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Impact of endotoxin exposure after exhausting exercise on the immune system in solid organ transplant recipients. 衰竭运动后内毒素暴露对实体器官移植受者免疫系统的影响。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2012-01-01
Ingmar Königsrainer, Markus Löffler, Sarah Bühler, Michael Walter, Luana Schafbuch, Stefan Beckert, Jörg Glatzle, Philipp Horvath, Hinnak Northoff, Silvio Nadalin, Alfred Königsrainer, Derek Zieker

Subsequent to prolonged exhausting exercise a transient immunosuppression is often observed in athletes. This so-called "open window" results in a reduced resistance of the athletes to viral and bacterial infections after an exhaustive exercise bout. Concerning the effect of bacterial endotoxin contact after exhausting exercise in transplant recipients, who are innately immunosuppressed by their medication, no data exists at present. After performing 81 km cycling, including ascending more than 1800 m in altitude, peripheral blood from 10 male kidney transplant recipients and from 10 healthy controls matched for age and gender was obtained. Simulating contact of the athletes with a pathogen post-exercise, the blood samples were incubated with Lipopolysaccharides (LPS). Thereafter microarray analysis was performed. Microarray analysis revealed a markedly oppositional pattern of gene expression in transplant recipients compared with their controls after LPS incubation. Especially immune response genes were significantly over-represented in controls immediately after the exhaustive exercise bout with LPS stimulation, whereas numerous apoptotic genes were over-represented in transplant recipients. Merging our previous data with these recent findings it should be discussed if transplant recipients need to reduce their immunosuppressive medication before performing exhaustive exercise.

在长时间的疲劳运动后,运动员经常观察到短暂的免疫抑制。这种所谓的“打开的窗口”导致运动员在一次彻底的运动后对病毒和细菌感染的抵抗力降低。移植受者是先天性免疫抑制者,对于其运动后接触细菌内毒素的影响,目前尚无资料。在完成81公里的骑行(包括海拔超过1800米)后,收集了10名男性肾移植受者和10名年龄和性别匹配的健康对照者的外周血。模拟运动员运动后与病原体的接触,血液样本与脂多糖(LPS)孵育。然后进行微阵列分析。微阵列分析显示,与LPS孵育后的对照组相比,移植受体的基因表达明显相反。尤其是免疫应答基因在LPS刺激下的力竭运动后立即在对照组中被过度表达,而许多凋亡基因在移植受体中被过度表达。将我们以前的数据与这些最近的发现结合起来,应该讨论移植受者在进行彻底运动之前是否需要减少免疫抑制药物。
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引用次数: 0
Immune responses to resistance exercise. 抵抗运动的免疫反应。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2012-01-01
Daniel J Freidenreich, Jeff S Volek

Resistance exercise induces changes in leukocyte redistribution, phenotypical surface expression and leukocyte functionality. Several factors have been shown to alter the temporal pattern and/or magnitude of response including manipulation of acute program variables, the aging process, and nutritional supplementation. Rest period length and load can modify the temporal pattern and/or magnitude of leukocytosis post exercise. Aging diminishes both the duration and magnitude of the post exercise leukocytosis and reduces leukocyte functionality. The few studies that assessed the effects of nutritional supplements (e.g., carbohydrate, whey protein, caffeine) peri-resistance exercise showed minimal effects on leukocyte responses. Sex differences exist in the timing and magnitude of leukocyte infiltration into skeletal muscle. The immune response to resistance exercise is only a small part of the recovery paradigm. A better understanding of how acute program variables and other factors such as aging, sex and nutritional supplementation affect the immune response to resistance exercise is important in the context of improving recovery, performance and health.

抗阻运动诱导白细胞再分布、表型表面表达和白细胞功能的改变。有几个因素可以改变反应的时间模式和/或强度,包括对急性程序变量的操纵、衰老过程和营养补充。休息时间的长短和负荷可以改变运动后白细胞增多的时间模式和/或强度。衰老减少了运动后白细胞减少的持续时间和幅度,并降低了白细胞的功能。少数评估营养补充剂(如碳水化合物、乳清蛋白、咖啡因)对抗阻期运动影响的研究显示,对白细胞反应的影响微乎其微。白细胞浸润骨骼肌的时间和大小存在性别差异。抵抗运动的免疫反应只是恢复模式的一小部分。更好地了解急性程序变量和其他因素(如年龄、性别和营养补充)如何影响抗阻运动的免疫反应,对于改善恢复、表现和健康非常重要。
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引用次数: 0
IL-17, neutrophil activation and muscle damage following endurance exercise. IL-17,中性粒细胞活化和耐力运动后肌肉损伤。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2012-01-01
Kaoru Sugama, Katsuhiko Suzuki, Kayo Yoshitani, Koso Shiraishi, Takashi Kometani

The T-cell subset Th17 is induced partly by interleukin (IL)-6 and activated by IL-23, and produces a proinflammatory cytokine IL-17. Since IL-6 increases dramatically following long-lasting endurance exercise, this response may also stimulate the induction of IL-17 and IL-23 after exercise. The aim of this study was to clarify the dynamics of IL-17 in association with endurance exercise-induced muscle damage and inflammatory responses. Fourteen male triathletes participated in a duathlon race consisting of 5 km of running, 40 km of cycling and 5 km of running. Venous blood and urine samples were collected before, immediately after 1.5 h and 3 h after the race. Plasma and urine were analyzed using enzyme-linked immunosorbent assays (ELISA). Haematological and biochemical variables such as neutrophil activation marker (myeloperoxidase: MPO), muscle damage marker (myoglobin: Mb) and soluble receptor activator of nuclear factor (NF)-KB ligand (sRANKL) were also determined to estimate the biological and pathological significance. Plasma concentrations oflL-6 (+26.0x), MPO (+3.2x) and Mb (+4.9x) increased significantly immediately after the race and IL-17 and IL-23 tended to increase. Furthermore, plasma concentrations of IL-12p40 and sRANKL increased significantly after the race. The measured parameters related to Thl 7 cytokines in the urinary output were closely correlated with each other and muscle damage marker. These findings suggest that IL-17 induced by IL-6 and activated by IL-23 or other IL-17 producing-cells and IL-23 might promote neutrophil activation and muscle damage following prolonged endurance exercise.

t细胞亚群Th17部分由白细胞介素(IL)-6诱导,并被IL-23激活,产生促炎细胞因子IL-17。由于IL-6在长期耐力运动后急剧增加,这种反应也可能刺激运动后IL-17和IL-23的诱导。本研究的目的是阐明IL-17在耐力运动诱导的肌肉损伤和炎症反应中的动态关系。14名男子铁人三项运动员参加了两项比赛,包括5公里的跑步、40公里的自行车和5公里的跑步。分别在赛前、赛后1.5 h和赛后3 h采集静脉血和尿样。采用酶联免疫吸附试验(ELISA)分析血浆和尿液。血液学和生化指标,如中性粒细胞激活标志物(髓过氧化物酶:MPO)、肌肉损伤标志物(肌红蛋白:Mb)和可溶性核因子受体激活剂(NF)-KB配体(sRANKL)也被测定,以估计生物学和病理学意义。血浆中fll -6 (+26.0x)、MPO (+3.2x)和Mb (+4.9x)浓度在比赛结束后立即显著升高,IL-17和IL-23有升高的趋势。此外,比赛结束后血浆IL-12p40和sRANKL浓度显著升高。尿量中与Thl - 7细胞因子相关的测量参数与肌肉损伤标志物密切相关。这些发现表明,IL-6诱导的IL-17被IL-23或其他产生IL-17的细胞激活,IL-23可能促进中性粒细胞的激活和长时间耐力运动后的肌肉损伤。
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引用次数: 0
Effects of moderate and high intensity exercise on T1/T2 balance. 中高强度运动对T1/T2平衡的影响。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2012-01-01
Guanggao Zhao, Shi Zhou, Allan Davie, Quansheng Su

Type 1 (TI) and Type 2 (T2) lymphocytes promote cell-mediated immunity and humoral immunity respectively. Evidence accumulated over the past two decades has demonstrated diverse responses of T1 and T2 cells to acute exercise or long-term training at moderate and high intensities. This brief review highlights the current findings from animal and human experimental models on the relationship between the T1 and T2 cell counts and the cytokines these cells produce, in response to moderate and high intensity exercise. The potential of using the T1/T2 balance as an indicator of immune function changes in response to exercise is discussed.

1型(TI)和2型(T2)淋巴细胞分别促进细胞免疫和体液免疫。过去二十年积累的证据表明,T1和T2细胞对急性运动或中高强度的长期训练有不同的反应。本文简要回顾了目前在动物和人类实验模型中发现的T1和T2细胞计数与这些细胞产生的细胞因子之间的关系,以应对中等和高强度的运动。本文讨论了利用T1/T2平衡作为运动后免疫功能变化指标的可能性。
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引用次数: 0
Killer cell immunoglobulin-like receptors and exercise. 杀手细胞免疫球蛋白样受体和运动。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Diana V Maltseva, Dmitry A Sakharov, Evgeny A Tonevitsky, Hinnak Northoff, Alexander G Tonevitsky

Exercise can alter human health in both beneficial (e. g. reduced risk of infection and of atherosclerosis) and adverse (e. g. anaphylaxis, exercise-induced asthma, and exacerbation of chronic illness) ways. Hitherto, the mechanisms linking exercise and health are not fully understood, but may rest on the capability of exercise to both increase circulating immune cells and modulate their activity. Natural killer (NK) cells, a major component of innate immunity, are one of the most sensitive populations of immune cells to exercise stress. NK cells play an important role in the detection and elimination of tumours and virus-infected cells. To mediate NK cell functions, there is an array of activating and inhibitory receptors with distinct specificities on their surface. Killer-cell immunoglobulin-like receptors (KIRs) which bind to MHC class I are a key example of receptors expressed by NK cells. The combination of MHC class I and KIR variants influences resistance to infections, susceptibility to autoimmune diseases, as well as complications of pregnancy. It is suggested that KIRs may also determine a considerable part of the effects of physical activity on human health. In this review we discuss KIRs in more detail, their role in the onset of human diseases, and the influence of acute exercise on KIR gene expression.

运动可以从有益(如降低感染和动脉粥样硬化的风险)和有害(如过敏反应、运动引起的哮喘和慢性疾病恶化)两方面改变人体健康。迄今为止,运动与健康之间的联系机制尚未完全清楚,但可能取决于运动增加循环免疫细胞和调节其活动的能力。自然杀伤细胞(NK)是先天免疫的重要组成部分,是对运动应激最敏感的免疫细胞群之一。NK细胞在检测和清除肿瘤和病毒感染细胞中起着重要作用。为了介导NK细胞的功能,在其表面有一系列具有不同特异性的激活和抑制受体。与MHC I类结合的杀伤细胞免疫球蛋白样受体(KIRs)是NK细胞表达的受体的一个关键例子。MHC I类和KIR变体的组合影响对感染的抵抗力、对自身免疫性疾病的易感性以及妊娠并发症。研究表明,基尔基尔也可能在很大程度上决定了体育活动对人类健康的影响。在这篇综述中,我们更详细地讨论了KIR,它们在人类疾病发病中的作用,以及急性运动对KIR基因表达的影响。
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引用次数: 0
Position statement. Part one: Immune function and exercise. 立场声明。第一部分:免疫功能和锻炼。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Neil P Walsh, Michael Gleeson, Roy J Shephard, Maree Gleeson, Jeffrey A Woods, Nicolette C Bishop, Monika Fleshner, Charlotte Green, Bente K Pedersen, Laurie Hoffman-Goetz, Connie J Rogers, Hinnak Northoff, Asghar Abbasi, Perikles Simon

An ever-growing volume of peer-reviewed publications speaks to the recent and rapid growth in both scope and understanding of exercise immunology. Indeed, more than 95% of all peer-reviewed publications in exercise immunology (currently >2, 200 publications using search terms "exercise" and "immune") have been published since the formation of the International Society of Exercise and Immunology (ISEI) in 1989 (ISI Web of Knowledge). We recognise the epidemiological distinction between the generic term "physical activity" and the specific category of "exercise", which implies activity for a specific purpose such as improvement of physical condition or competition. Extreme physical activity of any type may have implications for the immune system. However, because of its emotive component, exercise is likely to have a larger effect, and to date the great majority of our knowledge on this subject comes from exercise studies.

越来越多的同行评议出版物表明,最近运动免疫学的范围和理解都在快速增长。事实上,自1989年国际运动与免疫学学会(ISEI) (ISI知识网)成立以来,95%以上的运动免疫学同行评议出版物(目前超过2200份使用“运动”和“免疫”搜索词的出版物)已经出版。我们认识到“身体活动”这一通用术语与“运动”这一特定类别之间的流行病学差异,“运动”意味着为特定目的而进行的活动,如改善身体状况或参加比赛。任何类型的极端体育活动都可能对免疫系统产生影响。然而,由于运动的情感成分,它可能会产生更大的影响,迄今为止,我们对这一主题的大部分知识都来自运动研究。
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引用次数: 0
A review of sex differences in immune function after aerobic exercise. 有氧运动后免疫功能的性别差异研究综述。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Trevor L Gillum, Matthew R Kuennen, Suzanne Schneider, Pope Moseley

When menstrual phase and oral contraceptives are controlled for, males and females display marked differences in immune response to an exercise stress. In highly controlled research studies, sex differences in immune cell changes, cytokine alterations, along with morbidity and mortality after inoculation are apparent. Exercise has been hypothesized to serve as a model of various clinical stresses by inducing similar hormonal and immunological alterations. Thus, a greater understanding of sex differences in post exercise non-specific immune function may provide insight into more effective clinical approaches and treatments. This paper reviews the recent evidence supporting sex differences in post exercise immune response and highlights the need for greater control when comparing the post exercise immune response between sexes.

在控制经期和口服避孕药的情况下,男性和女性对运动应激的免疫反应有显著差异。在高度对照的研究中,免疫细胞变化、细胞因子改变以及接种后的发病率和死亡率的性别差异是明显的。运动被假设为各种临床压力的模型,通过诱导类似的激素和免疫改变。因此,更好地了解运动后非特异性免疫功能的性别差异可能为更有效的临床方法和治疗提供见解。本文综述了最近支持运动后免疫反应的性别差异的证据,并强调在比较运动后免疫反应时需要更好的控制。
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引用次数: 0
Position statement. Part two: Maintaining immune health. 立场声明。第二部分:保持免疫健康。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Neil P Walsh, Michael Gleeson, David B Pyne, David C Nieman, Firdaus S Dhabhar, Roy J Shephard, Samuel J Oliver, Stéphane Bermon, Alma Kajeniene

The physical training undertaken by athletes is one of a set of lifestyle or behavioural factors that can influence immune function, health and ultimately exercise performance. Others factors including potential exposure to pathogens, health status, lifestyle behaviours, sleep and recovery, nutrition and psychosocial issues, need to be considered alongside the physical demands of an athlete's training programme. The general consensus on managing training to maintain immune health is to start with a programme of low to moderate volume and intensity; employ a gradual and periodised increase in training volumes and loads; add variety to limit training monotony and stress; avoid excessively heavy training loads that could lead to exhaustion, illness or injury; include non-specific cross-training to offset staleness; ensure sufficient rest and recovery; and instigate a testing programme for identifying signs of performance deterioration and manifestations of physical stress. Inter-individual variability in immunocompetence, recovery, exercise capacity, non-training stress factors, and stress tolerance likely explains the different vulnerability of athletes to illness. Most athletes should be able to train with high loads provided their programme includes strategies devised to control the overall strain and stress. Athletes, coaches and medical personnel should be alert to periods of increased risk of illness (e.g. intensive training weeks, the taper period prior to competition, and during competition) and pay particular attention to recovery and nutritional strategies.

运动员进行的体能训练是影响免疫功能、健康和最终运动表现的一系列生活方式或行为因素之一。除了运动员训练计划的身体要求外,还需要考虑其他因素,包括潜在的病原体接触、健康状况、生活方式行为、睡眠和恢复、营养和社会心理问题。关于管理训练以保持免疫健康的普遍共识是,从一个低至中等规模和强度的计划开始;逐步和有周期地增加训练量和负荷;增加多样性以减少训练的单调性和压力;避免过度繁重的训练负荷,可能导致疲劳、疾病或受伤;包括非特定的交叉培训,以抵消陈旧;确保有足够的休息和恢复;并启动一项测试计划,以识别表现恶化的迹象和身体压力的表现。免疫能力、恢复、运动能力、非训练应激因素和应激耐受性等方面的个体差异可能解释了运动员对疾病的不同易感性。大多数运动员应该能够在高负荷下训练,只要他们的训练计划包括控制整体紧张和压力的策略。运动员、教练员和医务人员应警惕疾病风险增加的时期(例如,高强度训练周、比赛前和比赛期间的减量期),并特别注意恢复和营养策略。
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引用次数: 0
Plasma adenosine triphosphate and heat shock protein 72 concentrations after aerobic and eccentric exercise. 有氧和离心运动后血浆三磷酸腺苷和热休克蛋白72浓度。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Kishiko Ogawa, Ryosuke Seta, Takahiko Shimizu, Shoji Shinkai, Stuart K Calderwood, Koichi Nakazato, Kazue Takahashi

The endolysosome pathway has been proposed for secretion of heat shock protein (Hsp)72 with a regulatory role for extracellular adenosine triphosphate (ATP). Here, we tested the hypothesis that extracellular ATP mediates the increase in plasma Hsp72 after exercise. We measured plasma ATP Hsp72, cathepsin D, norepinephrine, free fatty acid, glucose, and myoglobin in 8 healthy young males (mean +/- SE: age, 22.3 +/- 0.3 years; height, 171.4 +/- 0.8 cm; weight, 68.8 +/- 3.1 kg; body mass index, 23.5 +/- 1.1 kg/cm2; VO2 max, 44.1 +/- 3.8 mL/kg/min) before and at 0, 10, 30, and 60 min after aerobic exercise (cycling) and elbow flexor eccentric exercise. Subjects cycled for 60 min at 70-75% VO2 max (mean +/- SE; 157.4 +/- 6.9 W). Eccentric strength exercise consisted of flexing the elbow joint to 90 degrees with motion speed set at 30 degrees/sec at extension and 10 degrees/sec at flexion. Subjects performed 7 sets of 10 eccentric actions with a set interval of 60 sec. The motion range of the elbow joint was 90 degrees-180 degrees. Compared with the levels of Hsp72 and ATP in plasma after bicycle exercise, those after eccentric exercise did not change. A significant group x time interaction was not observed for Hsp72 or ATP in plasma. A significant correlation was found between Hsp72 and ATP in plasma (r=0.79, P<0.05), but not between Hsp72 and norepinephrine (r=0.64, P=0.09) after bicycle exercise. A significant correlation between ATP and norepinephrine in plasma was found (r=0.89 P<0.01). We used stepwise multiple-regression analysis to determine independent predictors of exercise-induced elevation of eHsp72. Candidate predictor variables for the stepwise multiple-regression analysis were time (Pre, Post, Post10, Post30, Post60), exercise type (aerobic, eccentric), ATP, cathepsin D, norepinephrine, epinephrine, glucose, and FFA. In the regression model for Hsp72 in plasma, increased ATP and glucose were the strongest predictors of increased Hsp72 (ATP: R2=0.213, beta=0.473, P=0.000; ATP and glucose: R2=0.263, beta=0.534, P=0.000). Collectively, these results imply that ATP in plasma is a trigger of Hsp72 release after exercise.

热休克蛋白(Hsp)72的分泌有胞外三磷酸腺苷(ATP)的调节作用。在这里,我们验证了细胞外ATP介导运动后血浆Hsp72升高的假设。我们测量了8名健康年轻男性的血浆ATP、Hsp72、组织蛋白酶D、去甲肾上腺素、游离脂肪酸、葡萄糖和肌红蛋白。高度:171.4 +/- 0.8 cm;重量:68.8 +/- 3.1 kg;体质指数23.5 +/- 1.1 kg/cm2;在有氧运动(骑自行车)和肘关节屈肌偏心运动之前和之后的0,10,30和60分钟,VO2 max为44.1 +/- 3.8 mL/kg/min。受试者以70-75%最大摄氧量循环60分钟(平均+/- SE;(157.4 +/- 6.9 W)。偏心力量训练包括肘关节弯曲90度,运动速度设定为伸展30度/秒,弯曲10度/秒。受试者进行7组10次偏心动作,每组间隔60秒,肘关节活动范围为90度-180度。与自行车运动后血浆Hsp72和ATP水平相比,偏心运动后血浆Hsp72和ATP水平没有变化。血浆中Hsp72或ATP未观察到显著的组间相互作用。血浆中Hsp72与ATP有显著相关性(r=0.79, P
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引用次数: 0
Sex differences in immune variables and respiratory infection incidence in an athletic population. 运动人群中免疫变量和呼吸道感染发生率的性别差异。
IF 7.3 4区 医学 Q2 IMMUNOLOGY Pub Date : 2011-01-01
Michael Gleeson, Nicolette Bishop, Marta Oliveira, Tracey McCauley, Pedro Tauler

The purpose of this study was to examine sex differences in immune variables and upper respiratory tract infection (URTI) incidence in 18-35 year-old athletes engaged in endurance-based physical activity during the winter months. Eighty physically active individuals (46 males, 34 females) provided resting venous blood samples for determination of differential leukocyte counts, lymphocyte subsets and whole blood culture multi-antigen stimulated cytokine production. Timed collections of unstimulated saliva were also made for determination of saliva flow rate, immunoglobulin A (IgA) concentration and IgA secretion rate. Weekly training and illness logs were kept for the following 4 months. Training loads averaged 10 h/week of moderate-vigorous physical activity and were not different for males and females. Saliva flow rates, IgA concentration and IgA secretion rates were significantly higher in males than females (all P < 0.01). Plasma IgA, IgG and IgM concentrations and total blood leukocyte, neutrophil, monocyte and lymphocyte counts were not different between the sexes but males had higher numbers of B cells (P < 0.05) and NK cells (P < 0.001). The production of interleukins 1 beta, 2, 4, 6, 8 and 10, interferon-gamma and tumour necrosis factor-alpha in response to multi-antigen challenge were not significantly different in males and females (all P > 0.05). The average number of weeks with URTI symptoms was 1.7 +/- 2.1 (mean +/- SD) in males and 2.3 +/- 2.5 in females (P = 0.311). It is concluded that most aspects of immunity are similar in men and women in an athletic population and that the observed differences in a few immune variables are not sufficient to substantially affect URTI incidence. Sex differences in immune function among athletes probably do not need to be considered in future mixed gender studies on exercise, infection and immune function unless the focus is on mucosal immunity or NK cells.

本研究的目的是检查18-35岁冬季进行耐力运动的运动员免疫变量和上呼吸道感染(URTI)发病率的性别差异。80名身体活跃的个体(46名男性,34名女性)提供静息静脉血样本,用于测定白细胞计数、淋巴细胞亚群和全血培养多抗原刺激细胞因子的产生。定时采集未刺激唾液,测定唾液流速、免疫球蛋白A (IgA)浓度和IgA分泌率。在接下来的4个月里,每周的训练和疾病记录都被保存下来。训练负荷平均为10小时/周的中等强度体力活动,在男性和女性之间没有差异。男性的唾液流率、IgA浓度和IgA分泌率显著高于女性(均P < 0.01)。血浆IgA、IgG和IgM浓度以及白细胞、中性粒细胞、单核细胞和淋巴细胞总数在两性间无显著差异,但男性的B细胞和NK细胞数量较高(P < 0.05)。多抗原刺激下白细胞介素1 β、2、4、6、8和10、干扰素γ和肿瘤坏死因子α的产生在男女间无显著差异(均P > 0.05)。男性出现尿路感染症状的平均周数为1.7 +/- 2.1周(平均+/- SD),女性为2.3 +/- 2.5周(P = 0.311)。结论是,在运动人群中,男性和女性的大多数免疫方面是相似的,在一些免疫变量上观察到的差异不足以显著影响尿路感染的发病率。在未来关于运动、感染和免疫功能的混合性别研究中,运动员免疫功能的性别差异可能不需要考虑,除非重点是粘膜免疫或NK细胞。
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引用次数: 0
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Exercise Immunology Review
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