acute bout of exercise as compared with adults, and they demonstrate a faster recovery of the immune system following exercise. There is only limited evidence to suggest that moderate to high levels of habitual physical activity are associated with a reduction in the incidence of infection and illness in youth. Special consideration should be made for the young athlete training and competing during an illness or infection. Some of the unique exercise responses of the immune system in children may have important clinical relevance, but much more work is required in this area.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Cold applications for recovery in adolescent athletes: a systematic review and meta analysis

Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e.g. heats/finals). In recent years, a lot of emphasis has been put on recovery modalities. In particular, emphasis has been placed on the need to reduce the delayed onset of muscle soreness (DOMS) typically evident following training and competitive activities inducing a certain degree of muscle damage. One of the most used recovery modalities consists of cold-water immersion and/or ice/cold applications to muscles affected by DOMS. While the scientific literature has provided a rationale for such modalities to reduce pain in athletes and recreationally active adults, it is doubtful if this rationale is appropriate to aid training with adolescent athletes. In particular, since these methods have been suggested to potentially impair the muscle remodeling process leading to muscle hypertrophy. While this debate is still active in the literature, many coaches adopt such practices in youth populations, simply transferring what they see in elite sportspeople directly; without questioning the rationale, safety or effectiveness as well as the potential for such activity to reduce the adaptive potential of skeletal muscle remodeling in adolescent athletes. The aim of this review was to assess the current knowledge base on the use of ice/cold applications for recovery purposes in adolescent athletes in order to provide useful guidelines for sports scientists, medical practitioners, physiotherapists and coaches working with such populations as well as developing research questions for further research activities in this area. Based on the current evidence, it seems clear that evidence for acute benefits of such interventions are scarce and more work is needed to ascertain the physiological implications on a pre or peri-pubertal population.

Effects of a simulated tennis match on lymphocyte subset measurements

Tennis is an activity requiring both endurance and anaerobic components, which could have immunosuppressive effects postexercise.

PURPOSE

The purpose of this investigation was to determine the effect of a simulated tennis match on apoptotic and migratory markers on lymphocyte subsets.

METHOD

Male high school (n = 5) and college (n = 3) tennis players (M(age) = 18.9 +/- 3.3 years) completed 10 sets of a tennis protocol including serves, forehand strokes, and backhand groundstrokes with 1-min rest periods between sets. Apoptosis antigen 1 receptor (CD95) and chemokine receptor fractalkine (CX3CR1) expression was analyzed on helper T lymphocytes (CD4+), cytotoxic T lymphocytes (CD8+), and B lymphocytes (CD19+) twice, at resting baseline and immediately after all 10 sets of the tennis protocol.

RESULTS

An increase was observed in each lymphocyte subtype (p < .02, effect size = .41), and comparison of absolute changes revealed increases in CD4+/CD95+, CD8+/CD95+, and CD8+/CX3CR1 lymphocytes following the tennis protocol (p < .01, effect size = .43), but not in CD19+ cells.

CONCLUSIONS

A simulated tennis match has adequate intensity to induce immune modulations in terms of increased cell death and cellular migration in T lymphocyte subsets. Lymphocytopenia following tennis play is influenced by both apoptotic and migratory mechanisms.

Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season

The objective of the present study was to monitor the immunological and hormonal responses and the occurrence of upper respiratory symptoms in adolescent basketball athletes during the different stages of a sports season. Anthropometric measures, biochemical analyses (interleukin-6, interleukin-10, tumour necrosis factor-alpha, C-reactive protein, testosterone and cortisol), neuromuscular evaluations (standing vertical jumping ability, agility and estimated VO2max) and leukocyte counts were performed at four moments: 72 h before the season (-72 h); before the season (Pre-season); after six weeks, at the end of the preparatory period (Preparatory); and after 20 weeks, at the end of the competitive period (Competitive). Also, the occurrence of upper respiratory symptoms was collected weekly during all stages of the season. There were significant increases in monocytes, cortisol, tumour necrosis factor-alpha and C-reactive protein at the Competitive moment as compared to the Pre-season. In addition, interleukin-10 decreased at the Competitive moment as compared to the Pre-season. Occurrence of upper respiratory symptoms demonstrated increases (38%) during the competitive period as compared to the preparatory. These results suggest that periods of training and competition could increase the occurrence of upper respiratory symptoms in adolescent athletes and this may be due to the unwanted effects of an inflammatory process in response to the excessive stress of training and competition.

Concentrations of salivary testosterone, cortisol, and immunoglobulin A after supra-maximal exercise in female adolescents

The aim of this study was to examine the effect of supra-maximal exercise on circulating concentrations of salivary testosterone, salivary cortisol, and salivary immunoglobulin A in female adolescents. Nineteen apparently healthy females aged 15-16 years participated in this study. All participants completed 668 s sprints, interspersed with 30 s recovery intervals on a cycle ergometer. Salivary testosterone, cortisol, and immunoglobulin A samples were taken before and 5 min after exercise. Experimental procedures continued over two mornings, at least 3 h after a light breakfast. Participants refrained from performing any strenuous physical activity for at least 24 h prior to the exercise test. None of the participants were engaged in a structured training programme. The group mean (± s) for peak power output was 562 ± 113.0 W. Female adolescents recruited for this study showed no changes in salivary testosterone, cortisol or immunoglobulin A following repeated bouts of supra-maximal cycling (P > 0.05). To date, there has been a paucity of information concerning adolescents' hormonal and mucosal immune function responses to supra-maximal exercise. Our data provide further guidance with regard to physical activities and sports prescription for female adolescents. Further research, on a larger sample of females, is required to elucidate the physiological significance of these findings.

A suplementação de carboidrato maximiza o desempenho de tenistas?

O tênis é um esporte complexo, influenciado por muitas variáveis, tais como o tipo de quadra (lenta ou rápida), o tipo de bola e o padrão tático do jogador (ofensivo ou defensivo). Esse esporte é considerado uma atividade intermitente de longa duração que, provavelmente, recruta diferentes tipos de substratos energéticos. Portanto, devido às características do tênis, é plausível admitir que o carboidrato seja um importante combustível para essa atividade. O efeito ergogênico do carboidrato já foi comprovado no exercício de endurance. Entretanto, no tênis, poucos estudos investigaram o papel desse nutriente sobre o desempenho. O objetivo do presente artigo é apresentar e discutir os estudos disponíveis sobre os efeitos da suplementação de carboidrato no desempenho de tenistas. A literatura atual apresenta escasso número de estudos, com o agravante dos mesmos apresentarem resultados controversos. Portanto, os poucos estudos não permitem que a pergunta levantada no título do artigo seja respondida de maneira satisfatória. A controvérsia observada nos estudos é, provavelmente, consequência de modelos experimentais diferentes, tais como: a duração do treino/jogo/teste, os parâmetros utilizados para medir desempenho, o conteúdo inicial dos estoques de glicogênio e a análise/controle da dieta antes do experimento. Estudos adicionais, em condições reais de jogo, precisam ser conduzidos, a fim de avaliar o real efeito da suplementação de carboidrato sobre o desempenho no tênis.

Imunoglobulina A salivar (IgA-s) e exercício: relevância do controle em atletas e implicações metodológicas

O objetivo do presente estudo é realizar uma análise e discussão dos principais achados envolvendo o comportamento da imunoglobulina A salivar (IgA-s) em relação ao estímulo do exercício e evidenciar a importância de seu controle em atletas. O exercício físico é um importante modulador das características do sistema imune, sobretudo do comportamento da IgA-s, componente fundamental na proteção de infecções do trato respiratório superior (ITRS). No entanto, a relação direta entre baixas concentrações de IgA-s e ITRS precisa de mais evidências para ser confirmada. As concentrações de IgA-s durante e logo após um exercício intenso diminuem, deixando o indivíduo mais suscetível à infecção, porém, atletas envolvidos em atividades extenuantes não são clinicamente imunodeficientes, comparados com indivíduos sedentários. Essas modificações são transitórias, com retorno aos valores normais após aproximadamente 48 horas de repouso. A razão dessas alterações não é clara, mas se apresenta multifatorial: elevação de hormônios estressores; fatores nutricionais; ação de espécies reativas de oxigênio; e estresse psicológico. Apesar do efeito transitório das alterações provocadas nos elementos do sistema imune frente ao exercício, observa-se diferença na variabilidade da IgA-s em populações com diferentes níveis de condicionamento. Diferenças metodológicas - como o protocolo de exercício, o método de coleta, armazenamento e manipulação da saliva, a forma de expressão da IgA-s, o nível de hidratação, o controle da dieta, a sazonalidade do período de competição, a aclimatação entre outros fatores - devem ser levadas em consideração para comparação entre os estudos. Além disso, ajudam a explicar, em parte, os resultados adversos envolvendo exercício moderado e os intermitentes, em que se encontram aumento, redução e até ausência de alteração nos níveis de IgA-s. Investigações de elementos inovadores, como os toll-like receptors, e o avanço tecnológico podem colaborar para aumentar as evidências sobre o tema.

A pediatric perspective on inflammation and oxidative stress in response to exercise

Dr. Oded Bar-Or was a giant in the area of pediatric exercise science and made numerous contributions to the health of children around the world. He also had a significant impact on a relatively new area of pediatric exercise science — pediatric exercise immunology. Under his supervision, some aspects of the immunobiology of exercise have been unravelled from a pediatric perspective. In general, healthy children experience less inflammatory stress in response to standardized exercise, while demonstrating an exercise-induced elevation in the anabolic cytokine IL-8. Mechanisms for the maturity- and age-dependent changes in cytokine responses to exercise are unknown, but may involve oxidative stress. Studies of oxidative stress and exercise in children are scant, but preliminary data suggests that, like the inflammatory cytokine response to exercise, children may experience less oxidative stress in response to intense exercise. We propose that the links between exercise, inflammatory and oxidative stress, and growth factors will be important to understand in the context of how exercise contributes to optimal growth and development during childhood. This understanding will be particularly relevant for childhood diseases that restrict growth.

Immunological changes in response to exercise: influence of age, puberty, and gender

PURPOSE

This study tested the hypothesis that exercise-induced perturbation and recovery of the immune system would vary with age, puberty, and gender in healthy children and adolescents.

METHODS

Twelve-year-old girls (YG; N = 14) and boys (YB; N = 20), and 14-yr-old girls (OG; N = 11) and boys (OB; N = 13) cycled for 60 min at 70% VO2max. Blood was collected before, at 30 and 60 min of exercise, and at 30 and 60 min of recovery to measure total leukocytes, leukocyte and lymphocyte subsets, and cytokines. Age and pubertal (Tanner stage) effects within genders and gender effects within age and pubertal groups were determined.

RESULTS

Exercise-induced increases in lymphocytes, CD3-CD16+CD56+ counts, and IL-6 were approximately 83, 90, and 390% greater in OG versus YG (P < 0.05). Recovery leukocytosis and neutrophilia were approximately 56 and 35% greater in OB versus YB (P < 0.05). Pubertal stage did not have a statistically significant influence on responses in girls, but the lowest pubertal stage consistently showed smaller changes in lymphocytes and CD3-CD16+CD56+ counts. Recovery neutrophilia was approximately 120% greater in postpubertal boys versus prepubertal or pubertal boys (P < 0.05). Responses of lymphocytes and CD3-CD16+CD56+ counts, respectively, were approximately 120 and 82% greater in OG versus OB (P < 0.05), with no differences between YG and YB. Exercise-induced increases in total leukocytes, lymphocytes, and CD3-CD16+CD56+ counts were at least 35% greater in girls versus boys of similar pubertal status (P < 0.05). Regardless of age, puberty, or gender, IL-8 levels were significantly higher during recovery versus rest (P < 0.05).

CONCLUSION

These results highlight the need to control for age, puberty, and gender when interpreting immunologic responses to exercise in a pediatric population.

Sex-based effects on the distribution of NK cell subsets in response to exercise and carbohydrate intake in adolescents

Carbohydrate (CHO) supplementation and female sex independently influence the natural killer (NK) cell response to acute exercise. Consequently, this study sought to elucidate sex-based differences in the distribution of NK cell subsets (i.e., CD56dimand CD56bright) in response to exercise and CHO intake. Twenty-two healthy 14-yr-old girls ( n = 11) and boys ( n = 11) cycled for 60 min at 70% maximal oxygen consumption while drinking 6% CHO (CT) or flavored water (WT). Blood was collected at rest, during exercise (30 and 60 min), and during recovery (30 and 60 min) to identify CD3−CD56dimand CD3−CD56brightNK cells. The activation marker CD69 was also determined on CD3−CD56+cells. CD56dimresponses, expressed as proportions or cell counts, were greater ( P ≤ 0.01) in girls by 67 and 105%, respectively. CD56brightcell counts ( P = 0.006), but not CD56brightproportions ( P = 0.89), were greater in girls by 82%. Both CD56dimand CD56brightsubset responses, expressed as proportions or cell counts, were lower ( P ≤ 0.01) in CT vs. WT by 33–36%. The CD56bright-to-CD56dimratio decreased at 30 min of exercise but increased during recovery ( P < 0.001), with no effect of sex or CHO. Regardless of trial, CD3−CD56+cells expressed ∼18% higher levels of CD69 during recovery in girls but not boys ( P = 0.03), despite similar proportions and counts of CD69+cells. These results demonstrate sex-based differences in the distribution of NK cell subsets and activation status in response to exercise, but not CHO intake, and further support the need to control for sex in exercise immunology studies.

The effects of carbohydrate supplementation during repeated bouts of prolonged exercise on saliva flow rate and immunoglobulin A

The purpose of this study was to assess the effect of carbohydrate (CHO) feeding during different periods of two 90-min cycling bouts (the first bout began at 09:00?h and the second bout began at 13:30 h) at 60% maximal oxygen uptake(VO2max) on saliva flow rate and saliva immunoglobulin A (sIgA) responses to the second exercise bout. The study consisted of three investigations: carbohydrate supplementation during (1) the first hour of the recovery interval (CHO-REC), (2) during the first bout of exercise and (3) during the second bout of exercise. Each investigation included two trials completed in a counterbalanced order and separated by at least 4 days. Participants consumed a lemon-flavoured 10% w/v carbohydrate beverage or placebo (22 ml.kg-1 body mass) in the first hour of the recovery interval (n=8) and 500 ml just before exercise, followed by 250 ml every 20 min during exercise in the first (n=9) and second exercise bouts (n=9). Timed unstimulated saliva samples were collected at 10 min before exercise, after 48-50 min of exercise and during the last 2 min of exercise, at 1 h post exercise, 2 h post exercise (first exercise bout only), and 18 h post exercise (second exercise bout only). Venous blood samples were taken 5 min before exercise and immediately after exercise for both exercise bouts in all trials. The main findings of the present study were as follows. First, carbohydrate ingestion during both exercise bouts, but not during the recovery interval, better maintained plasma glucose concentrations and attenuated the increase in plasma adrenaline and cortisol concentrations after the second exercise bout compared with placebo. Second, carbohydrate feeding had no effect on saliva flow rate and sIgA secretion rate compared with placebo. Third, saliva flow rate and sIgA concentration returned to pre-exercise bout 1 values within 2 h in all trials. Fourth, there was no delayed effect of exercise on oral immunity. These findings suggest that carbohydrate ingestion during the first or second bout of exercise, but not during the recovery interval, is likely to better maintain plasma glucose concentrations and attenuate the responses of plasma stress hormones to a second exercise bout than ingestion of fluid alone. Two bouts of 90 min cycling at 60% VO2max on the same day appears to inhibit saliva flow rate during the second exercise bout but does not alter sIgA transcytosis. Our results show that carbohydrate ingestion during any period of two prolonged exercise bouts does not induce different effects on oral immunity compared with placebo.

Influence of carbohydrate ingestion on immune changes after 2 h of intensive resistance training

Thirty strength-trained subjects were randomized to carbohydrate (CHO) or placebo (Pla) groups and lifted weights for 2 h (10 exercises, 4 sets each, 10 repetitions, with 2- to 3-min rest intervals). Subjects received 10 ml·kg-1·h-1 CHO (6%) or Pla beverages during the weight training bout. Blood, saliva, and vastus lateralis muscle biopsy samples were collected before and after exercise. Blood cell counts were determined, and plasma was analyzed for IL-6, IL-10, IL-1 receptor antagonist (IL-1ra), IL-8, and cortisol. Muscle was analyzed for glycogen content and relative gene expression of 13 cytokines (IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p35, IL-12p40, IL-15, IFN-γ, TNF-α) by use of real-time quantitative RT-PCR. Significant but modest increases were measured for plasma IL-6, IL-10, IL-1ra, and IL-8, but the pattern of increase did not differ between CHO and Pla groups. The rate of decrease in muscle glycogen content did not differ between CHO and Pla ( P = 0.463). Muscle cytokine mRNA was detected preexercise for IL-1β, IL-6, IL-15, IL-8, and TNF-α, and of these, IL-1β, IL-6, IL-8, and TNF-α were significantly increased after the 2-h weight training bout. The increase in mRNA (fold difference from preexercise) did not differ between CHO and Pla groups. In summary, CHO vs. Pla ingestion did not alter modest increases measured for plasma IL-6, IL-10, IL-1ra, and IL-8, and muscle gene expression for IL-1β, IL-6, IL-8, and TNF-α in strength-trained subjects lifting weights intensively for 2 h.

Exercise immunology: nutritional countermeasures

In contrast to moderate physical activity, prolonged and intensive exertion causes numerous changes in immunity that reflect physiologic stress and suppression, and an increased risk of upper respiratory tract infection. Enzymes in immune cells require the presence of micronutrients, leading to attempts by investigators to alter changes in immunity following heavy exertion through use of nutritional supplements, primarily zinc, dietary fat, vitamin C and other antioxidants, glutamine, and carbohydrate. Except for carbohydrate supplementation, none of these nutrients has emerged as an effective countermeasure to exercise-induced immunosuppression. Data from several studies of endurance athletes suggest that carbohydrate compared to placebo ingestion is associated with an attenuated cortisol, growth hormone, and epinephrine response to heavy exertion, fewer perturbations in blood immune cell counts, lower granulocyte and monocyte phagocytosis and oxidative burst activity, and a diminished pro- and anti-inflammatory cytokine response. Overall, the hormonal and immune responses to carbohydrate compared to placebo ingestion during intensive exercise suggest that physiologic stress and inflammation are diminished, although clinical significance awaits further research.

Cytokine changes after a marathon race

The influence of carbohydrate (1 l/h of a 6% carbohydrate beverage), gender, and age on pro- and anti-inflammatory plasma cytokine and hormone changes was studied in 98 runners for 1.5 h after two competitive marathon races. The marathoner runners were randomly assigned to carbohydrate (C, n = 48) and placebo (P, n = 50) groups, with beverages administered during the races in a double-blind fashion using color codes. Plasma glucose was higher and cortisol was lower in the C than in the P group after the race (P < 0.001). For all subjects combined, plasma levels of interleukin (IL)-10, IL-1 receptor antagonist (IL-1ra), IL-6, and IL-8 rose significantly immediately after the race and remained above prerace levels 1.5 h later. The pattern of change in all cytokines did not differ significantly between the 12 women and 86 men in the study and the 23 subjects > or =50 yr of age and the 75 subjects <50 yr of age. The pattern of change in IL-10, IL-1ra, and IL-8, but not IL-6, differed significantly between the C and the P group, with higher postrace values measured for IL-10 (109% higher) and IL-1ra (212%) in the P group and for IL-8 (42%) in the C group. In conclusion, plasma levels of IL-10, IL-1ra, IL-6, and IL-8 rose strongly in runners after a competitive marathon, and this was not influenced by age or gender. Carbohydrate ingestion, however, had a major effect in attenuating increases in cortisol and two anti-inflammatory cytokines, IL-10 and IL-1ra.

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

Heavy exertion has acute and chronic influences on systemic immunity. In the resting state, the immune systems of athletes and non-athletes are more similar than disparate with the exception of NK cell activity, which tends to be elevated in athletes. Many components of the immune system exhibit adverse change after prolonged, heavy exertion. These immune changes occur in several compartments of the immune system and body (e.g. the skin, upper respiratory tract mucosal tissue, lung, blood and muscle). Although still open to interpretation, most exercise immunologists believe that during this 'open window' of impaired immunity (which may last between 3 and 72 h, depending on the immune measure) viruses and bacteria may gain a foothold, increasing the risk of subclinical and clinical infection. The infection risk may be amplified when other factors related to immune function are present, including exposure to novel pathogens during travel, lack of sleep, severe mental stress, malnutrition or weight loss.