Redox Homeostasis and Inflammation Responses to Training in Adolescent Athletes: a Systematic Review and Meta-analysis

The Impact of 5-Aminolevulinic Acid Supplementation on Redox Balance and Aerobic Capacity

We examined the impact of 5-aminolevulinic acid (5-ALA) and sodium-ferrous-citrate supplementation on aerobic capacity and redox balance through a placebo-controlled, double-blind trial. Fourteen healthy volunteers were randomly assigned to Pla + ALA (4-week placebo followed by 4-week 5-ALA supplementation) or ALA + Pla (4-week 5-ALA supplement followed by a 4-week placebo) group and administered 5-ALA (25 mg/day) or placebo once daily. The participants underwent submaximal incremental cycling tests at weeks 0, 2, 4, 6, and 8. In the cycling test at week 0, individual load-intensity stages required for blood lactate levels >2 mmol/L (lactate threshold, LT) and 4 mmol/L (onset of blood lactate accumulation, OBLA) were determined. The heart rate (HR), blood lactate (La), and oxidative stress markers (diacron reactive oxygen metabolite, d-ROMs; biological antioxidant potential, BAP) were measured at resting, LT, and OBLA states in each cycling test. Marker values were not significantly different between the groups. HR, La, and d-ROMs at resting, LT, and OBLA states were not significantly different among the conditions. BAP and BAP/d-ROMs ratios were significantly different in the OBLA state at week 4 of the 5-ALA group compared with that of the placebo group (p < 0.05). In conclusion, 5-ALA supplementation might improve redox balance during high-intensity aerobic exercise.

Antioxidative Stress Metabolic Pathways in Moderately Active Individuals

Physical activity (PA) is known to have beneficial effects on health, primarily through its antioxidative stress properties. However, the specific metabolic pathways that underlie these effects are not fully understood. This study aimed to investigate the metabolic pathways that are involved in the protective effects of moderate PA in non-obese and healthy individuals. Data on 305 young, non-obese participants were obtained from the Qatar Biobank. The participants were classified as active or sedentary based on their self-reported PA levels. Plasma metabolomics data were collected and analyzed to identify differences in metabolic pathways between the two groups. The results showed that active participants had increased activation of antioxidative, stress-related pathways, including lysoplasmalogen, plasmalogen, phosphatidylcholine, vitamin A, and glutathione. Additionally, there were significant associations between glutathione metabolites and certain clinical traits, including bilirubin, uric acid, hemoglobin, and iron. This study provides new insights into the metabolic pathways that are involved in the protective effects of moderate PA in non-obese and healthy individuals. The findings may have implications for the development of new therapeutic strategies that target these pathways.

Polyphenol Supplementation and Antioxidant Status in Athletes: A Narrative Review

Antioxidants in sports exercise training remain a debated research topic. Plant-derived polyphenol supplements are frequently used by athletes to reduce the negative effects of exercise-induced oxidative stress, accelerate the recovery of muscular function, and enhance performance. These processes can be efficiently modulated by antioxidant supplementation. The existing literature has failed to provide unequivocal evidence that dietary polyphenols should be promoted specifically among athletes. This narrative review summarizes the current knowledge regarding polyphenols' bioavailability, their role in exercise-induced oxidative stress, antioxidant status, and supplementation strategies in athletes. Overall, we draw attention to the paucity of available evidence suggesting that most antioxidant substances are beneficial to athletes. Additional research is necessary to reveal more fully their impact on exercise-induced oxidative stress and athletes' antioxidant status, as well as optimal dosing methods.

Preliminary results indicate that regular training induces high protection against oxidative stress in basketball players compared to soccer

In elite athlete several metabolic changes occur during regular training. These modifications are associated with changes in blood metabolic profile and can lead to adaptive mechanisms aimed at establish a new dynamic equilibrium, which guarantees better performance. The goal of this study was to characterize the plasma metabolic profile and redox homeostasis, in athletes practicing two different team sports such as soccer and basketball in order to identify potential metabolic pathways underlying the differences in training programs. A cohort of 30 male, 20 professional players (10 soccer and 10 basketballs) and 10 sedentary males as control were enrolled in the study. Plasma redox balance, metabolites and adiponectin were determined. The results show low levels of oxidative species (25.5%), with both high antioxidant capacity (17.6%) and adiponectin level (64.4%) in plasma from basketball players, in comparison to soccer players. Metabolic analysis indicates in basketball players a significant high plasma level of amino acids Valine and Ornithine both involved in redox homeostasis and anti-inflammatory metabolism.

Eccentric Training in Pulmonary Rehabilitation of Post-COVID-19 Patients: An Alternative for Improving the Functional Capacity, Inflammation, and Oxidative Stress

The purpose of this narrative review is to highlight the oxidative stress induced in COVID-19 patients (SARS-CoV-2 infection), describe longstanding functional impairments, and provide the pathophysiologic rationale that supports aerobic eccentric (ECC) exercise as a novel alternative to conventional concentric (CONC) exercise for post-COVID-19 patients. Patients who recovered from moderate-to-severe COVID-19 respiratory distress demonstrate long-term functional impairment. During the acute phase, SARS-CoV-2 induces the generation of reactive oxygen species that can be amplified to a "cytokine storm". The resultant inflammatory and oxidative stress process causes organ damage, particularly in the respiratory system, with the lungs as the tissues most susceptible to injury. The acute illness often requires a long-term hospital stay and consequent sarcopenia. Upon discharge, muscle weakness compounded by limited lung and cardiac function is often accompanied by dyspnea, myalgia, anxiety, depression, and sleep disturbance. Consequently, these patients could benefit from pulmonary rehabilitation (PR), with exercise as a critical intervention (including sessions of strength and endurance or aerobic exercises). Unfortunately, conventional CONC exercises induce significant cardiopulmonary stress and increase inflammatory and oxidative stress (OS) when performed at moderate/high intensity, which can exacerbate debilitating dyspnoea and muscle fatigue post-COVID-19. Eccentric training (ECC) is a well-tolerated alternative that improves muscle mass while mitigating cardiopulmonary stress in patients with COPD and other chronic diseases. Similar benefits could be realized in post-COVID-19 patients. Consequently, these patients could benefit from PR with exercise as a critical intervention.

Intracellular Oxidative Stress Induced by Physical Exercise in Adults: Systematic Review and Meta-Analysis

A physical exercise program is one of the commonly used methods for improving an individual’s antioxidative capacity. However, an inappropriate physical exercise program would induce extra oxidative stress (OS), and the relationship between the details of a physical exercise protocol and the severity of intracellular OS is still unclear. A systematic review and meta-analysis of randomized controlled trials were conducted by searching PubMed, Medline, and Web of Science with the eligibility criteria: (1) participants over 18 years old; (2) physical exercise interventions; (3) 8-hydroxydeoxyguanosine, F2-isoprostanes, and protein carbonyls (PCs) as outcome measures; (4) published in English and peer-reviewed. 12 studies were included, and the data of 8 in them were pooled together. The agreement between authors reached a kappa value of 0.73. The results of the meta-analysis showed that: (1) the level of OS did not depend on the absolute intensity of physical exercise but on both the intensity and the volume of exercise; (2) high-intensity aerobic exercise (HIAE) and a combined protocol of HIAE and resistance training had the highest potential to induce large OS in unhealthy people; (3) the OS induced by moderate-to-high intensity aerobic exercise was significantly larger than that induced by ordinary life activities in healthy adults; (4) high-intensity interval training and moderate-intensity aerobic exercise had the lowest and sub-lowest probabilities to induce high intracellular OS for unhealthy adults. activities induce OS in various tissues in the human body, and the severity of OS depends on many factors of physical exercises as well as the health condition of an individual. A high-intensity and high-volume physical exercise program has the largest possibility of inducing severe OS, while a moderate-intensity aerobic exercise program and a high-intensity interval training program with a relatively low volume might be beneficial to the redox balance for unhealthy individuals. In conclusion, continuous aerobic exercise under moderate-intensity or high-intensity interval training could be recommended to enhance the body’s capacity for maintaining redox balance, especially for unhealthy individuals. The PROSPERO Registration Number is CRD42022349687.

Serum Bilirubin Concentrations and the Prevalence of Gilbert Syndrome in Elite Athletes

Objectives

Bilirubin is a potent endogenous antioxidant and immunomodulating substance, which is also implicated in both cell signalling and various metabolic pathways. Mild elevation of systemic bilirubin concentrations provides substantial protection against many diseases of civilization. Rare published reports have suggested that serum bilirubin might also be relevant to sports performance. The purpose of the current study was to evaluate serum bilirubin concentrations and the prevalence of Gilbert syndrome (GS) in elite athletes.

Methods

The study was carried out in 536 consecutive healthy elite athletes and in 2594 individuals of the Czech post-MONICA study representing the general Czech population. Serum bilirubin concentrations, the prevalence of benign hyperbilirubinemia > 17 µmol/L (1 mg/dL, a phenotypic sign of GS), and a variant of the UGT1A1 gene promoter responsible for GS manifestation in Caucasians (rs81753472) were evaluated in study subjects.

Results

Compared to the general Czech population, significantly higher serum bilirubin concentrations were found in elite athletes (9.6 vs. 11.6 µmol/L, p < 0.001), both in men (11.3 vs. 12.6 µmol/L, p < 0.001) and women (8.3 vs. 10.5 µmol/L, p < 0.001). Furthermore, the prevalence of GS was also significantly higher in elite athletes (9.6 vs. 22%, p < 0.001) together with the tendency to higher frequencies of the genotypes (TA)_7/7 and (TA)_6/7UGT1A1.

Conclusion

Elite athletes have significantly higher concentrations of serum bilirubin, the most potent endogenous antioxidant substance known. Simultaneously, the prevalence of GS syndrome is also much higher in elite athletes, suggesting that a mild elevation of serum bilirubin might predispose to better sports performance.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00463-6.

Estimation of Redox Status in Military Pilots during Hypoxic Flight-Simulation Conditions—A Pilot Study

At high altitude conditions, the low-pressure atmospheric oxygen reduces the generation of energy, thus inducing a decrease in oxygen availability. As a result, endurance flights evoke imbalance in redox signaling, posing a safety risk for the pilots involved. The aim of the present study was to assess changes in the redox status of military pilots during flight simulation conditions according to their flight hours (experts vs. novice). A total of seven expert pilots and an equal number of novice pilots (trainees) were recruited from the Center for Airforce Medicine of the Greek Military Airforce. Glutathione (GSH) levels, catalase activity (CAT), total antioxidant capacity (TAC), lipid peroxidation through the thiobarbituric acid-reactive substances (TBARS), and protein oxidative damage through the assay of protein carbonyls (PCs) levels were assessed at two time points, once prior to and once immediately post a scheduled flight simulation. In the experienced pilots’ arms, GSH was significantly increased post-flight simulation, with TAC being simultaneously reduced. On the other hand, in the trainees’ arms, CAT and TAC were both increased post-flight. No differences were noted with regard to the TBARS and PCs post-simulation. When the two groups were compared, TAC and PCs were significantly lower in the trainees compared to the experienced pilots. The present study provides useful insight into the physiological redox status adaptations to hypobaric hypoxic flight conditions among pilots. In a further detail, an increase in GSH response post-flight simulation is being evoked in more experienced pilots, indicating an adaptation to the extreme flight conditions, as they battle oxidative stress.

Age and Sport Intensity-Dependent Changes in Cytokines and Telomere Length in Elite Athletes

Exercise-associated immune response plays a crucial role in the aging process. The aim of this study is to investigate the effect of sport intensity on cytokine levels, oxidative stress markers and telomere length in aging elite athletes. In this study, 80 blood samples from consenting elite athletes were collected for anti-doping analysis at an anti-doping laboratory in Italy (FMSI). Participants were divided into three groups according to their sport intensity: low-intensity skills and power sports (LI, n = 18); moderate-intensity mixed soccer players (MI, n = 31); and high-intensity endurance sports (HI, n = 31). Participants were also divided into two age groups: less than 25 (n = 45) and above 25 years old (n = 35). Serum levels of 10 pro and anti-inflammatory cytokines and two antioxidant enzymes were compared in age and sport intensity groups and telomere lengths were measured in their respective blood samples. Tumor necrosis factor-alpha (TNF-α) was the only cytokine showing significantly higher concentration in older athletes, regardless of sport intensity. Interleukin (IL)-10 increased significantly in HI regardless of age group, whereas IL-6 concentration was higher in the older HI athletes. IL-8 showed a significant interaction with sport intensity in different age groups. Overall, significant positive correlations among levels of IL-6, IL-10, IL-8 and TNF-α were identified. The antioxidant catalase activity was positively correlated with levels of TNF-α. Telomere length increased significantly with sport intensity, especially in the younger group. HI had longer telomeres and higher levels of pro- and anti-inflammatory cytokines, suggesting less aging in HI compared to low and moderate counterparts in association with heightened immune response. Investigation of the functional significance of these associations on the health and performance of elite athletes is warranted.

Acute moderate-intensity exercise increases total antioxidant capacity and anti-inflammatory responses in competitive cyclists: The role of adiponectin

High-intensity exercise can elicit acute changes in the biochemical and physiological processes in the body of an athlete, including increased oxidative stress and inflammation. The purpose of this study was to explore the effect of acute moderate-intensity exercise on total antioxidant capacity (TAC) and serum levels of anti-inflammatory adiponectin (APN), and inflammatory markers in competitive cyclists. Ten male cyclists (age 15–26 years, body mass index 19.4–24.7 kg/m2) participated in this study. Each subject performed the maximal oxygen uptake test (VO2peak) and completed a 10-min cycling exercise at a workload of 50% of the peak of VO2peak. Blood samples were collected on three different occasions: after an overnight fasting and at the exercise workloads of 50% and 100% VO2peak. We measured APN, TAC, inflammatory markers as well as assessed nutrient and energy intake for each participant. Baseline concentration of serum APN (10.92 µg/mL) significantly increased at 50% and at 100% VO2peak. In addition, TAC also increased after acute exercise (0.079 vs 0.093 nmol/µL). The concentration of APN at 50% VO2peak positively correlated with the CRP ( r = 0.640, p = 0.046) and negatively correlated with TNF-α ( r = −0.696, p = 0.025). This test showed that short (10 min) and medium-intensity (50% VO2peak) exercise activity in trained athletes evoked beneficial antioxidant and anti-inflammatory responses. Importantly, this response correlates with the increase in APN levels thereby showing that highly trained individuals have beneficial responses originating from adipose tissue. Our observations show that a short training at moderate activity can be an important preservative strategy during the recovery training period.

The Interplay between Oxidative Stress, Exercise, and Pain in Health and Disease: Potential Role of Autonomic Regulation and Epigenetic Mechanisms

Oxidative stress can be induced by various stimuli and altered in certain conditions, including exercise and pain. Although many studies have investigated oxidative stress in relation to either exercise or pain, the literature presents conflicting results. Therefore, this review critically discusses existing literature about this topic, aiming to provide a clear overview of known interactions between oxidative stress, exercise, and pain in healthy people as well as in people with chronic pain, and to highlight possible confounding factors to keep in mind when reflecting on these interactions. In addition, autonomic regulation and epigenetic mechanisms are proposed as potential mechanisms of action underlying the interplay between oxidative stress, exercise, and pain. This review highlights that the relation between oxidative stress, exercise, and pain is poorly understood and not straightforward, as it is dependent on the characteristics of exercise, but also on which population is investigated. To be able to compare studies on this topic, strict guidelines should be developed to limit the effect of several confounding factors. This way, the true interplay between oxidative stress, exercise, and pain, and the underlying mechanisms of action can be revealed and validated via independent studies.

Blood Profile of Cytokines, Chemokines, Growth Factors, and Redox Biomarkers in Response to Different Protocols of Treadmill Running in Rats

Both positive and negative aspects of sport performance are currently considered. The aim of our study was to determine time- and intensity-dependent effects of a single exercise bout on redox and inflammatory status. The experiment was performed on 40 male Wistar rats subjected to treadmill running for 30 min with the speed of 18 m/min (M30) or 28 m/min (F30), or for 2 h with the speed of 18 m/min (M120). Immunoenzymatic and spectrophotometric methods were applied to assess the levels of pro-inflammatory and anti-inflammatory cytokines, chemokines, growth factors, the antioxidant barrier, redox status, oxidative damage products, nitrosative stress, and their relationships with plasma non-esterified fatty acids. Treadmill running caused a reduction in the content of monocyte chemoattractant protein-1 (MCP1) and nitric oxide (M30, M120, F30 groups) as well as macrophage inflammatory protein-1α (MIP-1α) and regulated on activation, normal T-cell expressed and secreted (RANTES) (M30, F30 groups). We also demonstrated an increase in catalase activity as well as higher levels of reduced glutathione, advanced oxidation protein products, lipid hydroperoxides, malondialdehyde (M30, M120, F30 groups), and advanced glycation end products (F30 group). The presented findings showed the activation of antioxidative defense in response to increased reactive oxygen species' production after a single bout of exercise, but it did not prevent oxidative damage of macromolecules.