Circulating Levels of Adhesion Molecules and Markers of Endothelial Dysfunction in Acute Inflammation Induced by Prolonged Brisk Exercise: Rapid Endothelial Recovery and Potential Beneficial Effects.

The “Spartathlon” ultradistance foot race (246 Km continuous, prolonged, brisk exercise for up to 36 hours) provides a unique model of prolonged duration exercise that reveals dramatic systemic inflammatory changes. In this study we investigated endothelial function of athletes participating in this extreme physical stress paradigm. The circulating levels of adhesion molecules E-, L- and P-selectins, intracellular adhesion molecule-1 (ICAM-1), and vascular adhesion molecule-1 (VCAM-1), along with those of thrombomodulin (TM), N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac troponin T, were measured before, at the end of and at 48 h postrace. The E-, L-, P-selectins were quantified in plasma with a biochip array analyzer, the Evidence® (Randox Laboratories, Crumlin, UK). The determination of soluble ICAM-1 and soluble VCAM-1 in plasma was performed on the Luminex-100 system using the multiplex assay kit Linco Human Sepsis/Apoptosis (Linco Research, Inc., Missouri, USA), TM was measured with an immunoassay technique (Euroclone Life Sciences, Pero, Italy), while NT-pro-BNP and cardiac troponin T were quantitatively determined on the Roche Elecsys 2010 immunoassay analyzer (Roche Diagnostics, Mannheim, Germany). The table summarizes the results of the study.

Levels of L- and P-selectins remained the same before and at the end of the “Spartathlon” race, but had a similar decline 48 h postrace. E-selectin, ICAM-1 and TM reached a maximum value at the end of the race and returned to normal 48 h after the race. A similar profile was observed for VCAM-1 and NT-pro-BNP, with a tendency for a decrease 48 h postrace but without reaching complete normalization. Cardiac troponin T remained below the detection limit at all time points examined. The indices of endothelial damage and dysfunction were strongly affected during exercise, with a peak at the end of the “Spartathlon” race and a return to normal 48 h later. In parallel, the indices of endothelial protection were also affected, while no evidence for myocardial damage was observed. These findings suggest that although prolonged brisk exercise activates the endothelium, the latter expresses protective molecules and rapidly recovers, possibly participating in the beneficial effects of exercise on health.