Immunomodulatory effects of fucoidan in recreationally active adult males undertaking 3-weeks of intensified training

The aim of the current study was to determine whether daily fucoidan supplementation (Undaria pinnatifida extract containing >85% fucoidan, 1 g/day) for three-weeks in a double blind-placebo controlled cross-over trial (ACTRN12621000872831) could modulate alterations in faecal (calprotectin, lysozyme and IgA) and salivary (lactoferrin, lysozyme and IgA) markers of mucosal immune competence typically observed in response to both acute physical activity, and a period of intensified exercise training, in healthy recreationally active men (n = 12). Participants responded positively to the intensified training with 16-19% improvement in mean power that was not different between supplement groups. Faecal biomarkers and concentrations of lactoferrin, lysozyme and IgA from resting saliva samples were largely stable over the supplementation period. Concentrations of salivary biomarkers varied significantly over time in response to acute exercise, however differences between supplementation groups were modest. For salivary lysozyme, there was a trend for a lower magnitude of increase post-exercise (p = 0.08) and limited return towards pre-exercise in response to fucoidan. For salivary IgA, a greater acute exercise response was noted for IgA in response to fucoidan (~2.7-fold higher; p = 0.02). Different dosage and supplementation protocols and inclusion of additional immune markers should be considered in subsequent assessments of any potential benefits of fucoidan supplementation in healthy active adults.

Effects of Heat-Not-Burn Cigarette Smoking on the Secretion of Saliva and Its Innate Immune System Components

Saliva and salivary antimicrobial proteins play important roles in the innate immunity, which prevents infections of orally invading bacteria and viruses. In this study, we compared the secretion rates of salivary lactoferrin (Lac) and lysozyme (Lys) in heat-not-burn (HNB) cigarette smokers and non-smokers. The analysis population for this study included 212 members of the fire department, including 32 HNB cigarette smokers, 17 paper cigarette smokers, 14 combined HNB and paper cigarette smokers, and 149 non-smokers. Salivary Lac and Lys concentrations were assessed using enzyme immunoassay. Saliva secretion was significantly lower among HNB cigarette smokers (p < 0.01) than among non-smokers. Accompanying this result, salivary Lac and Lys secretion rates were significantly lower among smokers, particularly HNB cigarette smokers, than among non-smokers (all p < 0.01). Our findings suggest a possible adverse effect of HNB cigarette on the amount of Lac and Lys released into the oral cavity.

Effects of caffeinated beverage ingestion on salivary antimicrobial proteins responses to acute exercise in the heat

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 &lt; 0.01), with no difference in Tre and HR between the CAF and PLA (p &gt; 0.05), but RPE was higher in the PLA than in the CAF (p &lt; 0.05). sLac concentrations were significantly higher at T20 and T40 than at T–60 (p &lt; 0.01) and higher at T40 than at T0 and T20 (p &lt; 0.01), with no difference between the CAF and PLA (p &gt; 0.05). Compared with T–60, sAA activity was significantly increased at T0, T20, and T40 (p &lt; 0.01). sAA activity was significantly higher at T40 than at T0 and T20 (p &lt; 0.01), at T20 than at T0 (p &lt; 0.05), and in the CAF than in the PLA (p &lt; 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.

Salivary Aβ Secretion and Altered Oral Microbiome in Mouse Models of AD

BACKGROUND

Beta amyloid (Aβ) peptide containing plaque aggregations in the brain are a hallmark of Alzheimer's Disease (AD). However, Aβ is produced by cell types outside of the brain suggesting that the peptide may serve a broad physiologic purpose.

OBJECTIVE

Based upon our prior work documenting expression of amyloid β precursor protein (APP) in intestinal epithelium we hypothesized that salivary epithelium might also express APP and be a source of Aβ.

METHODS

To begin testing this idea, we compared human age-matched control and AD salivary glands to C57BL/6 wild type, App^NL-G-F , and APP/PS1 mice.

RESULTS

Both male and female AD, App^NL-G-F , and APP/PS1 glands demonstrated robust APP and Aβ immunoreactivity. Female App^NL-G-F mice had significantly higher levels of pilocarpine stimulated Aβ 1-42 compared to both wild type and APP/PS1 mice. No differences in male salivary Aβ levels were detected. No significant differences in total pilocarpine stimulated saliva volumes were observed in any group. Both male and female App^NL-G-F but not APP/PS1 mice demonstrated significant differences in oral microbiome phylum and genus abundance compared to wild type mice. Male, but not female, APP/PS1 and App^NL-G-F mice had significantly thinner molar enamel compared to their wild type counterparts.

CONCLUSION

These data support the idea that oral microbiome changes exist during AD in addition to changes in salivary Aβ and oral health.

Effects of exercise in hot and humid conditions and bovine colostrum on salivary immune markers

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, VO_2max 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.

Decreased salivary lactoferrin levels are specific to Alzheimer's disease

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.

Associations between self-reported physical activity and oral health: a cross-sectional analysis in 17,777 Spanish adults

Background The aim of this study was to assess the association between levels of physical activity and oral health in adults residing in Spain.Methods Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 adults aged ≥15 years; 52.0% females). The International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Oral health was self-reported through eight variables. Covariates included were sex, age, marital status, education, obesity, smoking and alcohol consumption.Results Dental caries (19.8% vs 27.8%), dental extraction (72.7% vs 75.4%), gingival bleeding (15.5% vs 19.1%), tooth movement (4.3% vs 5.9%) and missing tooth (57.9% vs 62.5%) were statistically significantly less frequent in the sufficient than insufficient physical activity group, whereas dental filling (74.2% vs 70.9%), dental material (36.6% vs 34.8%) and no missing tooth and no material (28.2% vs 25.1%) were statistically significantly more common. After adjustment, there was a negative relationship between physical activity and dental caries (OR = 0.72; 95%CI = 0.66-0.78), gingival bleeding (OR = 0.79; 95%CI = 0.72-0.86), tooth movement (OR = 0.83; 95%CI = 0.71-0.96) and missing tooth (OR = 0.91; 95%CI = 0.85-0.98). In contrast, physical activity was positively associated with dental material (OR = 1.16; 95%CI = 1.07-1.25).Conclusions Participation in physical activity is favourably associated with some but not all self-reported oral health correlates.

Salivary antimicrobial proteins and stress biomarkers are elevated during a 6-month mission to the International Space Station

As the international space community plans for manned missions to Mars, spaceflight-associated immune dysregulation has been identified as a potential risk to the health and safety of the flight crew. There is a need to determine whether salivary antimicrobial proteins, which act as a first line of innate immune defense against multiple pathogens, are altered in response to long-duration (>6 mo) missions. We collected 7 consecutive days of whole and sublingual saliva samples from eight International Space Station (ISS) crewmembers and seven ground-based control subjects at nine mission time points, ~180 and ~60 days before launch (L-180/L-60), on orbit at flight days ~10 and ~90 (FD10/FD90) and ~1 day before return (R-1), and at R+0, R+18, R+33, and R+66 days after returning to Earth. We found that salivary secretory (s)IgA, lysozyme, LL-37, and the cortisol-to-dehydroepiandrosterone ratio were elevated in the ISS crew before (L-180) and during (FD10/FD90) the mission. "Rookie" crewmembers embarking on their first spaceflight mission had lower levels of salivary sIgA but increased levels of α-amylase, lysozyme, and LL-37 during and after the mission compared with the "veteran" crew who had previously flown. Latent herpesvirus reactivation was distinct to the ~6-mo mission crewmembers who performed extravehicular activity ("spacewalks"). Crewmembers who shed at least one latent virus had higher cortisol levels than those who did not shed. We conclude that long-duration spaceflight alters the concentration and/or secretion of several antimicrobial proteins in saliva, some of which are related to crewmember flight experience, biomarkers of stress, and latent viral reactivation.NEW & NOTEWORTHY Spaceflight-associated immune dysregulation may jeopardize future exploration-class missions. Salivary antimicrobial proteins act as a first line of innate immune defense. We report here that several of these proteins are elevated in astronauts during an International Space Station mission, particularly in those embarking on their first space voyage. Astronauts who shed a latent herpesvirus also had higher concentrations of salivary cortisol compared with those who did not shed. Stress-relieving countermeasures are needed to preserve immunity and prevent viral reactivation during prolonged voyages into deep space.

Effects of Protein Versus Carbohydrate Supplementation on Markers of Immune Response in Master Triathletes: A Randomized Controlled Trial

Objective: This study examines the long-term effects of ingesting hydrolyzed beef protein versus carbohydrate on indirect markers of immunity during 10 weeks of endurance training in master-aged triathletes (n = 16, age 35-60 years). Methods: Participants were randomly assigned to either a hydrolyzed beef protein (PRO, n = 8) or nonprotein isoenergetic carbohydrate (CHO, n = 8) condition, which consisted of ingesting 20 g of each supplement, mixed with water, once a day immediately post workout, or before breakfast on nontraining days. Salivary human neutrophil peptides (HNP1-3) were measured before and after performing an incremental endurance test to volitional exhaustion at both pre and post intervention. Additionally, baseline levels of platelets, neutrophils, eosinophil basophils, monocytes, and lymphocytes were determined at pre and post intervention. Results: No significant changes in baseline concentration and secretion rate of salivary HNP1-3 were observed for either treatment. The CHO group showed a nonsignificant decrease in resting HNP1-3 concentrations following the intervention (p = 0.052, effect size d = 0.53). Protein supplementation demonstrated a significant reduction in lymphocyte counts pre to post intervention (mean [SD]: 2.30 [0.57] vs. 1.93 [0.45] 10³/mm³, p = 0.046, d = 0.77), along with a moderate but not statistically significant increase (d = 0.75, p = 0.051) of the neutrophil-to-lymphocyte ratio. Conclusions: In master-aged triathletes, postworkout ingestion of only protein, with no carbohydrate, may not be as effective as carbohydrate alone to attenuate negative long-term changes of some salivary and cellular immunological markers. Future studies should consider the co-ingestion of both macronutrients.

Realising the Potential of Urine and Saliva as Diagnostic Tools in Sport and Exercise Medicine

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.

Effects of prolonged running in the heat and cool environments on selected physiological parameters and salivary lysozyme responses

Introduction

Lysozyme is one of the salivary antimicrobial proteins which act as the “first line of defence” at the mucosal surface. The effects of prolonged exercise in the hot and cool environments among recreational athletes on salivary lysozyme responses are very limited in the literature, especially in the Asian countries.

Objective

To determine the effects of prolonged running in the hot and cool environments on selected physiological parameters and salivary lysozyme responses among recreational athletes.

Methods

Randomised and cross-over study design. Thirteen male recreational athletes (age: 20.9 ± 1.3 years old) from Universiti Sains Malaysia participated in this study. They performed two separate running trials; 90 min running at 60% of their respective maximum oxygen uptake (V˙O2max) One running trial was performed in the hot (31ºC) while the other was in the cool (18ºC) environment and this sequence was randomised. Each running trial was started with a 5 min warm-up at 50% of participant's respective V˙O2max Recovery period between these two trials was one week. In the both trials, saliva samples, blood samples, heart rate, ratings of perceived exertion, skin and tympanic temperatures, oxygen consumption, nude body weight, room temperature, and relative humidity were collected.

Results

Participants' skin temperature, tympanic temperature, body weight changes, heart rate, ratings of perceived exertion, and plasma volume changes were significantly higher (p < 0.05) in the hot trial compared to the cool trial. Saliva flow rate was not significantly (p = 0.949) different between the hot (0.32 ± 0.08 ml/min) and cool (0.27 ± 0.05 ml/min) trials. However, in each trial, it significantly decreased (p < 0.05) at post-exercise as compared to pre-exercise but it returned to baseline value at 1 h post-exercise. In addition, there were no significant differences between and within hot and cool trials in salivary lysozyme concentration (p = 0.925; 4.79 ± 1.37 and 4.44 ± 1.11 μg/ml respectively) and secretion rate (p = 0.843; 1.67 ± 1.1 and 1.17 ± 1.0 μg/min respectively).

Conclusion

This study found similar lysozyme responses between both hot and cool trials. Thus, room/ambient temperature did not affect lysozyme responses among recreational athletes. Nevertheless, the selected physiological parameters were significantly affected by room temperature.

Exercise increases lactoferrin, but decreases lysozyme in salivary granulocytes

INTRODUCTION

Intracellular lactoferrin (Lac) and lysozyme (Lys) content play an important role in regulating inflammation and promoting host protection. While exercise has demonstrated an increase in Lac and Lys concentration in exocrine solutions, little is known regarding intracellular concentration changes in response to exercise.

PURPOSE

To quantify intracellular Lac and Lys concentration before and after exercise in salivary CD45⁺CD15⁺ cells.

METHODS

11 males (20.3 ± 0.8 years, 57.2 ± 7.6 mL/kg/min V̇O_2pk, 11.1 ± 3.9% body fat) ran for 45 min at 75% of VO_2pk. 12 mL of stimulated saliva were collected pre and immediately post exercise. Saliva was filtered through a 30-µm filter before analysis of leukocytes (CD45⁺) and granulocytes (CD45⁺CD15⁺) using flow cytometry.

RESULTS

Median fluorescent intensity (MFI) of Lac increased from pre (64,268 ± 46,036 MFI) to post (117,134 ± 88,115 MFI) exercise (p <0.05). Lys MFI decreased with exercise (pre: 16,933 ± 8249; post: 11,616 ± 6875) (p <0.05).

CONCLUSION

Acute running resulted in an increased Lac concentration which could lead to a decrease in inflammation, adding further evidence of the anti-inflammatory effects of exercise. Conversely, the exercise-associated decrease of intracellular Lys content could be the cause of increased Lys in exocrine solutions.

Effects of protein-carbohydrate supplementation on immunity and resistance training outcomes: a double-blind, randomized, controlled clinical trial

Purpose

To examine the impact of ingesting hydrolyzed beef protein, whey protein, and carbohydrate on resistance training outcomes, body composition, muscle thickness, blood indices of health and salivary human neutrophil peptides (HNP1-3), as reference of humoral immunity followed an 8-week resistance training program in college athletes.

Methods

Twenty-seven recreationally physically active males and females (n = 9 per treatment) were randomly assigned to one of the three groups: hydrolyzed beef protein, whey protein, or non-protein isoenergetic carbohydrate. Treatment consisted of ingesting 20 g of supplement, mixed with orange juice, once a day immediately post-workout or before breakfast on non-training days. Measurements were performed pre- and post-intervention on total load (kg) lifted at the first and last workout, body composition (via plethysmography) vastus medialis thickness (mm) (via ultrasonography), and blood indices of health. Salivary HNP1-3 were determined before and after performing the first and last workout.

Results

Salivary concentration and secretion rates of the HNP1-3 decreased in the beef condition only from pre-first-workout (1.90 ± 0.83 μg/mL; 2.95 ± 2.83 μg/min, respectively) to pre-last-workout (0.92 ± 0.63 μg/mL, p = 0.025, d = 1.03; 0.76 ± 0.74 μg/min, p = 0.049, d = 0.95), and post-last-workout (0.95 ± 0.60 μg/mL, p = 0.032, d = 1.00; 0.59 ± 0.52 μg/min, p = 0.027, d = 1.02). No other significant differences between groups were observed.

Conclusions

Supplementation with a carbohydrate–protein beverage may support resistance training outcomes in a comparable way as the ingestion of only carbohydrate. Furthermore, the ingestion of 20 g of hydrolyzed beef protein resulted in a decreased level and secretion rates of the HNP1-3 from baseline with no negative effect on blood indices of health.

Electronic supplementary material

The online version of this article (doi:10.1007/s00421-016-3520-x) contains supplementary material, which is available to authorized users.

Recovery of the immune system after exercise

The notion that prolonged, intense exercise causes an "open window" of immunodepression during recovery after exercise is well accepted. Repeated exercise bouts or intensified training without sufficient recovery may increase the risk of illness. However, except for salivary IgA, clear and consistent markers of this immunodepression remain elusive. Exercise increases circulating neutrophil and monocyte counts and reduces circulating lymphocyte count during recovery. This lymphopenia results from preferential egress of lymphocyte subtypes with potent effector functions [e.g., natural killer (NK) cells, γδ T cells, and CD8⁺ T cells]. These lymphocytes most likely translocate to peripheral sites of potential antigen encounter (e.g., lungs and gut). This redeployment of effector lymphocytes is an integral part of the physiological stress response to exercise. Current knowledge about changes in immune function during recovery from exercise is derived from assessment at the cell population level of isolated cells ex vivo or in blood. This assessment can be biased by large changes in the distribution of immune cells between blood and peripheral tissues during and after exercise. Some evidence suggests that reduced immune cell function in vitro may coincide with changes in vivo and rates of illness after exercise, but more work is required to substantiate this notion. Among the various nutritional strategies and physical therapies that athletes use to recover from exercise, carbohydrate supplementation is the most effective for minimizing immune disturbances during exercise recovery. Sleep is an important aspect of recovery, but more research is needed to determine how sleep disruption influences the immune system of athletes.