Winter ambient training conditions are associated with increased bronchial hyperreactivity and with shifts in serum innate immunity proteins in young competitive speed skaters

Abstract

IntroductionRegular training modulates airway inflammation and modifies susceptibility to respiratory infections. The impact of exercise and ambient conditions on airway hyperreactivity and innate immunity has not been well studied. We aimed to assess exercise-related symptoms, lung function, airway hyperresponsiveness and innate immunity proteins in relation to meteorological conditions and exercise load in competitive athletes.Material and methodsThirty-six speed skaters were assessed during winter (WTP) and summer (STP) periods. The control group comprised 22 non-exercising subjects. An allergy questionnaire for athletes (AQUA) and IPAQ (International Physical Activity Questionnaire) were used to assess symptoms and exercise. Meteorological parameters were acquired from World Meteorological Organization resources. Serum innate immunity proteins were measured by ELISA.ResultsExercise-associated respiratory symptoms were reported by 79.4% of skaters. Despite similar exercise load and lung parameters during both periods, positive methacholine challenge was more frequent during winter (p = 0.04). Heat shock protein HSPA1 and IL-1RA were significantly decreased during STP compared to WTP and controls. During WTP, IL-1RA was elevated in skaters reporting exercise-induced symptoms (p = 0.007). sCD14 was elevated in athletes versus controls in both periods (p < 0.05). HSPA1 was significantly higher in WTP compared to STP irrespective of presence of respiratory tract infections (RTIs). IL-1RA in WTP was elevated versus STP (p = 0.004) only in RTI-negative athletes. Serum IL-1RA negatively correlated with most meteorological parameters during WTP.ConclusionsAmbient training conditions, but not training load, influence bronchial hyperreactivity and the innate immune response in competitive athletes assessed during winter. The protective effect of regular exercise against respiratory infections is associated with a shift in serum innate immunity proteins.

Exercise in Sub-zero Temperatures and Airway Health: Implications for Athletes With Special Focus on Heat-and-Moisture-Exchanging Breathing Devices

“…Among non-asthmatic skiers, up to 75% have returned positive responses to methacholine challenge (Karjalainen et al, 2000 ). Furthermore, a higher rate of positive methacholine challenge arose during winter in competitive speed skaters (Kurowski et al, 2018a ) and methacholine reactivity was increased after the coldest period of the year in cross-country skiers (Heir and Larsen, 1995 ). However, some of the hallmarks of airway inflammation observed in cross-country skiers are not consistent with those of atopic asthma, eosinophilic asthma or traditional models of exercise-induced bronchoconstriction, in line with the suggestion that “sports asthma,” including that exacerbated by training in cold and dry air, has a distinct phenotype (Couto et al, 2015 ).…”

“…Furthermore, baseline TNF-α in exhaled breath condensate was positively correlated with percentage decreases in FEV 1 following exercise challenge for both athletes during a hard training period and asthmatic subjects (Kurowski et al, 2018b ). Among speed skaters reporting exercise-induced respiratory symptoms, IL-1RA was elevated during the winter training period compared to asymptomatic athletes (Kurowski et al, 2018a ). Together these observations suggest a multifactorial inflammatory profile may develop during winter training in athletes that may be associated with symptoms and/or lung function.…”

Serum but not exhaled breath condensate periostin level is increased in competitive athletes

“…Exercise‐induced asthma and bronchoconstriction are believed to be underestimated in professional athletes . Changes in the serum levels of innate immunity proteins are known to occur in professional athletes during the training season, in response to exercise load and ambient training conditions . Increases in serum periostin may be associated with exercise‐induced bronchoconstriction but little evidence is available to support this …”

“…8,9 Changes in the serum levels of innate immunity proteins are known to occur in professional athletes during the training season, in response to exercise load and ambient training conditions. 10 Increases in serum periostin may be associated with exercise-induced bronchoconstriction but little evidence is available to support this. [11][12][13] Upregulated periostin expression is associated with tissue regeneration in response to injury, as well as with fibrotic pathological conditions such as scar formation, myocardial infarction, lung and muscle fibrosis, or liver cirrhosis.…”

Respiratory Infections

“…Serum levels of anti-inflammatory IL-1ra protein observed in young speed skaters were negatively correlated with ambient air temperature during winter season in the outdoor training area, suggesting that serum IL-1ra is partly reflecting cold air exposure in winter athletes. In addition, serum IL-1ra was significantly elevated in winter season only in athletes not reporting frequent respiratory tract infections [52] which adds further insight into the significance of anti-inflammatory cytokine properties in conditioning susceptibility to respiratory infections.…”