Cytokine and Stress Hormone Responses to Exercise-induced Hypoxemia Among Endurance-trained

NCT04305873 | Enrolling By Invitation

• 1 other identifier: EIAH1
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

It is well documented that exercise-induced arterial hypoxemia (EIAH) is highly prevalent among endurance-trained athletes performing heavy intensity exercise, regardless of sex and age. Although it has been shown that a drop in arterial oxyhemoglobin saturation (SaO2) during exercise (i.e. EIAH) negatively affects aerobic capacity measures such as VO2max and time trial performance, there remains a gap in the literature as to the physiological consequences of EIAH, and specifically acute cytokines and stress-related responses to hypoxemia during exercise. Exposure to hypoxic environments in which SaO2 is reduced and exercise can each, independently, alter/activate various pro- and anti-inflammatory markers and increases stress hormones. It follows then that EIAH athletes could be more susceptible to, and encounter more frequently, episodes of elevated levels of inflammatory cytokines and an exaggerated stress response than non-EIAH athletes; however, to the best of the investigators knowledge, this is yet to be confirmed. Therefore, it is hypothesized that highly trained endurance athletes who develop EIAH will experience more pronounced increases in inflammatory cytokines and stress hormones following a bout of heavy intensity exercise compared to athletes without EIAH.

Conditions

Exercise-induced Arterial Hypoxemia

Keywords

High intensity exercise; Endurance; Athletes; Desaturation; Stress response; Inflammatory markers

Outcome Measures

Primary Outcomes (5)

• Inflammatory cytokines

  Changes in Inflammatory cytokines (e.g. IL-6, IL-1b, IL-ra, IL-10)

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Inflammatory cytokine

  Changes in Inflammatory cytokine TNF-a

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Changes in Cortisol level

  Stress hormones

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Changes in epinephrine level

  Stress hormones

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Changes in norepinephrine level

  Stress hormones

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

Secondary Outcomes (4)

• Changes in number of Neutrophiles

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Changes in number of lymphocytes

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Changes in number of monocytes

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

• Immune markers

  Changes from baseline to immediately, 2 hour and 24 hour post 30 minutes run at half marathon pace (HM30)

Study Arms (3)

EIAH athletes

Athletes with arterial oxyhemoglobin saturation at maximal exercise during a graded exercise test \<93%

Non-EIAH athletes

Athletes with arterial oxyhemoglobin saturation at maximal exercise during a graded exercise test \>95%

Intermediate EIAH athletes

Athletes with arterial oxyhemoglobin saturation at maximal exercise during a graded exercise test of 93-95%

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Probability Sample

Study Population

Highly endurance trained athletes who have run a half marathon or marathon in the past.

You may qualify if:

• \) Physically active (minimum of 50 km running/week) and maximal oxygen consumption \> 55 and 50 ml/kg-1/min-1 for men and women, respectively.
• \) classified as low risk based on a medical questionnaire, body mass index and non-smoking status.
• \) No history of pulmonary, metabolic and/or cardiovascular disease.
• \) normal pulmonary function as defined by a ≥ 80% of predicted forced vital capacity (FVC), forced expired volume in one second (FEV1) and FEV1/FVC according the American Thoracic Society standards.

You may not qualify if:

• Smoking and/or any pulmonary, metabolic and/or cardiovascular disease.
• maximal oxygen consumption lower than set criteria.

Sponsors & Collaborators

• Gepner Yftach: lead

Study Sites (1)

Tel Aviv University

Tel Aviv, Israel

Location

Related Publications (22)

• Babb TG. Exercise ventilatory limitation: the role of expiratory flow limitation. Exerc Sport Sci Rev. 2013 Jan;41(1):11-8. doi: 10.1097/JES.0b013e318267c0d2.

  PMID: 23038244 BACKGROUND

• Bayliss DA, Millhorn DE. Central neural mechanisms of progesterone action: application to the respiratory system. J Appl Physiol (1985). 1992 Aug;73(2):393-404. doi: 10.1152/jappl.1992.73.2.393.

  PMID: 1399957 BACKGROUND

• Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol (1985). 1986 Jun;60(6):2020-7. doi: 10.1152/jappl.1986.60.6.2020.

  PMID: 3087938 BACKGROUND

• Behan M, Kinkead R. Neuronal control of breathing: sex and stress hormones. Compr Physiol. 2011 Oct;1(4):2101-39. doi: 10.1002/cphy.c100027.

  PMID: 23733699 BACKGROUND

• Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.

  PMID: 7154893 BACKGROUND

• Chapman RF, Emery M, Stager JM. Extent of expiratory flow limitation influences the increase in maximal exercise ventilation in hypoxia. Respir Physiol. 1998 Jul;113(1):65-74. doi: 10.1016/s0034-5687(98)00043-7.

  PMID: 9776552 BACKGROUND

• Duke JW, Stickford JL, Weavil JC, Chapman RF, Stager JM, Mickleborough TD. Operating lung volumes are affected by exercise mode but not trunk and hip angle during maximal exercise. Eur J Appl Physiol. 2014 Nov;114(11):2387-97. doi: 10.1007/s00421-014-2956-0. Epub 2014 Aug 2.

  PMID: 25085604 BACKGROUND

• Pearman T, Yanez B, Peipert J, Wortman K, Beaumont J, Cella D. Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy. Cancer. 2014 Sep 15;120(18):2902-9. doi: 10.1002/cncr.28758. Epub 2014 May 22.

  PMID: 24853866 BACKGROUND

• Johnson BD, Saupe KW, Dempsey JA. Mechanical constraints on exercise hyperpnea in endurance athletes. J Appl Physiol (1985). 1992 Sep;73(3):874-86. doi: 10.1152/jappl.1992.73.3.874.

  PMID: 1400051 BACKGROUND

• Johnson BD, Weisman IM, Zeballos RJ, Beck KC. Emerging concepts in the evaluation of ventilatory limitation during exercise: the exercise tidal flow-volume loop. Chest. 1999 Aug;116(2):488-503. doi: 10.1378/chest.116.2.488.

  PMID: 10453881 BACKGROUND

• McClaran SR, Harms CA, Pegelow DF, Dempsey JA. Smaller lungs in women affect exercise hyperpnea. J Appl Physiol (1985). 1998 Jun;84(6):1872-81. doi: 10.1152/jappl.1998.84.6.1872.

  PMID: 9609779 BACKGROUND

• Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. No abstract available.

  PMID: 16055882 BACKGROUND

• Weavil JC, Duke JW, Stickford JL, Stager JM, Chapman RF, Mickleborough TD. Endurance exercise performance in acute hypoxia is influenced by expiratory flow limitation. Eur J Appl Physiol. 2015 Aug;115(8):1653-63. doi: 10.1007/s00421-015-3145-5. Epub 2015 Mar 13.

  PMID: 25761731 BACKGROUND

• Romer LM, Dempsey JA, Lovering A, Eldridge M. Exercise-induced arterial hypoxemia: consequences for locomotor muscle fatigue. Adv Exp Med Biol. 2006;588:47-55. doi: 10.1007/978-0-387-34817-9_5.

  PMID: 17089878 BACKGROUND

• Amann M, Eldridge MW, Lovering AT, Stickland MK, Pegelow DF, Dempsey JA. Arterial oxygenation influences central motor output and exercise performance via effects on peripheral locomotor muscle fatigue in humans. J Physiol. 2006 Sep 15;575(Pt 3):937-52. doi: 10.1113/jphysiol.2006.113936. Epub 2006 Jun 22.

  PMID: 16793898 BACKGROUND

• Dempsey JA, Wagner PD. Exercise-induced arterial hypoxemia. J Appl Physiol (1985). 1999 Dec;87(6):1997-2006. doi: 10.1152/jappl.1999.87.6.1997.

  PMID: 10601141 BACKGROUND

• Constantini K, Tanner DA, Gavin TP, Harms CA, Stager JM, Chapman RF. Prevalence of Exercise-Induced Arterial Hypoxemia in Distance Runners at Sea Level. Med Sci Sports Exerc. 2017 May;49(5):948-954. doi: 10.1249/MSS.0000000000001193.

  PMID: 28009787 BACKGROUND

• Dominelli PB, Molgat-Seon Y, Griesdale DEG, Peters CM, Blouin JS, Sekhon M, Dominelli GS, Henderson WR, Foster GE, Romer LM, Koehle MS, Sheel AW. Exercise-induced quadriceps muscle fatigue in men and women: effects of arterial oxygen content and respiratory muscle work. J Physiol. 2017 Aug 1;595(15):5227-5244. doi: 10.1113/JP274068. Epub 2017 Jun 19.

  PMID: 28524229 BACKGROUND

• Richards JC, McKenzie DC, Warburton DE, Road JD, Sheel AW. Prevalence of exercise-induced arterial hypoxemia in healthy women. Med Sci Sports Exerc. 2004 Sep;36(9):1514-21. doi: 10.1249/01.mss.0000139898.30804.60.

  PMID: 15354032 BACKGROUND

• Hopkins SR, Barker RC, Brutsaert TD, Gavin TP, Entin P, Olfert IM, Veisel S, Wagner PD. Pulmonary gas exchange during exercise in women: effects of exercise type and work increment. J Appl Physiol (1985). 2000 Aug;89(2):721-30. doi: 10.1152/jappl.2000.89.2.721.

  PMID: 10926659 BACKGROUND

• Hopkins SR. Exercise induced arterial hypoxemia: the role of ventilation-perfusion inequality and pulmonary diffusion limitation. Adv Exp Med Biol. 2006;588:17-30. doi: 10.1007/978-0-387-34817-9_3.

  PMID: 17089876 BACKGROUND

• Rice AJ, Thornton AT, Gore CJ, Scroop GC, Greville HW, Wagner H, Wagner PD, Hopkins SR. Pulmonary gas exchange during exercise in highly trained cyclists with arterial hypoxemia. J Appl Physiol (1985). 1999 Nov;87(5):1802-12. doi: 10.1152/jappl.1999.87.5.1802.

  PMID: 10562625 BACKGROUND

MeSH Terms

Conditions

Fractures, Stress

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator,

Study Record Dates

• First Submitted: March 4, 2020
• First Posted: March 12, 2020
• Study Start: March 1, 2020
• Primary Completion: May 1, 2024
• Study Completion: September 1, 2024
• Last Updated: February 22, 2024

Record last verified: 2024-02

Locations

IL (1)