Aspects of physical training related with upper respiratory tract infections: a review
Shirko Ahmadi, Cayque Brietzke, Rodrigo Silveira, Raul Cosme Ramos do Prado, Ricardo Brietzke, Samuel da Silva Aguiar, Ricardo Yukio Asano, Hélio José Coelho-Júnior
The upper respiratory tract infections (URTI) are characterized by symptoms present, mainly, in the nose and pharynx. Physical exercise is one of the factors that can lead to development of URTI, causing a state of immunosuppression during a small-time interval, making the athlete susceptible to development of acute infectious states. Besides its influence in athlete’s quality of life and healthy, the progression of URTI seems to be associated with overtraining state, inducing reduction on physical performance. Several authors have been discussing how the variables of exercise training can alter the incidence and prevalence of URTI, and the present study was developed to present the current knowledge about this tissue, discussing how the modulation in the exercise training variables may interfere in the URTI. Methods: This is a review study. Results: Athletes with different levels of training and different categories in most diverse modalities seem to suffer from symptoms of URTI in training and competitive periods. Increasing of URTI symptoms seems to be related to internal training load and evidence has pointed out that suppression of serum and salivary immunoglobulin concentrations appear to be a factor which influences appearance of these symptoms and may even be used as markers of immune status of athlete. Conclusion: In point of view of reviewed articles, athletes with different levels of training and different categories in most diverse modalities seem to suffer from symptoms of URTI in training and competitive periods. Increasing of URTI symptoms seems to be related to internal training load and evidence has pointed out that suppression of serum and salivary immunoglobulin concentrations appear to be a factor which influences appearance of these symptoms and may even be used as markers of immune status of athlete. However, studies that verify and provide “cutoff points” that indicate a higher risk for URTI onset is still needed.
1. Nieman DC, Bishop NC. Nutritional strategies to counter stress to the immune system in athletes, with special reference to football. J Sports Sci. 2006;24(7):763-72.
2. Moreira A, Arsati F, Cury PR, Franciscon C, de Oliveira PR, de Araújo VC. Salivary immunoglobulin a response to a match in top-level brazilian soccer players. J Strength Cond Res. 2009;23(7):1968-73.
3. Moreira A, Kekkonen R, Korpela R, Delgado L, Haahtela T. Allergy in marathon runners and effect of Lactobacillus GG supplementation on allergic inflammatory markers. Respir Med. 2007;101(6):1123-31.
4. Schwellnus MP, Lichaba M, Derman EW. respiratory traCt symptoms in enduranCe athletes–Causes and ConsequenCes. Current Allergy & Clinical Immunology. 2010;23(2):53.
5. Spence L, Brown WJ, Pyne DB, Nissen MD, Sloots TP, McCormack JG, et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes. Med Sci Sports Exerc. 2007;39(4):577-86.
6. Gleeson M. Immune function in sport and exercise. J Appl Physiol (1985). 2007;103(2):693-9.
7. Nieman DC, Stear SJ, Castell LM, Burke LM. A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance: part 15. British journal of sports medicine. 2010;44(16):1202-5.
8. Nieman DC. Does Exercise Alter Immune Function and Respiratory Infections? President’s Council on Physical Fitness and Sports Research Digest. 2001.
9. Robinson D, Milne C. Medicine at the 2000 Sydney Olympic Games: the New Zealand health team. Br J Sports Med. 2002;36(3):229.
10. Nieman DC, Nehlsen-Cannarella SL, Fagoaga OR, Henson DA, Shannon M, Hjertman JME, et al. Immune function in female elite rowers and non-athletes. British Journal of Sports Medicine. 2000;34(3):181-7.
11. Teixeira RN, Lunardi A, da Silva RA, Lopes AD, Carvalho CR. Prevalence of musculoskeletal pain in marathon runners who compete at the elite level. Int J Sports Phys Ther. 2016;11(1):126-31.
12. Cox AJ, Gleeson M, Pyne DB, Callister R, Hopkins WG, Fricker PA. Clinical and laboratory evaluation of upper respiratory symptoms in elite athletes. Clinical Journal of Sport Medicine. 2008;18(5):438-45.
13. Pyne DB, Hopkins WG, Batterham AM, Gleeson M, Fricker PA. Characterising the individual performance responses to mild illness in international swimmers. Br J Sports Med. 2005;39(10):752-6.
14. Pyne DB, McDonald WA, Gleeson M, Flanagan A, Clancy RL, Fricker PA. Mucosal immunity, respiratory illness, and competitive performance in elite swimmers. Med Sci Sports Exerc. 2001;33(3):348-53.
15. Reid VL, Gleeson M, Williams N, Clancy RL. Clinical investigation of athletes with persistent fatigue and/or recurrent infections. Br J Sports Med. 2004;38(1):42-5.
16. Peters EM, Bateman ED. Ultramarathon running and upper respiratory tract infections. An epidemiological survey. S Afr Med J. 1983;64(15):582-4.
17. Ekblom B, Ekblom Ö, Malm C. Infectious episodes before and after a marathon race. Scandinavian journal of medicine & science in sports. 2006;16(4):287-93.
18. Pacque PFJ, Booth CK, Ball MJ, Dwyer DB. The effect of an ultra-endurance running race on mucosal and humoral immune function. Journal of sports medicine and physical fitness. 2007;47(4):496.
19. Nieman DC, Johanssen LM, Lee JW, Arabatzis K. Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness. 1990;30(3):316-28.
20. Zatsiorsky VM. Biomechanics of strength and strength training. Strength and power in sport. 2008;2:439-87.
21. Gleeson M. Mucosal immune responses and risk of respiratory illness in elite athletes. Exercise immunology review. 1999;6:5-42.
22. Brunelli DT, Borin JP, Rodrigues A, Bonganha V, Prestes J, Montagner PC, et al. Immune responses, upper respiratory illness symptoms, and load changes in young athletes during the preparatory period of the training periodization. Open access journal of sports medicine. 2012;3:43.
23. Brunelli DT, Rodrigues A, Lopes WA, Gáspari AF, Bonganha V, Montagner PC, et al. Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season. Journal of sports sciences. 2014;32(11):1050-9.
24. Nieman DC, Luo B, Dréau D, Henson DA, Shanely RA, Dew D, et al. Immune and inflammation responses to a 3-day period of intensified running versus cycling. Brain, behavior, and immunity. 2014;39:180-5.
25. Neville V, Gleeson M, Folland JP. Salivary IgA as a risk factor for upper respiratory infections in elite professional athletes. 2008.
26. Fricker PA, Pyne DB, Saunders PU, Cox AJ, Gleeson M, Telford RD. Influence of training loads on patterns of illness in elite distance runners. Clinical Journal of Sport Medicine. 2005;15(4):246-52.
27. Gleeson M, Bishop N, Oliveira M, Tauler P. Influence of training load on upper respiratory tract infection incidence and antigen‐stimulated cytokine production. Scandinavian journal of medicine & science in sports. 2013;23(4):451-7.
28. Ferrari HG, Gobatto CA, Manchado-Gobatto FB. Training load, immune system, upper respiratory symptoms and performance in welltrained cyclists throughout a competitive season. Biology of Sport. 2013;30(4):289.
29. Fahlman MM, Engels H-J. Mucosal IgA and URTI in American college football players: a year longitudinal study. Medicine and science in sports and exercise. 2005;37(3):374-80.
30. Moreira A, Mortatti AL, Arruda AFS, Freitas CG, de Arruda M, Aoki MS. Salivary IgA response and upper respiratory tract infection symptoms during a 21-week competitive season in young soccer players. The Journal of Strength & Conditioning Research. 2014;28(2):467-73.
31. Moreira A, de Moura NR, Coutts A, Costa EC, Kempton T, Aoki MS. Monitoring internal training load and mucosal immune responses in futsal athletes. The Journal of Strength & Conditioning Research. 2013;27(5):1253-9.
32. Moreira A, Arsati F, de Oliveira Lima‐Arsati YB, Simões AC, de Araujo VC. Monitoring stress tolerance and occurrences of upper respiratory illness in basketball players by means of psychometric tools and salivary biomarkers. Stress and Health. 2011;27(3):e166-e72.
33. Dias R, Frollini AB, Brunelli DT, Yamada AK, Leite RD, Simões RA, et al. Immune parameters, symptoms of upper respiratory tract infections, and training-load indicators in volleyball athletes. Int J Gen Med. 2011;4:837-44