Exercise-associated collapse in cyclists is unrelated to endotoxemia

G. E. Moore, M. E B Holbein, J. P. Knochel

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Endotoxemia occurs when intestinal ischemia allows bacterial lipopolysaccharide to translocate from colonic flora into the bloodstream, which triggers release of cytokines that can cause hypotension, rigors, fever, shock, and even death. Recently, blood endotoxin levels were shown to be higher in athletes needing medical attention (331) pg · ml-1) than in their competitors with similar performances (81 pg · ml-1). Though there were no data showing that these athletes had elevated core temperatures or severe illness, speculation followed that endotoxin may play a causal role in heat stroke. We examined the relationship between endotoxemia and mild post- exertional illness in 39 cyclists after a 100-mile ride. Thirteen cyclists had at least one of the following: orthostatic hypotension, rigors, nausea, vomiting, diarrhea, or syncope. Only 2/26 case-controls had any of these symptoms. Data were collected on vital signs, hemoglobin, sodium, creatine kinase, creatinine, and uric acid. Endotoxin titer was determined by chromogenic assay; tumor necrosis factor alpha (TNF-α) titer was determined by ELISA. One ill cyclist had an endotoxin level of 330 pg · ml-1, one control had an endotoxin level of 150 pg · ml-1, but endotoxin level was <64 pg · ml-1 in all others. Comparison of pre- and post-ride data showed that controls increased creatine kinase activity (154 ± 34 vs 561 ± 191 IU · dl, P < 0.05), creatinine concentration (1.5 ± 0.0 vs 1.6 ± 0.0 mg · dl-1, P < 0.05), and uric acid concentration (5.4 ± 0.3 vs 6.3 ± 0.3 mg · dl-1, P < 0.05). 111 cyclists had lower serum sodium than post-ride controls (138 ± 2 vs 142 ± 0.6 mEq · l-1, P < 0.05), but there were no differences between groups in CK, creatinine, or uric acid. These findings suggest that endotoxemia may complicate, but does not cause mild post- exertional illness in cyclists.

Original languageEnglish (US)
Pages (from-to)1238-1242
Number of pages5
JournalMedicine and Science in Sports and Exercise
Volume27
Issue number9
StatePublished - 1995

Fingerprint

Endotoxemia
Endotoxins
Exercise
Uric Acid
Creatinine
Creatine Kinase
Athletes
Sodium
Heat Stroke
Orthostatic Hypotension
Vital Signs
Syncope
Hypotension
Nausea
Vomiting
Lipopolysaccharides
Diarrhea
Shock
Hemoglobins
Fever

Keywords

  • HEAT ILLNESS
  • RHABDOMYOLYSIS

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Public Health, Environmental and Occupational Health
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Exercise-associated collapse in cyclists is unrelated to endotoxemia. / Moore, G. E.; Holbein, M. E B; Knochel, J. P.

In: Medicine and Science in Sports and Exercise, Vol. 27, No. 9, 1995, p. 1238-1242.

Research output: Contribution to journalArticle

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