C-Reactive Protein Is Elevated Only in High Creatine Kinase Responders to Muscle Damaging Exercise

Abstract

The purpose of this study was to investigate if exertional rhabdomyolysis induced by an acute bout of plyometric exercise in untrained individuals was associated with histological characteristics of skeletal muscle, creatine kinase (CK) polymorphism or secondary damage. Twenty-six healthy male untrained individuals completed a bout of plyometric exercise (10 sets of 10 maximal squat jumps, with each standardized to achieve at least 95% of individual maximal jump height). Blood samples were taken, and perceived pain was scored immediately before the exercise intervention and 6 h, 1, 2, and 3 days post-intervention. Muscle biopsies were collected 9 or 4 days before (baseline) and 3 days after plyometric jumps. Subjects were divided into two groups, high (n = 10) and low responders (n = 16), based on a cut-off limit for exertional rhabdomyolysis of peak CK activity ≥ 1000 U/L in any post-exercise blood sample. Perceived pain was more severe assessed in squat than standing position. Low responders perceived more pain at 6 h and 1 day, while high responders perceived more pain than low responders on days three and four after exercise; structural (dystrophin staining) and ultra-structural (transmission electron microscopy) analysis of muscle fibers revealed no baseline pathology; damage was evident in all individuals in both groups, with no difference between high and low responders in either damage or fiber type proportion. High responders had significantly higher total white blood cell and neutrophil counts 6 h and significantly higher C-reactive protein (CRP) 6 h and days one and two after exercise compared to low responders. High responders had significantly greater muscle myeloperoxidase (MPO) levels in baseline and 3 day post-exercise biopsies compared to baseline of low responders. MLCK C49T single polymorphism was present in 26% of volunteers, whose CK responses were not higher than those with MLCK CC or CT genotype. In conclusion, perceived pain is more effectively assessed with potentially affected muscle under eccentric strain, even if static. High CK responders also have pronounced CRP responses to unaccustomed plyometric exercise intervention. Exertional rhabdomyolysis after unaccustomed eccentric exercise may be related to underlying inability to resolve intramuscular MPO.

Effects of 120 g/h of Carbohydrates Intake during a Mountain Marathon on Exercise-Induced Muscle Damage in Elite Runners

“…Among them is the fact that plasma interleukin-6 (IL-6) was not measured, as this represents a reliable biochemical parameter for assessing inflammation induced by exercise and EIMD [76]. Moreover, C-reactive protein is an acute phase protein produced by the liver in response to IL-6 increases during systemic inflammation and is dependent on several factors such as individual response [77]. Along these lines, it has been demonstrated that CHO intake influences IL-6 but not C-reactive protein following a 32 km mountain trail race [66] and, therefore, it might have been interesting to measure these parameters.…”

The Effect of Orally Dosed Levagen+™ (palmitoylethanolamide) on Exercise Recovery in Healthy Males—A Double-Blind, Randomized, Placebo-Controlled Study

“…One study by Isaacs et al describes that only "high responders", those whose creatine kinase (CK)increased above 1000 U/L after muscle damaging exercise, had a corresponding increase in Mb. It was also noted that only "high responders" also increased C-reactive protein (CRP) [31]. However, those that were "low responders" did not have a corresponding increase in CK or CRP suggesting that changes in Mb, CK, and CRP have a non-linear relationship.…”

Dynamic urine proteome changes in a rat model of simvastatin-induced skeletal muscle injury

“…Three differential proteins in the SAMS group had been reported to be associated with muscle damage since day 3. For example, i) the fibrinogen gamma chain (FIBG) increased ≥10-fold after impact trauma in the muscle tissue of male Wistar rats [32]; ii) osteopontin (OSTP) was reported to be increased in patients with idiopathic inflammatory myopathies, both in muscle and in serum [34]; and iii) C-reactive protein (CRP) was reported to be elevated only in humans with high CK levels when undergoing muscle-damaging exercise [37]. In addition, five differential proteins were associated with the mechanism of SAMS.…”