Increased levels of alveolar and airway exhaled nitric oxide in runners

Abstract

AimThe objective of this study was to apply extended NO analysis for measurements of NO dynamics in the lung, divided into alveolar and airway contribution, in amateur runners and marathoners.MethodsThe athletes participated in either a marathon or a half marathon. The athletes self-reported their age, weight, height, training distance per week, competing distance, cardio-pulmonary health, atopic status, and use of tobacco. Measurements of exhaled NO (FENO) with estimation of alveolar NO (CANO) and airway flux (JawNO), ventilation, pulse oximetry, and peak flow were performed before, immediately after, and 1 hour after completing the race.ResultsAt baseline the alveolar NO was higher in amateur runners, 2.9 ± 1.1 ppb (p = 0.041), and marathoners, 3.6 ± 1.9 ppb (p = 0.002), than in control subjects, 1.4 ± 0.5 ppb. JawNO was higher in marathoners, 0.90 ± 0.02 nL s−1 (p = 0.044), compared with controls, 0.36 ± 0.02 nL s−1, whereas the increase in amateur runners, 0.56 ± 0.02 nL s−1, did not attain statistical significance (p = 0.165). Immediately after the race there was a decrease in FENO in both amateur runners and marathoners, whereas CANO and JawNO were decreased in marathoners only.ConclusionOur results support the view that there is an adaptation of the lung to exercise. Thus strenuous exercise increased both airway and alveolar NO, and this might in turn facilitate oxygen uptake.

Exercise Improves Lung Inflammation, but Not Lung Remodeling and Mechanics in a Model of Bleomycin-Induced Lung Fibrosis

“…Interestingly, the NO levels here were unaltered in nontrained fibrosis mice. Accordingly, Thornadtsson and collegues showed that higher NO levels in trained mice could reflect an adaptation of the lung to exercise training, which could lead to oxygen uptake improvement [ 38 ]. Therefore, we can suggest that aerobic exercise training could facilitate oxygen uptake through the NO-releasing in the pulmonary environment, even with alterations induced by bleomycin administration.…”

“…In addition, a study from Du et al (2019) has demonstrated that physical exercise can restore the synthesis of pulmonary hydrogen sulfide (H2S), improving the features of IPF in a model of pulmonary fibrosis induced by bleomycin [ 53 ]. This is of importance since H2S is a gasotransmitter similar to nitric oxide (NO), which has been increased in the exercised groups (Exe and Exe+Bleo), and according to the literature, increased levels of NO present protective effects in bleomycin model of pulmonary fibrosis [ 33 , 37 , 38 ]. Furthermore, a study from Prata et al (2017) has additionally demonstrated that angiotensin-converting enzyme 2 (ACE2) is activated by physical exercise leading to reduction of pulmonary fibrosis [ 54 ].…”

Marathoners' Breathing Pattern Protects Against Lung Injury by Mechanical Ventilation: A Pilot Study

“…The fact that the 2:2 breathing rhythm is favored empirically in situations such as a marathon, which has a long exercise load, suggests that this respiratory technique works effectively to prevent further progression of hypoxia and pulmonary edema. Moreover, the fact that the end-tidal CO 2 is not retained during a marathon, along with the increased metabolism over a long time, 13 suggests that the 2:2 breathing rhythm provides a su cient capacity for CO 2 elimination.…”

“…Moreover, since CO 2 is not retained during a marathon, where the metabolism is increased over an extended time, it has been suggested that the 2:2 breathing rhythm provides su cient capacity for CO 2 elimination. 13 In the present study, we developed a prototype ventilator that can perform intermittent positive pressure ventilation, mimicking the breathing cycle of the 2:2 breathing rhythm ( Fig. 1).…”

Marathoners’ breathing pattern protects against lung injury by mechanical ventilation: a pilot study

“…However, the 2:2 breathing pattern is empirically favored in marathon runners, presumably because it prevents the progression of additional hypoxemia and pulmonary edema during the marathon. Moreover, since CO 2 is not retained during a marathon, where the metabolism is increased over an extended time, it has been suggested that the 2:2 breathing pattern provides su cient capacity for CO 2 release [13].…”