Ischemic Preconditioning Enhances Performance and Erythrocyte Deformability of Responders

Abstract

This pilot study aimed to evaluate the differential effects of a remote ischemic preconditioning (rIPC) manoeuvre on performance and red blood cell (RBC) deformability compared to a sham control and a placebo setting. Ten male subjects performed three test settings in a single-blind, crossover, and randomized control design. All settings started with 20 min of rest and were followed by 4 cycles of occlusion/reperfusion consisting of 5 min each. During rIPC and placebo, the cuff pressure was inflated to 200 mmHg and 120 mmHg, respectively. During the sham control setting, 10 mmHg pressure was applied. All tests were followed by a cycle exercise with lactate diagnostics. Power at 2 and 4 mmol/l lactate thresholds were calculated. RBC deformability was measured before and after the respective manoeuvre. Results showed that no effect resulted from any manoeuvre on performance values or RBC deformability. But 6 subjects showed a higher power at the 2 mmol/l threshold, and 5 subjects exerted higher power at the 4 mmol/l threshold when the rIPC manoeuvre preceded the exercise. In these responsive subjects, RBC deformability also improved. Hence, rIPC effects are much influenced by the subjects' responsiveness, and improved RBC deformability might contribute to enhanced performance in responsive subjects.

Red Blood Cell Aging as a Homeostatic Response to Exercise-Induced Stress

“…These changes were associated with improved function, as indicated by an increase in deformability and a decrease in the tendency to aggregate ( Figure 5). Similar alterations with a concomitant increase in function, indicating a shift towards an overall younger RBC population, have been reported to result from various forms of exercise [10,[26][27][28][29].…”

“…In trained athletes, exercise has been reported to induce hemolysis [8,9]. Recently, this has been postulated to be associated with a shift towards a decrease in mean cell age of the RBC population and a concomitant improvement in function [10]. The Four Days Marches of Nijmegen in the Netherlands, the world's largest yearly voluntary walking event, presents the possibility to study the effect of prolonged, moderate-intensity exercise on the molecular mechanism of RBC aging in vivo.…”

Repeated sprint cycling performance is not enhanced by ischaemic preconditioning or muscle heating strategies

“…Previous work suggests IPC meaningfully enhances performance by approximately 1.5% in well-trained individuals (Ferreira et al, 2016), however, the current data show the difference in average power output between IPC and SHAM was just 1.2%, possibly supporting the "unclear" inference. It may be that IPC is less effective in highly-trained athletes (Hittinger et al, 2015) such as the current study cohort, compared to lesser-trained individuals (de Groot et al, 2010), although individual responders to IPC interventions should also be considered, regardless of training status (Tomschi, Niemann, Bloch, Predel, & Grau, 2018). The degree to which training status impacts the efficacy of IPC remains to be determined and should be further investigated.…”

Ozone Preconditioning: Waking up the dragon

“…Heightened energy output by the RBC mass translates directly into increased blood flow and energy delivery to peripheral tissues. RBCs possess the enzyme nitric oxide (NO) synthase and generate large amounts of NO in response to oxidative stress that not only increases RBC hardiness and deformability but interacts with endothelial-generated NO to maintain active vasodilation (a reliable proxy for blood energy content) [137][138][139][140][141][142][143][144][145][146][147][148]. Ozone-related oxidative stress triggers activation of hypoxia inducible factor-1 (HIF-1) which, in turn, augments release of vascular endothelial growth factor (VEGF) and erythropoietin (EPO) which stimulate angiogenesis, blood flow and oxygen delivery to peripheral tissues [149].…”