A Pilot Study on the Prediction of Non-Contact Muscle Injuries Based on ACTN3 R577X and ACE I/D Polymorphisms in Professional Soccer Athletes

Abstract

Muscle injuries are among the main reasons for medical leavings of soccer athletes, being a major concern within professional teams and their prevention associated with sport success. Several factors are associated with a greater predisposition to injury, and genetic background is increasingly being investigated. The aim of this study was to analyze whether ACTN3 R577X and ACE I/D polymorphisms are predictors of the incidence and severity of muscle injury in professional soccer athletes from Brazil, individually and in association. Eighty-three professional athletes from the first and second divisions of the Brazilian Championship were evaluated regarding the polymorphisms through blood samples. Nighty-nine muscle injuries were identified during the seasons of 2018, 2019 and 2020 and categorized according to severity. ACTN3 XX individuals had a higher frequency of severe injuries compared to the RX and RR genotypes (p = 0.001), and in the dominant model (compared to RX+RR), with p < 0.001. The trend p-value test showed an increased number of injuries/season following the order XX > RX > RR (p = 0.045). Those with the ACE II genotype had almost 2 fold the number of injuries per season compared to those with the ID+DD genotypes (p = 0.03). Logistic regression showed that the polymorphisms are predictors of the development of severe injury (ACTN3 R577X model with p = 0.004, R2: 0.259; ACE I/D model with p = 0.045, R2: 0.163), where ACTN3 XX individuals were more likely to suffer from severe injury (OR: 5.141, 95% CI: 1.472–17.961, p = 0.010). The combination of the ACTN3 577X allele and the ACE II genotype showed an increased number of injuries per season, enhanced by 100% (1.682 injuries/season versus 0.868 injuries/season, p = 0.016). Our findings suggest that both polymorphisms ACTN3 R577X and ACE I/D (and their interaction) are associated with the susceptibility and severity of non-contact muscle injury in soccer players.

Association between Total Genotype Score and Muscle Injuries in Top-level Football Players: a pilot study

“…Regarding the ACE I/D polymorphism, the present study supports previous ndings that showed the protective effect of the D-allele against muscle injuries [5,21] and muscle damage. More in detail, de Almeida et al [21] recently showed that Brazilian professional football players with the ACE II genotype had almost 2 fold the number of injuries per season compared to those with the ID + DD genotypes (p = 0.03).…”

“…Regarding the ACTN3 polymorphism, our results support previous ndings that showed the protective effect of the Rallele against muscle injuries [4,21] and muscle damage. According to a recent systematic review, athletes with the ACTN3 XX genotype may be more likely to sustain certain non-contact injuries, such as muscle damage, ankle sprains, and higher levels of exercise-induced muscle damage, which could hurt injury frequency and severity in comparison to RX and RR genotypes [27].…”

“…De Almeida et al [21] and Maestro et al [22] recently examined the combined impact of some polymorphisms on muscle injuries in professional soccer players and concluded that the likelihood of injuries may be in uenced by a polygenic pro le of genes involved in muscle performance. This pilot study aimed to investigate, for the rst time, the combined effect of four common gene polymorphisms previously reported to be associated with muscle injuries in elite Italian soccer players from different levels of competition.…”

The Association between ACTN3 R577X Polymorphism and Range of Motion: A Systematic Review and Meta-analysis

“…Generally, low ROM is known to increase the risk of muscle injury [42][43][44]. However, the X allele of ACTN3 R577X polymorphism has a higher ROM than the RR genotype and a higher risk of muscle injury [13][14][15]. A previous study suggested that the X allele had higher muscle damage such as creatine kinase activity and muscle soreness compared to the RR genotype [45].…”

“…ACTN3 R577X polymorphism influences muscle strength [9] and power/sprint athletic status [10]. Because deficiency of α-actinin-3 alters muscle structure, the ACTN3 R577X polymorphism is associated with muscle damage [11,12] and muscle injury [13][14][15]. ACTN3 R577X polymorphism, which regulates α-actinin-3 expression, influences not only muscle contractile properties such as muscle strength and power but also flexibility.…”