title: The inflammation, vascular repair and injury responses to exercise in fit males with and without Type 1 diabetes: an observational study.
abstract: BACKGROUND
  Type 1 diabetes is associated with raised inflammation, impaired endothelial progenitor cell mobilisation and increased markers of vascular injury. Both acute and chronic exercise is known to influence these markers in non-diabetic controls, but limited data exists in Type 1 diabetes. We assessed inflammation, vascular repair and injury at rest and after exercise in physically-fit males with and without Type 1 diabetes.
  
  
  METHODS
  Ten well-controlled type 1 diabetes (27 ± 2 years; BMI 24 ± 0.7 kg.m(2); HbA1c 53.3 ± 2.4 mmol/mol) and nine non-diabetic control males (27 ± 1 years; BMI 23 ± 0.8 kg.m(2)) matched for age, BMI and fitness completed 45-min of running. Venous blood samples were collected 60-min before and 60-min after exercise, and again on the following morning. Blood samples were processed for TNF-α using ELISA, and circulating endothelial progenitor cells (cEPCs; CD45(dim)CD34(+)VEGFR2(+)) and endothelial cells (cECs; CD45(dim)CD133(-)CD34(+)CD144(+)) counts using flow-cytometry.
  
  
  RESULTS
  TNF-α concentrations were 4-fold higher at all-time points in Type 1 diabetes, when compared with control (P < 0.001). Resting cEPCs were similar between groups; after exercise there was a significant increase in controls (P = 0.016), but not in Type 1 diabetes (P = 0.202). CEPCs peaked the morning after exercise, with a greater change in controls vs. Type 1 diabetes (+139 % vs. 27 %; P = 0.01). CECs did not change with exercise and were similar between groups at all points (P > 0.05). Within the Type 1 diabetes group, the delta change in cEPCS from rest to the following morning was related to HbA1c (r = -0.65, P = 0.021) and TNF-α (r = -0.766, P = 0.005).
  
  
  CONCLUSIONS
  Resting cEPCs and cECs in Type 1 diabetes patients with excellent HbA1c and high physical-fitness are comparable to healthy controls, despite eliciting 4-fold greater TNF-α. Furthermore, Type 1 diabetes patients appear to have a blunted post-exercise cEPCs response (vascular repair), whilst a biomarker of vascular injury (cECs) remained comparable to healthy controls.
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK. d.j.west@northumbria.ac.uk.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: West
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK. matthew.campbell@northumbria.ac.uk.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Campbell
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK. j.gonzalez@northumbria.ac.uk.
authors.forename: Javier T
authors.initials: JT
authors.lastname: Gonzalez
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK. mark.walker@newcastle.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Walker
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK. e.stevenson@northumbria.ac.uk.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Stevenson
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK. fahad.ahmed@newcastle.ac.uk.
authors.forename: Fahad W
authors.initials: FW
authors.lastname: Ahmed
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK. s.wijaya@newcastle.ac.uk.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wijaya
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK. jim.shaw@newcastle.ac.uk.
authors.forename: James A
authors.initials: JA
authors.lastname: Shaw
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK. jolanta.weaver@newcastle.ac.uk.
authors.forename: Jolanta U
authors.initials: JU
authors.lastname: Weaver
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000378:metabolism; D042783:Endothelial Cells / Q000166:cytology*; D066026:Endothelial Progenitor Cells / Q000166:cytology*; D004730:Endothelium, Vascular / Q000276:immunology* / Q000378:metabolism; D015444:Exercise; D005434:Flow Cytometry; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D008297:Male; D010809:Physical Fitness; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D014409:Tumor Necrosis Factor-alpha; C517652:hemoglobin A1c protein, human