Changes in gastrointestinal cell integrity after marathon running and exercise-associated collapse

Walter, Edward; Gibson, Oliver; Stacey, Michael; Hill, Neil; Parsons, Iain; Woods, David R.

doi:10.1007/s00421-021-04603-w

Cited by 18 publications

(24 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore NSE might be expected to increase with the evolution of endotoxaemic encephalopathy concomitant to exertional hyperthermia. This is suggested by the present work and supported by elevated I-FABP in our complementary reporting of the same casualties [ 14 ]. While the level of consciousness observed upon initial medical assessment was less depressed in these EHI cases than observed in other positive clinical studies of patients with SAE [ 18 ], traumatic brain injury [ 23 ] and cardiac arrest [ 24 ], this tallies with a discriminant value of NSE in the present investigation that was relatively lower in numerical value.…”

Section: Discussionsupporting

confidence: 89%

“…We have demonstrated compromise to the GI epithelium with early, substantial and sustained elevations in intestinal fatty acid binding protein (I-FABP) in marathon runners diagnosed with EHI [ 14 ]. This raises the question of whether these patients experienced significant injury to other organ systems in the evolution of their illness, which might have been detectable at the initial point of care (POC).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Medical personnel may find it challenging to distinguish severe Exertional Heat Illness (EHI), with attendant risks of organ-injury and longer-term sequalae, from lesser forms of incapacity associated with strenuous physical exertion. Early evidence for injury at point-of-incapacity could aid the development and application of targeted interventions to improve outcomes. We aimed to investigate whether biomarker surrogates for end-organ damage sampled at point-of-care (POC) could discriminate EHI versus successful marathon performance. Methods Eight runners diagnosed as EHI cases upon reception to medical treatment facilities and 30 successful finishers of the same cool weather marathon (ambient temperature 8 rising to 12 ºC) were recruited. Emerging clinical markers associated with injury affecting the brain (neuron specific enolase, NSE; S100 calcium-binding protein B, S100β) and renal system (cystatin C, cysC; kidney-injury molecule-1, KIM-1; neutrophil gelatinase-associated lipocalin, NGAL), plus copeptin as a surrogate for fluid-regulatory stress, were sampled in blood upon marathon collapse/completion, as well as beforehand at rest (successful finishers only). Results Versus successful finishers, EHI showed significantly higher NSE (10.33 [6.37, 20.00] vs. 3.17 [2.71, 3.92] ug.L-1, P<0.0001), cysC (1.48 [1.10, 1.67] vs. 1.10 [0.95, 1.21] mg.L-1, P = 0.0092) and copeptin (339.4 [77.0, 943] vs. 18.7 [7.1, 67.9] pmol.L-1, P = 0.0050). Discrimination of EHI by ROC (Area-Under-the-Curve) showed performance that was outstanding for NSE (0.97, P<0.0001) and excellent for copeptin (AUC = 0.83, P = 0.0066). Conclusions As novel biomarker candidates for EHI outcomes in cool-weather endurance exercise, early elevations in NSE and copeptin provided sufficient discrimination to suggest utility at point-of-incapacity. Further investigation is warranted in patients exposed to greater thermal insult, followed up over a more extended period.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Indeed, it has been suggested that damage to the gut can be a contributing factor in exertional heat stroke [ 18 ]. Recently, Walter and colleagues [ 19 ] demonstrated a substantially higher systemic concentration of a marker of enterocyte cell damage (intestinal fatty acid binding protein, iFABP) in athletes who collapsed after a marathon compared with those who did not, providing further evidence for the potential role and importance of the gut barrier in this pathway.…”

Section: Gastrointestinal Integritymentioning

confidence: 99%

The Use of Bovine Colostrum in Sport and Exercise

Davison

2021

Nutrients

View full text Add to dashboard Cite

There has been a great deal of interest in bovine colostrum within sports nutrition over the last 25 years. Studies have investigated the effects on body composition, physical performance, recovery, gut damage and permeability, immune function, and illness risk. This narrative review considers available evidence in each of these areas. Although some studies have shown protection against performance decrements caused by periods of intensified training, there is limited evidence for effects on body composition and physical performance. There is stronger evidence for benefit on gut permeability and damage markers and on immune function and illness risk, especially during periods of intensified training. The balance of available evidence for gut permeability and illness risk is positive, but further research is required to fully determine all mechanisms responsible for these effects. Early suggestions that supplementation with bovine colostrum products could increase systemic IGF-1 levels are not supported by the balance of available evidence examining a range of doses over both short- and long-term periods. Nevertheless, dose–response studies would be valuable for determining the minimum efficacious dose, although this is complicated by variability in bioactivity between products, making any dose–response findings applicable only to the specific products used in such studies.

show abstract

“…Data from others have suggested that it is equivocal whether heat stress or exercise is the primary determinant of increased GI permeability in EHI (Pires et al, 2017;Shing et al, 2014). Further to this, a recent study on the gut biomarker intestinal fatty acid-binding protein (I-FABP) suggests that after endurance exercise, I-FABP is raised (+130%) compared with pre-race levels, despite no change in core temperature, but is significantly higher (up to a further 10-fold) after EHI, and persists for several hours despite cessation of exercise and core temperature returning to baseline (Walter et al, 2021). Determining the independent and combined effects of heat stress and exercise on GI permeability may further our understanding of the pathophysiology of EHI, in particular, the subsequent endotoxemia and inflammatory response, which may support the development of preventative and/ or therapeutic interventions.…”

Section: Introductionmentioning

confidence: 95%

Exercise hyperthermia induces greater changes in gastrointestinal permeability than equivalent passive hyperthermia

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

Changes in gastrointestinal cell integrity after marathon running and exercise-associated collapse

Cited by 18 publications

References 32 publications

Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon

Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon

The Use of Bovine Colostrum in Sport and Exercise

Exercise hyperthermia induces greater changes in gastrointestinal permeability than equivalent passive hyperthermia

Contact Info

Product

Resources

About