Exercise and Immune Function Flashcards
J shaped curve - source
Nieman, 1994
S shaped curve - source
Malm, 2006
Draw diagram
Look at revision notes
Assessing URTI
Jackson Score Upper Respiratory Tract Illness Questionnaire
Complete the questionnaire on a daily basis
Numerical values are assigned to the ‘degree of discomfort’ scale
Monitoring infections
Diary style questionnaire
Recall questionnaire
Participants contact researcher/health professional when feeling ill
Report to a local clinic for a doctor/nurse evaluation when feeling ill
Objective measurements
Objective measurements
Providing specimens
- nasal swab
- throat swab
- mucous
- sputum
Specimen rated subjectively or objectively for colour, secretion, turgescence
Specimen examined using microbiological culture, microscopy and biochemical techniques
Protein identification/RNA, DNA sequencing
Strategies to reduce chance of infection - source
Gleeson & Walsh, 2012
Strategies to reduce chance of infection - Gleeson & Walsh, 2012
Prevention better than treatment
Updated on all vaccines needed for home/travel
Minimise contact with infected people and young children
Wash hands regularly
Carry alcohol gel
Do not share water bottles, towels, cups
When abroad, drink bottled water, avoid salad washed in local water
Ensure adequate energy intake - avoid crash diets
1st day of illness - Gleeson & Walsh, 2012
Avoid strenuous exercise
Avoid all exercise of experiencing muscle/joint pain, headache, fever, malaise, diarrhoea or vomiting
2nd day of illness - Gleeson & Walsh, 2012
Continue to avoid all exercise if experiencing muscle/joint pain, headache, fever, malaise, diarrhoea or vomiting
If there is no worsening of ‘above the collar’ symptoms, undertake light exercise
3rd day of illness - Gleeson & Walsh, 2012
If URTI symptoms still present, see GP
If there is no malaise or worsening of symptoms undertake exercise
4th day of illness - Gleeson & Walsh, 2012
If there is no symptom release, do not exercise, see GP
If this is first day of improvement, wait one day without fever and for improvement of symptoms before exercising
Measuring external load - source
Schwellnus et al., 2016
Measuring external load - Schwellnus et al., 2016
Hours of training
Distance run
Weight lifted
Number of games played
Life events
Daily hassles/travel
Measuring internal load - Schwellnus et al., 2016
Heart rate
RPE
Schwellnus et al., 2016
Subjective measures were more sensitive and consistent for measuring internal load
Important to monitor internal and external loads because athletes may perform more intense training or perceive loads as significantly harder, may lead to maladaptation
Some evidence that changes in external and internal training load associated with increased risk of illness
Markers of subclinical exercise
Can respond to acute and chronic exercise
Could be used to predict onset of acute illness
None of currently available markers meet the criteria of reliable markers
Reliable marker of subclinical exercise needs to be:
Highly sensitive
Respond to training load
Unaffected by other factors
Changes should occur before illness
Distinguishable from other adaptations
Relatively easy to measure
Not be invasive
Three Pillars of Exercise Immunology
Athletes report greater incidence of infections
Mucosal immunity is impaired
Immune cell function is impaired post-exercise
Need to assess immune competency with system-levels approach - source
Bruunsgard, 1997
Need to assess immune competency with system-levels approach - Bruunsgard, 1997
22 triathletes, 11 control triathletes, 22 nonathletic controls
Within 30 mins of finishing exercise
- Delayed-type hypersensitivity reaction-response to 7 common antigens
- Pneumococcal vaccination
Immune response assessed
- DTH 48 hr after application
- Antibody response to vaccination after 14 days
May suppress aspects of cell-mediated immunity but not vaccination response.
Depletion of nutrients that are immunomodulatory
Leucine
Glutamine
Carbohydrate
Leucine
Can stimulate an intracellular signalling cascade - rapamycin (mTOR)
Rapamycin blocks mTOR pathway signalling
mTOR pathway essential for DNA replication, cell cytotoxicity, cytokine secretion
Glutamine
Used at very high rates by lymphocytes and macrophages
Provides energy
Acts as precursor for purine and pyrimidine synthesis
Essential to replicate cells such as proliferating lymphocytes
Carbohydrate
May prevent the release of ‘immune-suppressive’ cytokines
May prevent ‘excessive’ or ‘inappropriate’ immune responses
May slow the rate that other factors are depleted maintaining blood glucose levels
Protein supplementation prevent impaired surveillance - source
Witard, 2013
Protein supplementation prevent impaired surveillance - Witard, 2013
Significantly decreased incidence of URTI with high intensity training and protein supplementation in elite cyclists.
Carbohydrate limits exercise-induced neuroendocrine disturbances - source
Scharhag et al., 2006
Carbohydrate limits exercise-induced neuroendocrine disturbances - Scharhag et al., 2006
14 male competitive cyclists and triathletes
3 standardised cycling session of 4 hrs
Ingested CHO beverages or placebo
CHO supplementation might attenuate the cortisol response to exercise
CHO supplementation might attenuate the IL-6 response to exercise
The IL-10 response will be less
Gleeson et al., 2012
Split athletes into illness-prone and illness-free
Significantly greater salivary rate in illness-free group
Significantly greater SigA secretion rate in illness-free group.
Hard to say whether this is due to exercise
Immunological aspects of nutrition - source
Gleeson, 2016
Immunological aspects of nutrition - Gleeson, 2016
CHO beverages
Antioxidant vitamins
Vitamin D3 supplements
Plant polyphenols
Probiotics
Colostrum
CHO beverages
Ingestion during prolonged exercise:
- lowers circulatory hormone
- lowers anti-inflammatory hormone
- delays appearance of symptoms of overreaching
Greater degree of immune depression without it
Maintains saliva flow rate - contains antimicrobial proteins
Antioxidant vitamins
Regular intake can reduce cortisol and anti-inflammatory cytokine response to prolonged exercise
Vitamin D3 supplements
Deficiencies lead to:
- impaired immune function
- increased respiratory infection risk
- associated with low saliva IgA secretion, low pro-inflammatory cytokine production by antigen-stimulated blood mononuclear cells
Plant polyphenols
Antioxidant, anti-inflammatory, anti-pathogenic, cardio-protective, anti-carcinogenic
Naturally present in apples, pears, green leafy vegetables
Probiotics
Reduce URI incidence
Fewer days of respiratory illness
Lower severity of URI
Colostrum
Elevates levels of antibodies in circulation and saliva
Prevents exercise-induced falls in salivary lysozyme
Speeds recovery of neutrophil function after strenuous exercise
Limits increase in gut permeability caused by strenuous exercise
Reduces risk of URI
