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Mucosal immunity, respiratory illness, and competitive performance in elite swimmers
Abstract
Exercise and training are known to elicit changes in mucosal humoral immunity, but whether these alterations have any impact on competitive performance remains unclear. This investigation examined relationships between salivary immunoglobulin (Ig) concentration, the incidence of respiratory tract illness (RTI), and competitive performance in elite swimmers.
Forty-one members of the Australian Swimming Team (21 males and 20 females) aged 15-27 yr were monitored during preparations for the 1998 Commonwealth Games. Twenty-five coaches and staff (19 males and 6 females) aged 32-65 yr, serving as "environmental controls," were also monitored. Salivary IgA, IgM, and IgG and albumin concentration (mg.L-1) were measured in both groups in May 1998 and again in August 1998, 17 d before competition. Subjects were categorized as "ill" (at least one RTI) or "healthy".
There were no significant changes in salivary IgA, IgM, or IgG concentration in the swimmers between May and August, nor were there any differences between healthy (N = 23) and ill (N = 18) swimmers. There was a significant positive relationship between IgM and performance in the male swimmers (r = 0.85, P < 0.001) but not for any other parameter. There was no significant difference in performance between ill and healthy swimmers (P = 0.11). Gold medal winners (N = 9) had higher IgM levels than other swimmers (N = 32) in May (P = 0.02) and higher IgG in August (P = 0.02).
These data indicate that a season of training by elite swimmers did not alter salivary immunoglobulin concentrations, and the presence of RTI had no significant impact on competitive performance.
... Nasal congestion, rhinorrhoea, sneezing and nasal itching are reported by up to 74% of competitive elite swimmers (Bougault, Turmel, & Boulet, 2010b;Gelardi et al., 2012;Zwick, Popp, Budik, Wanke, & Rauscher, 1990). Furthermore, studies have reported that nasal symptoms may be due to an acute viral infection or a post-infectious state during the high training level seasons (Pyne et al., 2001). ...
... Asthma symptoms, airway obstruction and increased bronchial responsiveness may arise as a result of repeated exposure to chlorine gas (Bernard, 2007). In these cases, histological analysis of the bronchial mucosa has shown a thickened basement membrane, eosinophilic inflammation, and a relative lack of T-lymphocytes (Pyne et al., 2001). ...
... However, high-level competition also seems to exacerbate at least some components of the allergic immune response, such as airway hyper responsiveness and airway inflammation, especially in allergic athletes (Gleeson et al., 2002;Seyfried, Tobin, Brown, & Ness, 1985). Therefore, excessive amounts of prolong and highintensity exercise impair the immune system as well as mucosal defense which contribute to an increased risk for respiratory tract illness in swimmers (Pyne et al., 2001) ...
LANGUAGE NOTE | Document text in English; abstract also in Chinese. There is growing interest in the potentially harmful effects in swimming pools, and the potential for swimming-related health hazards, which is gaining importance in competitive swimmers. This review was focused to discuss the following topics: (1) prevalence of respiratory difficulties in swimmers; (2) the possible factors and mechanisms which lead to the development of airway disorders in elite swimmers; (3) diet and nutrient supplementation for the management and prevention of airway problems. Summaries were concluded in this review according to the current knowledge of the respiratory problems in swimmers: (1) a high prevalence of respiratory symptoms and respiratory diseases in the elite swimmer population; (2) the potentially harmful effects in airway epithelial damage and lung permeability may caused by exposure in cold air, chlorinated products in swimming pools, and high intensity training in swimmers. (3) Observational studies have reported associations between airway symptoms and nutritional intervention (i.e. polyunsaturated fatty acid, dietary antioxidants, and vitamin D), which may have application for promoting health and sports performance for swimmers. 運動選手(如游泳選手)發生呼吸系統疾病問題逐漸受到重視，本篇綜評旨在討論下列課題：(1)選手發生呼吸道疾病之發生率；(2)發生呼吸疾病之可能原因及機轉；(3)飲食與營養補充對減低呼吸疾病症狀之探討。統整相關文獻後，獲以下結語：(1)游泳選手發生呼吸道疾病之情形高於其他運動者(如：冬季運動項目、短跑與長跑等)；(2)長期處於含氯物質及其氯產物環境，對吸呼道黏膜及肺組織將有所傷，而冷空氣環境及高強度訓練模式，亦是增加游泳選手發生呼吸道不適症狀的影響因素；(3)多元不飽和脂肪酸、抗氧化物質及維生素D等營養素，在減低呼吸疾病臨床研究上證實有改善效益，對於呼吸道疾病發生率較高的游泳選手而言，應是不錯的飲食及營養補充介入不錯的選擇。
... Nasal congestion, rhinorrhoea, sneezing and nasal itching are reported by up to 74% of competitive elite swimmers (Bougault, Turmel, & Boulet, 2010b;Gelardi et al., 2012;Zwick, Popp, Budik, Wanke, & Rauscher, 1990). Furthermore, studies have reported that nasal symptoms may be due to an acute viral infection or a post-infectious state during the high training level seasons (Pyne et al., 2001). ...
... Asthma symptoms, airway obstruction and increased bronchial responsiveness may arise as a result of repeated exposure to chlorine gas (Bernard, 2007). In these cases, histological analysis of the bronchial mucosa has shown a thickened basement membrane, eosinophilic inflammation, and a relative lack of T-lymphocytes (Pyne et al., 2001). ...
... However, high-level competition also seems to exacerbate at least some components of the allergic immune response, such as airway hyper responsiveness and airway inflammation, especially in allergic athletes (Gleeson et al., 2002;Seyfried, Tobin, Brown, & Ness, 1985). Therefore, excessive amounts of prolong and highintensity exercise impair the immune system as well as mucosal defense which contribute to an increased risk for respiratory tract illness in swimmers (Pyne et al., 2001) ...
... The influence of exercise on immune system function has been investigated in elite sports including swimming (12,35) kayaking (9,23) and running (30,32). In particular, upper respiratory tract infections (URTI) have been identified (26) as the most common infection experienced by highly trained athletes and are frequently responsible for athlete absence from training and competition (29). ...
... It has been demonstrated (4,12) that decreasing concentrations of sIgA are associated with a predisposition to respiratory illness and therefore can be a useful marker for respiratory infection risk (28). Saliva analysis has become a widely accepted and utilised measure in applied research and team sport monitoring strategies (7,23,35) due to the non-invasive nature of sample collection and improved analysis methodologies for determining the sIgA concentration (10). The sIgA concentration has been shown (21) to correlate more highly with URTI than serum antibodies or other immune parameters and as such provides a worthwhile measure for integrated athlete monitoring protocols in individual and team sports. ...
... Multiple studies (10,11,23) have investigated the effects of endurance exercise similar to that undertaken by elite surf lifesaving (SLS) athletes, reporting decreases in sIgA concentration in response to intense kayaking (9, 23) (>60% VO2max), a seven month swim training program (12) and marathon running (30). However, other studies (17,25,35) have reported no change in sIgA concentration following intermittent and continuous exercise, including soccer and rugby competition and prolonged (>1.5 hr in duration) swimming. Increased sIgA concentration following cycling (18) and basketball competition and training (39) have been reported to further demonstrate the acute impact of exercise on the immune system. ...
The present study examined the response of salivary immunoglobulin A (sIgA) to endurance surf lifesaving (SLS) competition. Elite SLS men (n = 10) and women (n =8) volunteered to participate in the present study. Saliva samples of 0.5 mL were collected daily commencing 54 h pre-event to 61 h post-event. Saliva samples were assessed using a portable system. Saliva samples were collected at rest and prior to physical exertion or activity at approximately 0500 hours to determine the pre-and post-competition baseline values, while the post-event sample collection occurred within 30 min of race completion for each athlete, between approximately 1300 – 1600 hours. A significant (p < 0.05) increase in sIgA concentration was observed 61 h post-event (49.21 ± 8.8 μl/mL) in males compared to all other time-point samples. The results of the present study indicate that there is a non-significant increase in sIgA concentration for both genders immediately following an endurance SLS event, lasting approximately 90 min. The mechanism responsible for the non-significant increases in sIgA concentrations observed post-event in both genders and significant increases in sIgA concentrations observed 61 h post event in males remains unclear and may reflect an immune-compensatory effect to protect the athlete from the acquisition of infection. Surf lifesaving athletes and coaches should monitor sIgA concentrations throughout major competition periods to observe fluctuations in mucosal immunity, which may reflect a predisposition to infection, and tailor exercise and recovery prescription accordingly to minimise the risk of infection and subsequent declines in performance.
... Some studies have shown that marathon runners and competitive swimmers undertaking large volume and high intensity training have a higher rate of URTI (Heath et al., 1991). However, there are some who do not support the theory that high volume/high intensity training results in an increase in URTI Pyne et al., 2000). While the "J" curve model suggests that both high volume and high intensity training may depress the immune response, few, if any, studies have quantified the effects of high volumes of endurance training on the CD4 + cell proliferative sequence of endurance athletes and older individuals. ...
... 1 Outcomes from the proposed research will have significant implications for older individuals and for those athletes involved in enduranc P current knowledge on the effects of such exercise upon the immune function has been limited to incremental exercise a oposed that immuno-suppression may result from over-training (Mackinnon 2000), possibly from the immuno-suppressive action of high concentrations of cortisol, and decreased m centrations (Gleeson et al., 1999;Pyne et al., 2000). Others have suggested that high volume/high intensity "excessive" training might impair lymphocyte activation (Mooren et al., 2001b). ...
... Furthermore, Pyne et al. (2000) assessed the immunoglobulin concentrations in highly trained swimmers and untrained individuals during preparation for the 1998 Commonwealth Games. Salivary IgA , IgM and IgG levels were measured as indicators of mucosal immune defences. ...
... The effect on performance was trivial for female swimmers, but had a modest negative effect on male swimmers (Pyne et al., 2005). However, we should consider that although the slight performance decrements associated with URS are small and often do not reach statistical significance, they may be sufficient to make the difference between a gold medal and finishing off the podium (Pyne et al., 2001). ...
... Self-reported URS, irrespective of origin, are a significant economic and social burden, causing absence from work, education and athletic training, poorer performance in work-related tasks (Smith, 2012), and performance decrements in athletic competition (Pyne et al., 2005;Pyne et al., 2001). Thus, in Chapter 4 ...
Since early studies investigated the influence of exercise on salivary secretory IgA (SIgA) in the 1980s, there has been demand for non-invasive biomarkers capable of monitoring the immune response to exercise, training and stress, and provide insight into whether such stressors may influence susceptibility to URTI. In spite of >30 years of research and ~200 original articles investigating a multitude of candidate markers, this tool remains elusive. Transmission of URTIs has been demonstrated via the nasal and ocular mucosae, so maintainence of a strong ‘first line of defence’ at mucosal surfaces is likely important for host defence. Tear fluid has been recently highlighted as a non-invasive medium for assessment of hydration status (through determination of tear osmolarity) and blood glucose concentrations (via glucose-sensing contact lenses). Prompted by the search for viable non-invasive immune biomarkers, this thesis set out to explore the potential of tear SIgA to assess immune status. First, in a prospective monitoring study, we demonstrated that tear SIgA secretion falls ~50% during the week before experiencing upper respiratory symptoms (URS), with a 30% reduction in tear SIgA secretion conferring a six-fold increased chance of experiencing URS in the following week. Next, we undertook three studies to explore the influence of everyday stressors on tear SIgA secretion. Both a two-hour bout of moderate intensity exercise and two-minutes of acute psychological stress caused an immediate ~50% decrease in tear SIgA concentration. The observations from the first study suggest that these reductions are of sufficient magnitude to temporarily compromise host defence, in line with the ‘open window’ theory. Dehydration, on the other hand, did not influence tear SIgA secretion. These studies provide the first experimental evidence that tear SIgA has potential as a non-invasive marker of mucosal immune competence that is sensitive to everyday stressors and has utility to assess common cold risk.
... The influence of training load on the immunity status has been the subject of some research in different environments of sporting participation (Gleeson et al 2000, MacKinnon 1997, Neiman 2000, 2001. The immunity parameter most commonly used in these studies was the salivary IgA (sIgA) level. ...
... The immunity parameter most commonly used in these studies was the salivary IgA (sIgA) level. Immune suppression with low values of salivary IgA associated with intense training have been reported, contrasting with na increment of IgA levels associated with moderate exercise (Gleeson et al 2000, MacKinnon 1997, Pyne et al 2001. Some research related to susceptibility to URTI episodes and IgA levels assume that high numbers of URTI episodes seem to be associated with low levels of salivary IgA. ...
Introduction The influence of training load on the immunity status has been the subject of some research in different environments of sporting participation (Gleeson et al 2000, MacKinnon 1997, 2000, Neiman 2000, Pyne et al 2000, 2001). The immunity parameter most commonly used in these studies was the salivary IgA (sIgA) level. Immune suppression with low values of salivary IgA associated with intense training have been reported, contrasting with na increment of IgA levels associated with moderate exercise (Gleeson et al 2000, MacKinnon 1997, 2000, Pyne et al 2001). Some research related to susceptibility to URTI episodes and IgA levels assume that high numbers of URTI episodes seem to be associated with low levels of salivary IgA. The aim of our study was to follow the daily variation of salivary IgA levels, before and after the training sessions, and to monitor the occurrence of URTI episodes during two weeks of different training dynamics within a group of Portuguese elite swimmers Methods Since the group controlled was relatively small, it is assumed that this project is a case study. The athletes studied were four elite Portuguese male swimmers; the control group was composed of five swimming coaches. The training load was assessed by the total volume and the meters swam in each intensity zone (Mujika and al 1995 Chatard and Mujika, 1999). In order to assess the immunity status, saliva samples were collected daily, before and after training sessions, and the salivary IgA concentrations were determined by nephelometry. Symptoms characteristics of upper respiratory infections were controlled daily during this period and in the following two weeks of the study. Results The volume and intensity of the training load of the first (intensive) week were higher than those of the second (recovering) week. The overall sIgA values assume an inverse behaviour than that of the training load – sIgA levels decrease as volume and intensity increase. On the intensive week all swimmers show little variation of sIgA levels while during the recovering week two of them show large variation of sIgA levels. When daily variation of sIgA values was analysed two different behaviours were found: two of the swimmers show high morning values while the other two show high levels after night training sessions. All swimmers show high values of sIgA at the end of the recovering week when the training load is reduced. The swimmer that exhibited the lowest value of sIgA at the beginning of the study had the higher number of URTI episodes and the swimmer with the higher initial value of sIgA had the lowest number of URTI episodes. The control group didn't report any episodes of URTI but had lower values of sIgA when compared to the elite swimmers.
... Numerous studies have proposed a correlation between the risk of upper respiratory tract infections and SIgA levels, particularly when combined with other antimicrobial proteins present in the saliva, such as amylase, defensins, lysozyme, and lactoferrin [19]. For athletes, contracting upper respiratory tract infections can have detrimental effects on their training regimens and performance capabilities [20,21]. Some scientific studies have investigated how acute exercise stress influenced the mucosal immune system, finding a temporary decrease in the level of SIgA after a session of intense exercise [20,[22][23][24][25]. ...
Featured Application: Monitoring salivary biomarkers demonstrates a potential application to assess the internal training load and recovery status of elite futsal players during congested competition periods, especially total protein and salivary immunoglobulin A. Tracking biomarker changes provides a practical tool for coaching staff to guide adjustments to training loads, nutrition , and recovery protocols to mitigate risks and optimize athlete performance and health.
Abstract: A congested match and training schedule could alter internal load, and this could be reflected in biomarkers of stress and immunity in elite futsal players. The aim of this study was to analyze the effects of a congested match and training schedule on internal load and levels of total protein, total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index, and the concentrations of salivary immunoglobulin A (SIgA) in 17 professional players from the same Portuguese elite futsal club (age: 23.07 ± 6.76 years old; height: 1.75 ± 0.06 m; body mass: 75.47 ± 7.47 kg; experience in playing in elite: 5.38 ± 2.03 years) who performed 5 matches and 16 training sessions in a period of 27 days. The salivary content of total protein, TOS, TAC, oxidative stress index, and SIgA were calculated before and after the training sessions and the unofficial matches under study. Saliva sampling was conducted 10 min before each match or training session and 40 min after (post-match and post-training). The MANOVA of repeated measures showed a significant difference for total protein and SIgA (p < 0.01). Total protein (sphericity = 0.007; statistical power = 0.818) and SIgA (sphericity = 0.018; statistical power = 0.693) are highly correlated with the time factor. The main findings revealed several key points: (a) There was a significant increase in total protein, SIgA, and TAC during acute load (pre-vs. post-session) in both training and match contexts. Specifically, total protein and SIgA displayed notable increments in both training and match settings, while TAC exhibited significant increases exclusively during matches. (b) No changes in TOS and oxidative stress index were observed during acute load in either training or match contexts. (c) A positive trend was noted between the chronic load during a congested week of the precompeti-tive season and the decrease in total protein and SIgA levels. (d) Additionally, a positive correlation between internal training loads and oxidative/antioxidant responses was found, as expressed by the oxidative stress index, without significant differences (p-value > 0.05) in acute and chronic loads during congested matches and training schedules.
... The effects of stressful events on mucosal immune responses have been widely analysed during inflammatory conditions in different species. Especially salivary IgA has been extensively studied in this context with contradictory results as there have been increases, decreases, or no changes in different studies [15][16][17][18][19]. Variable results have also been reported in fecal IgA concentrations [20][21][22][23][24]. Stressful situations like exercise, transport, hospitalization, surgery, and pain can regulate the mucosal immune system through two ways [25][26][27][28]. ...
... OR "motor skill" OR "sensory motor performance" OR "coordination" OR "motor coordination") )) NOT TS=((COPD OR "chronic obstructive pulmonary disease" OR cancer OR animal* OR HIV OR "human immunodeficiency virus" OR AIDS OR "acquired immunodeficiency syndrome" OR postoperative OR preoperative OR radiation OR food OR "Bone Density" OR "Bone Remodeling" OR "Intramuscular Absorption" OR "Taxis Response" OR "Chemotaxis" OR "Escape Reaction" OR Phototaxis OR "Flight, Animal" OR "Freezing Reaction, Cataleptic" OR "Immobility Response, Tonic" OR "Organ Motion" OR "Uterine Contraction" OR "Musculoskeletal Development" OR "Posture" OR "cystic fibrosis" OR chronic OR heat OR cold OR "Bovine Respiratory Disease Complex") ) Pyne et al. (2000) [1] Weidner, Anderson et al. (1997) [2] Fricker et al. (2005) [3] Van Tonder et al. (2016) [4] Cunniffe et al. (2011) [5] He et al. (2013) [6] Marinkovic et al. (2016) [7] Weidner et al. (1997) [8] Crameri et al. (2020) [ 9] Fikenzer et al. (2021) [10] Costello et al. (2021) [11] Komici et al. (2021) [12] Wagemans et al. (2021) [13] Csulak et al. (2021) [14] Anastasio et al. (2021) [15] Savicevic et al. (2021) [16] Vaudreuil et al. (2021) ...
Acute respiratory infections (ARinf) are common in athletes, but their effects on exercise and sports performance remain unclear. This systematic review aimed to determine the acute (short‐term) and longer‐term effects of ARinf, including SARS‐CoV‐2 infection, on exercise and sports performance outcomes in athletes. Data sources searched included PubMed, Web of Science and EBSCOhost, from January 1990 to 31 December 2021. Eligibility criteria included original research studies published in English, measuring exercise and/or sports performance outcomes in athletes/physically active/military aged 15–65 years with ARinf. Information regarding the study cohort, diagnostic criteria, illness classification and quantitative data on the effect on exercise/sports performance were extracted. Database searches identified 1707 studies. After full‐text screening, 17 studies were included ( n = 7793). Outcomes were acute or longer‐term effects on exercise (cardiovascular or pulmonary responses), or sports performance (training modifications, change in standardised point scoring systems, running biomechanics, match performance or ability to start/finish an event). There was substantial methodological heterogeneity between studies. ARinf was associated with acute decrements in sports performance outcomes (four studies) and pulmonary function (three studies), but minimal effects on cardiorespiratory endurance (seven studies in mild ARinf). Longer‐term detrimental effects of ARinf on sports performance (six studies) were divided. Training mileage, overall training load, standardised sports performance‐dependent points and match play can be affected over time. Despite few studies, there is a trend towards impairment in acute and longer‐term exercise and sports outcomes after ARinf in athletes. Future research should consider a uniform approach to explore relationships between ARinf and exercise/sports performance.
PROSPERO (CRD42020159259)
... These results suggest many symptoms indicative of an infection could be due to allergy or some other non-specific inflammatory stimuli. Evidence has revealed that only a small percentage of athletes experience recurrent infection symptoms, 107 an observation that has led to a search for common traits among susceptible individuals. Colbey et al. 108 found that athletes who reported symptoms for two or more days a month were high expressors of interferon alpha inducible protein 27 (IFI27). ...
The single stranded RNA virus SARS-CoV-2 has caused a massive addition to the already leading global cause of mortality, viral respiratory tract infections. Characterized by and associated with early and deleteriously enhanced production of pro-inflammatory cytokines by respiratory epithelial cells, severe COVID-19 illness has the potential to inflict acute respiratory distress syndrome and even death. Due to the fast spreading nature of COVID-19 and the current lack of a vaccine or specific pharmaceutical treatments, understanding of viral pathogenesis, behavioral prophylaxis, and mitigation tactics are of great public health concern. This review article outlines the immune response to viral pathogens, and due to the novelty of COVID-19 and the large body of evidence suggesting the respiratory and immune benefits from regular moderate intensity exercise, provides observational and mechanistic evidence from research on other viral infections that suggests strategically planned exercise regimens may help reduce susceptibility to infection, while also mitigating severe immune responses to infection commonly associated with poor COVID-19 prognosis. We propose that regular moderate intensity exercise should be considered as part of a combinatorial approach including widespread hygiene initiatives, properly planned and well-executed social distancing policies, and use of efficacious facial coverings like N95 respirators. Studies discerning COVID-19 pathogenesis mechanisms, transfer dynamics, and individual responses to pharmaceutical and adjunct treatments are needed to reduce viral transmission and bring an end to the COVID-19 pandemic.
... change in volume and intensity), or even discontinuation (12) . The higher incidence of URTI in athletes is related to the loss of points in international rankings, general decrease in physical performance, fatigue symptoms and fewer of gold medals in international competitions (13)(14)(15) . In this sense, the higher prevalence of diseases of the upper respiratory tract during pre-competitive and competitive periods can increase up to 3 times the chance of impairment of physical performance, so for those with lower incidence of URTI present higher results in international competitions, when compared to the "unhealthy" (13) . ...
The upper respiratory tract infections (URTI) are characterized by symptoms present, mainly, in the nose and pharynx. Physical exercise is one of the factors that can lead to development of URTI, causing a state of immunosuppression during a small-time interval, making the athlete susceptible to development of acute infectious states. Besides its influence in athlete’s quality of life and healthy, the progression of URTI seems to be associated with overtraining state, inducing reduction on physical performance. Several authors have been discussing how the variables of exercise training can alter the incidence and prevalence of URTI, and the present study was developed to present the current knowledge about this tissue, discussing how the modulation in the exercise training variables may interfere in the URTI. Methods: This is a review study. Results: Athletes with different levels of training and different categories in most diverse modalities seem to suffer from symptoms of URTI in training and competitive periods. Increasing of URTI symptoms seems to be related to internal training load and evidence has pointed out that suppression of serum and salivary immunoglobulin concentrations appear to be a factor which influences appearance of these symptoms and may even be used as markers of immune status of athlete. Conclusion: In point of view of reviewed articles, athletes with different levels of training and different categories in most diverse modalities seem to suffer from symptoms of URTI in training and competitive periods. Increasing of URTI symptoms seems to be related to internal training load and evidence has pointed out that suppression of serum and salivary immunoglobulin concentrations appear to be a factor which influences appearance of these symptoms and may even be used as markers of immune status of athlete. However, studies that verify and provide “cutoff points” that indicate a higher risk for URTI onset is still needed.
... These mechanisms are: secretion rate of hormones such as cortisol, Beta Androphine, physical stress, psychological stress, decrease in saliva flow and insufficient exercise intensity [Gleeson 2000;Mackinnon et al. 1992]. The results of the present study are consistent with Dimitriou et al. [2002], Reid et al. [2001], Pyne [2000], McDowell [1991] and one probable reason of this consistency is the low exercise intensity, because, probably this pattern of activity blocks IgA secretion [Dimitriou et al. 2002;McDowell et al. 1992;Pyne et al. 2001;Reid et al. 2001]. ...
... It has also been demonstrated in adult athletes that strenuous training might have an increased risk of infection because of transient immune suppression. [27][28] Chronic low dose exposure of chlorine can induce airway hyperresponsiveness and aggravate allergic Th2 inflammation. 29 Exposure to these chlorine-based chemical compounds can be manifested as clinical symptoms of upper respiratory dysfunction (chronic rhinitis, sneezing, irritated nasal sinuses, runny nose, etc.). ...
BACKGROUND: The aim of this study is to identify seasonal changes in total 25(OH) vitamin D (VD) concentrations and determine its influence on acute upper respiratory tract infection (URTI) morbidity among elite athletes engaged in water sports.
METHODS: The study was planned as a prospective, non-interventional, observational study. Study participants included 40 elite athletes and 30 control individuals. Serum levels of 25(OH) VD and TNF-α, IFN-γ, IL-4 and IL-6 were detected by ELISA technique. Morbidity and frequency of acute URTI in participants were determined by self-reported questionnaire during the year.
RESULTS: The predominance of VD insufficiency was found in both groups of elite athletes and in the control individuals. Prevalence of VD insufficiency/deficiency depends on the season, but independently on the season the highest values were observed among athletes. VD sufficiency was detected in 30% and 13.3% of the control individuals in August and February and only in 10% of swimmers in August. More than 3 episodes of URTI were detected only in the elite athletes in winter-spring. The elevated level of TNF-α, IL-4, IL-6 was detected in all athletes, but more expressed increase was observed in swimmers.
CONCLUSIONS: VD insufficiency is quite pronounced among elite athletes engaged in synchronized swimming and in swimmers. It is accompanied with a decrease of IFN-γ, increase of TNF-α, IL-4 and IL-6 level, and elevation of URTI morbidity. Seasonal monitoring and correction of the VD level for normalization of cytokine profile and decrease of URTI morbidity is definitely advised.
Clinical Trial Registration ID #NCT03623763
... L'immunoglobuline A salivaire (sIgA) est l'un des marqueurs de l'implication immunitaire les plus étudiés dans le champ des sciences du sport, puisqu'elle serait très fortement reliée aux risques d'infections respiratoires, de l'anglais « Upper Respiratory Tract Infection » (URTI) (Bishop & Gleeson, 2009 ;Mortatti et al., 2012). Ces infections sont connues pour affecter négativement la performance (Gleeson et al., 1995 ;Pyne et al., 2001). Différents auteurs ont observé une corrélation entre la réduction des charges d'entraînement et la réduction de sIgA et des symptômes d'URTI (Fredericks et al., 2012 ;Mortatti et al., 2013), alors que d'autres ont démontré que sIgA tendait à décroître trois jours avant l'apparition de symptômes d'URTI (Nakamura et al., 2006), ou encore qu'une baisse d'environ 28% de sIgA apparaîtrait pendant les trois semaines précédant la contraction d'URTI (Neville et al., 2008). ...
Le football moderne est caractérisé par des efforts intermittents de très haute intensité. Pendant un match, les joueurs réalisent des performances, qu'elles soient physiques ou techniques, en lien direct avec la spécificité de leur poste de jeu, leur rôle tactique et leur positionnement sur le terrain. Un match de football de haut niveau induit des variations de fréquence cardiaque, une baisse de réserves énergétiques, une augmentation des dommages musculaires, du stress oxydatif et une affectation du statut immunitaire. Incidences physiologiques auxquelles se rajoutent des modifications de perception de la fatigue, des douleurs musculaires, du bien-être, de la qualité du sommeil, du stress psychologique et de l'humeur. Toutes ces incidences se mesurent, se quantifient et s'analysent en lien direct avec des facteurs contextuels comme le lieu du match, le moment de la journée, le système de jeu, …, et les périodes d'enchainement de match (e.g. deux à trois matchs par semaine) qui peuvent avoir une influence significative. La présente thèse a pour objectif principal l'étude de l'influence de l'enchainement de matchs sur les performances physiques et sur les cinétiques de récupération mesurées sur des marqueurs sanguins, salivaires et des questionnaires de perception, sur des joueurs de football de haut-niveau
... 13,14 s-IgA is one of the most reported and widely used markers of immunological status during physical activity based on its risk relationship with URTI, 12 which has recently been reported to negatively affect physical performance. 15 More recently, the relationship between TL reduction and reductions in s-IgA and URTI symptoms has been recorded in futsal players. 16 Moreira et al. 6 also found that a 70-min training match induced a decrease in s-IgA levels in association with a high reported variability of responses among the players. ...
The aim of this investigation was to examine the salivary IgA (salivary immunoglobulin-A), RPE and pre-training wellness status across an international qualification and finals campaign. Data were collected for 37 elite male international soccer players (mean ± standard deviation, age: 24.9 ± 3.3 years; height: 182.5 ± 6 cm; mass: 73.1 ± 6.2 kg; positions: Goalkeeper, Center Defender, Wide Defender, Center Midfield, Wide Forward, and Center Forward) across two consecutive seasons. Training RPE, wellness questionnaire, and saliva samples were taken throughout the Euro 2016 qualifying and finals campaign. Results revealed how Readiness and Total Wellness (r = −0.28, p < 0.05) correlated to salivary immunoglobulin-A, in the day preceding games (MD−1). No correlation between wellness and salivary immunoglobulin-A was observed in MD−4; however, Energy correlated to salivary immunoglobulin-A between MD−3 and MD (from r = −0.18 to −0.22, p < 0.05), with significance observed between RPE and Total Wellness r = −0.22 (Total Wellness), r = −0.21 (Energy), r = −0.17 (Readiness), and r = −0.24 (Lower Body Soreness) (p < 0.05). It can be concluded from the data that all wellness markers except Sleep correlated to salivary immunoglobulin-A. Furthermore, it was revealed that Energy appeared to be the greatest wellness assessment marker related to salivary immunoglobulin-A. As a result of this specific investigation, it can be confirmed that the use of a pre-training subjective Wellness questionnaires may be a useful tool to monitor individual mucosal immunity response to training.
... Elite athletes frequently present with sino-nasal symptoms, which may negatively impact athletic performance and/or recovery. 57,58 The choice of treatment may depend on the severity of the symptoms and the initiating trigger responsible for the symptoms. Additionally, in order to remain in compliance with World Anti-Doping Agency (WADA) mandates, athletes with sino-nasal problems and treating providers must be cognizant of several medications which require therapeutic use exemptions 59 ( Table 1). ...
Physical exercise requires proper function of the upper and lower airways in order to meet exertional ventilatory requirements. Athletes performing frequent intensive exercise experience more sino-nasal symptoms and demonstrate objective decreases in sino-nasal function when compared with the general population. Sino-nasal dysfunction is known to interfere with sport performance. Nasal epithelial injury, neutrophilic influx, and decreased mucociliary clearance have been associated with intensive training. In this review, the authors provide a comprehensive overview of the prevalence of sino-nasal disease in athletes, the possible underlying pathophysiologic mechanisms, and a summary of diagnostic and treatment options.
... While the frequency of infectious URS in athletes is comparable to the general population, the timing does not follow typical seasonal fluctuations [4]. This pattern indicates that factors specific to the type of exercise and athlete behaviour can alter susceptibility to URS, particularly as episodes appear more frequently during periods of increased training load and around competition [5]. Successful competitive performance for an elite athlete is often determined by the narrowest of margins. ...
Upper respiratory symptoms remain the most common illness in athletes. Upper respiratory symptoms during heavy training and competition may impair performance. Preventing illness is the primary reason for the use of supplements, such as probiotics and prebiotics, for maintaining or promoting gut health and immune function. While exercise-induced perturbations in the immune system may increase susceptibility to illness and infection, growing evidence indicates that upper respiratory symptoms are related to a breakdown in the homeostatic regulation of the mucosal immune system of the airways. Balancing protection of the respiratory tract with normal physiological functioning requires dynamic orchestration between a wide array of immune parameters. The intestinal microbiota regulates extra-intestinal immunity via the common mucosal immune system and new evidence implicates the microbiota of the nose, mouth and respiratory tract in upper respiratory symptoms. Omics’ approaches now facilitate comprehensive profiling at the molecular and proteomic levels to reveal new pathways and molecules of immune regulation. New targets may provide for personalised nutritional and training interventions to maintain athlete health.
... This trend has also been noted in marathon running (40), triathlon (64), 60-minute cycle races (72), and a taekwondo competition (5). Finally, the incidence of upper respiratory tract illness (URTI) is associated with increases in training load and a reduction in SIgA levels (38,50,58). This association is supported by longitudinal studies examining triathletes (38), swimmers (23), kayakers (42), distance runners (43), football players (18), and rowers (50). ...
As yet, no studies have characterised fencing competitions. Therefore in elite male foilists and across two competitions, we investigated their countermovement jump (CMJ) height, testosterone (T), cortisol (C), alpha-amylase (AA), immunoglobulin A (IgA), heart rate (HR), blood lactate (BL) and rating of perceived exertion (RPE). Average (± SD) scores for RPE, BL and HR (average, max and percentage of time ≥ 80% HRmax) were highest in the knockout bouts compared to poules (8.5 ± 1.3 vs. 5.7 ± 1.3, 3.6 ± 1.0 vs. 3.1 ± 1.4 mmol/L, 171 ± 5 vs. 168 ± 8 bpm, 195 ± 7 vs. 192 ± 7 bpm, 74 vs. 68%) however, only significant (p < .05) for RPE. CMJ height, albeit non-significantly (p > .05), increased throughout competition and dropped thereafter. While responses of C, AA and IgA showed a tendency to increase during competition and drop thereafter (T and T:C doing the opposite), no significant differences were noted for any analyte. Results suggest that fencing is a high-intensity anaerobic sport, relying on alactic energy sources. However, some bouts evoke BL values of ≥ 4 mmol/L and thus derive energy from anaerobic glycolysis. High HR's appear possible on account of ample within and between-bout rest. The small competition load associated with fencing competitions may explain the non-significant findings found.
... It is believed that athletes who are free from illness prior to and during the competition are likely to perform better than their peers with illness. 2 This is because infection/ illness may result in fever and dehydration, decrease energy and protein storage, decrease muscle strength, less motivation, and lead to stress. Therefore, athletes, coaches, and fitness enthusiasts are very concerned regarding this matter. ...
Introduction: Lysozyme is one of the salivary antimicrobial proteins which act as the “first line of defence” at the mucosal surface. The effects of prolonged exercise in the hot and cool environments among recreational athletes on salivary lysozyme responses are very limited in the literature, especially in the Asian countries.
Objective: To determine the effects of prolonged running in the hot and cool environments on selected physiological parameters and salivary lysozyme responses among recreational athletes.
Methods: Randomised and cross-over study design. Thirteen male recreational athletes (age: 20.9 ± 1.3 years old) from Universiti Sains Malaysia participated in this study. They performed two separate running trials; 90 min running at 60% of their respective maximum oxygen uptake (V˙O2max) One running trial was performed in the hot (31ºC) while the other was in the cool (18ºC) environment and this sequence was randomised. Each running trial was started with a 5 min warm-up at 50% of participant's respective V˙O2max Recovery period between these two trials was one week. In the both trials, saliva samples, blood samples, heart rate, ratings of perceived exertion, skin and tympanic temperatures, oxygen consumption, nude body weight, room temperature, and relative humidity were collected.
Results: Participants' skin temperature, tympanic temperature, body weight changes, heart rate, ratings of perceived exertion, and plasma volume changes were significantly higher (p
... Salivary IgA (sIgA) is one of the most investigated markers of immunological involvement in physical activity as it might be related to the risk of upper respiratory tract infection (URTI) [107], which is well known to negatively affect training performance [108]. Different authors observed a correlation between a reduction in TL and a reduction in sIgA and URTI symptoms [109]. ...
... In addition to being informative about periodontal disease, secretory IgA serves as a marker of oral inflammation, which can exert an overall system inflammatory response with long-term impact on health (32). sIgA has also been used for diagnosis of dengue viral infection (33) and is a heavily used biomarker in the field of sports medicine (34)(35)(36). Other oral immune metrics take advantage of the presence of viral infection (e.g., herpes simplex virus) and bacterial activation (e.g., streptococcus) in saliva (37). ...
Saliva is an emerging biofluid with a significant number of applications in use across research and clinical settings. The present paper explores the reasons why saliva has grown in popularity in recent years, balancing both the potential strengths and weaknesses of this biofluid. Focusing on reasons why saliva is different from other common biological fluids such as blood, urine, or tears, we review how saliva is easily obtained, with minimal risk to the donor, and reduced costs for collection, transportation, and analysis. We then move on to a brief review of the history and progress in rapid salivary testing, again reviewing the strengths and weaknesses of rapid immunoassays (e.g., lateral flow immunoassay) compared to more traditional immunoassays. We consider the potential for saliva as an alternative biofluid in a setting where rapid results are important. We focus the review on salivary tests for small molecule biomarkers using cortisol as an example. Such salivary tests can be applied readily in a variety of settings and for specific measurement purposes, providing researchers and clinicians with opportunities to assess biomarkers in real time with lower transportation, collection, and analysis costs, faster turnaround time, and minimal training requirements. We conclude with a note of cautious optimism that the field will soon gain the ability to collect and analyze salivary specimens at any location and return viable results within minutes.
... Distinct studies have evaluated the relation between salivary IgA and different stressful circumstances, providing inconsistent results. There are some reports of stress-related decreases in IgA and others of increases or no change in this parameter [22][23][24][25][26]. One study [27] demonstrated that dexamethasone (a synthetic glucocorticoid), when administered to intact and adrenalectomized-ovariectomized rats, lowers pIgA levels in mucosal secretions and enhances them in serum. ...
Stress stimuli affect the immune system responses that occur at mucosal membranes, particularly IgA secretion. It has been suggested that acute stress increases the levels of IgA and that sympathetic innervation plays an important role in this process. We herein explore in a murine model how acute stress affects the Th1/Th2/Treg cytokine balance in NALT, and the possible role of glucocorticoids in this effect. Nine-week-old male CD1 mice were divided into three groups: unstressed (control), stressed (subjected to 4 h of immobilization), and stressed after pretreatment with a single dose of the corticosterone receptor antagonist RU-486. The parameters evaluated included plasma corticosterone and epinephrine, IgA levels in nasal fluid (by ELISA), the percentage of CD19⁺B220⁺IgA⁺ lymphocytes and CD138⁺IgA⁺ plasma cells, and the mRNA expression of heavy α chain, J chain and pIgR. Moreover, the gene and protein expression of Th1 cytokines (TNFα, IL-2 and INF-γ), Th2 cytokines (IL-4 and IL-5) and Treg cytokines (IL-10 and TGFβ) were determined in nasal mucosa. The results show that acute stress generated a shift towards the dominance of an anti-inflammatory immune response (Th2 and Treg cytokines), evidenced by a significant rise in the amount of T cells that produce IL4, IL-5 and IL-10. This immune environment may favor IgA biosynthesis by CD138⁺IgA⁺ plasma cells, a process mediated mostly by glucocorticoids.
... This situation may cause the suppression of the immune system and may lead to an increase of the risk for greater incidence of upper respiratory tract infections (URTI) (Bishop and Gleeson, 2009). It has been demonstrated in athletes that strenuous training might have an increased risk of infection because of transient immune suppression Pyne et al., 2001). In judo, there are some reports on the effect of training sessions such as the increase of neutrophil and myogenic enzymes serum con-centration after training sessions Yaegaki et al., 2008). ...
The objective of this study was to examine the internal training load (TL), IgA, and salivary steroid hormone responses in elite youth judo athletes during an entire annual training periodization. Ten male judo athletes (18?2 years, 72.3?12.3 kg, and 175?6 cm) competing at a state/national level were examined for the TL and salivary imune-endocrine responses variations over an annual judo season, divided in three macrocyles composed by distinct periods denominated preparatory period (PP), competitive period (CP) and transition period (TP). At the end of PP and CP, saliva samples were collected to determine cortisol, testosterone and IgA concentrations. Throughout PP and CP the session-rating of perceived exertion and the total duration of each session were monitored, allowing the internal TL and weekly training strain (TS) calculation. During all macrocycles, significant decreases in TL and TS were observed during CP compared with PP (P<0.05), although no significant differences were observed for immune-endocrine concentrations between PP and CP (P>0.05). Specific variations were observed comparing periods with similar characteristics throughout the macrocycles as higher TL and TS (PP1 to PP2 and PP3, P<0.05), increased testosterone (CP1 to CP3, P=0.024) and decreased testosterone-cortisol ratio (PP1 to PP2, P=0.005). The present findings suggest that the internal TL variations over an annual multipeak traditional periodization did not influence the resting mucosal immune-endocrinal responses in young judo athletes.
... The closest link that has been shown has been in the work of exercise immunologists of the Australian Institute of Sport and University of Queensland who were able to show that a decrease in salivary immunoglobulin (IgA) concentration is associated with a corresponding enhanced infection incidence in elite, overtrained swimmers and kayakers. 12,[16][17][18][19]65 However, the recent debate regarding the validity of the practise of expressing salivary IgA as a function of salivary total protein or albumin concentrations when these have different origins, 3 makes explanation of the results elusive and leaves exercise immunologists with little alternative but to acknowledge that the transient suppression of markers of immune function which have been reported in the last two decades may not be of clinical significance. ...
Despite more than 20 years of research into mechanisms which could result in the increased predisposition of athletes to ‘infection' incidence following excessive and prolonged exercise, definitive explanations are not yet available. A strong temporal relationship between the incidence of upper respiratory tract infection symptoms and immune system changes following excessive exercise load (EEL) have not been shown. T-helper cells are functionally polarised according to the cytokines which they produce. While exercise-induced upregulation of T-helper- 2 (TH2) cells and type 2 cytokines is indicative of enhanced activation of allergic responses, downregulation of T-helper-1 (TH1) cells and type 1 cytokines confirms suppression of cellular immune functions. The current knowledge regarding the exercise-induced kinetics of interleukin (IL)-4, a cytokine that is crucial in the activation of the TH2 cells, does, however, not appear to provide sufficient support for an upregulation of a type 2 response. Lowered or unchanged circulating concentrations of type1 cytokines (IL12, IL-2 and interferon γ) and short-term suppression of lymphocyte, natural killer cell and neutrophil function following EEL, reflect a transient, post-exercise suppression of cellular immunity. Despite a partial dampening thereof by the anti-inflammatory actions of IL-10, IL-1ra and IL-6, the evidence supporting a pro-inflammatory response to prolonged exercise and overtraining is unequivocal. At present, the data appear to support the theory that symptoms of ‘infection' experienced by athletes are the manifestation of a significant pro-inflammatory response, combined with a modest, transient suppression of cellular immune functions which may be clinically insignificant. South African Journal of Sports Medicine Vol.16(1) 2004: 3-9
... The stress of intense training of college swimmers can result in physiologic changes that predispose them to frequent upper respiratory infections (URIs). Studies have reported URI incidences of 42-45% during training periods ranging from 4 to 12 weeks [1][2][3] while other studies showed an 8-week incidence of respiratory illness of 84% [4]. These ill effects can be thwarted by the practice of reflective exercise (RE, a westernized form of Qigong) [5] shown by a reduction of URIs in varsity swimmers who maintained practice [6]. ...
. Athletes who develop an immunosuppressed state because of intensive training get upper respiratory infections (URIs) and may respond to meditation. Reflective exercise (RE), a westernized form of Qigong, combines meditation, breathing, and targeted mental attention to an internal pulsatile sensation, previously shown to protect varsity swimmers from URIs during the height of training. We report here the evaluation of cardiovascular parameters measured during meditation combined with targeted imagery (interoception) in a cohort of varsity swimmers taught RE.
Methods
. Thirteen subjects were enrolled on a prospective protocol that used the CareTaker, a noninvasive cardiovascular monitor before, during, and after RE training. Questionnaires regarding targeted mental imagery focusing on a pulsatile sensation were collected. The cardiovascular parameters include heart rate, blood pressure, and heart rate variability (HRV).
Results
. Increased variance in the subjects’ BP and HRV was observed over the training period of 8 weeks. In nine subjects there was an increased low frequency (LF) HRV that was significantly (
p
<
0.05
) associated with the subject’s awareness of the pulsatile sensation that makes up a basic part of the RE practice.
Summary
. These data support further evaluation of HRV measurements in subjects while meditating with mental imagery. This direction could contribute to better understanding of neurocardiac mechanisms that relate meditation to enhanced immunity.
... When over 20 points, it indicates a state of fatigue. These measurements allowed to distinguish a 3-wk overreaching period (weeks[19][20][21] and an 11-wk overtraining period (weeks[35][36][37][38][39][40][41][42][43][44][45]. ...
More than three quarters of all competitive swimming events are completed in less than two and a half minutes by athletes of at least national class. To prepare for these events, coaches manipulate training load (usually described as a combination of volume, intensity, frequency, and dry-land training) at various times of the season in an attempt to prepare their swimmers to peak just at the right time. Leading into competition, there is usually a phase of high load training followed by some kind of tapering (reduced load) program. Scientific data support bigger performance gains through a program based on high intensity and low volume prior to a high-load phase and taper phase leading into competition. Individual athletes will respond differently to such fluctuations in training load and will depend on parameters such as training status at the time and performance level. Individual responses can be monitored using simple observational or monitoring techniques, regression analysis, or with the help of a systems model. These analytical processes may be useful tools to establish individualized training programs.
... Team sport athletes are at increased risk of immune suppression, consequently increasing their susceptibility to symptoms of infection (9,10,12). Incidences of illnesses and infections, most commonly upper respiratory tract infections (URTI) are consequential to exhaustive exercise, particularly when accompanied with stressors of competition and additional travel demands (3,15). In turn, this can provide decrements in performance that are associated with the systemic acute phase reaction such as fever (4). ...
... The closest link that has been shown has been in the work of exercise immunologists of the Australian Institute of Sport and University of Queensland who were able to show that a decrease in salivary immunoglobulin (IgA) concentration is associated with a corresponding enhanced infection incidence in elite, overtrained swimmers and kayakers. 12,[16][17][18][19]65 However, the recent debate regarding the validity of the practise of expressing salivary IgA as a function of salivary total protein or albumin concentrations when these have different origins, 3 makes explanation of the results elusive and leaves exercise immunologists with little alternative but to acknowledge that the transient suppression of markers of immune function which have been reported in the last two decades may not be of clinical significance. ...
Despite more than 20 years of research into mechanisms which could result in the increased predisposition of athletes to ‘infection' incidence following excessive and prolonged exercise, definitive explanations are not yet available. A strong temporal relationship between the incidence of upper respiratory tract infection symptoms and immune system changes following excessive exercise load (EEL) have not been shown. T-helper cells are functionally polarised according to the cytokines which they produce. While exercise-induced upregulation of T-helper- 2 (TH2) cells and type 2 cytokines is indicative of enhanced activation of allergic responses, downregulation of T-helper-1 (TH1) cells and type 1 cytokines confirms suppression of cellular immune functions. The current knowledge regarding the exercise-induced kinetics of interleukin (IL)-4, a cytokine that is crucial in the activation of the TH2 cells, does, however, not appear to provide sufficient support for an upregulation of a type 2 response. Lowered or unchanged circulating concentrations of type1 cytokines (IL12, IL-2 and interferon γ) and short-term suppression of lymphocyte, natural killer cell and neutrophil function following EEL, reflect a transient, post-exercise suppression of cellular immunity. Despite a partial dampening thereof by the anti-inflammatory actions of IL-10, IL-1ra and IL-6, the evidence supporting a pro-inflammatory response to prolonged exercise and overtraining is unequivocal. At present, the data appear to support the theory that symptoms of ‘infection' experienced by athletes are the manifestation of a significant pro-inflammatory response, combined with a modest, transient suppression of cellular immune functions which may be clinically insignificant. South African Journal of Sports Medicine Vol.16(1) 2004: 3-9
... Several studies of athlete populations have shown that engaging in long-term strenuous training leads to a reduction of sIgA levels [9,10] with monitoring sIgA crucial for identifying the risk of infection in elite athletes [11]. Typically, sIgA levels in healthy elite able-bodied swimmers range between 43 μg/ml and 136 μg/ml at rest with illness causing a drop to between 22 μg/ml and 92 μg/ml [12,13,14]. While sIgA provides a quick and effective marker of athlete immune function [11], it may not be sensitive enough to identify training induced stress [15]. ...
The purpose of this study was to a) determine the heart rate variability (HRV) and saliva markers of immunity (salivary immunoglobulin A; sIgA) and stress (salivary alpha-amylase; sAA) responses to chronic training in elite swimmers with a disability; and b) identify the relationships between HRV, sIgA, sAA and training volume. Eight members of a high performance Paralympic swimming program were monitored for their weekly resting HRV, sIgA and sAA levels in the 14 weeks leading up to a major international competition. The 14 week training program included aerobic, anaerobic, power and speed, and taper training phases, while also incorporating two swimming step tests and two swimming competitions. Specific time (root mean square of the successive differences; RMSSD) and frequency (high frequency normalized units [HFnu]) domain measures, along with non-linear indices (standard deviation of instantaneous RR variability; SD1 and short term fractal scaling exponent; α1) of HRV were used for all analyses with effects examined using magnitude-based inferences. Relationships between HRV and saliva markers were identified by Spearman rank rho (ρ) correlation coefficients. Compared with week 1, SD1 was very likely lower (96/4/0, ES = -2.21), while sAA was very likely elevated (100/0/0, ES = 2.32) at the beginning of week 7 for all athletes. The training program did not alter HRV or saliva whereas competition did. There were also no apparent differences observed for HRV, sIgA and sAA between each of the training phases during the 14 week swimming program. Correlations were observed between sAA and SD1 (ρ = -0.212, p
... Furthermore, athletes who reported recurrent symptoms of URS had a higher training load and a lower salivary SIgA secretion rate than the symptom-free counterparts (Gleeson et al. 2012). URS cluster around competitions and detrimentally affect performance in elite swimmers (Pyne et al. 2001). ...
The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate–vigorous exercise during 2 phases of the 4-week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% peak oxygen uptake for 45 min at 2 time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately postexercise, and 1 h postexercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26% (95% confidence limits (CI) 6–46) lower at postexercise compared with pre-exercise during the synthetic follicular phase (p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8–30) lower at postexercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate–vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise.
... Apesar de nem todos os episódios de autorelatados constituírem verdadeiros casos de infecção, um número significativo deles confirmam esta etiologia [7]. Apesar de todos os inconvenientes alguma investigação publicada defende que este tipo de sintomas, não parece afectar o desempenho em nadadores de elevado rendimento [8][9], sendo mesmo compatíveis com as actividades normais de treino [10]. Os atletas têm necessidade de manter níveis de carga de treino muito exigentes o que provoca regularmente estados de fadiga importantes, para os quais se torna decisivo possuir marcadores da adaptabilidade. ...
Introdução A pesquisa centrada no comportamento de marcadores biológicos associados ao stress e à fadiga tem constituído preocupação recorrente no âmbito das Ciências do Desporto. No entanto, muito deste esforço tem estado predominantemente orientado para os requisitos bio-energéticos que suportam a performance de elevado nível [1-3]. Em desportos de resistência como é o caso da Natação Pura Desportiva (NPD), a metodologia do treino fundamenta-se na estimulação controlada de mecanismos de adaptação relacionados com a eficiência e a economia energética, modelada pela exigência das condições competitivas [4-6]. No entanto a resposta do organismo ao stress induzido pelo treino e pela competição é notoriamente global, implicando na resposta alterações diversas como as que se verificam ao nível hormonal, imunitário, e psicológico. Os programas de treino muito exigentes a que são submetidos os atletas de elite poderão induzir transtornos na adaptação quando não são respeitados condições equilibradas de treinabilidade e cargabilidade. A preservação da saúde dos atletas, nomeadamente os que integram planos de alto rendimento desportivo, é fundamental para que o cumprimento planificado das cargas de treino bem como a sua capacidade competitiva não sejam perturbados. Frequentemente treinadores e atletas reportam a ocorrência de doenças e lesões em períodos de intensificação da carga de treino ou de participação elevada em competições, o que poderá estar provavelmente relacionado com insuficiente recuperação da fadiga induzida neste processo. A percepção da possibilidade de existir uma relação estreita entre a probabilidade de ocorrer um estado de depressão imunitária, como por exemplo uma maior a predisposição para a contracção de infecções nomeadamente as do tracto respiratório superior (ITRS), e a participação em programas de treino especialmente intensos e de grande volume, justifica a existência de esforço nesta linha de investigação. Apesar de nem todos os episódios de auto-relatados constituírem verdadeiros casos de infecção, um número significativo deles confirmam esta etiologia [7]. Apesar de todos os inconvenientes alguma investigação publicada defende que este tipo de sintomas, não parece afectar o desempenho em nadadores de elevado rendimento [8-9], sendo mesmo compatíveis com as actividades normais de treino [10]. Os atletas têm necessidade de manter níveis de carga de treino muito exigentes o que provoca regularmente estados de fadiga importantes, para os quais se torna decisivo possuir marcadores da adaptabilidade. Fundamentalmente importa manter os atletas saudáveis para que possam competir e treinar o seu melhor nível. A monitorização de marcadores imunitários constitui-se como uma das mais importantes estratégias a considerar no controlo da adaptação à carga de treino. [11-18] . Um dos marcadores imunitários que se tem mostrado promissor nesta função é a IgA salivar [19-20]. Este parâmetro assume um papel fundamental na defesa do organismo, em particular no combate às ITRS. Este tipo de afecções constitui o mais frequente em atletas de elevado nível de rendimento. A IgA salivar enquanto parâmetro aparentemente sensível à influência da carga de treino, tem sido objecto de estudo generalizado neste domínio. Existe hoje algum consenso no interesse de monitorizar a IgA salivar em atletas que mostrem ITRS frequentes e tendência para mostrar valores reduzidos de IgA salivar, sobretudo nos momentos de incremento da carga de treino. Esta estratégia conserva, a par da sensibilidade em relação ao objecto, a vantagem do carácter não invasivo, o que pode fazer dela uma potente arma no controlo de um dos aspectos mais negativos associado à fadiga induzida pelo treino [20-21]. Apesar do esforço de investigação que tem vindo a ser feito, ainda não é completamente possível estabelecer uma relação clara entre carga de treino, sistema imunitário e performance [20, 22]. Objectivos O objectivo principal deste estudo foca-se na análise da resposta imunitária ao longo da época desportiva em resposta à variação da carga de treino, considerando os seguintes níveis de informação: 1. A taxa de ocorrência de episódios de ITRS; 2. A variação da IgA salivar controlada semanalmente ao longo da época de inverno; 3. A variação dos parâmetros imunitários sanguíneos Leucócitos, Linfócitos e subpopulações, Imunoglobulinas A, G, M do soro em momentos característicos atendendo ao modelo de periodização utilizada numa época de inverno em nadadores portugueses de nível nacional. Enquanto o recurso a amostras sanguíneas é indispensável para avaliar a resposta imunitária global, o controlo concomitante da IgA salivar, permite de forma menos invasiva controlar o efeito da carga de treino na resposta de um parâmetro imunitário particularmente sensível.
... In particular, salivary Immunoglobulin A (sIgA), the most abundant marker of mucosal immunity, has been shown to decrease in response to prolonged training in adult swimmers [4]. However, another study found no significant changes in sIgA after 15 weeks of training in elite swimmers [5] while there are no such studies in adolescent swimmers. ...
In this study we examined changes in the salivary concentrations of immunoglobulin A (sIgA), cortisol (sC), testosterone (sT), and testosterone-to-cortisol ratio (T/C) in 21 competitive swimmers, 11-15 years old, during a week leading to competition as compared to a control (noncompetition) week. No day-to-day changes or significant differences between weeks were observed for sIgA (47.9 ± 4.4 versus 54.9 ± 5.2 μg/mL for control versus competition week, resp.), sC (2.7 ± 0.2 versus 2.5 ± 0.2 ng/mL for control versus competition week, resp.), and T/C ratio (83.4 ± 7.0 versus 77.9 ± 7.7 for control versus competition week, resp.). In contrast, sT was significantly lower during the week of competition (154.5 ± 11.3 pg/mL) as compared to the control week (181.3 ± 11.5 pg/mL) suggesting that the swimmers were in a catabolic state, although this did not have a negative effect on their performance. In conclusion, salivary cortisol did not change between the two weeks, and thus competition stress was relatively low, and mucosal immunity was unaffected in these young athletes prior to competition.
В магістерській роботі розкрито теоретичні основи впливу тренувального навантаження і способи контролю. Узагальнено систему організації підготовки спортсменів. Проведено моніторинг здійснення комплексного контролю з урахуванням індивідуальних особливостей спортсмена. Розкрито відомі методики встановлення ступеня впливу на організм тренувального навантаження.
Висвітлено проведення комплексного біохімічного контролю для оцінки впливу тренувального навантаження на організм пауерліфтерів. Визначено проблеми наявної системи педагогічного контролю тренувального процесу пауерліфтера. Встановлена інформативність окремих показників біохімічного контролю для тренувального процесу пауерліфтера. Досліджена динаміка окремих показників біохімічного контролю у різних періодах підготовки пауерліфтера.
Objective
To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons.
Design
Systematic review and meta-analysis.
Data sources
Electronic databases: PubMed-Medline, EbscoHost and Web of Science.
Eligibility criteria
Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15–65 years.
Results
Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3).
Summary/conclusions
These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported.
PROSPERO registration number
CRD42020160472.
Objective
To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes.
Design
Systematic review and meta-analysis.
Data sources
PubMed, EBSCOhost, Web of Science, January 1990–July 2020.
Eligibility criteria
Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill.
Results
767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).
Conclusions
In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.
PROSPERO registration number
CRD42020160479.
Exhausting exercise can disturb immune and gastrointestinal functions. Nevertheless, the impact of it on mucosal-associated lymphoid tissue has not been studied in depth. Here, we aim to establish the effects of an intensive training and exhausting exercise on the mucosal immunity of rats and to approach the mechanisms involved. Rats were submitted to a high-intensity training consisting of running in a treadmill 5 days per week for 5 weeks, involving 2 weekly exhaustion tests. At the end, samples were obtained before (T), immediately after (TE) and 24 h after (TE24) an additional final exhaustion test. The training programme reduced the salivary production of immunoglobulin A, impaired the tight junction proteins’ gene expression and modified the mesenteric lymph node lymphocyte composition and function, increasing the ratio between Tαβ+ and B lymphocytes, reducing their proliferation capacity and enhancing their interferon-γ secretion. As a consequence of the final exhaustion test, the caecal IgA content increased, while it impaired the gut zonula occludens expression and enhanced the interleukin-2 and interferon-γ secretion. Our results indicate that intensive training for 5 weeks followed or not by an additional exhaustion disrupts the mucosal-associated lymphoid tissue and the intestinal epithelial barrier integrity in rats.
This review presents current summarized knowledge on definition, causes, symptoms and evidence of overtraining syndrome in athletes. Analysis of biochemical, physiological, endocrine, neuronal and mycological parameters, each of which is potentially involved in understanding of the metabolic aspects of overtraining syndrome, is required to study the latter. The development of overtraining syndrome is explained by numerous hypotheses with their own strengths and weaknesses. Each theory is centered around a key parameter, disbalance of which can lead to overtraining during the execution
of long-term high intensity training loads. Obviously none of isolated markers can be used for diagnostic purposes. A comprehensive approach to explain overtraining syndrome development is provided by a theory of cytokines.
Background:
The aim of this study is to determine seasonal changes of total serum 25(OH) vitamin D (VD) concentration and its influence on upper respiratory tract infection (URTI) morbidity among water sports elite athletes.
Methods:
The study was planned as a prospective, non-interventional, observational study. Study participants included 40 elite athletes and 30 control individuals. Serum levels of 25(OH) VD and TNF-α, IFN-γ, IL-4 and IL-6 were detected by ELISA technique. Frequency of acute URTI in participants was determined by medical cards and self-reported questionnaire during the year.
Results:
VD deficiency/insufficiency dominated in both groups of elite athletes, especially in synchronized swimmers (100%) in comparison with the control individuals (63.3%) (P≤0.05). Prevalence of VD deficiency/insufficiency depends on the season, but independently on the season the highest values were observed among athletes. VD sufficiency was detected in 30% and 13.3% of the control individuals in August and February and only in 10% of swimmers in August. More than 3 episodes of URTI were detected only in elite athletes in winter-spring. The elevation of TNF-α, IL-4, IL-6 and decrease of IFN-γ levels were detected in all athletes, but they were more expressed in swimmers.
Conclusions:
VD insufficiency is quite pronounced among elite athletes engaged in synchronized swimming and swimmers. It is accompanied with a decrease of IFN-γ, increase of TNF-α, IL-4 and IL-6 level, and elevation of URTI morbidity. Seasonal monitoring and correction of the VD level for normalization of cytokine profile and decrease of URTI morbidity is definitely advised.
This review presents current summarized knowledge on definition, causes, symptoms and evidence of overtraining syndrome in athletes. Analysis of biochemical, physiological, endocrine, neuronal and mycological parameters, each of which is potentially involved in understanding of the metabolic aspects of overtraining syndrome, is required to study the latter. The development of overtraining syndrome is explained by numerous hypotheses with their own strengths and weaknesses. Each theory is centered around a key parameter, disbalance of which can lead to overtraining during the execution of long-term high intensity training loads. Obviously none of isolated markers can be used for diagnostic purposes. A comprehensive approach to explain overtraining syndrome development is provided by a theory of cytokines.
In der Immunologie wird die Abwehr einer Infektion durch den Körper untersucht. Der Mensch ist ständig umgeben von Mikroorganismen, die Krankheiten verursachen können. Das Immunsystem vollführt ein geniales Abwehrprogramm, damit der Mensch trotz ständiger Gefahren nur selten krank wird. Darüber hinaus verfügt unser Körper über die Fähigkeit, sich Infektionskrankheiten, von denen wir einmal betroffen waren, zu merken und eine lang andauernde Immunität dagegen zu entwickeln. Dieses Kapitel beschäftigt sich im ersten Teil mit den Grundlagen des Immunsystems sowie dem akut ablaufenden und erworbenen Immunsystem. Im zweiten Abschnitt werden der Einfluss von akuten und länger andauernden sportlichen Belastungen auf das Immunsystem und einige Studien zu diesem Thema beschrieben. Im letzten Teil dieses Kapitels beschäftigen wir uns mit Inaktivität und dessen Einfluss auf Erkrankungen wie Diabetes, Karzinome, Alter usw. Hier spielt das Immunsystem eine tragende Rolle, weil sowohl durch die Inaktivität selbst sowie auch durch diverse Krankheiten die Immunfunktion verändert bzw. beeinträchtigt ist.
The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI) symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1), after the intensified phase (T2), and after tapering (T3). A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; p<0.001), and a significant decrease in salivary immunoglobulin A concentration was detected (F=7.48; p=0.004) at T3 compared to T1 (p=0.02) and T2 (p=0.05). However, there was no significant difference between phases for severity of URTI (χ²= 2.83; p=0.242). The Yo-Yo IR1 test performance increased from T2 and T3 compared to T1 (F=58.24; p<0.001). There was no significant effect of aerobic fitness level on salivary immunoglobulin A response (F=1.095; p=0.344). In summary, the present findings suggest that an intensified training load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.
This chapter is divided into three major parts. The first part covers how exercise is associated with respiratory infection. Exercise’s effect on mucosal immunity, allergic rhinitis and airway inflammation is discussed as well as how certain viruses can affect respiratory infection risk in the athletic population. In the chapter’s second section, the influence of acute exercise on our immune system is explored. More specifically, the alterations in the innate immune system and acquired immune system in response to exercise and the mechanisms leading to these alterations are elucidated. Finally, the third part is on the effects of chronic exercise on the immune system. In this part, the beneficial anti-inflammatory effect of regular physical activity and health implication that this has on prevention and treatment of various diseases, which includes cancer, dementia, cardiovascular and pulmonary diseases, is discussed. In addition, the potential harmful effects of a high-intensity training period are also addressed. There is little research in these areas with resistance-type exercise, and unless stated otherwise, the studies mentioned here are with endurance-type exercise, such as running, rowing, cycling and swimming.
Background:
Respiratory illnesses are a leading cause of morbidity and medical discharge in the military. This study aimed to investigate the effects of baseline aerobic fitness on haematological, salivary and mood variables, and simultaneously, in a novel approach, to identify factors precipitating illness and attrition rate in recruits during military training.
Methods:
Thirty-five healthy male recruits from an Army Training Regiment undertaking 12 weeks of training were prospectively investigated. Their 2.4 km run time (RT) was used as a surrogate of baseline aerobic fitness. Saliva and venous blood samples were analysed for secretory IgA, full blood counts and cell cytokine production (interleukin (IL) 6 and IL-8), respectively. Each recruit completed questionnaires on mood profile, and gastrointestinal and upper respiratory tract symptoms (URTS).
Results:
Significant salivary and haematological perturbations were observed and coincided with increased duration of URTS/week and mood disturbance over this military training period. From Start to End: leucocyte count decreased by 28% (p<0.001); neutrophil percentage (%) decreased by 13% (p<0.01); lymphocyte % increased by 17% (p<0.05); the neutrophil:lymphocyte ratio decreased by 22% (p<0.01); eosinophil% increased by 71% (p<0.01). From Start to Mid to End: monocyte% increased by 68% at Mid (p<0.01) but only by 30% at End (p<0.01); IL-6 increased by 39% at Mid (p<0.01) and a further 61% by End. The 2.4 km RT was significantly associated with URTS duration (p<0.01). In addition, a 1-min increase in 2.4 km RT increased a recruit's risk 9.8-fold of developing URTS lasting, on average, 3.36 days/week. In recruits ranked with high-URTS duration their RT was 48 s slower (p<0.01) than those with low-URTS, and their attrition rate reached 45%.
Conclusions:
The least fit recruits may have found training more physically demanding as reflected in the higher URTS duration, which may have led to a high attrition rate from the Army. It is worth considering that baseline aerobic fitness might be an important factor in illness development and attrition rate in recruits during this type of military training.
Scope and Purpose: Athletes are susceptible to upper respiratory tract infections during intensive trainings, as well as during the first or the second week after participating in the long-distance road cycling competitions. Therefore, the influence of duration of such cycling on amounts of immunoglobulin in blood of cyclists was studied in this research. Materials and Methods: 16 professional cyclists between the ages 17_20 and with the average height and weight of 168 cm and 59 kg, respectively, were divided into two groups of eight. The first group was riding for 1 and the second one for 3 hours. To measure the amounts of IgA and IgG, the blood samples of these two groups were gathered both before and immediately after the activity. The data were then analyzed through a correlated T-test and an independent one. Results: The findings showed that there was not a significant reduction in the secretory immunoglobulin A and G in the first group considering the samples before and after the activity (α = 0.05). But there existed a significant reduction of secretory immunoglobulin A and G for the second group after the 3-hour activity (α = 0.05). Discussion: According to these results, there is a significant fall in the levels of immunoglobulin A and G right after the long-distance cycling of higher duration and the athletes may be susceptible to upper respiratory tract infections during intensive trainings as well as the first or the second week after participating in the long-distance competitions.
The present review examines the effects of exercise on mucosal immunity in recreational and elite athletes and the role of mucosal immunity in respiratory illness. Habitual exercise at an intense level can cause suppression of mucosal immune parameters, while moderate exercise may have positive effects. Saliva is the most commonly used secretion for measurement of secretory antibodies in the assessment of mucosal immune status. Salivary IgA and IgM concentrations decline immediately after a bout of intense exercise, but usually recover within 24 h. Training at an intense level over many years can result in a chronic suppression of salivary immunoglobulin levels. The degree of immune suppression and the recovery rates after exercise are associated with the intensity of exercise and the duration or volume of the training. Low levels of salivary IgM and IgA, particularly the IgA1 subclass, are associated with an increased risk of respiratory illness in athletes. Monitoring mucosal immune parameters during critical periods of training provides an assessment of the upper respiratory tract illness risk status of an individual athlete. The mechanisms underlying the mucosal immune suppression are unknown.
The aim of this study was to investigate the effects of acute aerobic and anaerobic exercise on humoral immune system parameters (IgA, IgG, IgM, C3, C4) in elite sportsman. Forty elite volleyball players and twenty healthy age-matched sedentary subjects were enrolled in this study. Subjects in the exercise group were randomly divided into two groups. Twenty athletes forming Group 1 (G1) performed 30-minutes of aerobic exercise on treadmill after determination of workload using the Karvonen protocol. Twenty athletes forming Group 2 (G2) performed anaerobic exercise for 30 seconds according to the Wingate test protocol. The sedentary subjects were enrolled as the control group. Blood samples were obtained from the control group once and five times from the exercise groups (prior to exercise, immediately post exercise, 4 hours post exercise, and two and five days after the exercise protocol). Immunoglobulin A (IgA) Immunoglobulin G (IgG), Immunoglobulin M (IgM), complement C3 and C4 levels were determined from each sample. Statistical analysis was performed using SPSS for Windows; and comparisons were made using Kruskal Wallis Variance Analysis and Wilcoxon Signed Rank Tests. P
Eleven marathon runners (42.7 +/- 2.1 yrs, 54.2 +/- 1.8 ml.kg-1.min-1) and nine sedentary controls (44.2 +/- 1.2 yrs, 33.3 +/- 1.1 ml.kg-1.min-1) were studied during 30 min of rest, a graded maximal treadmill test using the Balke protocol, and 45 min of recovery to determine the effects of training and acute exercise on complement and immunoglobulin levels. Three baseline and five recovery blood samples were obtained in addition to repeated 5-min samples during exercise. Data for the exercise period were analyzed using a multiple regression approach to repeated measures ANOVA to allow comparison between groups on a percent VO2max basis. Groups did not differ during any of the three phases for IgG, IgA, or IgM. Resting levels of complement C3 (0.89 +/- 0.05 vs 1.27 +/- 0.10 g/L, P less than 0.001) and C4 (0.19 +/- 0.02 vs 0.29 +/- 0.03 g/L, P less than 0.001) were significantly lower in athletes than in controls. Exercise complement C3 [F(1,18) = 14.1, P = 0.001] and C4 [F(1,18) = 7.6, P = 0.013], and recovery complement [F(1,18) = 19.4, P less than 0.001] and C4 [F(1,18) = 13.5, P = 0.002] were also lower in the athletes than in sedentary controls. Acute increases during exercise were not associated with changes in catecholamines or cortisol. These data suggest that blood concentrations of C3 and C4, but not IgG, IgA, or IgM, are decreased during rest, graded maximal exercise, and recovery in marathon runners in comparison with sedentary controls.
This review focuses on saliva as a measure of mucosal immunity in man. The review will cover studies of parameters that modify the early ontogeny patterns of mucosal immunity and the impact of infections and physiological variables on the human mucosal immune system. The most significant modifiers of human mucosal immunity are events that occur in the neonatal maturation period and, later in life, the interplay between the immune system and the neuroendocrine systems. IgA antibodies are the predominant isotype involved in the human mucosal immune response and are important for protection at mucosal surfaces. The level of IgA in mucosal secretions is modified by antigenic stimulation as well as by many physiological variables. Studies have also revealed that IgM plays a significant immunoregulatory role at mucosal surfaces, particularly during episodes of infection or stress. The detection patterns of IgD in saliva of neonates suggests a role for IgD in the initial maturation process of mucosal immunity. The role of IgG at mucosal surfaces is unclear and although IgG may play a compensatory role in IgA deficiency, the detection of high levels of IgG in saliva appears to be associated with periods of increased membrane permeability.
The brain and immune system form a bidirectional communication network in which the immune system operates as a diffuse sense organ, informing the brain about events in the body. This allows the activation of immune cells to produce physiological, behavioral, affective, and cognitive changes that are collectively called sickness, which function to promote recuperation. Fight-flight evolved later and coopted this immune-brain circuitry both because many of the needs of fight-flight were met by this circuitry and this cooptation allowed the immune system to respond to potential injury in anticipatory fashion. Many sequelae of exposure to stressors can be understood from this view and can take on the role of adaptive responses rather than pathological manifestations. Finally, it is argued that activation of immune-brain pathways is important for understanding diverse phenomena related to stress such as depression and suppression of specific immunity.
A large number of studies have failed to show whether exercise-induced perturbations in immune function are associated with the incidence of infection. "Sports immunology", examining the interaction of physical, psychological and environmental stress on immunity, is emerging as a sub-discipline of sports medicine. A series of studies by our research team has profiled the immune responses of elite swimmers during training. Serum immunoglobulin and IgG subclass levels were lower in swimmers than controls. Suppression of mucosal immune parameters has been associated with the risk of upper respiratory tract infection. Swimmers with a lower pre-season salivary IgA and/or lower pre-exercise salivary IgA level were more likely to contract an URTI during a 7-month training period. In a shorter 12-week study, infected swimmers had a mean salivary IgM concentration that dropped more sharply after a single training session. Significant declines in natural killer cell count and neutrophil oxidative activity were not associated with URTI. Despite systemic and mucosal immunosuppression a cohort of swimmers were also able to mount an antibody response to pneumococcal vaccine equivalent to that of sedentary individuals. Observations of chronic suppression of aspects of host defence and the significant relationship between changes in mucosal immune parameters and URTI, provide a framework for assessment of the immune status of athletes. The underlying causes of upper respiratory tract distress symptoms may be infective, inflammatory or allergic in origin: a differential diagnosis has implications for treatment and management.
The effects of exercise on the immune system has been shown to be dependent on the level of fitness of the subjects, the degree of intensity, and the duration of the exercise. A reduction in salivary IgA levels occurs after individual sessions of exercise.
The purpose of this study was to assess the relationship between changes in salivary IgA and training volume, psychological stress, and infection rates in a cohort of 26 elite swimmers over a 7-month training period and to compare the changes with a group of 12 moderately exercising controls.
Salivary IgA concentrations were measured by an electroimmunodiffusion. Exercise gradings were assessed by a standardized aerobic-anaerobic rating system. Psychological stress/anxiety was evaluated by the Spielberger State-Trait Anxiety Inventory. Infections were physician-verified.
Salivary IgA levels showed an inverse correlation with the number of infections in both elite swimmers and moderately exercising control subjects. The pretraining salivary IgA levels in swimmers were 4.1% lower for each additional month of training and 5.8% lower for each additional infection. The posttraining salivary IgA levels in swimmers were not significantly correlated with infection rates but were 8.5% lower for each additional 1 km swum in a training session and 7.0% lower for each additional month of training. The number of infections observed in the elite swimmers was predicted from regression models by the preseason (P = 0.05) and the mean pretraining salivary IgA levels (P = 0.006). The trends in pretraining salivary IgA levels over the 7-month season, calculated as individual slopes of pretraining IgA levels over time, were also predictive of the number of infections (P = 0.03) in the swimmers.
These results indicate that measurement of salivary IgA levels over a training season may be predictive for athletes at risk of infection.
The impact of a 12-week training program by elite swimmers on systemic and mucosal immunity was studied prospectively to examine the relationship between changes in immune parameters and the incidence of respiratory illness. Saliva was collected before and after selected training sessions at 2 weekly intervals. There were significant decreases in salivary IgA (p=0.05) and salivary IgM (p < 0.0001) concentrations after individual training sessions, but no significant changes in salivary IgG or albumin concentrations. Over the 12-week training program there were small but statistically significant increases in pre-exercise concentrations of salivary IgA (p<0.001), IgM (p=0.015) and IgG (p=0.003) and post-exercise salivary IgA (p <0.001). There were no significant trends over the 12 weeks for any class of serum immunoglobulins but a significant fall in NK-cell numbers (p<0.001). There were no associations between serum or salivary immunoglobulin levels or NK-cell numbers and upper respiratory tract illness (URTI) during the 12-week program. The data indicated that despite changes in some immune parameters during this final training program prior to competition there were no associations detected with URTI for this cohort of elite swimmers.
Purpose:
The purpose of this study was to assess research aimed at measuring performance enhancements that affect success of individual elite athletes in competitive events.
Analysis:
Simulations show that the smallest worthwhile enhancement of performance for an athlete in an international event is 0.7-0.4 of the typical within-athlete random variation in performance between events. Using change in performance in events as the outcome measure in a crossover study, researchers could delimit such enhancements with a sample of 16-65 athletes, or with 65-260 in a fully controlled study. Sample size for a study using a valid laboratory or field test is proportional to the square of the within-athlete variation in performance in the test relative to the event; estimates of these variations are therefore crucial and should be determined by repeated-measures analysis of data from reliability studies for the test and event. Enhancements in test and event may differ when factors that affect performance differ between test and event; overall effects of these factors can be determined with a validity study that combines reliability data for test and event. A test should be used only if it is valid, more reliable than the event, allows estimation of performance enhancement in the event, and if the subjects replicate their usual training and dietary practices for the study; otherwise the event itself provides the only dependable estimate of performance enhancement. Publication of enhancement as a percent change with confidence limits along with an analysis for individual differences will make the study more applicable to athletes. Outcomes can be generalized only to athletes with abilities and practices represented in the study.
Conclusion:
estimates of enhancement of performance in laboratory or field tests in most previous studies may not apply to elite athletes in competitive events.
Eleven physical education students performed graded cycle ergometer exercise till exhaustion (Test I) and a week later a 30 min submaximal exercise (Test II). Unstimulated saliva was collected before, and 5 and 60 min after each test. Immunoglobulin A (IgA) was determined by radial immunodiffusion. The post-exercise IgA levels in saliva depended on the duration of exercise. Absolute values were higher 5 min after both exercises and returned to initial ones 60 min later after Test I but were markedly lower after Test II. Since protein levels sharply increased after the exercise, the relative IgA concentrations were lower 5 min post-exercise from the pre-exercise ones.
The extent and duration of changes on lymphocyte function and serum immunoglobulin (Ig) levels were examined in 12 women who walked 45 min at 60% VO2 max in a laboratory setting. A 2-factor, 2 x 6 design with repeated measures on both factors was utilized. The first factor was condition (exercise and rest), and the second factor was time (six times of measurement over a 24-h period), with treatment order counterbalanced. The 45-min walk, in comparison to rest in a seated position, was not associated with significant changes in circulating numbers of interleukin-2-activated T cells (CD5 and CD25) or on spontaneous or concanavalin-A-stimulated lymphocyte proliferation. A trend for decreased phytohemagglutinin-stimulated lymphocyte proliferation in comparison to the rest condition, however, was seen 1.5 h following the exercise bout (p = 0.047). The patterns of change for serum IgG, IgA, and IgM were significantly different (p = 0.001, p less than 0.001, p = 0.010, respectively) between conditions. IgG rose 7.2% immediately following exercise, and then returned to baseline 1.5 h later, which contrasted significantly with changes in the rest condition. These same patterns of change occurred also with IgA and IgM, but increases immediately following exercise were not significant, although a trend was seen for IgA (p = 0.03). The 45-min walk had no effect on plasma cortisol and epinephrine levels relative to the rest condition, but was associated with a significant 89% increase in norepinephrine.(ABSTRACT TRUNCATED AT 250 WORDS)
The immune system is proposed as the key to understanding the etiology and treatment of psychosocial disease. There is a dense communication network between the immune system and the central nervous system (CNS). Immune cell cytokines, via direct action on the CNS, induce fever, alter sleep, pain perception and pituitary hormone release and reduce appetite and activity in animals. Interleukin-2 and interferon given to humans result in global behavioral and cognitive pathology. Activation of the immune system by pathogens produces global cognitive and behavioral pathology also. Recently, controlled trials have demonstrated that diet can cause psychosocial disease, presumably by an immune mechanism. Immune system abnormalities have been identified in manic-depressive psychosis, schizophrenia and alcoholism. Lithium carbonate is not only prophylactic for all three of these diseases, but it also powerfully stimulates the immune system. This is proposed as the mechanism of lithium's therapeutic effect. The antipsychotics, haloperidol and the phenothiazines, affect the immune system also. The rapid development of AIDS dementia complex can be explained by the remarkable influence the immune system has on the CNS.
Saliva immunoglobulin A (IgA) and cortisol levels were measured in 21 male members of a major midwestern swim team. Saliva samples were collected before and after training sessions four times during the fall season; the training intensity was light, moderate, heavy and during the taper period before a major competitive meet. Saliva IgA levels were decreased after each training session, reaching statistical significance with the moderate training intensity. Over the 3-month training period the pre-session and post-session IgA levels both decreased significantly during the heavy and taper training intensities later in the fall season. Cortisol levels were significantly elevated only after the heavy-intensity training session. The Profile of Mood States (POMS) was used to assess the swimmers' overall mood on each test day. No significant correlations were found between the global POMS score and IgA or cortisol. Also, cortisol and IgA were not significantly correlated except after the light training session. Results from this study indicate that acute bouts of exercise can reduce salivary IgA levels and that chronic exercise of high intensity can reduce the resting levels of IgA. These changes may render the athletes more vulnerable to respiratory infections after exercise and even at rest during the later stages of the competitive season.
The impact of long-term training on systemic and mucosal immunity was assessed prospectively in a cohort of elite swimmers over a 7-month training season in preparation for national championships. The results indicated significant suppression (P < 0.05) of serum IgA, IgG and IgM and salivary IgA concentration in athletes associated with long-term training at an intensive level. There was also a trend towards lower IgG2 subclass levels in serum in athletes compared with controls (P = 0.07). There were no significant changes in numbers or percentages of B or T cell subsets, but there was a significant fall in natural killer (NK) cell numbers and percentages in athletes over the training season (P < 0.05). After individual training sessions there was a significant decrease in salivary IgA levels for athletes compared with controls (P = 0.002). In athletes there was a downward trend in salivary IgA levels over the 7-month training period in both the pre-exercise (P = 0.06) and post-exercise samples (P = 0.04). There were no significant trends in salivary IgG levels over the study period in either athletes or controls. The only significant change in salivary IgM levels was an increase in detection rate in the pre-competition phase in athletes (P = 0.03). The study suggests that training of elite athletes at an intensive level over both short- and long-time frames suppresses both systemic and mucosal immunity. Protracted immune suppression linked with prolonged training may determine susceptibility to infection, particularly at times of major competitions.
There is a general perception among athletes, coaches and sports physicians that athletes are susceptible to infectious illness, such as upper respiratory tract infection (URTI), during intensive training and major competition; recent epidemiological evidence is consistent with this perception. Recent studies have focused on the effects of exercise on immune parameters in order to better understand mechanisms by which exercise training may influence resistance to infection. Intensive exercise has been shown to transiently alter a number of immune parameters including circulating leukocyte and subset numbers, plasma cytokine concentrations, natural killer cell activity, secretory immunoglobulin A secretion rate, and neutrophil and macrophage phagocytic activity. Many of these changes persist for several hours or even days after intensive exercise. Some athletes have been shown to exhibit low resting or postexercise values on some nonspecific immune parameters compared with clinical norms, such as complement, acute phase proteins, and neutrophil activation. In addition, extended periods of intensive exercise training have been associated with progressive decreases in some immune parameters such as neutrophil function and certain subclasses of serum and secretory immunoglobulin. These data suggest the possibility of clinically relevant immune suppression in well-trained athletes. Psychological stress associated with training and competition at the elite level may be an additive factor to the effects of intensive exercise on immune function.
We investigated whether the physical exercise of an olympic distance triathlon affected the salivary IgA excretion of triathletes, as a biomarker for mucosal immune defence. 42 triathletes participated in the study. It was found that the salivary flow rate was decreased significantly after the race, thereby resulting in a significant reduction of the total salivary IgA output. The salivary IgA concentration (mg IgA/ml) did not differ, but expressed as total salivary protein, a significant reduction was observed. This was on the account of the salivary protein concentration (mg protein/ml), which was significantly increased. In contrast to the IgA secretion, the salivary amylase activity was increased significantly after the race. Therefore, our data suggest that the exercise of a triathlon may decrease the level of IgA-mediated immune protection at the mucosal surface. As triathletes may during the race be exposed to micro-organisms present in the swimming water, a decreased IgA-mediated immunity during the race may pose triathletes at an increased risk of infections.
There are ethical objections to inducing cumulative muscle damage and associated decrements of performance deliberately in a healthy athlete. Available data on acute and chronic over-exertion thus include the changes of immune response observed following a single bout of exhausting exercise, sequential observations made on top-level competitors as they approach peak training periods, and longitudinal laboratory studies of heavy (but not necessarily damaging) bouts of training. In all three of these situations, subclinical muscle damage initiates an acute inflammatory response, with a resulting deterioration in physical performance. Although much smaller in degree and shorter in duration, the associated changes in immune function are similar to those seen in sepsis. There have been major advances in immunological technique over the past decade, and significant changes in a number of elements of the immune response can be identified in athletes during periods of heavy training. The most promising immunological marker of excessive training seems a decrease in salivary IgA concentration. However, no single change occurs with sufficient consistency to identify the individual competitor who is at risk of overtraining. Mechanisms can be conceived that convert a sequence of excessive training bouts into an acute and then a chronic inflammatory process, but the syndrome of overtraining has a complex overlay of biological and psychological influences. It remains more easily detected by decreases in physical performance and alterations in mood state than by changes in immune function.
The purpose of this study was to assess research aimed at measuring performance enhancements that affect success of individual elite athletes in competitive events.
Simulations show that the smallest worthwhile enhancement of performance for an athlete in an international event is 0.7-0.4 of the typical within-athlete random variation in performance between events. Using change in performance in events as the outcome measure in a crossover study, researchers could delimit such enhancements with a sample of 16-65 athletes, or with 65-260 in a fully controlled study. Sample size for a study using a valid laboratory or field test is proportional to the square of the within-athlete variation in performance in the test relative to the event; estimates of these variations are therefore crucial and should be determined by repeated-measures analysis of data from reliability studies for the test and event. Enhancements in test and event may differ when factors that affect performance differ between test and event; overall effects of these factors can be determined with a validity study that combines reliability data for test and event. A test should be used only if it is valid, more reliable than the event, allows estimation of performance enhancement in the event, and if the subjects replicate their usual training and dietary practices for the study; otherwise the event itself provides the only dependable estimate of performance enhancement. Publication of enhancement as a percent change with confidence limits along with an analysis for individual differences will make the study more applicable to athletes. Outcomes can be generalized only to athletes with abilities and practices represented in the study.
estimates of enhancement of performance in laboratory or field tests in most previous studies may not apply to elite athletes in competitive events.
This review focuses on studies of immunity in elite athletes and specifically addresses the role of mucosal immunity in respiratory illness and associations with the intensity, volume and duration of exercise. Investigations of mucosal immunity have mostly studied the response of salivary immunoglobulins to exercise, although nasopharyngeal secretions and breast milk have also been examined. Habitual exercise at an intense level can cause suppression of mucosal immune parameters. Salivary IgA and IgM concentrations decline immediately after a bout of intense exercise and usually recover within 24 h. Training at an intense level can result in a chronic suppression of mucosal immunoglobulin levels over many years, and in some endurance sports a decline over a training season has been observed. The degree of suppression is associated with the intensity of the exercise and the duration or volume of the training. Low levels of salivary IgM and IgA, particularly the IgA1 subclass, are associated with an increased risk of respiratory illness. Monitoring mucosal immune parameters during critical training periods and establishing personal profiles for individual athletes may provide an assessment of the risk status of an athlete for URTI and allow effective management by the athlete and coach. Despite suppression of mucosal immune parameters, elite athletes are capable of normal responses to novel oral vaccinations, indicating that mucosal immune mechanisms are intact. The mechanisms underlying the mucosal immune suppression are unknown but most likely reflect alterations in T-lymphocyte cytokine control mechanisms.