Exercise and Immune Function

Question 1

J shaped curve - source

Answer 1

Nieman, 1994

Question 2

S shaped curve - source

Answer 2

Malm, 2006

Question 3

Draw diagram

Answer 3

Look at revision notes

Question 4

Assessing URTI

Answer 4

Jackson Score Upper Respiratory Tract Illness Questionnaire

Complete the questionnaire on a daily basis

Numerical values are assigned to the ‘degree of discomfort’ scale

Question 5

Monitoring infections

Answer 5

Diary style questionnaire

Recall questionnaire

Participants contact researcher/health professional when feeling ill

Report to a local clinic for a doctor/nurse evaluation when feeling ill

Objective measurements

Question 6

Objective measurements

Answer 6

Providing specimens

• nasal swab
• throat swab
• mucous
• sputum

Specimen rated subjectively or objectively for colour, secretion, turgescence

Specimen examined using microbiological culture, microscopy and biochemical techniques

Protein identification/RNA, DNA sequencing

Question 7

Strategies to reduce chance of infection - source

Answer 7

Gleeson & Walsh, 2012

Question 8

Strategies to reduce chance of infection - Gleeson & Walsh, 2012

Answer 8

Prevention better than treatment

Updated on all vaccines needed for home/travel

Minimise contact with infected people and young children

Wash hands regularly

Carry alcohol gel

Do not share water bottles, towels, cups

When abroad, drink bottled water, avoid salad washed in local water

Ensure adequate energy intake - avoid crash diets

Question 9

1st day of illness - Gleeson & Walsh, 2012

Answer 9

Avoid strenuous exercise

Avoid all exercise of experiencing muscle/joint pain, headache, fever, malaise, diarrhoea or vomiting

Question 10

2nd day of illness - Gleeson & Walsh, 2012

Answer 10

Continue to avoid all exercise if experiencing muscle/joint pain, headache, fever, malaise, diarrhoea or vomiting

If there is no worsening of ‘above the collar’ symptoms, undertake light exercise

Question 11

3rd day of illness - Gleeson & Walsh, 2012

Answer 11

If URTI symptoms still present, see GP

If there is no malaise or worsening of symptoms undertake exercise

Question 12

4th day of illness - Gleeson & Walsh, 2012

Answer 12

If there is no symptom release, do not exercise, see GP

If this is first day of improvement, wait one day without fever and for improvement of symptoms before exercising

Question 13

Measuring external load - source

Answer 13

Schwellnus et al., 2016

Question 14

Measuring external load - Schwellnus et al., 2016

Answer 14

Hours of training

Distance run

Weight lifted

Number of games played

Life events

Daily hassles/travel

Question 15

Measuring internal load - Schwellnus et al., 2016

Answer 15

Heart rate

RPE

Question 16

Schwellnus et al., 2016

Answer 16

Subjective measures were more sensitive and consistent for measuring internal load

Important to monitor internal and external loads because athletes may perform more intense training or perceive loads as significantly harder, may lead to maladaptation

Some evidence that changes in external and internal training load associated with increased risk of illness

Question 17

Markers of subclinical exercise

Answer 17

Can respond to acute and chronic exercise

Could be used to predict onset of acute illness

None of currently available markers meet the criteria of reliable markers

Question 18

Reliable marker of subclinical exercise needs to be:

Answer 18

Highly sensitive

Respond to training load

Unaffected by other factors

Changes should occur before illness

Distinguishable from other adaptations

Relatively easy to measure

Not be invasive

Question 19

Three Pillars of Exercise Immunology

Answer 19

Athletes report greater incidence of infections

Mucosal immunity is impaired

Immune cell function is impaired post-exercise

Question 20

Need to assess immune competency with system-levels approach - source

Answer 20

Bruunsgard, 1997

Question 21

Need to assess immune competency with system-levels approach - Bruunsgard, 1997

Answer 21

22 triathletes, 11 control triathletes, 22 nonathletic controls

Within 30 mins of finishing exercise

• Delayed-type hypersensitivity reaction-response to 7 common antigens
• Pneumococcal vaccination

Immune response assessed

• DTH 48 hr after application
• Antibody response to vaccination after 14 days

May suppress aspects of cell-mediated immunity but not vaccination response.

Question 22

Depletion of nutrients that are immunomodulatory

Answer 22

Leucine

Glutamine

Carbohydrate

Question 23

Leucine

Answer 23

Can stimulate an intracellular signalling cascade - rapamycin (mTOR)

Rapamycin blocks mTOR pathway signalling

mTOR pathway essential for DNA replication, cell cytotoxicity, cytokine secretion

Question 24

Glutamine

Answer 24

Used at very high rates by lymphocytes and macrophages

Provides energy

Acts as precursor for purine and pyrimidine synthesis

Essential to replicate cells such as proliferating lymphocytes

Question 25

Carbohydrate

Answer 25

May prevent the release of 'immune-suppressive' cytokines May prevent 'excessive' or 'inappropriate' immune responses May slow the rate that other factors are depleted maintaining blood glucose levels

Question 26

Protein supplementation prevent impaired surveillance - source

Answer 26

Witard, 2013

Question 27

Protein supplementation prevent impaired surveillance - Witard, 2013

Answer 27

Significantly decreased incidence of URTI with high intensity training and protein supplementation in elite cyclists.

Question 28

Carbohydrate limits exercise-induced neuroendocrine disturbances - source

Answer 28

Scharhag et al., 2006

Question 29

Carbohydrate limits exercise-induced neuroendocrine disturbances - Scharhag et al., 2006

Answer 29

14 male competitive cyclists and triathletes 3 standardised cycling session of 4 hrs Ingested CHO beverages or placebo CHO supplementation might attenuate the cortisol response to exercise CHO supplementation might attenuate the IL-6 response to exercise The IL-10 response will be less

Question 30

Gleeson et al., 2012

Answer 30

Split athletes into illness-prone and illness-free Significantly greater salivary rate in illness-free group Significantly greater SigA secretion rate in illness-free group. Hard to say whether this is due to exercise

Question 31

Immunological aspects of nutrition - source

Answer 31

Gleeson, 2016

Question 32

Immunological aspects of nutrition - Gleeson, 2016

Answer 32

CHO beverages Antioxidant vitamins Vitamin D3 supplements Plant polyphenols Probiotics Colostrum

Question 33

CHO beverages

Answer 33

Ingestion during prolonged exercise: - lowers circulatory hormone - lowers anti-inflammatory hormone - delays appearance of symptoms of overreaching Greater degree of immune depression without it Maintains saliva flow rate - contains antimicrobial proteins

Question 34

Antioxidant vitamins

Answer 34

Regular intake can reduce cortisol and anti-inflammatory cytokine response to prolonged exercise

Question 35

Vitamin D3 supplements

Answer 35

Deficiencies lead to: - impaired immune function - increased respiratory infection risk - associated with low saliva IgA secretion, low pro-inflammatory cytokine production by antigen-stimulated blood mononuclear cells

Question 36

Plant polyphenols

Answer 36

Antioxidant, anti-inflammatory, anti-pathogenic, cardio-protective, anti-carcinogenic Naturally present in apples, pears, green leafy vegetables

Question 37

Probiotics

Answer 37

Reduce URI incidence Fewer days of respiratory illness Lower severity of URI

Question 38

Colostrum

Answer 38

Elevates levels of antibodies in circulation and saliva Prevents exercise-induced falls in salivary lysozyme Speeds recovery of neutrophil function after strenuous exercise Limits increase in gut permeability caused by strenuous exercise Reduces risk of URI