Salivary IL-21 and IgA responses to a competitive match in elite basketball players

Recovery in elite youth basketball players: The responsiveness of the psychophysiological measurements and the role of testosterone concentration

This study investigated the recovery responses to the Total Quality Recovery (TQR), Well-Being questionnaire (WBQ), and Heart Rate (HR) responses to Submaximal Running Test (SRT), and the influence of salivary testosterone concentration (TEST) on these responses in 25 elite youth (U15) male basketball players. TQR, WBQ, and HR measurements were assessed after 48 hours of rest (T1), 24 hours after the 1st day of training (T2) and 24 hours after the 2nd day of training (T3). Salivary sampling was conducted at T1 and T3. A significant decrease was observed for TQR (F = 4.06; p = 0.01) and for WBQ (F = 5.37; p = 0.008) from T1 to T3. No difference among the three-time points was observed for HR and HR Recovery, and the TEST concentration did not influence the results. These results show that TQR and WBQ are sensitive to acute transient alterations in training loads (TL) and may be utilized to monitor recovery in elite youth basketball players. The HR related measurements presented limited responsiveness, and the TEST seems not to influence the recovery of these players who are competing at highest performance level.

The Immunological and Hormonal Responses to Competitive Match-Play in Elite Soccer Players

This study aimed to examine the salivary immunoglobulin A (s-IgA) and salivary cortisol (s-Cort) responses to competitive matches in elite male soccer players. Data were collected for 19 players (mean ± SD, age: 26 ± 4 years; weight: 80.5 ± 8.1 kg; height: 1.83 ± 0.07 m; body-fat 10.8 ± 0.7%) from a Russian Premier League team throughout a 6-week period during the 2021-2022 season. Physical match loads were measured through an optical tracking system. s-IgA and s-Cort were assessed one day before each match (MD - 1), 60-min before kick-off, 30-min post-match, and 48-h post-match (MD + 2). At 60-min before kick-off, s-IgA values were lower than at MD - 1 (90% CI difference 15.7-71.3 μg/mL). Additionally, compared to 60-min before kick-off, s-IgA was higher at 30-min post-match (90% CI difference 1.8-57.8 μg/mL) and at MD + 2 (90% CI difference 5.4-60.5 μg/mL). At 30-min post-match, s-Cort was higher than at 60-min before kick-off (90% CI difference 4.84-7.86 ng/mL), while on MD + 2 s-Cort was higher than at 60-min before kick-off (90% CI difference 0.76-3.72 ng/mL). Mixed model regressions revealed that longer playing time and total distance covered, and higher number of high-intensity accelerations, involved smaller s-IgA differences between 30-min post-match and 60-min before kick-off, and between 60-min before kick-off and MD + 2. Additionally, greater high-intensity and sprint distances, and a higher number of high-intensity and maximal accelerations, involved smaller s-Cort differences between 60-min before kick-off and MD + 2. In conclusion, the present results demonstrate that using salivary monitoring combined with match load may be a useful tool to monitor individual mucosal immunity and hormonal responses to match-play and the subsequent recovery periods in elite soccer players.

The Impact of Acute and Chronic Exercise on Immunoglobulins and Cytokines in Elderly: Insights From a Critical Review of the Literature

The level of immunoglobulins and cytokines changes with an ageing immune system. This review summarizes findings from studies that have examined the impact of acute and chronic exercise on immunoglobulins and cytokines in the elderly. Our literature analysis revealed that acute endurance exercise resulted in increased secretory salivary immunoglobulin A (SIgA), while acute bouts of muscle strengthening exercise (i.e., isokinetic, eccentric, knee extensor exercise) increased plasma/muscle interleukin (IL)-6, IL-8 and tumor necrosis factor alpha (TNF-α) levels. Chronic exercise in the form of short-term endurance training (i.e., 12-16 weeks) and long-term combined endurance and resistance training (i.e., 6-12 months) induced increases in salivary SIgA concentration. We additionally identified that short-term endurance training at moderate intensities and the combination of endurance, strength, balance, and flexibility training increase plasma IL-10 and reduce plasma IL-6 and TNF-α in healthy elderly adults and male patients with chronic heart failure. Strength training for 6-12 weeks did not alter plasma IL-1β, IL-2, IL-6 and TNF-α concentration in healthy elderly adults and patients with chronic-degenerative diseases, while 12 weeks of resistance training decreased muscle TNF-α mRNA in frail elderly individuals. Short-term (i.e., 10-24 weeks) moderate- to high-intensity strength training reduced LPS–IL-6, LPS, IL-1β, LPS–TNF-α and circulating concentrations of TNF-α and increased IL-10 in healthy elderly women and older people with cognitive impairment, respectively. In conclusion, it appears that acute bouts of endurance exercise and short-term chronic exercise training exercise are appropriate methods to enhance mucosal immune function, reduce systemic markers of inflammation, and promote anti-inflammatory processes in elderly individuals.

Part I: Relationship among Training Load Management, Salivary Immunoglobulin A, and Upper Respiratory Tract Infection in Team Sport: A Systematic Review

Immunoglobulin A (IgA), which is the first line of defense against upper respiratory tract viruses, has been related with training load management. This article aimed to systematically identify and summarize (1) the studies that have found a relationship between training load and salivary IgA in team sports, and (2) the studies that have highlighted a relationship between IgA and upper respiratory tract infection (URTI) in team sports. A systematic review of relevant articles was carried out using two electronic databases (PubMed and WoK) until 3 October 2020. From a total of 174 studies initially found, 24 were included in the qualitative synthesis. This systematic review confirmed that lower values of IgA occurred after greater training load (intensity/volume) and congested periods. In this scenario, a low level of IgA was correlated with higher URTI, which makes training load management mandatory to healthcare avoiding immunosuppression. Therefore, physical fitness and conditioning coaches should carefully manage training load progression, avoiding high-intensity sessions in two consecutive days. In addition, they should not program high-intensity training sessions during at least the two days following competition.

Salivary IgA as a Potential Biomarker in the Evaluation of Respiratory Tract Infection Risk in Athletes

In recent years, there has been attention focused on the value of salivary IgA (sIgA) as a potential biomarker for the identification of athletes who may be at increased risk of developing respiratory tract infection (RTI). The utility of sIgA, in this context, is based on biological plausibility and several observational studies revealing an apparent association between sIgA and RTI susceptibility. The overall published evidence evaluating the value of sIgA in this context is however conflicting, and there is currently a lack of clear guidance as to whether this marker has a place in the health surveillance and care of athletes. In this review, we critically appraise the literature assessing the potential for sIgA to be used in this context, evaluating it against 4 key biomarker characteristics, including its (1) practicality, (2) reproducibility, (3) specificity/sensitivity, and (4) potential clinical impact and relevance. This process reveals that although there is an apparent association between respiratory illness and sIgA in many studies, with some promising results, overall there remains a paucity of evidence supporting its overall value in this context. Key deficiencies in the metrics employed to endorse a valid biomarker are apparent, including a lack of reproducibility and low specificity and sensitivity in the detection of RTI susceptibility. The review outlines these issues and makes future recommendations.

The effect of acute stress on salivary markers of inflammation: A systematic review and meta-analysis

BACKGROUND

Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress.

METHOD

The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [d_av]).

RESULTS

Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, d_av = 0.27), IL-10 (k = 11, d_av = 0.34), TNF-α (k = 10, d_av = 0.57), and IFN-γ (k = 6, d_av = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, d_av = 0.16) and IL-8 (k = 7, d_av = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations.

CONCLUSIONS

This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.

Changes in different salivary biomarkers related to physiologic stress in elite handball players: the case of females

This study evaluates pre- and post-match concentrations of salivary cortisol, alpha-amylase (AA) and immunoglobulin A (lgA) in a group of 21 elite female handball players in the Spanish national women's league. The players' mean age was 23.0 ± 5.4 years. The concentration of the biomarkers was determined using ELISA. Mean playing time was 25.2 min. The players' cortisol concentration increased significantly (p < 0.05) whereas the IgA concentration fell significantly (p < 0.01) at the end of the match. There were no significant changes in the concentrations of AA between pre and post-match timepoints. The changes observed in the study also depended on the position played; defenders exhibited the highest cortisol and lowest IgA concentrations after the match. Larger changes in cortisol and IgA were seen in those who played for more than 30 min. The present study shows that a competitive handball match increases physiologic stress in females, with activation of the hypothalamic-pituitary-adrenal axis and the adrenergic system, resulting in decreased immunocompetence.

Interleukin-21 and its association with chronic periodontitis

Context:

Interleukin-21 (IL-21) is a pleiotropic cytokine, well documented to contribute to the development of Th17 cells which have been shown to play an important role in the pathogenesis of periodontitis. Periodontal disease is a chronic infection of tooth-supporting tissue.

Aim:

This study evaluates the saliva and serum levels of IL-21 in patients with chronic periodontitis and periodontally healthy individuals.

Settings and Design:

The present study was carried out in the Department of Microbiology in association with Department of Oral Medicine and Radiology, Maratha Mandal's N.G.H Institute of Dental Sciences and Research Centre, Belgavi, Karnataka.

Materials and Methods:

Fifty samples of each group were included in the present study. The levels of IL-21 were assessed using a commercially available enzyme-linked immunosorbent assay (ELISA) kit and the results were expressed as pg/mL.

Statistical Analysis Used:

Statistical analysis was performed using SPSS 17.0 software. Data were expressed as mean ± standard deviation and interquartile ranges and comparison of controls and cases by Mann–Whitney test.

Results:

Serum and salivary levels of IL-21 were significantly higher in chronic periodontitis group than in controls (P < 0.001). Clinical periodontal parameters correlated positively with serum IL-21 levels.

Conclusions:

IL-21 is highly expressed in patients with chronic periodontitis and correlated well with clinical parameters of periodontal destruction. Therefore, IL-21 appears to play a role in tissue destruction and can be used as diagnostic biomarker in chronic periodontitis. Saliva can be considered to be a useful alternative to serum as a diagnostic sample.

Respiratory Infections

Respiratory infections are the most frequent cause of athletes’ visits in medical practices. Simultaneously, contradictory beliefs are generally held regarding influence of repeated exercise on immunity reflected in susceptibility to infections. Many tend to claim that exercise weakens the immunity and renders regular exercisers more prone to develop airway infections. On the other hand, voices are heard in favor of the possible beneficial influence of regular exercise on immune system efficiency. This chapter focuses on the associations of various kinds of exercise with respiratory infection susceptibility. Influence of exercise, in particular associated with competitive performance, on selected innate and acquired immune response mechanisms is also addressed.

Intensified Training Period Increases Salivary IgA Responses But Does Not Affect the Severity of Upper Respiratory Tract Infection Symptoms in Prepuberal Rhythmic Gymnasts

This study examined the effect of a 4-week intensified training (IT) period, followed by a 2-week tapering period (TP), on salivary immunoglobulin A (SIgA), salivary cortisol, and the severity of upper respiratory tract infection symptoms in 23 rhythmic gymnasts [12.1 (2.6) y; 143.9 (13.7) cm; 37.2 (9.4) kg]. Saliva sampling was conducted at pre- and post-IT, and post-TP (analyzed using enzyme-linked immunosorbent assay). The Wisconsin Upper Respiratory Symptom Survey (WURSS-21) questionnaire was completed daily to analyze the severity of upper respiratory tract infection symptoms. The session rating of the perceived exertion was used to determine the internal training load and the acute:chronic workload ratio. A higher SIgA concentration [SIgA_abs (μg/mL); F = 7.6; P = .001] for post-IT [234 (104)] versus pre-IT [173 (91)], and post-TP [182 (70)], and a higher SIgA secretion rate [SIgA_rate (μg/min); F = 3.4; P = .04] for post-IT [69 (28)] versus pre-IT [55 (27)], and post-TP [58 (22)] were observed. No significant change was observed for cortisol (F = 0.81; P = .45) or for the severity of upper respiratory tract infection symptoms (χ² = 2.81; P = .24). Internal training load was higher during IT (vs TP; effect size = 2.37). The acute:chronic workload for the IT weeks varied from 1.2 (0.3) to 1.4 (0.3). These results suggest that a 4-week IT may temporarily augment the oral mucosal immunity, and an acute:chronic workload of 1.2-1.4 seems to be a safe approach to periodized training loads in youth rhythmic gymnasts.

Competition stage influences perceived performance but does not affect rating of perceived exertion and salivary neuro-endocrine-immune markers in elite young basketball players

This study examined the effects of competition stage on the salivary concentration of testosterone (T), cortisol (C), alpha-amylase (sAA), and IL-1ß cytokine, perceived performance (PP) and session rating of perceived exertion (session-RPE) in elite youth basketball players (age, 15.8 ± 0.8 yrs.; stature, 190.9 ± 7.9 cm; body mass, 90.0 ± 16.9 kg) from two age-categories (U16; n = 7; U17; n = 7). Two winning playoff matches (FM; playing for the championship; 1 for each age-category) and two winning regular stage matches (RM; 1 for each age category, played against opponents ranked 2nd place), were assessed in the current study. Saliva samples were collected before and after each match and analyzed by ELISA; PP and session-RPE were assessed after each match. The results from the two-way ANOVA (condition; FM and RM) with repeated measures (pre-and post-matches) showed a significant effect for time (increase from pre-to-post matches) in T (F = 7.0, p < .001), C (F = 34.0, p < .001), and sAA (F = 25.0, p < .001), but not for IL-1ß (p > .05). No effect of condition or interaction (FM and RM) was observed on salivary markers. PP was higher for FM, compared to RM (effect size; ES = 0.85), despite no clear difference in session-RPE (ES = 0.22). A higher PP for FM might be associated with the fact that players were no longer concerned about issues linked to social dominance and status threats after FM, but they might be uncertain about their status after RM. Additionally, when playing against a high-level opponent, the players might perceive their opponent as a threat against status stability, regardless of the stage of the competition, which might explain the similar change in salivary neuro-endocrine-immune-related markers.

The anticipatory stress response to sport competition; a systematic review with meta-analysis of cortisol reactivity

Objective

Athletes anticipating sport competition regularly experience distinct emotional and physiological responses as a result of the expected psychosocial and physical stress. Specifically, cortisol, an indicator of hypothalamic-pituitary-adrenal axis activation, prepares the athlete for the psychological and physiological demands of competition. The objective of this meta-analysis is to analyse the magnitude of the anticipatory cortisol response in athletes preparing to participate in sport competition and to examine the influence of gender, level of competition and data collection time.

Design

Systematic review with meta-analysis.

Data sources

Four electronic databases were searched to March 2017: PubMed, PsycINFO, SPORTDiscus and Scopus.

Eligibility criteria for selecting studies

(1) Athletes participating in real sport competition;(2) salivary cortisol concentration collected before competition in addition to baseline sample(s);(3) original research article published in English language.

Results

Data from 25 studies provided 27 effect sizes. A significant anticipatory cortisol response of g=0.85, p<0.001 was identified. Males had a stronger trend for greater cortisol reactivity (g=1.07) than females (g=0.56, p=0.07). Females and athletes competing at international level did not demonstrate a significant anticipatory stress response. There were no significant differences between level of competition, type of sport or time of competition. Meta-regression indicated that the anticipatory cortisol response is greater when assessed closer to the start of competition (Q=6.85, p=0.009).

Summary/conclusion

The anticipatory cortisol response before sport competition reflects moderate cortisol reactivity that prepares athletes optimally for the demands of sport competition via the influence on cognitive processes and attentional control. However, both female athletes and international competitors did not demonstrate a significant anticipatory cortisol response, possibly due to differences in appraisal of the stress of sport competition.

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.

Mucosal immunity and upper respiratory tract infections during a 24-week competitive season in young ice hockey players

The aim of this study was to examine upper respiratory tract infections (URTI) and their associations with resting saliva and blood immune and endocrine parameters in ice hockey players. Twenty-seven participants (age 16.5 ± 0.5 years) completed the 24-week study period. The counts/concentrations of immune and endocrine markers were compared between healthy-prone athletes (≤2 episodes of URTI during the study period) and illness-prone athletes (≥3 episodes of URTI) and between the URTI state (when athletes had infections) and the healthy state (the time without URTI). There were no differences in concentration/counts of saliva and blood immune and endocrine parameters between the illness-prone and illness-free athletes. Athletes had significantly lower sIgA, sIgA1 and sIgA2 concentrations (sIgA: 119.88 ± 66.88, 144.10 ± 75.0 µg/ml; sIgA1: 90.2 ± 40.64, 108.44 ± 29.8 U; sIgA2: 67.58 ± 30.1, 80.3 ± 25.61 U, respectively) and significantly higher WBC, neutrophil, monocyte and eosinophil count values and IL-1ra concentration at the time when they had symptoms of URTI than in the period without symptoms of infections. There were no differences in salivary cortisol concentration between the period of URTI symptoms and the period without URTI symptoms. In conclusion, we observed lower concentrations of salivary immunoglobulins and higher levels of blood immune parameters during URTI in athletes, which may confirm the suppression of mucosal immunity and initiation responses to pathogenic infections by innate immunity.

Salivary Biomarker Responses to Two Final Matches in Women's Professional Football

The aim of this study was to examine the link between salivary concentrations of cortisol, testosterone, immunoglobulin A (IgA) and the rate of perceived exertion (RPE) as a measure of internal load after two final matches played 3 days apart by professional women football players. Saliva samples were taken before and after the two matches (M1, M2). RPE was used to monitor the exercise intensity after each match. Testosterone concentrations increased after each match (M1: +42%, p = 0.002; M2: +50%, p < 0.001) while cortisol increased only after M1 (+116%, p < 0.001). The testosterone-to-cortisol ratio decreased only after M1 (-32.4%, p < 0.001). IgA concentration did not change after any match. Testosterone concentrations were correlated with IgA concentrations after each match (M1: R = 0.59, p = 0.008; M2: R=0.51, p = 0.02). RPE was correlated with cortisol concentrations after M1 (R = 0.57; p = 0.01), but not after M2 (R = 0.38; p = 0.07). All these results suggest that salivary cortisol and testosterone concentrations increase especially after the first match of a final, without affecting IgA levels. We speculate that increased testosterone concentration in women after football matches may play a protecting role against immune suppression usually observed after intense exercise. Key pointsIn our sample space, IgA concentrations did not change for teams even, before and after separated match. Suggesting that salivary IgA determinations after physical activities remain under debate.Testosterone concentrations were the only one hormone showing a consequent increase in both matches after physical activity carrying.The T/C ratio decrease only after M1 according with a higher cortisol level reach after M1 get-together, suggesting a differential impact over anxiety-associated team performance. So M2 play gives a more stable psychological state.

Does small-sided-games' court area influence metabolic, perceptual, and physical performance parameters of young elite basketball players?

The purpose of this study was to investigate the effect of court size on physiological responses and physical performance of young elite basketball players. Twelve male basketball players (18.6 ± 0.5 years; 88.8 ± 14.5 kg; 192.6 ± 6.5 cm) from an under-19 team performed two small-sided games (matches) with different court areas (28x15 m and 28x9 m; 28x15 and 28x9 protocols). The number of players (3x3) was kept the same in each protocol. The players performed a repeated-sprint ability (RSA) test before and after each match. Blood lactate concentration was collected before (pre) and after (post) the matches, and the session rating of perceived exertion (session-RPE) was determined 30 minutes after the match. Best and mean time in the RSA test were not different between the 28x15 and the 28x9 match protocols (p > 0.05). A significant difference was observed for lactate concentration from pre- to post-match (p < 0.05) in both protocols (28x15 and 28x9); however, there was no significant interaction between protocols. A similar session-RPE mean score (28x15: 7.2 ± 1.4 and 28x9: 6.6 ± 1.4) was detected for both protocols (p > 0.05, ES=0.41). In summary, the results of the current study suggest that the different court areas induced similar responses. Although there was no significant difference in effort perception, players tended to perceive a greater effort in the larger court size.

Salivary hormones and anxiety in winners and losers of an international judo competition

The purpose of this study was to investigate the responses of salivary hormones and salivary secretory immunoglobulin A (SIgA) and anxiety in winners and losers during an international judo competition. Twenty-three trained, male, national-level judo athletes provided three saliva samples during a competition day: morning, in anticipation of competition after an overnight fast, mid-competition, and post-competition within 15 min post-fight for determination of salivary cortisol, salivary testosterone, salivary testosterone/cortisol ratio, SIgA absolute concentrations, SIgA secretion rate and saliva flow rate. The competitive state anxiety inventory questionnaire was completed by the athletes (n = 12) after the first saliva collection for determination of somatic anxiety, cognitive anxiety and self-confidence. Winners were considered 1-3 ranking place (n = 12) and losers (n = 11) below third place in each weight category. Winners presented higher anticipatory salivary cortisol concentrations (p = 0.03) and a lower mid-competition salivary testosterone/cortisol ratio (p = 0.003) compared with losers with no differences for salivary testosterone. Winners tended to have higher SIgA secretion rates (p = 0.07) and higher saliva flow rates (p = 0.009) at mid-competition. Higher levels of cognitive anxiety (p = 0.02) were observed in the winners, without differences according to the outcome in somatic anxiety and self-confidence. The results suggest that winners experienced higher levels of physiological arousal and better psychological preparedness in the morning, and as the competition progressed, the winners were able to control their stress response better.

Correlation between Surgeon's experience, surgery complexity and the alteration of stress related physiological parameters

Introduction

In the present work we analyzed the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in oral surgeons, randomly recruited according to their expertise level.

Materials and methods

Each surgeon performed three different surgical procedures with increasing degrees of technical difficulty and under time-limited conditions, to assess whether these variants may influence the risks of stress-induced secondary hypertension among the involved health professionals. sC and sIgA samples and cardiovascular function measurements were taken up before, during, and two hours after every surgery. Salivary samples and cardiovascular measurements were taken also during non-surgical days, as baseline controls.

Results

We observed that more experienced surgeons showed a higher stress management ability compared to those with less experience or, generally, younger, which are more exposed to the risks of developing secondary hypertension. Nevertheless, indipendently of sex and experience, oral surgeons are constantly exposed to high risks of developing stress-related diseases.

Conclusions

On the basis of the issues addressed and the results obtained, we have highlighted the importance of the investigated stress biomarkers to monitor and to prevent stress-related pathologies among oral surgeons. This approach is aimed to emphasize the significance of these specific stress-biomarkers, which represent a powerful instrument to evaluate stress levels in oral surgeons, and that may help to reduce the most severe life-threatening risks to which they are daily exposed. In conclusion, final goal of this study is to suggest an useful guideline to monitor the stress levels of oral and maxillofacial surgeons in order to improve their quality of life, which is inevitably reflected on the quality of the performances provided and, finally, to prevent possible mistakes in their daily activities.

Lymphocyte glucose and glutamine metabolism as targets of the anti-inflammatory and immunomodulatory effects of exercise

Glucose and glutamine are important energetic and biosynthetic nutrients for T and B lymphocytes. These cells consume both nutrients at high rates in a function-dependent manner. In other words, the pathways that control lymphocyte function and survival directly control the glucose and glutamine metabolic pathways. Therefore, lymphocytes in different functional states reprogram their glucose and glutamine metabolism to balance their requirement for ATP and macromolecule production. The tight association between metabolism and function in these cells was suggested to introduce the possibility of several pathologies resulting from the inability of lymphocytes to meet their nutrient demands under a given condition. In fact, disruptions in lymphocyte metabolism and function have been observed in different inflammatory, metabolic, and autoimmune pathologies. Regular physical exercise and physical activity offer protection against several chronic pathologies, and this benefit has been associated with the anti-inflammatory and immunomodulatory effects of exercise/physical activity. Chronic exercise induces changes in lymphocyte functionality and substrate metabolism. In the present review, we discuss whether the beneficial effects of exercise on lymphocyte function in health and disease are associated with modulation of the glucose and glutamine metabolic pathways.