title: Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review.
abstract: BACKGROUND
  Prolonged and strenuous physical exercise increases intestinal permeability, allowing luminal endotoxins to translocate through the intestinal barrier and reach the bloodstream. When recognized by the immune system, these endotoxins trigger a systemic inflammatory response that may affect physical performance and, in severe cases, induce heat stroke. However, it remains to be elucidated whether there is a relationship between the magnitude of exercise-induced hyperthermia and changes in intestinal permeability.
  
  
  OBJECTIVE
  In this systematic review, we evaluated whether an exercise-induced increase in core body temperature (TCore) is associated with an exercise-induced increase in intestinal permeability.
  
  
  METHODS
  The present systematic review screened the MEDLINE/PubMed and Web of Science databases in September 2016, without any date restrictions. Sixteen studies that were performed in healthy participants, presented original data, and measured both the exercise-induced changes in TCoreand intestinal permeability were selected. These studies assessed intestinal permeability through the measurement of sugar levels in the urine and measurement of intestinal fatty acid binding protein or lipopolysaccharide levels in the blood.
  
  
  RESULTS
  Exercise increased both TCoreand intestinal permeability in most of the 16 studies. In addition, a positive and strong correlation was observed between the two parameters (r = 0.793; p < 0.001), and a TCoreexceeding 39 °C was always associated with augmented permeability.
  
  
  CONCLUSIONS
  The magnitude of exercise-induced hyperthermia is directly associated with the increase in intestinal permeability.
authors.affiliation: Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil.|Department of Physical Education, Institute of Life Sciences, Universidade Federal de Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
authors.forename: Washington
authors.initials: W
authors.lastname: Pires
authors.affiliation: Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Christiano E
authors.initials: CE
authors.lastname: Veneroso
authors.affiliation: Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Samuel P
authors.initials: SP
authors.lastname: Wanner
authors.affiliation: Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Diogo A S
authors.initials: DAS
authors.lastname: Pacheco
authors.affiliation: Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
authors.forename: Gisele C
authors.initials: GC
authors.lastname: Vaz
authors.affiliation: Department of Physical Education, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.|Department of Health, Exercise Science and Sport, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Fabiano T
authors.initials: FT
authors.lastname: Amorim
authors.affiliation: Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Cajsa
authors.initials: C
authors.lastname: Tonoli
authors.affiliation: Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Danusa D
authors.initials: DD
authors.lastname: Soares
authors.affiliation: Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil. coimbrac@icb.ufmg.br.|Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. coimbrac@icb.ufmg.br.
authors.forename: Cândido C
authors.initials: CC
authors.lastname: Coimbra
mesh_terms: D015444:Exercise / Q000502:physiology*; D005334:Fever; D018883:Heat Stroke; D006358:Hot Temperature; D006801:Humans; D006979:Hyperthermia, Induced; D007408:Intestinal Absorption / Q000502:physiology*; D007413:Intestinal Mucosa / Q000502:physiology*; D010539:Permeability