Some aspects of the acute phase response after a marathon race, and the effects of glutamine supplementation

Abstract

Strenuous exercise may be associated with immune suppression. However, the underlying mechanism is not known. A decrease in the plasma level of glutamine, which is utilised at a high rate by cells of the immune system, and an increase in the plasma level of some cytokines may impair immune functions such as lymphocyte proliferation after prolonged, exhaustive exercise. In two separate studies of the Brussels marathon, using similar protocols, the time course of the changes in the plasma concentrations of some amino acids (glutamine, glutamate, alanine, tryptophan and branched chain amino acids), acute phase proteins and cytokines (interleukins IL-1 alpha, IL-2, IL-6, tumour necrosis factor type a) was measured in male athletes. The numbers of circulating leucocytes and lymphocytes were also measured. Amino acid and cytokine concentrations have not previously been measured concomitantly in marathon runners; the measurement of some of these parameters the morning after the marathon (16 h) is novel. Another novel feature is the provision of glutamine versus placebo to marathon runners participating in the second study. In both studies the plasma concentrations of glutamine, alanine and branched chain amino acids were decreased immediately after and 1 h after the marathon. Plasma concentrations of all amino acids returned to pre-exercise levels by 16 h after exercise. The plasma concentration of the complement anaphylotoxin C5a increased to abnormal levels after the marathon, presumably due to tissue damage activating the complement system. There was also an increase in plasma C-reactive protein 16 h after the marathon. The plasma levels of IL-1 alpha were unaffected by the exercise, while that of IL-2 was increased 16 h after exercise. Plasma IL-6 was increased markedly (approximately 45-fold) immediately after and at 1 h after exercise. Neopterine, a macrophage activation marker, was significantly increased post-exercise. There was a marked leucocytosis immediately after the marathon, which returned to normal 16 h later. At the same time there was a decrease in the number of T-lymphocytes, which was further reduced within 1 h to below pre-exercise levels. Glutamine supplementation, as administered in the second study, did not appear to have an effect upon lymphocyte distribution.

Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis

“…It has been postulated that restoring glutamine levels after prolonged exercise to physiological levels may help the immune system to resist infections. Although oral provision of glutamine, or branched chain amino acids as a glutamine precursor, abolishes the post-exercise plasma glutamine decrease, it has no consistent effect on lymphocyte or neutrophil counts (Rohde et al, 1998;Walsh et al, 2000;Peters et al, 2001a;Krzywkowski et al, 2001a), salivary IgA (Krzywkowski et al, 2001b), oxidative burst activity (Walsh et al, 2000), NKCA (Rohde et al, 1998;Walsh et al, 2000) or plasma IL-6 (Castell et al, 1997;Hiscock et al, 2003) after exercise. Although it was suggested that glutamine could enhance Th1-type immune response in swimmers submitted to 4 weeks of intensive training, there was no significant difference in glutamine levels between athletes who developed URT infection and those who did not (Mackinnon and Hooper, 1996).…”

“…Doses of 1500 mg of vitamin C daily were reported to attenuate the increase in these cytokines after exercise (Nieman et al, 2000b;Peters et al, 2001a) or have no effect (Nieman et al, 2002b) at lower doses of 1000 or 500 mg daily (Nieman et al, 1997b;Peters et al, 2001b). Of the two studies where glutamine was given as a supplement, one study showed glutamine to augment the increase of plasma IL-6 (Hiscock et al, 2003) after exercise, while the other (Castell et al, 1997) did not. Polyunsaturated fatty acids had no effect on plasma TNF-alfa, IL-6, TGF-beta and IL-1ra (Toft et al, 2000).…”

“…The evidence has shown that prolonged periods of intense training may lead to high numbers of neutrophil and low numbers of lymphocytes in blood counts (Nieman et al, 1995(Nieman et al, , 1998aPedersen et al, 1997), impaired phagocytosis (Nieman et al, 1997a) and neutrophilic function (Nieman et al, 2000a), decreased oxidative burst activity (Nieman et al, 1997a), natural killer cell cytolytic activity (NKCA) (Shinkai et al, 1993;Nieman, 1997) and mucosal immunoglobulin levels (Nieman et al, 2002a). Intense training or endurance exercise may also enhance release of pro-inflammatory cytokines such as tumour necrosis factor alfa (TNF-alfa), interleukin-1b (IL-1b) and interleukin-6 (IL-6), followed closely by anti-inflammatory cytokines, such as interleukin-10 (IL-10) and interleukin-1 receptor antagonist (IL-1ra) (Castell et al, 1997;Nieman et al, 2001).…”

Glutamina: aspectos bioquímicos, metabólicos, moleculares e suplementação

“…Em atletas no estado de repouso, Castell e Newsholme (49) observaram que a concentração plasmática de glutamina aumentou cerca de 30 minutos após a ingestão oral de uma solução com L-glutamina (100mg/kg de peso corporal), podendo retornar aos valores basais no decorrer de aproximadamente duas horas.…”

Competitive Edge: Review of the Role of Glutamine, Arginine and β -Hydroxy- β -Methylbutyrate Supplements for Enhancing Athletic Performance in Addition to Benefiting the Body During Times of Stress, Illness and Wound Healing

“…They found that the glutamine group showed fewer infections compared to the placebo group. of the immune system is affected by glutamine feeding during the transient immunodepression (suppression that occurs after prolonged, strenuous exercise)" [7]. However, evidence indicates that neutrophils might be implicated instead of lymphocytes as previously thought [5][6][7].…”