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Ringleb M, Javelle F, Haunhorst S, Bloch W, Fennen L, Baumgart S, Drube S, Reuken PA, Pletz MW, Wagner H, Gabriel HHW, Puta C. Beyond muscles: Investigating immunoregulatory myokines in acute resistance exercise - A systematic review and meta-analysis. FASEB J 2024; 38:e23596. [PMID: 38597350 DOI: 10.1096/fj.202301619r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
Myokines, released from the muscle, enable communication between the working muscles and other tissues. Their release during physical exercise is assumed to depend on immune-hormonal-metabolic interactions concerning mode (endurance or resistance exercise), duration, and intensity. This meta-analysis aims to examine the acute changes of circulating myokines inducing immunoregulatory effects caused by a bout of resistance exercise and to consider potential moderators of the results. Based on this selection strategy, a systematic literature search was conducted for resistance exercise intervention studies measuring interleukin (IL-) 6, IL-10, IL-1ra, tumor necrosis factor (TNF-) α, IL-15, IL-7, transforming growth factor (TGF-) β1, and fractalkines (FKN) before and immediately after resistance exercise in healthy individuals. Random-effects meta-analysis was performed for each myokine. We identified a moderate positive effect of resistance exercise for IL-6 and IL-1ra. Regarding IL-15 and TNF-α, small to moderate effects were found. For IL-10, no significant effect was observed. Due to no data, meta-analyses for IL-7, TGF-β1, and FKN could not be performed. No moderators (training status, type of exercise, risk of bias, age, sex, time of day, exercise volume, exercise intensity, exercise dose) of the results were detected for all tested myokines. Taken together, this systematic review and meta-analysis showed immediate positive effects of an acute resistance exercise session on IL-6, IL-1ra, TNF-α, and IL-15 levels.
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Affiliation(s)
- Miriam Ringleb
- Department of Movement Science, University of Münster, Münster, Germany
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
- Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Friedrich-Schiller-University Jena, Jena, Germany
| | - Florian Javelle
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Simon Haunhorst
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Friedrich-Schiller-University Jena, Jena, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Lena Fennen
- Department of Movement Science, University of Münster, Münster, Germany
| | - Sabine Baumgart
- Institute for Immunology, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Sebastian Drube
- Institute for Immunology, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
| | - Philipp A Reuken
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Mathias W Pletz
- Institute for Immunology, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Heiko Wagner
- Department of Movement Science, University of Münster, Münster, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany
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Haunhorst S, Bloch W, Javelle F, Krüger K, Baumgart S, Drube S, Lemhöfer C, Reuken P, Stallmach A, Müller M, Zielinski CE, Pletz MW, Gabriel HHW, Puta C. A scoping review of regulatory T cell dynamics in convalescent COVID-19 patients - indications for their potential involvement in the development of Long COVID? Front Immunol 2022; 13:1070994. [PMID: 36582234 PMCID: PMC9792979 DOI: 10.3389/fimmu.2022.1070994] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Background Recovery from coronavirus disease 2019 (COVID-19) can be impaired by the persistence of symptoms or new-onset health complications, commonly referred to as Long COVID. In a subset of patients, Long COVID is associated with immune system perturbations of unknown etiology, which could be related to compromised immunoregulatory mechanisms. Objective The objective of this scoping review was to summarize the existing literature regarding the frequency and functionality of Tregs in convalescent COVID-19 patients and to explore indications for their potential involvement in the development of Long COVID. Design A systematic search of studies investigating Tregs during COVID-19 convalescence was conducted on MEDLINE (via Pubmed) and Web of Science. Results The literature search yielded 17 relevant studies, of which three included a distinct cohort of patients with Long COVID. The reviewed studies suggest that the Treg population of COVID-19 patients can reconstitute quantitatively and functionally during recovery. However, the comparison between recovered and seronegative controls revealed that an infection-induced dysregulation of the Treg compartment can be sustained for at least several months. The small number of studies investigating Tregs in Long COVID allowed no firm conclusions to be drawn about their involvement in the syndrome's etiology. Yet, even almost one year post-infection Long COVID patients exhibit significantly altered proportions of Tregs within the CD4+ T cell population. Conclusions Persistent alterations in cell frequency in Long COVID patients indicate that Treg dysregulation might be linked to immune system-associated sequelae. Future studies should aim to address the association of Treg adaptations with different symptom clusters and blood parameters beyond the sole quantification of cell frequencies while adhering to consensualized phenotyping strategies.
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Affiliation(s)
- Simon Haunhorst
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Florian Javelle
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Sabine Baumgart
- Institute for Immunology, Jena University Hospital, Jena, Germany
| | - Sebastian Drube
- Institute for Immunology, Jena University Hospital, Jena, Germany
| | | | - Philipp Reuken
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Andreas Stallmach
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Michael Müller
- Department of Infection Immunology, Leibniz Institue for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - Christina E. Zielinski
- Department of Infection Immunology, Leibniz Institue for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - Mathias W. Pletz
- Institute for Immunology, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Holger H. W. Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Jena, Germany
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Haunhorst S, Bloch W, Ringleb M, Fennen L, Wagner H, Gabriel HHW, Puta C. Acute effects of heavy resistance exercise on biomarkers of neuroendocrine-immune regulation in healthy adults: a systematic review. Exerc Immunol Rev 2022; 28:36-52. [PMID: 35452397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The nervous system integrates the immune system in the systemic effort to maintain or restore the organism's homeostasis. Acute bouts of exercise may alter the activity of specific pathways associated with neuroendocrine regulation of the immune system. OBJECTIVE To examine the acute effects of heavy resistance exercise on biomarkers of neuroendocrine-immune regulation in healthy adults. METHODS A systematic literature search was conducted using PubMed, Cochrane Controlled Trials Register, Web of Science and SportDiscus with no date restrictions up to March 2021. Clinical trials in English or German were included if they measured the blood plasma or serum concentrations of specific biomarkers of neuroendocrine-immune regulation (adrenaline, noradrenaline, acetylcholine, vasoactive intestinal peptide (VIP), cortisol, growth hormone, calcitonin gene-related peptide (CGRP), substance p, serotonin, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) or glia-derived neurotrophic factor (GDNF)) in a resting state prior to and no later than 60 minutes after an acute bout of heavy resistance exercise in healthy adults. RESULTS 7801 records were identified through literature search, of which 36 studies, with a total of 58 intervention groups, met the inclusion criteria. Evidence was found that an acute bout of heavy resistance exercise increased the levels of adrenaline (median: 185%), noradrenaline (median: 113%) and GH (median: 265%) immediately after the exercise. Mixed results were found for cortisol (median: 0%), suggesting that its response might be more sensitive to the configuration of the exercise scheme. The limited evidence regarding the effects on BDNF and ACTH allows no firm conclusions to be drawn about their response to heavy resistance exercise. The vast majority of the included studies reported a return of the biomarker concentrations to their baseline value within one hour after the termination of the exercise bout. No studies were identified that investigated the response of acetylcholine, VIP, CGRP, substance p, serotonin, NGF or GDNF to heavy resistance exercise. CONCLUSIONS A bout of heavy resistance exercise alters the circulating concentrations of selected biomarkers of neuroendocrine-immune regulation. Both subject characteristics, such as sex as well as exercise parameters, such as rest intervals appear to have the potential to influence these effects.
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Affiliation(s)
- Simon Haunhorst
- Department of Movement Science, University of Münster, Münster, Germany
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Miriam Ringleb
- Departement of Movement Science, University of Münster, Münster, Germany
| | - Lena Fennen
- Departement of Movement Science, University of Münster, Münster, Germany
| | - Heiko Wagner
- Departement of Movement Science, University of Münster, Münster, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases related to Professional Activities, Friedrich-Schiller-University Jena, Jena, Germany
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Steidten T, Baumbach P, May R, Gabriel B, Herbsleb M, Markov A, Granacher U, Kellmann M, Bloch W, Gabriel HHW, Puta C. Overnight Immune Regulation and Subjective Measures of Sleep: A Three Night Observational Study in Adolescent Track and Field Athletes. Front Sports Act Living 2021; 3:689805. [PMID: 34651124 PMCID: PMC8506008 DOI: 10.3389/fspor.2021.689805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
To ensure health maintenance of young athletes, immunological stress due to physical exercise has to be balanced for performance development and health maintenance. Sleep is an important influencing factor for immune regulation because of its regenerating effect. In an attempt to assess overnight immune regulation, this observational study aimed to examine associations between changes in capillary immunological blood markers and measures of sleep in adolescent athletes. Over a period of three nights, 12 male (n = 6) and female (n = 6) adolescent track and field athletes aged 16.4 ± 1.1 years were monitored for their sleep behavior (e.g., sleep duration, sleep depth) and immune regulation by using subjective (e.g., sleep) and objective (capillary blood markers) measurement tools. Over the 4 day (three nights), athletes followed their daily routines (school, homework, free time activities, and training). Training was performed for different disciplines (sprint, hurdles, and long-jump) following their daily training routines. Training included dynamic core stability training, coordination training, speed training, resistance training, and endurance training. Capillary blood samples were taken 30-45 min after the last training session (10:00-12:00 a.m. or 5:00-6:00 p.m.) and every morning between 7:00 and 10:00 a.m. Changes in capillary blood markers from post-training to the next morning and morning-to-morning fluctuations in capillary blood markers were analyzed over a three-night period using a generalized estimating equations (GEE) statistical approach. Associations of overnight changes with measures of sleep were analyzed using GEE. We found significant decreases in white blood cell count (WBC), granulocytes (GRAN), granulocytes% (GRAN%), monocytes (MID), and granulocyte-lymphocyte-ratio. In contrast, lymphocytes% (LYM%) increased significantly and systemic inflammation index showed no difference from post-training to the next morning. Furthermore, there was a significant decrease in WBC and GRAN between morning 1 and morning 3. At morning 4, values returned to baseline (morning 1), irrespective if athletes performed a training session or rested on day 3. Furthermore, sleep duration was significantly and negatively associated with changes in WBC (βz = -0.491) and lymphocytes (βz = -0.451). Our results indicate that overnight sleep duration is an important parameter of immunological overnight regulation for adolescent athletes.
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Affiliation(s)
- Thomas Steidten
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Friedrich Schiller University, Jena, Germany
| | - Philipp Baumbach
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany
| | - Rico May
- Physical Education/English/Sports Theory, Sports High School, Johann Chr. Fr. GutsMuths Jena, Jena, Germany
| | - Brunhild Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Adrian Markov
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Michael Kellmann
- Faculty of Sport Science, Ruhr University, Bochum, Germany
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Holger H. W. Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Friedrich Schiller University, Jena, Germany
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Herbsleb M, Schumann A, Lehmann L, Gabriel HHW, Bär KJ. Cardio-Respiratory Fitness and Autonomic Function in Patients with Major Depressive Disorder. Front Psychiatry 2019; 10:980. [PMID: 32116813 PMCID: PMC7011194 DOI: 10.3389/fpsyt.2019.00980] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/10/2019] [Indexed: 11/27/2022] Open
Abstract
Patients with major depressive disorder (MDD) have an augmented risk of cardiovascular morbidity and mortality. Although a link between depression and autonomic dysfunction as well as reduced cardio-respiratory fitness (CRF) is well documented, the underlying cause is a matter of debate. Therefore, we studied the interplay between autonomic function, body composition and severity of the disease to disentangle possible physiological factors influencing the assumed lack of CRF in MDD patients. We investigated seventeen patients suffering from MDD and seventeen control subjects matched with respect to age, sex, body-mass-index, and smoking habits. A resting baseline assessment and a cardiopulmonary exercise test including a prolonged recovery period were performed to study autonomic function (i.e., heart rate responses and heart rate variability) during rest, exercise and recovery as well as CRF. Most investigated autonomic indices were significantly different at rest, during exercise as well as during recovery indicating altered autonomic modulation. Nevertheless, none of our participants was classified as chronotropically incompetent. As expected, a reduced CRF (i.e., peak oxygen uptake and peak power output, p < 0.01) was observed in patients compared to controls. In addition, a correlation of baseline heart rate and of heart rate during recovery with the ventilatory threshold 1 (p < 0.05) was found in patients only, indicating a relation to the lack of CRF. Furthermore, we observed a positive correlation of the severity of the disease with the weekly sitting time (p < 0.01) as well as a negative correlation with the activity time in the intensity domain walking (p < 0.001) and with the total score of the International Physical Activity Questionnaire (p < 0.01) for patients. This study shows that patients with MDD have altered autonomic function not only during resting conditions but also during exercise as well as recovery from exercise. Intervention studies are needed to evaluate how the described autonomic alterations can be influenced by increasing CRF due to appropriate exercise training programs.
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Affiliation(s)
- Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University, Jena, Germany.,Psychiatric Brain and Body Research Group, Department of Psychosomatic Medicine, University Hospital, Jena, Germany
| | - Andy Schumann
- Psychiatric Brain and Body Research Group, Department of Psychosomatic Medicine, University Hospital, Jena, Germany
| | - Luisa Lehmann
- Psychiatric Brain and Body Research Group, Department of Psychosomatic Medicine, University Hospital, Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University, Jena, Germany
| | - Karl-Jürgen Bär
- Psychiatric Brain and Body Research Group, Department of Psychosomatic Medicine, University Hospital, Jena, Germany
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Kurz E, Herbsleb M, Gabriel HHW, Hilberg T. Posturographic and ankle muscle activation characteristics in patients with haemophilia. Haemophilia 2018; 25:136-143. [PMID: 30520541 DOI: 10.1111/hae.13650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 10/05/2018] [Accepted: 11/05/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The objective of this work was to examine the interrelations of posturographic and surface EMG (SEMG) characteristics of ankle muscles in patients with haemophilia while standing naturally. METHODS Surface EMG of five bilaterally recorded ankle muscles was conducted in 24 patients with haemophilia (PwH, age: 42 [11] years, mean [SD], 22 A, 2 B, 21 severe, 3 moderate) with median (quartiles) WFH orthopaedic joint score of 30 (20/39) points and 24 non-haemophilic controls (Con, age: 42 [12]). Force plate (IBS) signals were captured simultaneously during bipedal stance with eyes open. Load proportion of the left and right sides as well as heel and forefoot were calculated via four independent pressure transducers. Overall, weight distribution (WD) indices are reported with higher results representing a poorer WD. RESULTS Analyses of WD showed large differences between groups (PwH: 10.2 [5.4], Con: 5.2 [2.9], P < 0.001, d = 1.15). After clustering PwH, large effects (P = 0.02, ηp 2 > 0.16) were found for amplitude ratios of the lateral gastrocnemius (LG) muscle. In PwH, the degree of joint alteration of the right lower limb was associated with load proportion of the left side (ρ > 0.64, P = 0.001). CONCLUSION Patients with greater dysbalance showed higher forefoot loads and appeared to compensate their altered joint situations with considerably higher amplitude ratios of LG. Further studies should investigate whether therapeutic interventions could alter postural alignment and muscle activation and how these can influence patients' joint function and symptoms.
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Affiliation(s)
- Eduard Kurz
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.,Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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Granacher U, Puta C, Gabriel HHW, Behm DG, Arampatzis A. Editorial: Neuromuscular Training and Adaptations in Youth Athletes. Front Physiol 2018; 9:1264. [PMID: 30246794 PMCID: PMC6139302 DOI: 10.3389/fphys.2018.01264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 08/21/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
- Urs Granacher
- Research Focus Cognition Sciences, Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
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Puta C, Steidten T, Baumbach P, Wöhrl T, May R, Kellmann M, Herbsleb M, Gabriel B, Weber S, Granacher U, Gabriel HHW. Standardized Assessment of Resistance Training-Induced Subjective Symptoms and Objective Signs of Immunological Stress Responses in Young Athletes. Front Physiol 2018; 9:698. [PMID: 29922184 PMCID: PMC5996067 DOI: 10.3389/fphys.2018.00698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/18/2018] [Indexed: 02/01/2023] Open
Abstract
From a health and performance-related perspective, it is crucial to evaluate subjective symptoms and objective signs of acute training-induced immunological responses in young athletes. The limited number of available studies focused on immunological adaptations following aerobic training. Hardly any studies have been conducted on resistance-training induced stress responses. Therefore, the aim of this observational study was to investigate subjective symptoms and objective signs of immunological stress responses following resistance training in young athletes. Fourteen (7 females and 7 males) track and field athletes with a mean age of 16.4 years and without any symptoms of upper or lower respiratory tract infections participated in this study. Over a period of 7 days, subjective symptoms using the Acute Recovery and Stress Scale (ARSS) and objective signs of immunological responses using capillary blood markers were taken each morning and after the last training session. Differences between morning and evening sessions and associations between subjective and objective parameters were analyzed using generalized estimating equations (GEE). In post hoc analyses, daily change-scores of the ARSS dimensions were compared between participants and revealed specific changes in objective capillary blood samples. In the GEE models, recovery (ARSS) was characterized by a significant decrease while stress (ARSS) showed a significant increase between morning and evening-training sessions. A concomitant increase in white blood cell count (WBC), granulocytes (GRAN) and percentage shares of granulocytes (GRAN%) was found between morning and evening sessions. Of note, percentage shares of lymphocytes (LYM%) showed a significant decrease. Furthermore, using multivariate regression analyses, we identified that recovery was significantly associated with LYM%, while stress was significantly associated with WBC and GRAN%. Post hoc analyses revealed significantly larger increases in participants’ stress dimensions who showed increases in GRAN%. For recovery, significantly larger decreases were found in participants with decreases in LYM% during recovery. More specifically, daily change-scores of the recovery and stress dimensions of the ARSS were associated with specific changes in objective immunological markers (GRAN%, LYM%) between morning and evening-training sessions. Our results indicate that changes of subjective symptoms of recovery and stress dimensions using the ARSS were associated with specific changes in objectively measured immunological markers.
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Affiliation(s)
- Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Thomas Steidten
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Philipp Baumbach
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany
| | - Toni Wöhrl
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Rico May
- Sportgymnasium Jena "Johann Chr. Fr. GutsMuths", Jena, Germany
| | - Michael Kellmann
- Faculty of Sport Science, Ruhr University, Bochum, Germany.,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Brunhild Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Stephanie Weber
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
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Weber S, Puta C, Lesinski M, Gabriel B, Steidten T, Bär KJ, Herbsleb M, Granacher U, Gabriel HHW. Symptoms of Anxiety and Depression in Young Athletes Using the Hospital Anxiety and Depression Scale. Front Physiol 2018; 9:182. [PMID: 29563884 PMCID: PMC5845908 DOI: 10.3389/fphys.2018.00182] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/20/2018] [Indexed: 01/09/2023] Open
Abstract
Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery. While normative data regarding symptoms of anxiety and depression for the general population is available (Hinz and Brähler, 2011), hardly any information exists for adolescents in general and young athletes in particular. Therefore, the aim of this study was to assess overall symptoms of anxiety and depression in young athletes as well as possible sex differences. The survey was carried out within the scope of the study "Resistance Training in Young Athletes" (KINGS-Study). Between August 2015 and September 2016, 326 young athletes aged (mean ± SD) 14.3 ± 1.6 years completed the Hospital Anxiety and Depression Scale (HAD Scale). Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows: late childhood (12-14 years) and late adolescence (15-18 years). The participating young athletes were recruited from Olympic weight lifting, handball, judo, track and field athletics, boxing, soccer, gymnastics, ice speed skating, volleyball, and rowing. Anxiety and depression scores were (mean ± SD) 4.3 ± 3.0 and 2.8 ± 2.9, respectively. In the subscale anxiety, 22 cases (6.7%) showed subclinical scores and 11 cases (3.4%) showed clinical relevant score values. When analyzing the depression subscale, 31 cases (9.5%) showed subclinical score values and 12 cases (3.7%) showed clinically important values. No significant differences were found between male and female athletes (p ≥ 0.05). No statistically significant differences in the HADS scores were found between male athletes of late childhood and late adolescents (p ≥ 0.05). To the best of our knowledge, this is the first report describing questionnaire based indicators of symptoms of anxiety and depression in young athletes. Our data implies the need for sports medical as well as sports psychiatric support for young athletes. In addition, our results demonstrated that the chronological classification concerning age did not influence HAD Scale outcomes. Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.
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Affiliation(s)
- Stephanie Weber
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
| | - Melanie Lesinski
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Brunhild Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
| | - Thomas Steidten
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
| | - Karl-Jürgen Bär
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena, Jena, Germany
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Hilberg T, Eichler E, Gläser D, Prasa D, Stürzebecher J, Gabriel HHW. Blood coagulation and fibrinolysis before and after exhaustive exercise in patients with IDDM. Thromb Haemost 2017; 90:1065-73. [PMID: 14652638 DOI: 10.1160/th03-05-0264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryDiabetes mellitus involves changes in haemostasis which leads to the opinion that diabetes mellitus is a hypercoagulable state. However, little is known about the relationship of exercise and haemostasis in diabetics. Therefore, first of all the aim was to investigate if differences in blood coagulation and fibrinolysis can be demonstrated in subjects with insulin-dependent diabetes mellitus (IDDM) compared to controls and secondly, if differences concerning exercise induced changes can be seen in diabetics. 16 moderately fit subjects with IDDM and 16 matched controls underwent a maximal step test. Blood samples were taken after a 30 min rest, immediately and 1h after exercise and in addition after 30 min rest 7 days later at the same time of day. The rest values (mean of the two rest samples) in extrinsic total thrombin potential (TTPex, P=0.049), tPA-activity (P=0.007) were significantly higher and in PAI-1-antigen (P=0.002) -activity (P=0.049) lower in the diabetic group. APTT, PT, TAT (only control), TTPin, tPA-activity and -antigen and PAP were increased immediately and D-dimer (only control) 1 h after exercise, whereas PAI-1-activity and -antigen (only control) decreased immediately or 1 h after exercise (all minimal P<0.05). The increase of tPA-antigen and decrease in PAI-1-antigen after exercise were both lower in the diabetics (P<0.05).IDDM led to higher extrinsic total thrombin and fibrinolytic potential at rest, and reducing the exercise provoked distribution of tPA-antigen and decrease of PAI-1-antigen. Nevertheless a higher thrombotic risk after maximal exercise has not been investigated in young IDDM patients without complications and in good metabolic control.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstr. 42, D-07749 Jena, Germany.
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11
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Nothnagel H, Puta C, Lehmann T, Baumbach P, Menard MB, Gabriel B, Gabriel HHW, Weiss T, Musial F. How stable are quantitative sensory testing measurements over time? Report on 10-week reliability and agreement of results in healthy volunteers. J Pain Res 2017; 10:2067-2078. [PMID: 28919806 PMCID: PMC5587201 DOI: 10.2147/jpr.s137391] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Quantitative sensory testing (QST) is a diagnostic tool for the assessment of the somatosensory system. To establish QST as an outcome measure for clinical trials, the question of how similar the measurements are over time is crucial. Therefore, long-term reliability and limits of agreement of the standardized QST protocol of the German Research Network on Neuropathic Pain were tested. Methods QST on the lower back and hand dorsum (dominant hand) were assessed twice in 22 healthy volunteers (10 males and 12 females; mean age: 46.6±13.0 years), with sessions separated by 10.0±2.9 weeks. All measurements were performed by one investigator. To investigate long-term reliability and agreement of QST, differences between the two measurements, correlation coefficients, intraclass correlation coefficients (ICCs), Bland–Altman plots (limits of agreement), and standard error of measurement were used. Results Most parameters of the QST were reliable over 10 weeks in healthy volunteers: Almost-perfect ICCs were observed for heat pain threshold (hand) and mechanical pain sensitivity (back). Substantial ICCs were observed for heat pain threshold (back), pressure pain threshold (back), mechanical pain sensitivity (hand), and vibration detection threshold (back and hand). Some QST parameters, such as cold detection threshold, exhibited low ICCs, but also very low variability. Generally, QST measures exhibited narrow limits of agreement in the Bland–Altman plots. Conclusion The standardized QST protocol of the German Research Network on Neuropathic Pain is feasible to be used in treatment trials. Moreover, defining a statistically meaningful change is possible, which is a prerequisite for the use of QST in clinical trials as well as in long-term investigations of disease progression.
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Affiliation(s)
- Helen Nothnagel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Jena, Germany.,Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Jena, Germany.,Center for Interdisciplinary Prevention of Diseases Related to Professional Activities
| | - Thomas Lehmann
- Department of Medical Statistics, Computer Sciences and Documentation, Friedrich Schiller University
| | - Philipp Baumbach
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Germany
| | - Martha B Menard
- Crocker Institute, Kiawah Island, SC.,School of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA, USA
| | - Brunhild Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Jena, Germany
| | - Thomas Weiss
- Department of Biological and Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Frauke Musial
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
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Puta C, Franz M, Blume KR, Gabriel HHW, Miltner WHR, Weiss T. Are There Abnormalities in Peripheral and Central Components of Somatosensory Evoked Potentials in Non-Specific Chronic Low Back Pain? Front Hum Neurosci 2016; 10:521. [PMID: 27799904 PMCID: PMC5065995 DOI: 10.3389/fnhum.2016.00521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 09/30/2016] [Indexed: 12/19/2022] Open
Abstract
Chronic low back pain (CLBP) was shown to be associated with longer reflex response latencies of trunk muscles during external upper limb perturbations. One theoretical, but rarely investigated possibility for longer reflex latencies might be related to modulated somatosensory information processing. Therefore, the present study investigated somatosensory evoked potentials (SEPs) to median nerve stimulation in CLBP patients and healthy controls (HC). Latencies of the peripheral N9 SEP component were used as the primary outcome. In addition, latencies and amplitudes of the central N20 SEP component, sensory thresholds, motor thresholds and nerve conduction velocity were also analyzed in CLBP patients and HC. There is a trend for the CLBP patients to exhibit longer N9 latencies at the ipsilateral Erb’s point compared to HC. This trend is substantiated by significantly longer N9 latencies in CLBP patients compared to normative data. None of the other parameters showed any significant difference between CLBP patients and HC. Overall, our data indicate small differences of the peripheral N9 SEP component; however, these differences cannot explain the reflex delay observed in CLBP patients. While it was important to rule out the contribution of early somatosensory processing and to elucidate its contribution to the delayed reflex responses in CLBP patients, further research is needed to find the primary source(s) of time-delayed reflexes in CLBP.
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Affiliation(s)
- Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University JenaJena, Germany; Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Friedrich Schiller University JenaJena, Germany
| | - Marcel Franz
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena Jena, Germany
| | - Kathrin R Blume
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University Jena Jena, Germany
| | - Wolfgang H R Miltner
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena Jena, Germany
| | - Thomas Weiss
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena Jena, Germany
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Puta C, Schulz B, Schoeler S, Magerl W, Gabriel B, Gabriel HHW, Miltner WHR, Weiss T. Enhanced sensitivity to punctate painful stimuli in female patients with chronic low back pain. BMC Neurol 2012; 12:98. [PMID: 22998460 PMCID: PMC3488472 DOI: 10.1186/1471-2377-12-98] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 09/19/2012] [Indexed: 01/31/2023] Open
Abstract
Background Chronic low back pain (CLBP) has been shown to be associated with various pathophysiological changes at several level of the sensorimotor system, pointing to a general hypersensitivity in CLBP patients. The aim of the present study was to investigate signs of generalized mechanical pain hypersensitivity in CLBP patients on the hand and on the painful site of the back. Methods Pinprick stimulation according to a validated standardized quantitative sensory testing protocol was used in 14 female CLBP patients and 14 healthy controls (HC) matched for sex and age. Stimulus response functions to pinprick stimulation on the skin were examined at the affected back and reference sites (hand palmar and hand dorsum). Data from CLBP patients were compared with HC and with reference data from the German Research Network on Neuropathic Pain. Results We found significant differences in the stimulus response functions between CLBP patients and HC. Pain ratings to the pinpricks were increased for low and moderate pinprick stimuli in CLBP patients. Importantly, this kind of specific pinprick hyperalgesia was found not only for the affected body site (back), but also for the remote reference sites (hand dorsum and hand palmar). Conclusions We interpret our results as pointing to changes in the nociceptive processing in CLBP at higher levels of the neuraxis, possibly thalamus and/or attentional control, rather than changes of spinal processing. Alternatively, there might be a higher vulnerability to noxious stimulation in CLBP patients.
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Affiliation(s)
- Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Wöllnitzer Strasse 42, Jena D-07749, Germany.
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14
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Herbsleb M, Abou-Hamdan R, Puta C, Donath L, Kobelt R, Stanek FD, Hilberg T, Gabriel HHW. [Severe and moderate haemophilia under prophylactic replacement treatment--maximal knee extensor and flexor torque of children and adolescents]. Hamostaseologie 2012; 32 Suppl 1:S62-S69. [PMID: 22961403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/02/2012] [Indexed: 06/01/2023] Open
Abstract
UNLABELLED Due to its influence on haemophilic arthropathy, the evaluation of knee extensor (K(Ext)) and flexor (K(Flex)) torques plays an important role in the preventive and rehabilitative context of haemophilia. Thus, the present study aimed at investigating maximal static torque (M(Max)) of K(Ext) and K(Flex). 14 boys with haemophilia (8 severe, 6 moderate; age: 11.7 ± 2.8 years; prophylactic treatment > 5 years) and 14 healthy carefully pair-matched controls (age: 11.5 ± 2.7 years) were separately measured for the left and right leg for M(Max). Furthermore, the ratio K(Flex)/K(Ext )was calculated and the joint situation assessed using the Haemophilia Joint Health Score. RESULTS No significant group-effect was observed for M(Max) of the K(Ext) and K(Flex) as well as for the ratio K(Flex)/K(Ext) (p>0.05). Despite significant higher joint scores in haemophilic children compared to their healthy controls (p<0.01), patients merely showed minor joint impairments. CONCLUSION Children and adolescents with severe and moderate haemophilia under prophylactic replacement treatment with a good joint status showed comparable maximal strength performance of relevant knee muscles compared to their healthy peers.
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Affiliation(s)
- M Herbsleb
- Lehrstuhl für Sportmedizin und Gesundheitsförderung, Friedrich-Schiller-Universität Jena, Jena.
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15
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Abstract
UNLABELLED Cell-derived procoagulant microparticles (MP) might be able to contribute to exercise-induced changes in blood hemostasis. PURPOSES This study aimed to examine (i) the concentration and procoagulant activity of cell-derived MP after a moderate endurance exercise and (ii) the differences in the release, clearance, and activity of MP before and after exercise between trained and untrained individuals. METHODS All subjects performed a single bout of physical exercise on a bicycle ergometer for 90 min at 80% of their individual anaerobic threshold. MP were identified and quantified by flow cytometry measurements. Procoagulant activity of MP was measured by a prothrombinase activity assay as well as tissue factor-induced fibrin formation in MP-containing plasma. RESULTS At baseline, no differences were observed for the absolute number and procoagulant activities of MP between trained and untrained subjects. However, trained individuals had a lower number of tissue factor-positive monocyte-derived MP compared with untrained individuals. In trained subjects, exercise induced a significant increase in the number of MP derived from platelets, monocytes, and endothelial cells, with maximum values at 45 min after exercise and returned to basal levels at 2 h after exercise. Untrained subjects revealed a similar increase in platelet-derived MP, but their level was still increased at 2 h after exercise, indicating a reduced clearance compared with trained individuals. Procoagulant activities of MP were increased immediately after exercise and remained elevated up to 2 h after exercise. CONCLUSIONS We conclude that increased levels of MP were found in healthy individuals after an acute bout of exercise, that the amount of circulating MP contributes to an exercise-induced increase of hemostatic potential, and that there were differences in kinetic and dynamic characteristics between trained and untrained individuals.
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Affiliation(s)
- Maik Sossdorf
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, and Department of Sports Medicine, Institute of Sports Science, Jena Friedrich-Schiller University, Jena, Germany.
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Nötzel D, Puta C, Wagner H, Anders C, Petrovich A, Gabriel HHW. [Altered hip muscle activation in patients with chronic non-specific low back pain]. Schmerz 2011; 25:199-204, 206. [PMID: 21424336 DOI: 10.1007/s00482-010-1010-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to examine postural control in patients with chronic non-specific low back pain (CNRS). Furthermore the influence of visual information (eyes open versus eyes closed) was analyzed. MATERIAL AND METHODS A total of 8 patients with CNRS and 12 healthy control subjects were examined. Surface electromyography (SEMG) recordings were made from 5 trunk and 5 lower limb muscles as well as one hip muscle during application of distal lateral perturbation. RESULTS Healthy controls (mean ± standard deviation: 96.42±64.77 µV) showed a significantly higher maximum amplitude of the gluteus medius muscle in comparison to patients with CNRS (56.29±39.63 µV). Furthermore activation of several lower limb muscles was found to be dependent on visual information. CONCLUSION Patients showed an altered reflex response of the gluteus medius muscle which could be associated with reduced hip stability.
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Affiliation(s)
- D Nötzel
- Institut für Sportwissenschaft, Lehrstuhl für Sportmedizin, Friedrich-Schiller-Universität Jena.
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Herbsleb M, Tutzschke R, Czepa D, Gabriel HHW, Hilberg T. [Maximal isometric strength measures of the quadriceps muscles. Feasibility and reliability in patients with haemophilia]. Hamostaseologie 2010; 30 Suppl 1:S97-S103. [PMID: 21046058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
UNLABELLED The quadriceps femoris muscle (QF) plays an important role in locomotion. However, assessing the total number of attempts to evaluate the maximal isometric strength (Fmaxiso) regarding reliability and feasibility remain less characterised. PATIENTS, METHODS 28 patients with haemophilia (H) (26 severe, 2 moderate) and 27 healthy controls (C) matched for age (H: 44 ± 11, C: 42 ± 12) and anthropometric data were measured separately for the left and right leg for Fmaxiso of QF using m3 diagnos (SCHNELL®). We repeated the Fmaxiso measures after 48 h in 14 H and 13 C. RESULTS The system m3 diagnos showed strong reliability (ICC = 1.0; SEM = 0.0; CA = 1.0). H and C demonstrated significant differences in Fmaxiso (H r = 153 Nm, l = 164 Nm; K r= 289 Nm, l = 280 Nm; p ≤ 0.001). Additionally, H and C revealed significant differences between the 1st and 3rd to 6th attempts. No differences were observed between the 3rd, 4th, 5th and 6th attempts. CONCLUSION Both groups showed high test-retest-reliability of Fmaxiso (ICC/SEM: H l = 0.98/7.1 r = 0.99/4.9; K l = 0.69/11.3 r = 0.95/5.8). Starting from the 3rd attempt, reliable measurements of the Fmaxiso in patients suffering from severe haemophilia are feasible.
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Affiliation(s)
- M Herbsleb
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzer Street 42, 07749 Jena, Germany.
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Boettger S, Puta C, Yeragani VK, Donath L, Müller HJ, Gabriel HHW, Bär KJ. Heart rate variability, QT variability, and electrodermal activity during exercise. Med Sci Sports Exerc 2010; 42:443-8. [PMID: 19952826 DOI: 10.1249/mss.0b013e3181b64db1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Various measures of autonomic function have been developed, and their applicability and significance during exercise are controversial. METHODS Physiological data were therefore obtained from 23 sport students before, during, and after exercise. Measures of R-R interval variability, QT variability index (QTvi), and electrodermal activity (EDA) were calculated. We applied an incremental protocol applying 70%, 85%, 100%, and 110% of the individual anaerobic threshold for standardized comparison. RESULTS Although HR increased stepwise, parasympathetic parameters such as the root mean square of successive differences were not different during exercise and do not mirror autonomic function satisfactorily. Similar results were observed with the approximate entropy of R-R intervals (ApEnRR). In contrast, the increase in sympathetic activity was well reflected in the EDA, QTvi, and ApEn of the QT interval (ApEnQT)/ApEnRR ratio. CONCLUSION We suggest that linear and nonlinear parameters of R-R variability do not adequately reflect vagal modulation. Sympathetic function can be assessed by EDA, QTvi, or ApEnQT/ApEnRR ratio.
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Affiliation(s)
- Silke Boettger
- Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany
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Boettger S, Müller HJ, Oswald K, Puta C, Donath L, Gabriel HHW, Bär KJ. Inflammatory changes upon a single maximal exercise test in depressed patients and healthy controls. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:475-8. [PMID: 20116411 DOI: 10.1016/j.pnpbp.2010.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 01/15/2010] [Accepted: 01/22/2010] [Indexed: 01/09/2023]
Abstract
Patients with major depressive disorder (MDD) have repeatedly been described to exhibit both a humoral as well as a cellular pro-inflammatory state. Acute exercise, representing physical stress, can further aggravate such an immune dysbalance. In the light of recommended exercise programmes for depressed patients, we aimed to investigate the inflammatory response to exercise in patients with MDD. Blood cells counts and concentrations of the pro-inflammatory cytokines IL-1ss and IL-6 as well as the anti-inflammatory cytokine IL-10 were obtained before and after a single maximum exercise test in 15 patients suffering from MDD and 15 controls applying a stepwise exhaustion protocol. Patients showed increased white cell counts before and after exercise. While starting from different baseline levels, however, the relative increase in both humoral and cellular inflammatory parameters did not differ between groups. The results from this study suggest that physical training programmes for MDD patients do not bear a dramatically increased risk for acute pro-inflammatory exacerbations. Thus, continuous training programmes that have been shown to reduce the pro-inflammatory state in these patients can be recommended.
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Affiliation(s)
- Silke Boettger
- Department of Psychiatry and Psychotherapy, University Hospital, Philosophenweg 3, 07743 Jena, Germany
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Donath L, Boettger S, Puta C, Wetzig F, Mueller HJ, Bär KJ, Gabriel HHW. Dissociation of performance parameters at the IAT requires specific exercise recommendations for depressed patients. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:131-5. [PMID: 19852995 DOI: 10.1016/j.pnpbp.2009.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 10/06/2009] [Accepted: 10/13/2009] [Indexed: 11/17/2022]
Abstract
Aerobic exercise training is considered an adequate complementary treatment strategy for major depressive disorder (MDD). However, there is a need for comparative methodological investigations to determine the appropriate exercise intensity for these patients. The study compared submaximal exercise intensity determination with those derived from maximal parameters such as percentages of heart rate reserve (HRR), maximal heart rate (HR(max)) and peak oxygen uptake (VO(2peak)) of patients and controls. An exhaustive incremental bicycle exercise test was completed by 15 female MDD patients and matched controls. The individual anaerobic lactate threshold (IAT) as a gold standard to determine individual aerobic exercise intensity was assessed according to Stegmann and coworkers. Exercise intensities at 70 and 85% of HR(max), 70 and 85% of HRR and 50 to 80% of VO(2peak) were compared to the IAT. Patients suffering from MDD switched earlier to anaerobic metabolism than matched healthy controls. But interestingly, the level of self-rated perceived exertion, concentration of lactate, respiratory exchange ratio and heart rate at the IAT level revealed no significant difference between both groups. Due to a growing number of clinical aerobic exercise treatments in depressive disorders exercise intensities >70% of (a) HR(max), (b) HRR, (c) VO(2peak) should be amended by the IAT and Borg scale measurements to avoid over challenging as well as increased anaerobic metabolism.
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Affiliation(s)
- Lars Donath
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Woellnitzer Strasse 42, D-07749 Jena, Germany.
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Hilberg T, Gläser D, Schmidt V, Lösche W, Franke G, Schneider K, Gabriel HHW. Short-term exercise and platelet activity, sensitivity to agonist, and platelet-leukocyte conjugate formation. Platelets 2009. [DOI: 10.1080/0953710021000057541-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hilberg T, Eichler E, Gläser D, Schmidt V, Gabriel HHW. Platelet activity, reactivity and platelet-leukocyte conjugate formation before and after exhaustive or moderate exercise in patients with IDDM. Platelets 2009; 15:101-8. [PMID: 15154602 DOI: 10.1080/09537100310001646941] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diabetes mellitus alters blood coagulation and platelet function which supports the suggestion that diabetes mellitus is a hypercoagulable state. Firstly the aim of the study was to investigate if differences in platelet activity, reactivity and platelet-leukocyte conjugate (PLC) formation can be observed in subjects with IDDM; secondly, if differences can be seen between the diabetic and control group concerning exercise-induced changes in platelet activation and conjugate formation; and thirdly, if different types of exercise lead to different patterns in platelet activation. Sixteen subjects with IDDM and 16 controls underwent a maximal step test and an endurance test (90% IAT, 45 min). Blood samples were taken after 30 min rest, and immediately and 1 h after completion of exercise. CD62P expression and differentiated platelet-leukocyte conjugates (CD45, CD14, CD41) were detected flow-cytometrically with and without stimulation with TRAP-6. The rest values of the platelet-granulocyte (PGC) and platelet-lymphocyte conjugates (PLyC) were higher (P < 0.05) in the diabetics. After exercise, platelet reactivity (CD62P-TRAP; P < 0.05) but not the activity (CD62P-unstimulated), as well as all different conjugates with or without stimulation were increased (P < 0.05) independently from the group. Differences according to the type of exercise were barely observable. IDDM without vascular complications leads to higher PCG and PLyC at rest and to identical increases in differentiated platelet-leukocyte formation after exercise in comparison with matched controls.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Germany.
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Hilberg T, Deigner HP, Möller E, Claus RA, Ruryk A, Gläser D, Landre J, Brunkhorst FM, Reinhart K, Gabriel HHW, Russwurm S. Transcription in response to physical stress--clues to the molecular mechanisms of exercise-induced asthma. FASEB J 2005; 19:1492-4. [PMID: 16027142 DOI: 10.1096/fj.04-3063fje] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To clarify stress-induced immunological reactions and molecular events during exercise and the potential relevance to exercise-induced bronchoconstriction, transcriptional responses to standardized physical stress were determined. Six healthy, young volunteers underwent an endurance exercise of 90% of their individual anaerobic threshold for 90 min. Time-dependent alterations in the expression pattern of leukocytes from healthy, trained subjects were analyzed by DNA microarrays before and 2 h and 6 h after exercise. Starting out from a large collection of cDNA library clones comprising more than 70,000 human expressed sequence tags, we selected, designed, and immobilized oligonucleotide probes (60-70mers) for transcripts of 5000 stress- and inflammation-relevant genes. Exercise-induced stress provoked changes in the expression of 433 gene activities 2 h and/or 6 h after exercise, which could be grouped into six clusters. The most prominent feature was an enhanced transcription of two genes, coding for 5-lipoxygenase (ALOX5) and ALOX5-activating protein. Moreover, enhanced levels of leukotriene B4 (LTB4) and LTC4 (P<0.05) were detected in plasma after exercise. Our data demonstrate that exercise alters the activities of a distinct number of genes. In particular, they possibly provide novel insights into the molecular mechanisms of exercise-induced bronchoconstriction and suggest that enhanced transcription of ALOX5 and its activating protein together with a present predisposition of the subject critically contribute to exercise-induced asthma.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine Friedrich-Schiller-University Jena, Germany.
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Scharhag J, Meyer T, Gabriel HHW, Schlick B, Faude O, Kindermann W. Does prolonged cycling of moderate intensity affect immune cell function? Br J Sports Med 2005; 39:171-7; discussion 171-7. [PMID: 15728699 PMCID: PMC1725141 DOI: 10.1136/bjsm.2004.013060] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prolonged exercise may induce temporary immunosuppression with a presumed increased susceptibility for infection. However, there are only few data on immune cell function after prolonged cycling at moderate intensities typical for road cycling training sessions. METHODS The present study examined the influence on immune cell function of 4 h of cycling at a constant intensity of 70% of the individual anaerobic threshold. Interleukin-6 (IL-6) and C-reactive protein (CRP), leukocyte and lymphocyte populations, activities of natural killer (NK), neutrophils, and monocytes were examined before and after exercise, and also on a control day without exercise. RESULTS Cycling for 4 h induced a moderate acute phase response with increases in IL-6 from 1.0 (SD 0.5) before to 9.6 (5.6) pg/ml 1 h after exercise and CRP from 0.5 (SD 0.4) before to 1.8 (1.3) mg/l 1 day after exercise. Although absolute numbers of circulating NK cells, monocytes, and neutrophils increased during exercise, on a per cell basis NK cell activity, neutrophil and monocyte phagocytosis, and monocyte oxidative burst did not significantly change after exercise. However, a minor effect over time for neutrophil oxidative burst was noted, tending to decrease after exercise. CONCLUSIONS Prolonged cycling at moderate intensities does not seem to seriously alter the function of cells of the first line of defence. Therefore, the influence of a single typical road cycling training session on the immune system is only moderate and appears to be safe from an immunological point of view.
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Affiliation(s)
- J Scharhag
- Institute of Sports and Preventive Medicine, University of Saarland, Campus, Building 39.1, 66123 Saarbrücken, Germany.
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Hilberg T, Gläser D, Prasa D, Stürzebecher J, Gabriel HHW. Pure eccentric exercise does not activate blood coagulation. Eur J Appl Physiol 2005; 94:718-21. [PMID: 15906078 DOI: 10.1007/s00421-005-1353-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2005] [Indexed: 11/27/2022]
Abstract
Eccentric exercise can cause skeletal muscle damage with ultrastructural disruption, inflammation and increased proteolytic enzyme activity. It may be possible that these changes are able to trigger blood coagulation in vivo. The aim of the study was to investigate changes in blood coagulation via the measurement of aPTT, the thrombin potential (total [TTP] and endogenous [ETP], both intrinsic [in] and extrinsic [ex]) and the thrombin generation (prothrombinfragment 1 + 2 [F1 + 2] and thrombin-antithrombin complex [TAT]) after pure eccentric exercise. Seventeen healthy non-smokers (28 +/- 6 years, VO2-peak 59 +/- 7 ml/min/kg) underwent pure eccentric down jumps (9 x 28 isolated down jumps in 90 min, drop from a height of 55 cm), a cycle exercise (90% of the individual anaerobic threshold for 60-90 min) and a control experiment on different days. Blood samples were drawn after a 30-min rest, immediately, and 2 h after exercise. After the cycle exercise, a clear shortening by 12% (P<0.001) in aPTT and an increase in TTPin (13%; P<0.05) and TAT (33%; P<0.05) in comparison to the control experiment were seen, while after eccentric exercise only minimal changes in aPTT and thrombin potential (TTPin, ETPin) and no thrombin generation (F1 + 2 and TAT) were found. In contrast to concentric dynamic exercise, e.g. cycle ergometry, only insignificant changes in thrombin potential and no thrombin generation could be observed after skeletal muscle damage induced by pure eccentric exercise. It can be concluded that the mechanical impact associated with eccentric exercise does not activate blood coagulation.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstr. 42, 07749 Jena, Germany.
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26
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Hilberg T, Gläser D, Koksch M, Schmidt V, Sossdorf M, Gabriel HHW. Differentiation of platelet-leukocyte conjugate formation by short term exercise. Clin Hemorheol Microcirc 2004; 31:217-26. [PMID: 15322327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Platelet-leukocyte conjugates are increased in cardiovascular disease, but exercise is also able to trigger platelet-leukocyte formation in healthy subjects. The aim was to investigate the heterogeneity of platelet-leukocyte conjugate formations triggered by short term exercise. 18 healthy non-smokers underwent a 90 second maximal test on a SRM cycle ergometry system and a control experiment. Blood samples were taken after 30 min rest, immediately before and after, 15 min and 1 h after exercise. The different platelet-leukocyte conjugates were detected by flow cytometry via CD45, CD14, CD16, CD41, together with CD62P antibodies for the investigation of platelet activation in the conjugates. In addition, a stimulation of conjugate formation in vitro with 8 microM TRAP-6 was initiated. Immediately after exercise platelet-granulocyte (+24%), and -lymphocyte (+17%) conjugates were increased (p<0.01), while the platelet-monocyte conjugates (+40%) were enhanced (p<0.05) 15 min after exercise. The differentiation after stimulation showed that the regular (CD14(+)16(-); +32%) and mature (CD14(+)16(+); +35%) monocytes were both increased after exercise (p<0.01) but the regular monocytes were preferred (p<0.001) in platelet-monocyte conjugate formation. In addition, these conjugates revealed the highest CD62P expression. Maximal short term exercise is useful for the investigation of platelet-leukocyte formation; e.g., it could be shown, that regular monocytes may be preferred in conjugate formation and that these conjugates revealed the highest CD62P expression.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, D-07749 Jena, Germany.
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Hilberg T, Gläser D, Reckhart C, Prasa D, Stürzebecher J, Gabriel HHW. Blood coagulation and fibrinolysis after long-duration treadmill exercise controlled by individual anaerobic threshold. Eur J Appl Physiol 2003; 90:639-42. [PMID: 12883904 DOI: 10.1007/s00421-003-0907-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2003] [Indexed: 10/26/2022]
Abstract
For rehabilitation training it is recommended that the intensity of exercise should be clearly below the individual anaerobic threshold (IAT). We investigated blood coagulation, particularly endogenous thrombin potential (ETP) and fibrinolysis following a standardized treadmill (TR) ergometer test at 90% IAT for 60-120 min. Sixteen healthy male non-smokers underwent the TR test. Blood samples were taken after a 30-min rest, immediately after exercise, and 2 h after exercise completion. Extrinsic and intrinsic total (TTP(ex+in)) and endogenous (ETP(ex+in)) thrombin potential, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), plasmin-alpha2-antiplasmin complex (PAP), D-dimer, tissue plasminogen activator antigen and activity (tPA-AG and tPA-ACT) and plasminogen activator inhibitor type 1 antigen and activity (PAI-1-AG and PAI-1-ACT) were measured. Immediately after TR, F1+2, TAT and TTP(ex+in) were increased ( P<0.05) while ETP(ex+in) remained unchanged. In contrast, PAP, D-dimer, tPA-AG, tPA-ACT ( P<0.05) were distinctly enhanced while PAI-1-ACT was decreased ( P<0.05) immediately after exercise. The changes in tPA-AG, tPA-ACT, and PAI-1-ACT were reversed to nearly baseline while the enhancement in PAP and D-dimer was prolonged by more than 2 h after exercise. Long-duration exercise between 60 and 120 min controlled by IAT (90%) on a TR ergometer only implicates a small increase in thrombin generation markers and total (free and alpha(2)-macroglubulin-bound thrombin), but not in endogenous (free) thrombin potential alone. In contrast, fibrinolysis is distinctly increased after this type of exercise. Endurance exercise with an intensity below 90% IAT and a duration below 2 h generates a more favourable condition for fibrinolysis than for blood coagulation in healthy young subjects. Data are given as mean (SD).
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstrasse. 42, 07749, Jena, Germany.
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Heine GH, Weindler J, Gabriel HHW, Kindermann W, Ruprecht KW. Oral premedication with low dose midazolam modifies the immunological stress reaction after the setting of retrobulbar anaesthesia. Br J Ophthalmol 2003; 87:1020-4. [PMID: 12881348 PMCID: PMC1771790 DOI: 10.1136/bjo.87.8.1020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS An acute immunological stress reaction was previously reported to occur after the painful setting of retrobulbar anaesthesia before intraocular surgery. This study was conducted to find out whether an oral low dose premedication with midazolam would modify the immunological stress reaction. METHODS 32 patients undergoing intraocular surgery using retrobulbar anaesthesia were included in a randomised, double blind trial. They received premedication with either 3.75 mg midazolam or placebo 30 minutes before the retrobulbar injection. Counts of leucocyte subpopulations, cardiovascular, and psychometric parameters were measured repetitively before and after the retrobulbar injection. RESULTS The numbers of leucocytes increased significantly in the placebo group after the setting of retrobulbar anaesthesia (before retrobulbar injection: 6687 (SD 1025) cells x10(6)/l; after injection: 7067 (1022) cells x10(6)/l, p=0.0009) caused by rising numbers of neutrophils (before injection: 4111 (1063) cells x10(6)/l; after injection: 4352 (1147) cells x10(6)/l, p=0.0007) and natural killer cells (before injection: 290 (84) cell x10(6)/l; after injection 354 (133) cells x10(6)/l, p=0.003). There was no significant increase in total leucocytes (before injection: 5997 (1288) cells x10(6)/l; after injection: 6189 (1215) cells x10(6)/l) or in any leucocyte subpopulation in the midazolam group. A significant rise in systolic blood pressure occurred in the placebo group, but not in the midazolam group. CONCLUSION A low dose premedication with midazolam attenuates the immunological and cardiovascular stress reactions occurring with retrobulbar anaesthesia.
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Affiliation(s)
- G H Heine
- Department of Nephrology, University of Saarland, Homburg, Germany.
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Abstract
In whole blood flow cytometric platelet assays sample fixation using paraformaldehyde (PFA) is considered very advantageous to prevent spontaneous activation of platelets in vitro. However, fixation is an important variable in activation assays and its influence on platelets is poorly understood. Using a direct immunofluorescence labelling technique and whole blood flow cytometry, the effect of PFA fixation was investigated for 4 different epitopes on platelet surface each of which mirrors a different aspect of platelet activation, namely P-selectin (CD62P), GP IIbIIa complex (CD41), the fibrinogen binding site of the activated GP IIaIIIb complex (PAC-1) and GP Ib-V-IX complex (CD42b). Platelets fixed with PFA (0.5%) before antibody labelling showed significant (P<0.01) increases in mean fluorescence intensity (MFI) of CD62P (1.10 +/- 0.14 vs. 0.94 +/- 0.12 arbitrary units of fluorescence), CD41 (27.3 +/- 6.3 vs. 15.6 +/- 2.1) and PAC-1 (6.21 +/- 1.25 vs. 0.55 +/- 0.12) when compared to unfixed samples. At the same time, MFI of CD42b was reduced from 28.2 +/- 1.6 to 22.6 +/- 2.3 (P<0.01). When fixation was initiated after antibody labelling, we observed less prominent increases in MFI of CD41 (P<0.05) and PAC-1 (P<0.05) while there was no significant difference for CD62P and rather a moderate rise in CD42b than a decrease (P<0.05). Because these alterations cannot be explained by unspecific effects only, it must be concluded that PFA induces a systematic stimulation of platelets. The lowest in vitro platelet activation was found when antibody labelling was started immediately after blood sampling and when samples were analysed within 10 minutes after being stored without fixation of 4 degrees C in the dark.
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Affiliation(s)
- Volker Schmidt
- Department of Sports Medicine, Friedrich-Schiller-Universität Jena, Germany
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30
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Abstract
INTRODUCTION Maximal exercise may be a trigger for cardiovascular events. The aim of the study was to investigate changes in blood coagulation and fibrinolysis following maximal short-term exercises with different durations up to 90 s. METHODS A total of 15 healthy nonsmokers underwent three isokinetic maximal tests on an SRM cycle ergometry system with durations of 15, 45, and 90 s. Blood samples were taken after a 30-min rest, immediately before and after exercise, 15 min, and 1 h after completion of exercise. For the investigation of blood coagulation, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin III complex (TAT), intrinsic and extrinsic total (TTPin+ex), and endogenous thrombin potential (ETPin+ex) were measured. For testing fibrinolysis, determinations of plasmin-alpha(2)-antiplasmin complex (PAP), tissue-type plasminogen activator (tPA)-antigen, plasminogen activator inhibitor (PAI)-1-antigen and D-dimer were used. RESULTS Immediately after the exercise tests, only F1+2 (15- and 90-s test) and TTPin (45 and 90 s) showed a moderate increase (p<0.05), while TAT and ETP was unchanged. In contrast, a clear increase in PAP and tPA-antigen already after 15 s maximal exercise in relation to the exercise duration time could be investigated. These effects were not totally reversed to baseline 15 min after exercise; D-dimer and PAI-1-antigen still remained unchanged after these types of exercise. CONCLUSIONS Maximal short-term exercise does not lead to a relevant activation of blood coagulation in healthy young subjects, it is only slightly altered within the normal range. In contrast, fibrinolysis is clearly activated, and the increase is directly dependent on exercise duration. Additionally, it could be shown for the first time that fibrinolysis is already activated after 15 s maximal exercise duration.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstr. 42, D-07749, Jena, Germany.
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Hilberg T, Schmidt V, Lösche W, Gabriel HHW. Platelet activity and sensitivity to agonists after exhaustive treadmill exercise. J Sports Sci Med 2003; 2:15-22. [PMID: 24616605 PMCID: PMC3937570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2002] [Accepted: 12/30/2002] [Indexed: 06/03/2023]
Abstract
The extent of platelet activation after exhaustive exercise remains under discussion. Previous studies have provided contrary data, probably due to differences in the methodologies and the enrolled subjects. In the present study a maximal treadmill exercise (TR) was used to test platelet activity and -reactivity in 13 healthy non-smoking men. Blood samples were taken after a 30min rest, immediately before and after exercise, and 1h after completion of exercise. Platelets were analysed by whole blood flow cytometry either directly or after in vitro stimulation by incubating the blood samples for 10min with TRAP-6 (10µM) or ADP (5µM or 2,5µM). Binding of an anti-CD62P antibody or a PAC1 antibody directed against the activated fibrinogen receptor GPIIb/IIIa were used as a measure of platelet activation. Immediately after TR the percent CD62P positive platelets (%PC) unstimulated increased (p<0.01) from 0.77±0.06 to 1.12± 0.09 %PC and in PAC1 (p<0.05) from 2.32 ±0.54 to 3.83±0.81 %PC (mean±SEM). After ADP-stimulation an increase from 4.18±1.02 to 5.69±1.40 %PC in CD62P (p<0.01) and from 45.7±3.4 to 57.9±6.6 %PC in PAC1 (p<0.05) after TR were detected. Using TRAP-6-stimulation only the increase of PAC1 (p<0.01) after TR was different in comparison with the control experiment without exercise. Soluble CD62P in plasma as a marker of platelet and endothelial cell activation was also enhanced (p<0.05) after TR. Although these results indicate that exhaustive exercise lead to a small platelet activation and an increase in platelet reactivity, it is rather doubtful that these changes alone implicate a prothrombotic situation in healthy young non-smokers.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena , Germany
| | - Volker Schmidt
- Department of Sports Medicine, Friedrich-Schiller-University Jena , Germany
| | - Wolfgang Lösche
- Centre of Vascular Biology and Medicine, Erfurt, Friedrich-Schiller-University Jena , Germany
| | - Holger H W Gabriel
- Department of Sports Medicine, Friedrich-Schiller-University Jena , Germany
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Hilberg T, Glä D, Schmidt V, Lösche W, Franke G, Schneider K, Gabriel HHW. Short-term exercise and platelet activity, sensitivity to agonist, and platelet-leukocyte conjugate formation. Platelets 2003; 14:67-74. [PMID: 12745448 DOI: 10.1080/0953710021000057541] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Strenuous exercise may be partially responsible for cardio-vascular events. The aim was to investigate the platelet activity, reactivity and different platelet-leukocyte-conjugate formation following maximal short-term exercises. Fifteen healthy non-smokers underwent three isokinetic maximal tests on a SRM cycle ergometry system with durations of 15, 45 and 90 s. Blood samples were taken after a 30-min rest, immediately before and after exercise, and 15 min and 1 h after completion of exercise. Platelets were detected flow-cytometrically by CD41, and activated platelets by CD62P. In addition, stimulation of the platelets in vitro with 7.5 microM TRAP-6 was initiated. For testing platelet-leukocyte-conjugates, antibodies against CD45, CD14 and CD41 were used. After the exercise tests the percent of non-stimulated CD62P-positive platelets (%PC) was unchanged. In contrast, an increase in %PC (CD62P) TRAP-6 stimulated (15-s test: 37.2+/-10.3 to 46.2+/-12.3%, P < 0.05; 90-s test: 40.6+/-9.5 to 51.7+/-10.2%, P < 0.01) and in platelet-granulocyte, platelet-lymphocyte, and platelet-monocyte conjugate formation 15 min after exercise (45- and 90-s test; P < 0.05) were observed in comparison with the changes on the control day. The changes nearly reversed 1 h after exercise. Maximal short-term exercise only leads to a moderate increase of platelet reactivity and to an increase in the different platelet-leukocyte conjugates. The implications of the changes in platelet-leukocyte conjugate formation should be investigated in future studies.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Germany.
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Meyer T, Gabriel HHW, Auracher M, Scharhag J, Kindermann W. Metabolic profile of 4 h cycling in the field with varying amounts of carbohydrate supply. Eur J Appl Physiol 2003; 88:431-7. [PMID: 12527974 DOI: 10.1007/s00421-002-0712-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2002] [Indexed: 11/28/2022]
Abstract
Several laboratory studies have demonstrated a performance-enhancing effect of carbohydrate (CHO) supplementations during endurance sessions of long duration. However, the transferability of these results to real training and competition circumstances has not been conclusively shown. Therefore, we tried to test the influence of graded CHO substitution on substrate utilization and selected physiological parameters under standardized but practically orientated field conditions. Fourteen endurance-trained male subjects [mean (SD): 25 (5) years, 72 (9) kg, .VO(2max) 67 (6) ml.min(-1).kg(-1), individual anaerobic threshold (IAT) 269 (30) W] after a stepwise increasing pre-test had to perform three 4-h endurance rides on their own bicycles with simultaneous spiroergometry: constant workload 70% IAT (monitoring by SRM-System). Before and during exercise, solutions without (0%), with 6% or 12% CHO were administered double-blindly and in randomized order (total volume: 50 ml.kg(-1)). After cessation of exercise, significant differences between 0% and both CHO concentrations were detected for blood glucose (GLU; 75 mg dl(-1) for 0% vs 101 mg dl(-1) for 6% vs 115 mg dl(-1) for 12%; P<0.001) and respiratory exchange ratio (0.84 vs 0.88 vs 0.90; P<0.01; correlation to GLU: r=0.46, P<0.05). Free fatty acids (0.19 vs 0.16 vs 0.10 mmol l(-1)) and glycerol (0.41 vs 0.22 vs 0.12 mmol l(-1)) were significantly different between the endurance trials in a dose-dependent manner (both P<0.001). Lactate concentration ( P=0.42) and heart rate ( P=0.12) had no significant influence from CHO substitution. We conclude that CHO substitution during 4-h endurance training inhibits lipolysis in a dose-dependent manner and enhances aerobic glycolysis. This proves that earlier laboratory findings can be replicated under field conditions using modern portable equipment.
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Affiliation(s)
- T Meyer
- Institute of Sports and Preventive Medicine, University of Saarland, Faculty of Clinical Medicine, 66041 Saarbrücken, Germany.
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Hilberg T, Herbsleb M, Puta C, Gabriel HHW, Schramm W. Physical training increases isometric muscular strength and proprioceptive performance in haemophilic subjects. Haemophilia 2003; 9:86-93. [PMID: 12558784 DOI: 10.1046/j.1365-2516.2003.00679.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sufficient muscular strength and proprioception lessen the risk of joint damage, however, both are impaired in haemophilic subjects. The aim of the study was to investigate proprioceptive performance and isometric muscular strength before and after a specialized training in haemophilic subjects (H) compared with two groups of control subjects (C). Nine subjects with severe haemophilia A, and eight 'active' C (AC) without haemophilia took part in a physical training programme over a 6-month period. Eleven 'passive' C (PC) were requested to avoid any additional training during this period. Proprioceptive performance and isometric strength were determined before and after the training programme. The maximal isometric muscular strength in the legs, bilaterally measured by knee extensor (and leg press) was increased (P < 0.05) by 34% (29%) after training in the H and by 20% (28%) in the AC groups while remaining unchanged in the PC group. The performance in one-leg-stand tests after training was increased (P < 0.05) in the H and AC groups. An improvement of angle reproduction of 20 degrees and 40 degrees (P < 0.05) in the H compared with the PC groups was seen in the tests. Quantitative sensory testing by the tuning fork showed an increase (P < 0.05) in performance of both H and AC groups. The results of the present study confirm that specific sports therapy focused on proprioceptive function and accompanied by gentle strength training with low resistance and 20-25 repetitions is able to increase proprioceptive performance and muscular strength with a minimal stress to the joints. It is strongly recommended that specialized sports therapy be included as an integral component of the complete treatment regimen of haemophilic subjects.
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Affiliation(s)
- T Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Germany.
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Scharhag J, Meyer T, Gabriel HHW, Auracher M, Kindermann W. Mobilization and oxidative burst of neutrophils are influenced by carbohydrate supplementation during prolonged cycling in humans. Eur J Appl Physiol 2002; 87:584-7. [PMID: 12355200 DOI: 10.1007/s00421-002-0642-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2002] [Indexed: 10/27/2022]
Abstract
Prolonged, strenuous exercise may lead to suppressive effects on the immune system, which might be responsible for a greater susceptibility to opportunistic infections. The aim of this study was to examine the influence of carbohydrate substitution (CHS) during prolonged, strenuous exercise on neutrophil granulocytes and their oxidative burst (intracellular oxidation of dihydrorhodamine(123) to rhodamine(123) after induction by formylized 1-methionyl-1-leucyl-1-phenylalanin) using flow cytometry. In three trials different concentrations of CHS (placebo compared to 6% and 12% CHS; 50 ml.kg(-1)) were given randomly to 14 endurance trained cyclists [mean (SD) age 25 (5) years, maximal oxygen uptake 67 (6) ml.min(-1).kg(-1)] cycling for 4 h in a steady state at 70% of their individual anaerobic threshold. Blood samples were taken before, immediately after cessation, 1 h and 19 h after exercise. A significant rise in neutrophil counts was observed immediately after cessation and 1 h after exercise with a return to normal rest values 19 h after exercise for all three conditions ( P<0.001). The relative proportions of rhodamine(123)+ neutrophils were significantly diminished in all three conditions 1 h after exercise ( P<0.01), while the mean fluorescence intensity was lowest in the placebo trial and differed significantly to the 12% CHS trial ( P=0.024) and almost significantly to the 6% CHS trial ( P=0.052). In conclusion, these data suggest a beneficial effect of CHS on the neutrophil oxidative burst and a possible attenuation of the susceptibility to infections, presumably due to the reduction of metabolic stress in prolonged, strenuous exercise.
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Affiliation(s)
- J Scharhag
- Institute of Sports and Preventive Medicine, University of Saarland, Postfach 15 11 50, 66041 Saarbrücken, Germany.
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Hilberg T, Schmidt V, Gläser D, Schammne D, Lösche W, Gabriel HHW. Platelet activity, sensitivity to agonist, and platelet--leukocyte conjugate formation after long-term exercise. Platelets 2002; 13:273-7. [PMID: 12189012 DOI: 10.1080/0953770021000007249] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
For rehabilitation training it is recommended that the intensity of exercise should be distinctly below the individual anaerobic threshold (IAT). We investigated platelet activity, reactivity and platelet-leukocyte conjugate formation following a stardardized treadmill (TR) ergometer test at 90% IAT for 60-120 min. Seventeen healthy male non-smokers underwent TR. Blood samples were taken after a 30-min rest, immediately after exercise, and 2 h after exercise completion. Platelets were detected flow cytometrically by CD41 in whole blood, activated platelets by CD62P. In addition, stimulation of platelets in vitro with 7.5 microM TRAP-6 was performed. For testing platelet-leukocyte conjugates, antibodies against CD45 and CD41 were used. After TR the percent of non-stimulated CD62P-positive platelets (%PC) remained unchanged (1.65 +/- 0.56 to 1.73 +/- 0.79%PC) (mean +/- SD). In contrast, an increase (P<0.05) from 31.9 +/- 13.5 to 37.4 +/- 15.0 %PC in CD62P, TRAP-6 stimulated and enhanced (P<0.01) platelet-leukocyte conjugates (11.7 +/- 3.7 to 16.1 +/- 6.9, CD41-%PC) after TR were observed. Both changes were independent of thrombin generation measured by F1+2 and TAT, and reversible after 2 h. Long-term exercise (90% IAT) on a treadmill ergometer only leads to a moderate increase of platelet reactivity and platelet-leukocyte conjugates. The determination of platelet-leukocyte conjugates may offer the possibility to detect an early activation stage of platelets in vivo.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Jena, Germany.
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Abstract
PURPOSE Although under normal circumstances exercise prevents thrombosis, there are cases in the literature that indicate a connection between exercise and the onset of thrombosis. In the average population, hereditary thrombophilia is a major cause of thrombosis. However, nothing is known about the prevalence of hereditary thrombophilia in elite athletes. Because high-performance sports are known to carry an increased risk of thrombogenesis, measures to avoid thrombosis must be initiated in cases of known hereditary thrombophilia. METHODS Hereditary thrombophilia was checked for in 173 elite athletes, members of the German national team. Antithrombin III, protein C, protein S, and the APC ratio, followed by a molecular genetic analysis, were measured, and molecular analysis of factor II G20210A mutation was used to detect the presence of an antithrombin III-, protein C- and protein S-deficiency, as well as factor V Leiden (factor V 506Arg to Gln) and factor II G20210A mutation. RESULTS No definite antithrombin III-, protein C- or protein S-deficiency was found. In 12 cases, an APC resistance caused by a factor V Leiden mutation (11 heterozygous; 1 homozygous) was detected. In 10 cases, a heterozygous factor II G20210A was observed; a combination of both mutations was not found. For factor V Leiden, this corresponds to a prevalence of 6.9% (CI 95% 3.6-11.8%) in our group, similar to prevalence rates in the general population. Additionally, the observed prevalence of 5.8% (CI 95% 2.8-10.4%) of factor II G20210A is nearly within the range as reported by several authors. CONCLUSION Based on the observed prevalence of APC resistance and factor II G20210A mutation in our group of athletes, along with consideration of additional circumstantial risks, screening tests for elite athletes should be considered to allow the undertaking of preventive measures.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Jena, Germany.
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