2014年“第61届美国运动医学会年会”专栏：慢性持续性低度炎症与运动、健康和疾病的研究进展

摘要：背景：研究表明慢性低度炎症在多数非传染性疾病的发病中起着关键作用,2014年ACSM年会把炎症在运动、健康和疾病中的作用作为热点专题。目的：探讨运动、营养、衰老、脂肪和骨骼肌与慢性炎症的关联。方法：分析归纳目前本方向年会的热点研究结果及进展。结果与结论：1.衰老及不良生活方式是慢性低度炎症的重要致炎因素;2.急性运动可促进产生炎症因子,规律运动可以减低炎性标志物;3.运动能降低骨骼肌慢性炎症;4.运动能降低脂肪组织的慢性炎症; 5.规律运动是降低年龄相关的慢性炎症反应的一种手段;6.营养补给对急性运动诱导的炎性反应的干预效果有待进一步研究。本年会的研究表明运动的抗炎作用可能是其降低慢性低度炎性疾病发生的重要机制。     

Serum macrophage migration inhibitory factor as a potential biomarker to evaluate therapeutic response in patients with allergic asthma: an exploratory study

Background: Previous studies have shown that macrophage migration inhibitory factor(MIF) is involved in the pathogenesis of asthma. This study aimed to investigate whether serum MIF reflects a therapeutic response in allergic asthma.Methods: We enrolled 30 asthmatic patients with mild-to-moderate exacerbations and 20 healthy controls, analyzing the parameter levels of serum MIF, serum total immunoglobulin E(tIgE), peripheral blood eosinophil percentage(EOS%), and fractional exhaled nitric oxide(FeNO). Lung function indices were used to identify disease severity and therapeutic response.Results: Our study showed that all measured parameters in patients were at higher levels than those of controls. After one week of treatment, most parameter levels decreased significantly except for serum tIgE. Furthermore, we found that serum MIF positively correlated with EOS% as well as FeNO, but negatively correlated with lung function indices. Receiver operator characteristic(ROC) curve analysis indicated that among the parameters, serum MIF exhibited a higher capacity to evaluate therapeutic response. The area under the curve(AUC) of MIF was 0.931, with a sensitivity of 0.967 and a specificity of 0.800.Conclusions: Our results suggested that serum MIF may serve as a potential biomarker for evaluating therapeutic response in allergic asthma with mild-to-moderate exacerbations.     

中药热奄包治疗慢性盆腔炎的护理体会

目的:总结中药热奄包治疗慢性盆腔炎的护理体会。方法:将加有跌打酊蒸热后的中药热奄包对慢性盆腔炎患者进行治疗,每次30分钟,每天一次,一个疗程10次,连续2个疗程后,观察疗效。结果:治疗组总有效率达83.4%,与对照组总有效率比较,P0.05。结论:中药热奄包治疗慢性盆腔炎,疗效确切,简单方便,患者无痛苦。     

他汀类药物的调脂外作用

他汀类药物是一类主要降低血脂的药物,临床已广泛应用于多种心血管疾病的治疗。近期研究发现其除具有调节血脂作用外,还有较为重要的调脂外作用,如抗氧化作用,保护血管内皮细胞,抑制平滑肌细胞的增殖和迁移等,为进一步扩大他汀类药物的临床应用提供了理论和实践依据。     

Mechanisms of beneficial effects of exercise training on non-alcoholic fatty liver disease (NAFLD): Roles of oxidative stress and inflammation

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder which is associated with accumulation of fats in the liver. It causes a wide variety of pathological effects such as non-alcoholic steatohepatitis (NASH) and cirrhosis, insulin resistance, obesity, hypertension, dyslipidaemia, diabetes and cardiovascular disease. The molecular mechanisms that cause the initiation and progression of NAFLD are not fully understood. Oxidative stress (OS) induced by reactive oxygen species (ROS) and inflammation are likely a significant mechanism which can lead to hepatic cell death and tissue injury. Mitochondrial abnormalities, down-regulation of several antioxidant enzymes, glutathione (GSH) depletion and decreased activity of GSH-dependent antioxidants, accumulation of leukocytes and hepatic inflammation are the major sources of ROS overproduction in NAFLD. Excessive production of ROS suppresses the capacity of other antioxidant defence systems in NAFLD and causes further oxidative damage. Regular exercise can be considered as an effective strategy for treatment of NAFLD. It improves NAFLD by reducing intrahepatic fat content, increasing β-oxidation of fatty acids, inducing hepato-protective autophagy, overexpressing peroxisome proliferator-activated receptor- γ (PPAR-γ), as well as attenuating hepatocyte apoptosis and increasing insulin sensitivity. Exercise training also suppresses ROS overproduction and OS in NAFLD via up-regulation of several antioxidant enzymes and anti-inflammatory mediators. Therefore, an understanding of these molecules and signalling pathways gives us valuable information about NAFLD progression and a method for developing a suitable clinical treatment. This review aimed to evaluate sources of ROS and OS in NAFLD and the molecular mechanisms involved in the beneficial effects of exercises on NAFLD.     

Effects of sensory-level high-volt pulsed electrical current ondelayed-onset muscle soreness

Abstract

Ten healthy males and ten healthy females aged 21.5 ± 3.2 years (mean ± s) participated in the study, which was designed to evaluate the effectiveness of sensory level-high volt pulsed electrical current (HVPC) on delayed-onset muscle soreness (DOMS). Arm discomfort, elbow extension range of motion and isometric elbow flexion strength were obtained as baseline measurements. Delayed-onset muscle soreness was induced in the participants' dominant or non-dominant arm using two sets of 20 maximal eccentric elbow flexion contractions. After the induction of DOMS, the participants were randomly divided into an experimental condition (HVPC) or a placebo condition. The experimental condition consisted of 20 min of HVPC immediately after the induction of DOMS, and 20 min every 24 h for three consecutive days thereafter. The participants in the placebo condition received an intervention similar in design; however, no electrical current was administered. Baseline measurements were reevaluated at 24, 48, 72 and 96 h after the induction of DOMS. Three weeks later, the participants returned and the protocol was repeated on the contralateral limb, using the opposite intervention (HVPC or placebo). Repeated-measures analysis of variance revealed a significant increase in overall arm discomfort, decrease in elbow extension and decrease in isometric strength for both conditions over time. No significant main effect of treatment, or time-by-treatment interaction, was found for the HVPC condition when compared with the placebo condition for any variable. Sensory-level HVPC, as utilized in our application, was ineffective in reducing the measured variables associated with DOMS.     

Environmental conditions,air pollutants,and airway cells in runners: A longitudinal field study

Abstract

Runners have increased numbers of neutrophils in the airways at rest and after exercise compared with sedentary individuals. The aim of this study was to determine whether Mediterranean seasonal changes in temperature, humidity or airborne pollutants affect the airway cells of runners training outdoors in an urban environment. In nine male amateur runners, cell composition, apoptosis, and inflammatory mediators were measured in induced sputum collected at rest (baseline) and the morning after races held in the fall (21 km), winter (12 km), and summer (10 km). Concentrations of air pollutants were below the alert threshold at all times. Neutrophil differential counts tended to increase after all races (P = 0.055). Apoptosis of neutrophils increased with ozone (P < 0.005) and particulate matter <10 μm (PM₁₀) (P < 0.05) exposure. Bronchial epithelial cell counts were low at all times and weakly correlated with ozone and PM₁₀ concentrations. Apoptotic bronchial epithelial cells increased after all races (P < 0.05). Inflammatory mediators in induced sputum were low at baseline and after the races, and correlated with neutrophil differential counts only at rest. In conclusion, apoptosis of airway cells in runners appears to be affected by both exercise and environmental conditions. Apoptosis of neutrophils increased with exposure to environmental pollutants while apoptosis of bronchial epithelial cells increased after intense exercise. Since no relationship was observed between neutrophil counts and inflammatory mediators 20 h after races, airways inflammation at this time point appears blunted in healthy runners and little affected by exposure to mild seasonal changes and airborne pollutants.     

Vitamin C supplementation does not influence plasma and blood mononuclear cell IL-6 and IL-10 levels after exercise

Abstract

The aim of this study was to determine whether the highest vitamin C supplementation associated with complete bioavailability influences the plasma and blood mononuclear cell IL-6 and IL-10 response to exercise. A double-blinded study of supplementation with vitamin C was performed. After 15 days of supplementation with vitamin C (500 mg · day^?1, n = 16) or a placebo (n = 15), participants in the study completed a 15-km run competition. Blood samples were taken before and after competition. Oxidative stress markers, antioxidants, cortisol, IL-6 and IL-10 were determined in plasma or serum. IL-6 and IL-10 protein and mRNA levels were measured in blood mononuclear cells. Although higher plasma and blood mononuclear cell vitamin C levels were observed in the supplemented group when compared with the placebo one, the two groups showed identical exercise-induced changes in all the measured parameters. Exercise induced increased IL-6 and IL-10 levels in plasma and blood mononuclear cells. IL-6 and IL-10 mRNA levels in blood mononuclear cells increased after the competition. After recovery, IL-6 mRNA returned to basal levels and IL-10 mRNA levels remained elevated. In conclusion, exercise induced increased IL-6 and IL-10 production in blood mononuclear cells. However, vitamin C supplementation did not influence IL-6 and IL-10 response to exercise.     

The microcycle of inflammation and performance changes after a basketball match

Abstract

Basketball incorporates intense eccentric muscle activity that induces muscle microtrauma and an inflammatory response. This study investigated time-dependent inflammatory and performance responses during a weekly microcycle after a basketball match. Twenty elite-standard players underwent a trial that comprised a match followed by a 6-day simulated in-season microcycle. The trial was preceded by a control condition that did not have a match. Blood sampling and tests of maximal-intensity exercise performance and muscle damage occurred before each condition, immediately after the match and daily thereafter for 6 consecutive days. The match induced marked increases in heart rate, lactate, ammonia, glucose, non-esterified fatty acids and triglycerides. Performance deteriorated for 24–48 h after the match, whereas knee flexor and extensor soreness increased for 48 and 24 h post-match, respectively. Inflammatory (leukocytes, C-reactive protein, creatine kinase activity, adhesion molecules, cortisol, uric acid and cytokines) and oxidative stress (malondialdehyde, protein carbonyls, oxidised glutathione, antioxidant capacity, catalase and glutathione peroxidase) markers increased for ~24 h and subsided thereafter. Reduced glutathione declined for 24 h after exercise. These results suggest that a basketball match elicits moderate and relatively brief (~24–48 h) inflammatory responses, is associated with marked but short-lived performance deterioration, but is less stressful than other intermittent-type sports.     

Reproducibility of measurement techniques used for creatine kinase,interleukin-6 and high-sensitivity C-reactive protein determination over a 48 h period in males and females

To examine the reproducibility of three measurement techniques used to determine creatine kinase, interleukin-6 and high-sensitivity C-reactive protein, 50 participants had blood samples taken on two occasions. Fingertip plasma samples were analysed using the Reflotron for CK determination. Venous blood samples collected into serum separator tubes were used for IL-6 and hs-CRP analyses. IL-6 was measured using an enzyme linked immune assay development kit. The hs-CRP was measured by an in-house ELISA method. Dependent t-tests showed no systematic bias between samples. The interdian CV was 20.0% for CK, 15.3% for IL-6 and 44.2% for hs-CRP. The intraclass correlation coefficient was 0.90 for CK, 0.98 for IL-6 and 0.70 for hs-CRP. The 95% limits of agreement were ?69.7 to 63.5 IU/L for CK, ?1.48 to 1.80 pg/ml for IL-6 and ?1.10 to 0.91 µg/L for hs-CRP. The results demonstrate low absolute reproducibility, which may obscure a true experimental effect.