title: Developing a multi-component immune model for evaluating the risk of respiratory illness in athletes.
abstract: Clinical and laboratory identification of the underlying risk of respiratory illness in athletes has proved problematic. The aim of this study was to determine whether clinical data, combined with immune responses to standardised exercise protocols and genetic cytokine polymorphism status, could identify the risk of respiratory illness (symptoms) in a cohort of highly-trained athletes. Male endurance athletes (n=16; VO2max 66.5 ± 5.1 mL.kg-1.min-1) underwent a clinical evaluation of known risk factors by a physician and comprehensive laboratory analysis of immune responses both at rest and after two cycling ergometer tests: 60 min at 65% VO2max (LONG); and 6 x 3 min intervals at 90% VO2max (INTENSE). Blood tests were performed to determine Epstein Barr virus (EBV) status and DNA was genotyped for a panel of cytokine gene polymorphisms. Saliva was collected for measurement of IgA and detection of EBV DNA. Athletes were then followed for 9 months for self-reported episodes of respiratory illness, with confirmation of the underlying cause by a sports physician. There were no associations with risk of respiratory illness identified for any parameter assessed in the clinical evaluations. The laboratory parameters associated with an increased risk of respiratory illnesses in highly-trained athletes were cytokine gene polymorphisms for the high expression of IL-6 and IFN-ɣ; expression of EBV-DNA in saliva; and low levels of salivary IgA concentration. A genetic risk score was developed for the cumulative number of minor alleles for the cytokines evaluated. Athletes prone to recurrent respiratory illness were more likely to have immune disturbances that allow viral reactivation, and a genetic predisposition to pro-inflammatory cytokine responses to intense exercise.
authors.affiliation: School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.|Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Gleeson
authors.affiliation: Department of Physiology, Sports Science and Medicine, Australian Institute of Sport, Belconnen, ACT 2616, Australia.|Research Institute for Sports and Exercise, University of Canberra, Canberra, ACT 2601, Australia.
authors.forename: David B
authors.initials: DB
authors.lastname: Pyne
authors.affiliation: Department of Physiology, Sports Science and Medicine, Australian Institute of Sport, Belconnen, ACT 2616, Australia.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Elkington
authors.affiliation: School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.|Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.
authors.forename: Sharron T
authors.initials: ST
authors.lastname: Hall
authors.affiliation: Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.|Department of Medicine, John Hunter Hospital, New Lambton, NSW 2305, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
authors.affiliation: Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Oldmeadow
authors.affiliation: School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.|Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Wood
authors.affiliation: School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.|Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Callister
mesh_terms: D000328:Adult; D056352:Athletes; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood / Q000235:genetics*; D004279:DNA, Viral / Q000302:isolation & purification; D020022:Genetic Predisposition to Disease; D005838:Genotype; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007249:Inflammation / Q000235:genetics* / Q000276:immunology; D008297:Male; D010101:Oxygen Consumption; D012141:Respiratory Tract Infections / Q000276:immunology*; D012307:Risk Factors; D012463:Saliva / Q000276:immunology; D055815:Young Adult
chemical_list: D016207:Cytokines; D004279:DNA, Viral; D007070:Immunoglobulin A; D002097:C-Reactive Protein
keywords: athletes; exercise; inflammation; respiratory infections