A.-M. Lecoq’s research while affiliated with CHR Metz-Thionville and other places

Objectifs En raison des possibles effets dopants, l’Agence mondiale antidopage a instauré certaines restrictions concernant l’utilisation des substances appartenant à la classe pharmacologique des bêta-2 agonistes. En 2010, tous les bêta-2 agonistes sont interdits, à l’exception du salbutamol et du salmétérol par inhalation, ces administrations locales nécessitant une déclaration d’usage. Nous proposons, à partir de la littérature scientifique actuelle, de faire un état des lieux des connaissances concernant les effets ergogéniques des bêta-2 agonistes. Actualités Parallèlement, certaines hypothèses à propos des mécanismes d’action potentiellement impliqués dans l’amélioration de performance sont présentées. La plupart des études ont été conduites suite à des inhalations de bêta-2 agonistes à dose thérapeutique et ne mettent pas en évidence d’amélioration de la performance sportive, probablement en raison des faibles doses administrées n’entraînant pas de passage systémique significatif. Au contraire, la quasi-totalité des études conduites après administration orale (par exemple, aiguë et de courte durée) montrent une amélioration de la performance sportive, quelle que soit l’intensité de l’exercice effectué. Les mécanismes à l’origine de cet effet ergogénique des bêta-2 agonistes lors d’une prise systémique restent mal connus, mais celui-ci ne résulte pas d’un effet anabolisant. L’hypothèse « énergétique » ne peut être qu’une réponse partielle et un effet des bêta-2 agonistes à la fois au niveau central et périphérique doit être considéré. Perspectives De nouvelles études apparaissent nécessaires en particulier afin de : (1) déterminer les effets ergogéniques d’une prise orale de terbutaline et de bambuterol ; (2) vérifier les répercussions d’une inhalation de courte durée à dose supra-thérapeutique et (3) fixer un seuil urinaire de positivité pour la terbutaline, le salmétérol et le formotérol.

This study examined the relationships between plasma and saliva adrenocortical hormones in response to long-duration submaximal exercise. In nine healthy, physically active, female volunteers, blood and saliva samples were taken at rest and every 30 min during a 120-min cycling trial at 50-55% VO(2max) for cortisol and dehydroepiandrosterone (DHEA) analysis. Correlation analysis revealed a moderate but significant relationship between plasma and saliva cortisol (r = 0.35, P < 0.02) and plasma and saliva DHEA (r = 0.47, P < 0.001) during the submaximal exercise. When expressed in percent of resting values, the correlations between the plasma and saliva concentrations were higher for both hormones during the exercise (cortisol: r = 0.72; DHEA: r = 0.68, P < 0.001). The results thus suggest that, even under prolonged exercise conditions, non-invasive saliva samples may offer a practical approach to assessing pituitary-adrenal function, especially when compared with individual basal values.

Given the high correlation between the serum and saliva hormone values demonstrated at rest, saliva provides a convenient non-invasive way to determine dehydroepiandrosterone (DHEA) and cortisol concentrations. However, to our knowledge, pituitary adrenal recovery following short-term suppression with corticosteroids has never been investigated in saliva. The aim of this study was therefore to examine how steroid hormone concentrations in saliva are influenced by short-term corticosteroid administration. We studied saliva DHEA and cortisol concentrations before, during (day 1-day 7) and following (day 8-day 16) the administration of oral therapeutic doses of prednisone (50 mg daily for 1 week) in 11 healthy recreationally trained women. Mean saliva DHEA and cortisol concentrations decreased immediately after the start of prednisone treatment (P < 0.05). Three days after concluding prednisone administration, both saliva DHEA and cortisol had returned to pretreatment levels. These data are consistent with previous studies on blood samples and suggest that non-invasive saliva samples may offer a practical approach to assessing pituitary-adrenal function continuously during and after short-term corticosteroid therapy.

Objective To assess in females obese, reproducibility, relative intensity of six-minutes walking test (6MWT) and its relations with quality of life and maximal oxygen uptake (VO2 pic).

In order to test the hypothesis that short-term corticoid intake alters food intake, body composition and adipokines secretion in healthy volunteers with regular sport practice, nutrient intake was assessed in eight male athletes with and without prednisolone (PRED, 60 mg/day for 1 week) ingestion in a random, double blind, crossover design. Body weight, body composition, adipokines (i.e., leptin, adiponectin and TNF-alpha), insulin and blood glucose were determined before and at the end of each treatment. PRED did not induce any significant change in body weight, body composition or food intake. Insulin and TNF-alpha were not significantly altered with PRED compared to placebo but blood glucose, leptin and adiponectin concentrations at rest appear significantly increased after PRED treatment (P < 0.05). Our data show that 1 week glucocorticoid treatment does not promote obesity in recreationally trained men but further studies are necessary to understand its effects on the metabolically active hormones, leptin and adiponectin.

In order to test the hypothesis that salbutamol would change substrate oxidation during submaximal exercise, eight recreationally trained men twice performed 1 h at 60% VO(2) peak after ingestion of placebo or 4 mg of salbutamol. Gas exchange was monitored and blood samples were collected during exercise for GH, ACTH, insulin, and blood glucose and lactate determination. With salbutamol versus placebo, there was no significant difference in total energy expenditure and substrate oxidation, but the substrate oxidation balance was significantly modified after 40 min of exercise. ACTH was significantly decreased with salbutamol during the last 10 min of exercise, whereas no difference was found between the two treatments in the other hormonal and metabolic parameters. The theory that the ergogenic effect of salbutamol results from a change in substrate oxidation has little support during relatively short term endurance exercise, but it is conceivable that longer exercise duration can generate positive findings.

To examine whether acute glucocorticoid (GC) intake alters performance and selected hormonal and metabolic variables during submaximal exercise. In total, 14 recreational male athletes completed two cycling trials at 70-75% maximum O(2) uptake starting 3 h after an ingestion of either a lactose placebo or oral GC (20 mg of prednisolone) and continuing until exhaustion, according to a double-blind randomised protocol. Blood samples were collected at rest, after 10, 20, 30 minutes, and at exhaustion and recovery for measurement of growth hormone (GH), adrenocorticotropic hormone (ACTH), dehydroepiandrosterone (DHEA), prolactin, insulin, blood glucose, lactate and interleukin (IL)-6 determination. Cycling duration was not significantly changed after GC or placebo administration (55.9 (5.2) v 48.8 (2.9) minutes, respectively). A decrease in ACTH and DHEA (p<0.01) was observed with GC during all of the experiments and in IL-6 after exhaustion (p<0.05). No change in basal, exercise or recovery GH, prolactin, insulin or lactate was found between the two treatments but blood glucose was significantly higher with GC (p<0.05) at any time point. From these data, acute systemic GC administration does seem to alter some metabolic markers but did not influence performance during submaximal exercise.

We examined the hypothesis that acute therapeutic glucocorticoid intake could change the contribution of fat and carbohydrate (CHO) in energy production during exercise. Nine healthy recreationally-trained male subjects twice performed submaximal exercise (60 min at 60 % VO2max) after ingestion of placebo (Pla) or 20 mg of prednisolone (Pred), according to a double blind and randomized protocol. Respiratory exchange was monitored during exercise and blood samples were collected at rest, every 10 min during exercise and after 5, 10, and 20 min of passive recovery. Pred intake significantly increased total energy expenditure during exercise, but CHO oxidation was lower and fat oxidation higher after Pred vs. Pla. ACTH and IL-6 concentrations were significantly decreased with Pred during exercise, whereas no variations were found in GH, insulin, blood glucose, and lactate between the 2 treatments. In conclusion, it appears that acute prednisolone systemic administration does reduce total carbohydrate oxidation during submaximal exercise. Further studies are necessary to clarify the mechanisms involved and to determine whether this modification in the substrate oxidation balance under glucocorticoid administration in recreationally-trained male subjects could result in a competitive advantage in elite athletes.

To investigate the effects of short-term prednisolone ingestion combined with intense training on exercise performance, hormonal (adrenocorticotrophic hormone (ACTH), prolactin, luteinising hormone (LH), growth hormone (GH), thyroid-stimulating hormone (TSH), dehydroepiandrosterone (DHEA), testosterone, insulin) and metabolic parameters (blood glucose, lactate, bicarbonate, pH). Eight male recreational athletes completed four cycling trials at 70-75% peak O(2) consumption until exhaustion just before (1) and after (2) either oral placebo or prednisolone (60 mg/day for 1 week) treatment coupled with standardised physical training (2 hours/day), according to a double-blind and randomised protocol. Blood samples were collected at rest, during exercise and passive recovery for the hormonal and metabolic determinations. Time of cycling was not significantly changed after placebo but significantly increased (p<0.05) after prednisolone administration (50.4 (6.2) min for placebo 1, 64.0 (9.1) min for placebo 2, 56.1 (9.1) min for prednisolone 1 and 107.0 (20.7) min for prednisolone 2). There was no significant difference in any measured parameters after the week of training with placebo but a decrease in ACTH, DHEA, PRL, GH, TSH and testosterone was seen with prednisolone treatment during the experiment (p<0.05). No significant change in basal, exercise or recovery LH, insulin, lactate, pH or bicarbonate was found between the two treatment, but blood glucose was significantly higher under prednisolone (p<0.05) at all time points. Short-term glucocorticoid administration induced a marked improvement in endurance performance. Further studies are needed to determine whether these results obtained in recreational male athletes maintaining a rigorous training schedule are gender-dependent and applicable to elite athletes.

IntroductionThe aim of the study is to assess the effects of a short-term therapeutical prednisolone intake on erythropoietin (EPO) secretion.