糖皮质激素与免疫功能的关系及在运动免疫学中的作用

Relation of glucocorticoid to immunity and the role of glucocorticoid in exercise immunology

学术背景:长期以来,糖皮质激素作为一种免疫抑制剂,一直被认为对免疫功能只有抑制作用;然而运动免疫学中的许多研究结果却难以用糖皮质激素的抑制理论作解释。目的:分析糖皮质激素与免疫功能的关系及其在运动免疫学中的作用。检索策略:应用计算机检索Medline 1970-01/2007-12有关糖皮质激素与免疫功能及运动免疫学关系方面的文章,检索词为"gluco corticoid(GC),immunity,exercise",限定语言种类为English。同时检索中国期刊网1990-01/2007-12有关糖皮质激素与免疫功能以及运动免疫学关系方面的文章,检索词为"糖皮质激素,免疫,运动",并限定语言种类为中文。同时查阅相关的教材书。对资料进行初审,选择有关糖皮质激素与免疫功能关系的文献,特别是糖皮质激素提高免疫功能,以及运动与上呼吸道疾病关系的文献。排除综述类及重复文献。共检索到75篇文献,30篇文献符合纳入标准,排除45篇;同时参考了3本教材中的相关内容。文献评价:纳入的33篇文献中有关糖皮质激素调节免疫功能经典理论的文献12篇,有关糖皮质激素调节免疫功能新观点的文献14篇,有关应用糖皮质激素调节免疫功能的新观点分析运动免疫学中两个基本理论的文献7篇。资料综合:近年来发现糖皮质激素与免疫功能的关系比较复杂,在一定的条件下,它对免疫功能具有加强作用。在运动与健康的关系中,现在比较一致的观点是,中等强度的运动有益于身体健康,而在大强度的运动后运动员抵抗力下降,更易患急性上呼吸道疾病,上呼吸道疾病主要是由病毒引起的一种疾病,运用糖皮质激素对免疫功能的作用可以比较合理的解释运动中有机体产生这些变化的原因。结论:低浓度的糖皮质激素对免疫功能具有增强作用,高浓度的糖皮质激素抑制细胞免疫增强体液免疫;大强度的训练后运动员抵抗力下降,更易患急性上呼吸道疾病是由于大强度的训练后运动员细胞免疫功能下降,体液免疫增强的结果。

BACKGROUND： For a long time, glucocorticoid has been thought to have a general suppressive effect on immunity; however it is difficult to explain many findings with the suppression theory of glucocorticoid. OBJECTIVE： To investigate the relation of glucocorticoid with immunity and the exertion of this kind of relation on exercise immunology. RETRIEVAL STRATEGY： The articles related to the correlation of glucocorticoid with immunity and exercise immunology were searched on Medline database published between January 1970 and December 2007 with the key words ＂exercise, glucocorticoid （GC）, immunity＂ in English. Meanwhile, the China National Knowledge Infrastructure was retrieved for the correlative literatures published between January 1990 and December 2007 with the key words ＂exercise, glucocorticoid, immunity＂ in Chinese. Some correlative teaching materials were also consulted. All the data were checked primarily, the articles about the relation of glucocorticoid and immunity were selected, especially the articles about glucocorticoid enforcing the immunity and about the relation between exercise and upper respiratory tract infection. Articles on reviews and repetitive researches were excluded. Totally 75 papers were collected, and 30 of them accorded with the inclusive criteria, whereas 45 exclusive articles were old and repetitive. Meanwhile the correlative contents in three teaching materials were referenced. LITERATURE EVALUATION： Among the 33 included articles, there were 12 ones referring to the classical theory of glucocorticoid regulate immunity, 14 referring to the new viewpoints of glucocorticoid regulate immunity, and 7 referring to the analysis of two basic theories of exercise immunology by the new viewpoints of glucocorticoid regulate immunity. DATA SYNTHESIS： Recently, the researchers have found that the relation between glucocorticoid and immunity is complicated. On some condition, glucocorticoid has an enforced effect on immunity. There is a consistent viewpoint on the relation of exercise and immunity, that is moderate intensity exercise is good to health, but sportsmen are prone to decrease immunity and have a kind of disease called upper respiratory tract infection after high intensity exercise. Upper respiratory tract infection is a disease that is mainly brought by virus. These changes of organism in exercise can be reasonably explained with the influence of glucocorticoid on immunity. CONCLUSION： Low concentration of glucocorticoid may enforce immunity function, and high concentration of glucocorticoid inhibits cell immunity and enhances humour immunity. That many sportsmen are easy to decrease immunity and have a kind of disease called upper respiratory tract infection, is mainly attributed to the falling of cell immune function and the enhancing of humour immune function of sportsman after high intensity exercise.