Routine exercise alters measures of immunity and the acute phase reaction.

PURPOSE: To expand our understanding of the overall anti-inflammatory nature of routine exercise; we compared resting blood values from adults who habitually undertake frequent, moderate levels of exercise to reference interval values assumed to reflect values largely from non-exercisers. This information would be useful for clinicians interpreting blood tests assessing inflammatory, immune and acute phase responses. METHODS: Blood samples were collected from 119 community adult self-reported routine exercisers (61 males and 58 females aged 18-60 years). Samples were analysed for 20 cellular and non-cellular biomarkers which included 11 immunological and 9 acute phase reactants. These data were compared to reference intervals from the same hospital laboratory that performed the analyses on our participants' samples. Individual analyte values were also compared with participants' self-reported 150 day exercise patterns which included exercise frequency, intensity and duration. RESULTS: In general, mean values for routine exercise participants fell at the lower end of laboratory reference interval for most inflammatory analytes. More than 10 % of participants had numbers of CD19(+), CD8(+) and 16/56(+) NK cells below the low end of the respective reference interval. More than 10 % of observed acute phase reactant values (for C3, haptoglobin and ferritin) were also below the low end of the reference interval. At rest IgM (r = -0.22) and IgG (r = -0.31) values correlated negatively (p < 0.05) with exercise load. CONCLUSIONS: Routine exercise appears to lower resting numbers of a variety of immune cell-types as well as the concentration of several classical acute phase reactants. These wide-ranging systemic effects are presumably adaptive changes, not pathology and collectively confirm the well-reported and clinically important anti-inflammatory effects of exercise.

Distribution of fat, non-osseous lean and bone mineral mass in international Rugby Union and Rugby Sevens players.

Differences in the body composition of international Rugby Union and Rugby Sevens players, and between players of different positions are poorly understood. The purpose of this study was to examine differences in the quantity and regional distribution of fat, non-osseous lean and bone mineral mass between playing units in Rugby Union and Rugby Sevens. Male Rugby Union (n=21 forwards, 17 backs) and Rugby Sevens (n=11 forwards, 16 backs) players from the Australian national squads were measured using dual-energy X-ray absorptiometry. The digital image of each player was partitioned into anatomical regions including the arms, legs, trunk, and android and gynoid regions. Compared with backs, forwards in each squad were heavier and exhibited higher absolute regional fat (Union 43-67%; ±~17%, range of % differences; ±~95% confidence limits (CL); Sevens 20-26%; ±~29%), non-osseous lean (Union 14-22%; ±~5.8%; Sevens 6.9-8.4%; ±~6.6%) and bone mineral (Union 12-26%; ±~7.2%; Sevens 5.0-11%; ±~7.2%) mass. When tissue mass was expressed relative to regional mass, differences between Rugby Sevens forwards and backs were mostly unclear. Rugby Union forwards had higher relative fat mass (1.7-4.7%; ±~1.9%, range of differences; ±~95% CL) and lower relative non-osseous lean mass (-4.2 to -1.8%; ±~1.8%) than backs in all body regions. Competing in Rugby Union or Rugby Sevens characterized the distribution of fat and non-osseous lean mass to a greater extent than a player's positional group, whereas the distribution of bone mineral mass was associated more with a player's position. Differences in the quantity and distribution of tissues appear to be related to positional roles and specific demands of competition in Rugby Union and Rugby Sevens.

Periodization of altitude training: A collective case study of high-level swimmers.

The objective was to quantify parallel changes in performance and physiological measures in relation to periodization of sequential altitude training over a season in elite swimmers. The altitude training of four female and two male international swimmers in selected seasons was examined using a collective case study approach. All swimmers were a medalist in World (WC) and/or European Championships (EC) 2013, 2014, 2016 and 2018 in short or long course competition. A traditional periodization model was employed using three macrocycles with 3-4 altitude camps (duration 21-24 days each) scheduled over the season, following a polarized training intensity distribution (TID) with a volume ranged between 729 km and 862 km. The timing of return from altitude prior to competition was between 20-32 days, with 28 days the most common period. Competition performance was assessed with major (international) and minor (regional or national) competitions. Hemoglobin concentration, hematocrit, anthropometric characteristics, were measured before and after each camp. Competition performance following the altitude training camps improved by 0.6% ± 0.8% (personal best time; mean ± SD) (95% confidence limits (CL) 0.1%-1.1%), 1.6% ± 0.7% (95% CL 1.2% to 2.0%) (season best time) and 1.6% ± 0.5% (95% CL 1.3%-1.9%) (previous season time). Hemoglobin concentration increased 4.9% from pre-to post-altitude training camps, while hematocrit increased by 4.5%. The sum of six skinfolds reduced by 14.4% (95% CL 18.8%-9.9%) and 4.2% (95% CL 2.4%-9.2%) for the two males (EC), and by 15.8% (95% CL 19.5%-12.0%) for two females (WC). Three to four altitude training camps in a competitive season, around 21-24 days of duration, scheduling the last return between 20-32 days before the main competition, integrated in a traditional periodized sequence, can induce worthwhile improvements in international swimming performance, hematological parameters, and anthropometric characteristics.

Lower white blood cell counts in elite athletes training for highly aerobic sports.

White cell counts at rest might be lower in athletes participating in selected endurance-type sports. Here, we analysed blood tests of elite athletes collected over a 10-year period. Reference ranges were established for 14 female and 14 male sports involving 3,679 samples from 937 females and 4,654 samples from 1,310 males. Total white blood cell counts and counts of neutrophils, lymphocytes and monocytes were quantified. Each sport was scaled (1-5) for its perceived metabolic stress (aerobic-anaerobic) and mechanical stress (concentric-eccentric) by 13 sports physiologists. Substantially lower total white cell and neutrophil counts were observed in aerobic sports of cycling and triathlon (~16% of test results below the normal reference range) compared with team or skill-based sports such as water polo, cricket and volleyball. Mechanical stress of sports had less effect on the distribution of cell counts. The lower white cell counts in athletes in aerobic sports probably represent an adaptive response, not underlying pathology.

Oral administration of the probiotic Lactobacillus fermentum VRI-003 and mucosal immunity in endurance athletes.

OBJECTIVE: To evaluate the ability of a probiotic Lactobacillus fermentum VRI-003 (PCC) to enhance the mucosal immune system of elite athletes. DESIGN AND SETTING: A double-blind, placebo-controlled, crossover trial was conducted over a 4-month period of winter training. PARTICIPANTS; 20 healthy elite male distance runners. INTERVENTIONS: PCC was given at a daily dose of 1.26 x 10(10) as a freeze-dried powder in gelatin capsules. Placebo capsules contained an inert excipient. MAIN OUTCOME MEASURES: Treadmill performance (monthly), mucosal and systemic immunity (monthly), training (daily) and illness (daily) were assessed. Serum cytokine levels, salivary IgA levels and incidence, duration and severity of respiratory tract infections were measured. RESULTS: Subjects reported less than half the number of days of respiratory symptoms during PCC treatment (30 days) compared with placebo (72 days, p<0.001). Illness severity was also lower for episodes occurring during the PCC treatment (p = 0.06). There were no significant differences in the mean change in salivary IgA and IgA1 levels, or in interleukin (IL)4 and IL12 levels, between treatments. However, PCC treatment elicited a twofold (p = 0.07) greater change in whole-blood culture interferon gamma (IFNgamma) compared with placebo. No substantial changes in running performance measures were seen over the study period. CONCLUSIONS: Prophylactic administration of PCC was associated with a substantial reduction in the number of days and severity of respiratory illness in a cohort of highly trained distance runners. Maintenance of IFNgamma levels may be one mechanism underpinning the positive clinical outcomes.

The effect of exercise on innate mucosal immunity.

METHODS: The authors conducted a prospective observational study comparing salivary lactoferrin and lysozyme concentration over 5 months (chronic changes) in elite rowers (n=17, mean age 24.3+/-4.0 years) with sedentary individuals (controls) (n=18, mean age=27.2+/-7.1 years) and a graded exercise test to exhaustion (acute changes) with a cohort of elite rowers (n=11, mean age 24.7+/-4.1). RESULTS: Magnitudes of differences and changes were interpreted as a standardised (Cohen's) effect size (ES). Lactoferrin concentration in the observational study was approximately 60% lower in rowers than control subjects at baseline (7.9+/-1.2 microg/ml mean+/-SEM, 19.4+/-5.6 microg/ml, p=0.05, ES=0.68, 'moderate') and at the midpoint of the season (6.4+/-1.4 microg/ml mean +/- SEM, 21.5+/-4.2 microg/ml, p=0.001, ES=0.89, 'moderate'). The concentration of lactoferrin at the end of the study was not statistically significant (p=0.1) between the groups. There was no significant difference between rowers and control subjects in lysozyme concentration during the study. There was a 50% increase in the concentration of lactoferrin (p=0.05, ES=1.04, 'moderate') and a 55% increase in lysozyme (p=0.01, ES=3.0, 'very large') from pre-exercise to exhaustion in the graded exercise session. CONCLUSION: Lower concentrations of these proteins may be indicative of an impairment of innate protection of the upper respiratory tract. Increased salivary lactoferrin and lysozyme concentration following exhaustive exercise may be due to a transient activation response that increases protection in the immediate postexercise period.

Respiratory symptoms and inflammatory responses to Difflam throat-spray intervention in half-marathon runners: a randomised controlled trial.

OBJECTIVE: In this study, the effects of Difflam Forte Anti-inflammatory Throat Spray on the incidence of upper respiratory symptoms (URS) and inflammatory responses after a half-marathon race were investigated. DESIGN AND SETTING: Double-blind placebo-controlled randomised trial conducted in association with a half-marathon event. PARTICIPANTS: 45 well-trained half-marathon runners. INTERVENTIONS: Difflam (n = 25) or placebo (n = 20) throat sprays were self-administered three times daily for 1 week before and 2 weeks after the race. MAIN OUTCOME MEASURES: Self-reported respiratory symptoms; plasma prostaglandin E(2), myeloperoxidase, interleukin (IL) 6, IL8, IL10 and IL1 receptor antagonist (IL1ra) concentrations; and salivary myeloperoxidase and IL6 concentrations. RESULTS: All subjects completed the intervention without reporting any adverse events. The proportion of athletes reporting URS was not substantially different between Difflam (52%) and placebo (56%) groups (p = 0.82). However, symptom severity scores were approximately 29% lower during Difflam treatment (4.7 (7.4) vs 6.6 (9.6)) AU). Post-exercise responses in plasma inflammatory markers did not differ substantially between Difflam and placebo groups. Post-race increases in salivary myeloperoxidase ( approximately 63%; trivial to moderate difference; p = 0.13) and salivary IL6 ( approximately 50%; trivial to moderate difference; p = 0.25) were greater in the Difflam group. CONCLUSIONS: Prophylactic use of the Difflam reduced the severity, but not the frequency, of URS among half-marathon runners. Post-race increases in systemic inflammatory markers were not altered by Difflam use, but markers of local inflammation (salivary myeloperoxidase and IL6) were augmented in the Difflam compared with the placebo group.

Influence of chronic dietary carbohydrate supplementation on plasma cytokine responses to exercise.

This study examined the influence of 28 days of dietary carbohydrate (CHO) supplementation on plasma cytokine responses to cycle ergometry. Sixteen highly trained male cyclists and triathletes (age: 30.6+/-5.6 y; VO2max: 64.8+/-4.7 mL x kg(-1) x min(-1); mean+/-SD) participated in the study. One group (n=8) consumed a higher-CHO (8.5+/-1.7 g x kg(-1) body mass.day (-1)) diet for 28 days; a second group (n=8) consumed a moderate-CHO diet (5.3+/-0.4 g x kg (-1) x day (-1)). Total daily energy intakes were similar between the two groups. Cytokine responses to cycle ergometry were assessed prior to and again following the dietary intervention period. The cycle ergometry protocol involved 100 min steady state cycling at 70% VO2max followed by a time trial of approximately 30 min. Athletes were provided with 15 mL x kg (-1) x h (-1) of water during each trial. Blood samples were collected pre-, immediately post- and 1 h post-exercise for determination of plasma glucose and pro-inflammatory (IL-6, IL-8) and anti-inflammatory (IL-10, IL-1ra) cytokine concentrations. Cytokine responses to cycle ergometry were not substantially altered following the 28-day higher-CHO diet. In contrast, following the 28-day moderate-CHO diet, there were approximately 30-50% reductions (p=0.08-0.11) in anti-inflammatory cytokine responses post-exercise. These findings suggest that increased dietary CHO content alone does not effectively attenuate the pro-inflammatory cytokine response to exercise, however, there may be a small reduction in the anti-inflammatory cytokine response.

Probiotics, immunity and exercise: a review.

Nutritional practices that promote good health and optimal athletic performance are of interest to athletes, coaches, exercise scientists and dietitians. Probiotic supplements modulate the intestinal microbial flora and offer promise as a practical means of enhancing gut and immune function. The intestinal microbial flora consists of diverse bacterial species that inhabit the gastrointestinal tract. These bacteria are integral to the ontogeny and regulation of the immune system, protection of the body from infection, and maintenance of intestinal homeostasis. The interaction of the gut microbial flora with intestinal epithelial cells and immune cells exerts beneficial effects on the upper respiratory tract, skin and uro-genital tract. The capacity for probiotics to modulate perturbations in immune function after exercise highlight their potential for use in individuals exposed to high degrees of physical and environment stress. Future studies are required to address issues of dose-response in various exercise settings, the magnitude of species-specific effects, mechanisms of action and clinical outcomes in terms of health and performance.

Improved running economy and increased hemoglobin mass in elite runners after extended moderate altitude exposure.

There is conflicting evidence whether hypoxia improves running economy (RE), maximal O(2) uptake (V(O)(2max)), haemoglobin mass (Hb(mass)) and performance, and what total accumulated dose is necessary for effective adaptation. The aim of this study was to determine the effect of an extended hypoxic exposure on these physiological and performance measures. Nine elite middle distance runners were randomly assigned to a live high-train low simulated altitude group (ALT) and spent 46+/-8 nights (mean+/-S.D.) at 2860+/-41m. A matched control group (CON, n=9) lived and trained near sea level ( approximately 600m). ALT decreased submaximal V(O)(2) (Lmin(-1)) (-3.2%, 90% confidence intervals, -1.0% to -5.2%, p=0.02), increased Hb(mass) (4.9%, 2.3-7.6%, p=0.01), decreased submaximal heart rate (-3.1%, -1.8% to -4.4%, p=0.00) and had a trivial increase in V(O)(2max) (1.5%, -1.6 to 4.8; p=0.41) compared with CON. There was a trivial correlation between change in Hb(mass) and change in V(O)(2max) (r=0.04, p=0.93). Hypoxic exposure of approximately 400h was sufficient to improve Hb(mass), a response not observed with shorter exposures. Although total O(2) carrying capacity was improved, the mechanism(s) to explain the lack of proportionate increase in V(O)(2max) were not identified.

Pacing in Swimming: A Systematic Review.

BACKGROUND: Pacing strategy, or how energy is distributed during exercise, can substantially impact athletic performance and is considered crucial for optimal performance in many sports. This is particularly true in swimming given the highly resistive properties of water and low mechanical efficiency of the swimming action. OBJECTIVES: The aim of this systematic review was to determine the pacing strategies utilised by competitive swimmers in competition and their reproducibility, and to examine the impact of different pacing strategies on kinematic, metabolic and performance variables. This will provide valuable and practical information to coaches and sports science practitioners. DATA SOURCES: The databases Web of Science, Scopus, SPORTDiscus and PubMed were searched for published articles up to 1 August 2017. STUDY SELECTION: A total of 23 studies examining pool-based swimming competitions or experimental trials in English-language and peer-reviewed journals were included in this review. RESULTS: In short- and middle-distance swimming events maintenance of swimming velocity is critical, whereas in long-distance events a low lap-to-lap variability and the ability to produce an end spurt in the final lap(s) are key. The most effective strategy in the individual medley (IM) is to conserve energy during the butterfly leg to optimise performance in subsequent legs. The pacing profiles of senior swimmers remain relatively stable irrespective of opponents, competition stage or type, and performance time. CONCLUSION: Implementing event-specific pacing strategies should benefit the performance of competitive swimmers. Given differences between swimmers, there is a need for greater individualisation when considering pacing strategy selection across distances and strokes.

Validation of a skinfold based index for tracking proportional changes in lean mass.

BACKGROUND: The lean mass index (LMI) is a new empirical measure that tracks within-subject proportional changes in body mass adjusted for changes in skinfold thickness. OBJECTIVE: To compare the ability of the LMI and other skinfold derived measures of lean mass to monitor changes in lean mass. METHODS: 20 elite rugby union players undertook full anthropometric profiles on two occasions 10 weeks apart to calculate the LMI and five skinfold based measures of lean mass. Hydrodensitometry, deuterium dilution, and dual energy x ray absorptiometry provided a criterion choice, four compartment (4C) measure of lean mass for validation purposes. Regression based measures of validity, derived for within-subject proportional changes through log transformation, included correlation coefficients and standard errors of the estimate. RESULTS: The correlation between change scores for the LMI and 4C lean mass was moderate (0.37, 90% confidence interval -0.01 to 0.66) and similar to the correlations for the other practical measures of lean mass (range 0.26 to 0.42). Standard errors of the estimate for the practical measures were in the range of 2.8-2.9%. The LMI correctly identified the direction of change in 4C lean mass for 14 of the 20 athletes, compared with 11 to 13 for the other practical measures of lean mass. CONCLUSIONS: The LMI is probably as good as other skinfold based measures for tracking lean mass and is theoretically more appropriate. Given the impracticality of the 4C criterion measure for routine field use, the LMI may offer a convenient alternative for monitoring physique changes, provided its utility is established under various conditions.

Anthropometry profiles of elite rugby players: quantifying changes in lean mass.

OBJECTIVE: To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes. METHODS: Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfolds(x), for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes. RESULTS: The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits +/-0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits +/-2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits +/-3.1%) during the club season. A small decrease in LMI (approximately 1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits +/-2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons. CONCLUSIONS: Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes.

Positional differences in fitness and anthropometric characteristics in Australian football.

To evaluate the utility of fitness assessment and trends in drafting of players in the Australian Football League, we analysed height, mass, skinfolds, 20-m sprint, vertical jump, agility run and endurance assessed in the 495 players attending the annual national draft camps between 1999 and 2004. Effects of player position and assessment year were expressed as standardised mean differences (Cohen effect sizes) and interpreted qualitatively. Effect of birth month on chance of being drafted, which may be important in team sports, was also analysed. Compared with midfield players, ruckmen, tall forwards and tall defenders were decisively taller (effect-size range 1.33-1.95, large) and heavier (1.30-1.63, large), but had poorer sprint speed (0.23-0.57, small), aerobic ability (0.66-1.18, moderate) and agility (0.64-1.11, moderate). The only substantial changes in fitness scores over the 5-year period were an increase in height (0.76, moderate) and an increase in 20-m sprint time (0.39, small). A majority (65%) of players attending the camps were born in the first half of a given year, but their chance of being drafted (70%) was similar to that of players born in the second half (64%). We conclude that fitness assessment is useful for differentiating between player positions and identifying some annual trends in recruitment in Australian football, and that players with a second half birth month have been disadvantaged with lower representation at the national draft camp.

Characterising the individual performance responses to mild illness in international swimmers.

OBJECTIVES: To determine individual differences in the impact of illness on the change in performance of swimmers in international competitions. METHODS: Subjects were members of the Australian swimming team (33 male and 39 female, aged 15-27 years). Swimmers provided a weekly seven day recall of symptoms of illness during final six weeks of preparations for international competition over a three year period. Swimmers were categorised as either ill (one or more episodes of illness) or healthy. The measure of performances was the international point score. Mean changes in points score were calculated for healthy and ill swimmers between a national championship and an international competition ( approximately 16 weeks later). Likelihoods of substantial effects of illness on an individual's true change in performance (beneficial/trivial/harmful) were estimated from means and standard deviations, assuming a smallest substantial change of 6 points. RESULTS: Illness was reported before international performances by 38% of female and 35% of male swimmers. For female swimmers the change in performance was -3.7 (21.5) points (mean (SD)) with illness and -2.6 (19.0) points when healthy; for male swimmers the changes were -1.4 (17.5) points with illness and 5.6 (13.2) points when healthy. The likelihoods that illness had a substantial beneficial/trivial/harmful effect on performance of an individual swimmer were 32%/31%/37% for female and 17%/31%/52% for male participants (90% confidence limits approximately +/-10% to 20%). CONCLUSIONS: Although mild illness had only a trivial mean effect on female swimmers and a small harmful mean effect on male swimmers, there were substantial chances of benefit and harm for individuals.

Fitness testing and career progression in AFL football.

Relationships between fitness testing and career progression in the Australian Football League (AFL) are under-explored. This study investigated relationships between anthropometric and fitness tests conducted at the annual AFL National Draft Camp and subsequent career progression of players. A total of 283 players was tested over three consecutive camps (1999-2001). The anthropometric and fitness measures were: height, mass, sum of skinfolds, 20-m sprint test, vertical jump (standing and bilateral running), agility run and a multi-stage incremental shuttle run. The five outcome variables were: drafted (yes/no), AFL debut (yes/no), number of AFL games played to the end of 2003, and subjective ratings of career potential and career value (5-point scale). Of 205 players (72%) subsequently drafted, 166 (59%) eventually made their AFL debut. Players drafted to AFL clubs were faster over 5 m, 10 m and 20 m, ran further in the shuttle run and ran marginally faster in the agility test than players not drafted. Multi-regression analysis showed small to moderate correlations (r = 0.27-0.31) between the designated outcome variables and selected fitness tests: 20-m sprint time (faster), agility run test (faster), and running vertical jump (higher absolute height and smaller difference between left and ride sides). Regression analysis for the standing vertical jump relative to standing reach height showed a counterintuitive negative correlation with positive outcomes, possibly reflecting non-compliance with testing procedures by the less successful athletes. We conclude that the 20-m sprint, jump, agility and shuttle run tests have a small but important association with career progression of AFL footballers.

Improved running economy in elite runners after 20 days of simulated moderate-altitude exposure.

To investigate the effect of altitude exposure on running economy (RE), 22 elite distance runners [maximal O(2) consumption (Vo(2)) 72.8 +/- 4.4 ml x kg(-1) x min(-1); training volume 128 +/- 27 km/wk], who were homogenous for maximal Vo(2) and training, were assigned to one of three groups: live high (simulated altitude of 2,000-3,100 m)-train low (LHTL; natural altitude of 600 m), live moderate-train moderate (LMTM; natural altitude of 1,500-2,000 m), or live low-train low (LLTL; natural altitude of 600 m) for a period of 20 days. RE was assessed during three submaximal treadmill runs at 14, 16, and 18 km/h before and at the completion of each intervention. Vo(2), minute ventilation (Ve), respiratory exchange ratio, heart rate, and blood lactate concentration were determined during the final 60 s of each run, whereas hemoglobin mass (Hb(mass)) was measured on a separate occasion. All testing was performed under normoxic conditions at approximately 600 m. Vo(2) (l/min) averaged across the three submaximal running speeds was 3.3% lower (P = 0.005) after LHTL compared with either LMTM or LLTL. Ve, respiratory exchange ratio, heart rate, and Hb(mass) were not significantly different after the three interventions. There was no evidence of an increase in lactate concentration after the LHTL intervention, suggesting that the lower aerobic cost of running was not attributable to an increased anaerobic energy contribution. Furthermore, the improved RE could not be explained by a decrease in Ve or by preferential use of carbohydrate as a metabolic substrate, nor was it related to any change in Hb(mass). We conclude that 20 days of LHTL at simulated altitude improved the RE of elite distance runners.

Exercise, training, and neutrophil function.

Although neutrophils are critical to host defense, they are also involved in the pathology of various inflammatory diseases. Neutrophils, representing 60% of circulating leukocytes in human subjects, are readily accessible to experimental investigation. Discrete aspects of, neutrophil function can be quickly and accurately assessed in vitro using a variety of techniques that involve assessment of intracellular and extracellular functional activities. Moderate exercise has variable effects on neutrophil function, but intense exercise is potentially immunosuppressive. Endurance training also suppresses most neutrophil functions chronically. A greater understanding of some fundamental aspects of neutrophil function and the uncovering of newly defined roles underlines potential applications in general and sports medicine. However, the practical value of this knowledge for monitoring the health and training programs of elite athletes requires further clarification. The current knowledge of neutrophil and immune functional measurements has not progressed to an extent that routine profiling in athletes can be used diagnostically.

Regulation of neutrophil function during exercise.

In recent years there has been considerable interest in how exercise and training may affect the immune system. There is now substantial cross-sectional and epidemiological evidence that exercise causes significant changes in the distribution and function of a number of cellular and humoral immune parameters. Neutrophils represent one of the key nonspecific host defence cell populations responsible for the phagocytosis of many microbial, bacterial and viral pathogens. The neutrophil is also known to be involved in the synthesis and release of immunomodulatory cytokines that influence both T cell and B cell activities. Therefore, it plays an important role in both the efferent (phagocytosis and degranulation) and afferent (release of immunomodulatory molecules) limbs of the immune response. Neutrophils and macrophages respond both to phagocytosable particles (e.g. bacteria, viruses and cell debris) and to a number of soluble factors. There is an increase in the number of circulating neutrophils with exercise as a result of demargination of cells from endothelial tissues (mediated by catecholamines) and bone marrow (mediated by cortisol), or as part of the phagocytic and inflammatory response to exercise-induced tissue damage. Following exercise-induced mobilisation into the circulation and migration into tissues, neutrophils undergo adherence, phagocytosis (engulfment) of bacteria or tissue fragments, degranulation of cytoplasmic granules and, ultimately, activation of the respiratory burst. The capacity of the respiratory burst largely determines the cytotoxic potential of the neutrophil. The respiratory burst involves a sudden increase in nonmitochondrial oxidative metabolism, resulting in the production of the superoxide anion (O2-) and other reactive oxygen species by the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase enzyme complex located at the plasma membrane. Although the biochemistry of the respiratory burst has been well studied, the mechanisms by which exercise and training may influence its activity are not well characterised or understood. Studies on the acute effects of exercise show that exercise generally elicits an initial activation of neutrophils-evidenced by release of cytoplasmic enzymes (degranulation) with secondary changes in key effector functions such as the phagocytic and respiratory burst activity. The nature of the functional changes is still unclear, as some studies show a transient suppression of the respiratory burst and/or phagocytic capacity immediately after exercise, while others report that moderate intensity exercise elicits an enhanced response. The variability in findings may be attributable to differences in the age, gender and initial fitness levels of the people studied, the intensity and duration of the exercise protocols used, and the different methodological procedures employed.(ABSTRACT TRUNCATED AT 400 WORDS)