Pneumococcal antibody responses in elite swimmers

The ability of elite swimmers to mount an antibody response to the pneumococcal vaccine, Pneumovax 23, was assessed at the end of an intensive 12-week training programme. Antibody titres to six pneumococcal polysaccharide types were measured in 20 elite swimmers (10 male, 10 female) aged 17–23 years and 19 sedentary age- and sex-matched students (eight male, 11 female) aged 18–23 years. Blood samples were tested 14 days apart to assess the magnitude of the antibody response and changes in serum immunoglobulin isotypes and IgG subclasses. There were no significant differences in any of the pneumococcal antibody responses to the Pneumovax between swimmers and controls, and no gender effect, either before or after vaccination. The clinically adequate response to the vaccine was greatest for the pneumococcal serotype 4, which was 97% for the total study population. There were no significant correlations between the magnitude of any of the pneumococcal antibody responses and (i) changes in the scores for the swimmers’ international performance; (ii) infection rates in either swimmers or controls; (iii) any psychological variables, assessed by the Profile of Mood States (POMS) questionnaire for either swimmers or controls. Swimmers had significantly lower concentrations of serum IgG2 (P = 0·04) and IgG3 (P = 0·002) before pneumococcal vaccination. The swimmers had an increase in all immunoglobulin isotypes and IgG subclasses post-vaccination, suggesting a polyclonal response to the vaccine that was not observed in control subjects. The magnitude of the subclass responses after vaccination was significantly greater in swimmers compared with controls for IgG1 (P = 0·04), IgG3 (P = 0·04) and IgG4 (P = 0·01). The data indicated that elite swimmers undertaking an intensive training programme were capable of mounting an antibody response to pneumococcal antigens equivalent to that of age- and sex-matched sedentary control subjects, despite the swimmers having lower prevaccination levels of serum immunoglobulins.     

Cytokine production by monocytes, neutrophils, and dendritic cells is hampered by long-term intensive training in elite swimmers

Elite level athletes seem to be prone to illness especially during heavy training phases. The aim of this study was to investigate the influence of long term intensive training on the functional features of innate immune cells from high competitive level swimmers, particularly the production of inflammatory mediators and the possible relationship with upper respiratory symptoms (URS) occurrence. A group of 18 swimmers and 11 healthy non athletes was studied. Peripheral blood samples were collected from athletes after 36?h of resting recovery from exercise at four times during the training season and at three times from non athletes. Samples were incubated in the presence or absence of LPS and IFN-?? and the frequency of cytokine-producing cells and the amount produced per cell were evaluated by flow cytometry. In addition, plasma cortisol levels were measured and URS recorded through daily logs. The athletes, but not the controls, showed a decrease in the number of monocytes, neutrophils, and dendritic cell (DC) subsets and in the amount of IL-1??, IL-6, IL-12, TNF-??, and MIP-1?? produced after stimulation, over the training season. Differences were most noticeable between the first and second blood collections (initial increase in training volume). Athlete??s cortisol plasma levels partially correlated with training intensity and could help explain the reduced in vitro cell response to stimulation. Our results support the idea that long-term intensive training may affect the function of innate immune cells, reducing their capacity to respond to acute challenges, possibly contributing to an elevated risk of infection.     

Effect of intense swimming training on rhinitis in high‐level competitive swimmers

Background Rhinitis is commonly reported by swimmers. Seasonal allergic rhinitis may impair athletes' performance and quality of life (QOL). No data are currently available on the changes of nasal symptoms during and after a swimming season. We aimed to determine in competitive swimmers: (1) the prevalence of rhinitis and its impact on their QOL during an intense training programme, (2) the changes in nasal symptoms and QOL after a resting period and (3) the relationship between rhinitis and airway hyperresponsiveness (AHR). Methods Thirty‐nine swimmers and 30 healthy controls answered the Rhinitis Quality of Life Questionnaire (RQLQ) and scored nasal symptoms on a seven‐point Likert scale during the week preceding their visit. Subjects had allergy skin prick tests and a methacholine challenge. Peak nasal inspiratory flows were also measured. The athletes performed these tests during an intense training period (V1), outside the pollen season and after at least 2 weeks without swimming (V2). Results At V1, rhinitis symptoms were reported by 74% of swimmers and 40% of controls (P<0.01). Eighty‐four percent of swimmers and 72% of controls were atopic (NS). RQLQ score was higher in swimmers compared with controls at V1 (27.3 ± 28.5 vs. 9.5 ± 12.7, respectively, P<0.005). The presence of AHR during training did not correlate with the presence of rhinitis symptoms. At V2, the nasal symptoms and RQLQ scores were similar in swimmers and controls. Conclusion Intense swimming training is associated with an increase in nasal symptoms and impairment in QOL in most competitive swimmers. Such an increase is not related to seasonal allergen exposure in atopic athletes and probably results from chlorine derivative exposure. Cite this as: V. Bougault, J. Turmel and L. P. Boulet, Clinical & Experimental Allergy, 2010 (40) 1238–1246.     

Influence of altitude training modality on performance and total haemoglobin mass in elite swimmers

We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.     

Humoral immunity in nasal mucosa of patients with common variable immunodeficiency

Humoral immunodeficiency, as reflected by the low serum immunoglobulin (Ig) concentrations in adult patients with common variable immunodeficiency (CVID), was even more severely expressed at the B-cell level in their nasal mucosa. No Ig-producing cells could be detected by immunohistochemistry in 11 of 19 mucosal specimens. The epithelial distribution of secretory component (SC) was normal in all specimens, but a sign of SC-dependent IgM transport was seen in only three. Epithelial IgA was completely lacking. All patients had had recurrent lower respiratory tract infections and 16 had recurrent or chronic infections of the upper respiratory tract. A previous report indicated that the intestinal mucosa is a privileged site for maturation of B cells in patients with CVID; the present study shows that this does not hold true for the nasal mucosa. This difference in B-cell maturation may in part explain the preferential susceptibility to infections in the respiratory tract of patients with CVID.     

Disconnect between standardized field‐based testing and mannitol challenge in Scottish elite swimmers

Background Elite swimmers have high rates of rhinoconjunctivitis and exercise‐induced bronchoconstriction. Moreover, exposure to chlorine and chlorine metabolites is known to induce bronchial hyper‐reactivity. Objective To assess the early and late effects of chlorine and exercise on the unified airway of elite swimmers, and to compare the response to mannitol and field‐based exercise challenge. Methods The Scottish national squad underwent exhaled tidal (FE_NO) and nasal (N_NO) nitric oxide measurement, peak nasal inspiratory flow (PNIF), and forced expiratory volume in 1 s before, immediately after, and 4–6 h post‐swimming. A sport‐specific exercise test was carried out during an intensive lactate set (8 min at 80% maximum hear rate). All swimmers underwent mannitol challenge, and completed a health questionnaire. Results N=61 swimmers were assessed: 8/59 (14%) of swimmers had a positive mannitol challenge. Nine out of 57 (16%) of swimmers had a positive exercise test. Only one swimmer was positive to both. Swimmers with a positive mannitol had a significantly higher baseline FE_NO (37.3 vs. 18.0 p.p.b., P=0.03) than those with a positive exercise challenge. A significant decrease in FE_NO was observed pre vs. immediate and delayed post‐chlorine exposure: mean (95% CI) 18.7 (15.9–22.0) p.p.b. vs. 15.9 (13.3–19.1) p.p.b. (P<0.01), and 13.9 (11.5–16.7) p.p.b. (P<0.01), respectively. There were no significant differences in N_NO. Mean PNIF increased from 142.4 L/min (5.8) at baseline to 162.6 L/min (6.3) immediately post‐exposure (P<0.01). Delayed post‐exposure PNIF was not significantly different from pre‐exposure. Conclusions No association was found between mannitol and standardized field‐based testing in elite swimmers. Mannitol was associated with a high baseline FE_NO; however, exercise/chlorine challenge was not. Thus, mannitol may identify swimmers with a ‘traditional’ inflammatory asthmatic phenotype, while field‐based exercise/chorine challenge may identify a swimmer‐specific bronchoconstrictor response. A sustained fall in FE_NO following chlorine exposure suggests that a non‐cellular, perhaps neurogenic, response may be involved in this group of athletes. Cite this as: K. L. Clearie, P. A. Williamson, S. Vaidyanathan, P. Short, A. Goudie, P. Burns, P. Hopkinson, K. Meldrum, L. Howaniec and B. J. Lipworth, Clinical & Experimental Allergy, 2010 (40) 731–737.     

Mucosal immunity in extrinsic allergic alveolitis: salivary immunoglobulins and antibody against inhaled avian antigens among pigeon breeders

BACKGROUND: Inhaled antigens from pigeons can cause extrinsic allergic alveolitis (EAA); a model disease of pulmonary inflammation. Among pigeon breeders, serum antibody and sensitized lymphocytes specific for these antigens have been described primarily, but not always, with disease. Antibody activity within the lung may have a closer association with disease, however, sampling by alveolar lavage at bronchoscopy is impractical for screening, therefore we used saliva to quantify the mucosal antibody response. OBJECTIVE: To establish: (a) if antibody activity against inhaled avian antigens was detectable in the saliva of pigeon breeders, (b) if the distribution of saliva antibody and total immunoglobulin levels were quantitatively or qualitatively different from serum, and (c) whether the hypersensitivity symptoms of EAA were associated more with the mucosal or the systemic humoral immune response. MEASURES: Saliva and serum total and avian antigen-specific IgG, IgA (IgA1 and IgA2) antibody activity in 87 pigeon breeders and 24 control subjects with no avian exposure. Albumin levels were used as a protein reference and cotinine levels confirmed smoking status. Specific hypersensitivity symptoms and various exposure indices to pigeons were established by interview. RESULTS: Absolute levels and relative proportions (vs albumin) of IgG, IgA and IgA1 in saliva, and IgG in serum, were significantly higher in pigeon breeders compared with controls, suggesting mucosal inflammation. Avian antigen-specific antibody of all isotypes was readily demonstrable in saliva (predominantly IgA) and serum (predominantly IgG) from pigeon breeders, and there were no significant titres in controls. The levels of IgG antibody in saliva and in serum correlated significantly (r = 0.52, P < 0.001), and both correlated with the raised immunoglobulin levels. In both saliva and serum the IgG rather than the IgA antibody activity was associated with symptoms of EAA. CONCLUSIONS: Antibody activity in saliva and serum, representing the mucosal and systemic responses, respectively, were both strongly stimulated by inhaled antigens. The IgG antibody titres of saliva and serum correlated significantly and were a useful index of inflammation, as measured by the raised total immunoglobulin levels, and symptoms. This suggests that IgG antibody in serum may reflect clinical and immunological sensitization of the lung mucosa. Collecting saliva is noninvasive, and saliva antibody measurement is a convenient method for monitoring EAA, especially in children, and will facilitate sampling for example in epidemiological studies of antibody prevalence.     

The influence of stroke mechanics into energy cost of elite swimmers

The purpose of this study was to analyze the relationships between energy cost (C), swimming velocity (v), stroke frequency (SF) and stroke length (SL) in top-level swimmers. Eighteen elite swimmers (four freestylers, five backstrokers, five breaststrokers and four butterflyers) performed an intermittent set of n × 200 m swims (n ≤ 8) with increasing velocity. The oxygen consumption was measured breath-by-breath by a portable metabolic cart (K4 b2, Cosmed, Rome, Italy). A respiratory snorkel and valve system with low hydrodynamic resistance was used to measure pulmonary ventilation and collect expiratory gases. Blood samples were taken from the ear lobe before and after each swim to analyze the blood lactate concentration (YSI 1500L, Yellow Springs, OH, USA). At Backstroke, Breaststroke and Butterfly strokes, increases of SF were associated to increases of C, even when controlling the v. The increases in SL only promoted significant decreases in the C in Breaststroke. There was a significant and polynomial relationship between v and SF for all competitive swimming techniques. The polynomial relationship between v and SL was significant only in Freestyle and Butterfly stroke. Partial correlations between v and SF controlling the effect of SL and between v and SL controlling the effect of SF, were positive and significant for all techniques. It is concluded that manipulation of stroke mechanics variables (SF and SL) may be one of the factors through which C in competitive swimming can be altered for a given v.     

The effect of endurance training on the ventilatory response to exercise in elite cyclists

The purpose of this study was to investigate the effects of endurance training on the ventilatory response to acute incremental exercise in elite cyclists. Fifteen male elite cyclists [mean (SD) age 24.3 (3.3) years, height 179 (6) cm, body mass 71.1 (7.6) kg, maximal oxygen consumption (V˙O_2max) 69 (7) ml · min⁻¹ · kg⁻¹] underwent two exercise tests on a cycle ergometer. The first test was assessed in December, 6 weeks before the beginning of the cycling season. The second test was performed in June, in the middle of the season. During this period the subjects were expected to be in a highly endurance-trained state. The ventilatory response was assessed during an incremental exercise test (20 W · min⁻¹). Oxygen consumption (V˙O₂), carbon dioxide production (V˙CO₂), minute ventilation (V˙ _E), and heart rate (HR) were assessed at the following points during the test: at workloads of 200 W, 250 W, 300 W, 350 W, 400 W and at the subject's maximal workload, at a respiratory exchange ratio (R) of 1, and at the ventilatory threshold (Th_vent) determined using the V-slope-method. Post-training, the mean (SD) V˙O_2max was increased from the pre-training level of 69 (7) ml · min⁻¹ · kg⁻¹ (range 61.4–78.6) to 78 (6) ml · min⁻¹ · kg⁻¹ (range 70.5–86.3). The mean post-training V˙O₂ was significantly higher than the pre training value (P < 0.01) at all work rates, at Th_vent and at R=1. V˙O₂ was also higher at all work rates except for 200 W and 250 W. V˙ _E was significantly higher at Th_vent and R=1. Training had no effect on HR at all workloads examined. An explanation for the higher V˙O₂ cost for the same work rate may be that in the endurance-trained state, the adaptation to an exercise stimulus with higher intensity is faster than for the less-trained state. Another explanation may be that at the same work rate, in the less-endurance-trained state power is generated using a significantly higher anaerobic input. The results of this study suggest the following practical recommendations for training management in elite cyclists: (1) the V˙O₂ for a subject at the same work rate may be an indicator of the endurance-trained state (i.e., the higher the V˙O₂, the higher the endurance-trained capacity), and (2) the need for multiple exercise tests for determining the HR at Th_vent during a cycling season is doubtful since at Th_vent this parameter does not differ much following endurance training. Accepted: 19 October 1999     

The effects of classic altitude training on hemoglobin mass in swimmers

Aim of the study was to determine the influence of classic altitude training on hemoglobin mass (Hb-mass) in elite swimmers under the following aspects: (1) normal oscillation of Hb-mass at sea level; (2) time course of adaptation and de-adaptation; (3) sex influences; (4) influences of illness and injury; (5) interaction of Hb-mass and competition performance. Hb-mass of 45 top swimmers (male 24; female 21) was repeatedly measured (~6 times) over the course of 2 years using the optimized CO-rebreathing method. Twenty-five athletes trained between one and three times for 3–4 weeks at altitude training camps (ATCs) at 2,320 m (3 ATCs) and 1,360 m (1 ATC). Performance was determined by analyzing 726 competitions according to the German point system. The variation of Hb-mass without hypoxic influence was 3.0 % (m) and 2.7 % (f). At altitude, Hb-mass increased by 7.2 ± 3.3 % (p < 0.001; 2,320 m) and by 3.8 ± 3.4 % (p < 0.05; 1,360 m). The response at 2,320 m was not sex-related, and no increase was found in ill and injured athletes (n = 8). Hb-mass was found increased on day 13 and was still elevated 24 days after return (4.0 ± 2.7 %, p < 0.05). Hb-mass had only a small positive effect on swimming performance; an increase in performance was only observed 25–35 days after return from altitude. In conclusion, the altitude (2,320 m) effect on Hb-mass is still present 3 weeks after return, it decisively depends on the health status, but is not influenced by sex. In healthy subjects it exceeds by far the oscillation occurring at sea level. After return from altitude performance increases after a delay of 3 weeks.     

壳聚糖体内抗幽门螺杆菌作用及其对机体体液免疫反应的调节

目的研究壳聚糖体内抗幽门螺杆菌（Hp）作用，及其对机体体液免疫反应的调节作用。方法建立BALB／c小鼠Hp感染的动物模型后，随机分为8组：（1）对照组；（2）PPI组；（3）AM组；（4）AM＋PPI组；（5）壳聚糖组；（6）壳聚糖＋PPI组；（7）壳聚糖＋AM组；（8）壳聚糖＋AM＋PPI组。分别给予上述药物每日2次灌胃，共2周。停药后4周，处死小鼠，无菌条件下取胃黏膜、唾液和血清。采用定量Hp培养和病理改良Giemsa染色法检测胃黏膜内Hp感染。用ELISA法检测血清、唾液和胃黏膜内Hp抗体，用SP免疫组织化学法检测胃黏膜内分泌型IgA（sIgA）。结果以上8组的却根除率分别为0、0、41．7％、58．3％、58．3％、66．7％、83．3％、91．7％，其中（3）～（8）组的肋根除率与（1）和（2）组比较差异有统计学意义（P〈0．05）。Hp定植密度研究发现各组之间Hp定植密度差异有统计学意义（P〈0．001），坳定植密度在（3）～（8）组显著低于（1）和（2）组（P〈0．05），（7）组显著低于（3）组（P〈0．05），（8）组显著低于（4）组（P〈0．05）。血清中抗Hp　IgG、IgG1、IgG2a及唾液中抗Hp　IgA含量，各组差异无统计学意义（P〉0．05）。胃黏膜中抗Hp　IgA含量，在壳聚糖组和壳聚糖＋AM组显著高于无壳聚糖组（P〈0．05）。胃黏膜sIgA阳性腺体百分率，含壳聚糖组显著高于不含壳聚糖组（P〈0．05）。结论壳聚糖在体内有抗Hp作用，并与AM有协同作用，它与PPI和AM三者联用的Hp根除率高达91．7％，有望成为一抗Hp新药。壳聚糖可促进胃黏膜局部抗Hp　IgA和sIgA的产生，因此它在体内的抗Hp作用除了直接杀灭Hp外，其对机体免疫调节效应可能参与了抗菌机制。     

The effect of training on the recovery from immobilization-induced bone loss in rats

We studied the effect of exercise on the recovery from osteoporosis induced by immobilization in growing laboratory rats. The right hind limb of male rats was immobilized by cast for 2 weeks. The rats were then divided into control and exercise groups. The controls were allowed to move freely in their cages and the exercise group was running for 1 hour every day. After 2 weeks immobilization, the ash weight of the immobilized tibia decreased to 85.2±0.6% (P < 0.001) from that of contralateral tibia. After removal of the cast, the bone mass recovered and, in 9 weeks, the decrease of ash weight was reduced to 2.9 ± 0.8% and 4.2±0.3% in the control and exercise groups, respectively. There was no statistical difference in ash weights between the running and control groups and the trabecular bone volume in the distal femur was also equal in both groups. Immobilization reduced the incorporation of [⁴⁵Ca] into the tibia. After remobilization, the [⁴⁵Ca]-incorporation was found to be significantly higher in the recovering leg than in the control leg. Exercise further stimulated [⁴⁵Ca]-incorporation into the recovering tibia.     

The impact of vaccines on heterologous adaptive immunity

BackgroundVaccines induce antigen-specific memory in adaptive immune cells that enables long-lived protection against the target pathogen. In addition to this, several vaccines have beneficial effects greater than protection against their target pathogen. These non-specific effects are proposed to be the result of vaccine-induced immunomodulation. In the case of bacille Calmette–Guérin (BCG) vaccine, this involves induction of innate immune memory, termed ‘trained immunity’, in monocytes and natural killer cells.ObjectivesThis review discusses current evidence for vaccine-induced immunomodulation of adaptive immune cells and heterologous adaptive immune responses.ContentThe three vaccines that have been associated with changes in all-cause infant mortality: BCG, diphtheria–tetanus–pertussis (DTP) and measles-containing vaccines (MCV) alter T-cell and B-cell immunity. The majority of studies that investigated non-specific effects of these vaccines on the adaptive immune system report changes in numbers or proportions of adaptive immune cell populations. However, there is also evidence for effects of these vaccines on adaptive immune cell function and responses to heterologous stimuli. There is some evidence that, in addition to BCG, DTP and MCV, other vaccines (that have not been associated with changes in all-cause mortality) may alter adaptive immune responses to unrelated stimuli.ImplicationsThis review concludes that vaccines alter adaptive immune cell populations and heterologous immune responses. The non-specific effects differ between various vaccines and their effects on heterologous adaptive immune responses may also involve bystander activation, cross-reactivity and other as yet undefined mechanisms. This has major implications for future vaccine design and vaccination scheduling.     

免疫球蛋白治疗儿童难治性癫痫的近、远期疗效与体液免疫功能的研究

目的 :探讨人血免疫球蛋白治疗儿童难治性癫痫的近、远期疗效和体液免疫功能的变化。方法 :对 36例儿童难治性癫痫辅加人血免疫球蛋白治疗 ,随访 6个月～ 1年 ,分别采用ELISA法和速率散射浊度法对 36例病儿和 2 2例健康儿童进行Ig、C3、C4CH5 0的检测 ,并给予治疗前后配对比较。结果 :36例病儿经辅加免疫球蛋白治疗后 17例终止发作 ,5例显效 ,6例有效 ,8例无效 ,近期总有效率为 77 8%。随访≥ 1年者 2 8例 (77 8% ) ,其中 13例 (4 6 4 % )复发 ,远期有效率为 5 3 6 % ,临床显效时间在用药后 1周内 ,EEG也出现同步显著改善。体液免疫的结果是治疗前癫痫组Ig中的IgG、IgM和C3、C4、CH5 0明显低于对照组 (P <0 0 1) ;治疗后癫痫患儿IgG、IgM和C3、C4、CH5 0明显高于治疗前 (P <0 0 1) ,特别是C3、C4、CH5 0升高最为明显。半年后复检Ig和C3、C4、CH5 0又降低 ,配对比较差异有显著性 (P <0 0 1)。结论 :癫痫患儿体液免疫功能明显低下 ,给予人血免疫球蛋白后 77 8%病例近期临床发作得到控制 ,EEG转为正常或好转 ,也可使血IgG、IgM和C3、C4、CH5 0含量短期内升高 ,这可能是人血免疫球蛋白能有效治疗癫痫的机制之一。