Dupilumab for Treatment of Food-Dependent, Exercise-Induced Anaphylaxis: Report of One Case

Food-dependent,exercise-induced anaphylaxis(FDEIA)is a potentially life-threatening disorder that often occurs with exercise,and patients typically have eaten a specific food within hours before disease onset.This disease is exceedingly rare,with a prevalence of 0.02%.No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly.Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years.As the anaphylactic symptoms had not been controlled after traditional treatments,the patient was given subcutaneous injection of dupilumab seven times within 33 weeks.During dupilumab treatments,the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis.Thus,dupilumab may improve the allergic reactions in FDEIA patients.

Variations in Inflammatory Cells and IL-6 in Long-Distance Runners Susceptible to Exercise-Induced Bronchospasm and Previously Treated with Salbutamol

Background: Exercise-Induced Bronchospasm (EIB) is an inflammatory condition characterized by severe airway constriction following the mobilization of inflammatory cells and interleukin-6 (IL-6). When severe, EIB can require the use of pressurized salbutamol to treat athletes. This study investigated the nature of the systemic changes in inflammatory cells and post-exercise IL-6 concentrations after salbutamol treatment in EIB-susceptible distance runners. Materials and Methods: This was an experimental study that enrolled 12 long-distance runners. In Session A, the participants completed a treadmill exercise test, and those who had a maximum expiratory volume per second (FEV1) that was decreased by at least 10% compared to their base value were placed in the EIB-susceptible group (EIB+) (n = 6). Those whose FEV1 did not meet this criterion were placed in the nonresponsive (EIB?) group (n = 6). Before the Session B exercise, athletes in the BIE+ group inhaled two puffs of salbutamol (EIB+ Salb), while their EIB? counterparts received no treatment. Spirometry was performed before and after the exercise using a Spirobank G portable spirometer. Blood samples were taken before, immediately after and 2 hours after the stress test. Results: The mean post-exercise FEV1 values were not significantly different (p > 0.05) between the EIB+ Salb group and the EIB? group. The systemic changes in inflammatory cells and IL-6 concentrations in the EIB+ runners after salbutamol treatment were similar to those observed in their EIB? counterparts. Conclusion: Salbutamol pretreatment improved the systemic immune status of EIB-susceptible athletes.

Study on Mechanism of Dendrobium officinale Kimura et Migo in Preventing and Treating Exercise-induced Muscle Damage(EIMD)in Rats

[Objectives]This study was conducted to observe the mechanism of Dendrobium officinale Kimura et Migo on gastrocnemius muscle in rats with exercise-induced muscle damage(EIMD).[Methods]The micro-injury model of skeletal muscle was established by treadmill training.Forty two SD rats were randomly divided into a control group,1,12 and 24 h exercise groups,D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group,and D.officinale 2 ml+24 h exercise group,with 6 rats in each group.Various D.officinale groups were given the drug once in the morning and once in the evening at a dose of 2 ml/time,a week in advance.Except for the quiet group,the samples were collected from the 1,12 and 24 h exercise groups after anesthesia following 1,12 and 24 h of exercise for the last time,respectively,and the D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group and D.officinale 2 ml+24 h exercise group were also sampled after anesthesia following 1,12 and 24 h of exercise for the last time,respectively.The contents of ATP,CK-MM and CK in rat serum were determined by enzyme-linked immunosorbent assay(ELISA).The histopathological changes of gastrocnemius muscle were observed by HE staining.PCR and Western-blot detection were carried out to analyze the effects of D.officinale on IGF-1 mRNA and protein expression in gastrocnemius muscle.[Results]Compared with the quiet group,the ATP contents in the serum of rats in the 1,12 and 24 h exercise groups significantly decreased(P<0.01),while the CK and CK-MM contents significantly increased(P<0.01).The expression of IGF-1 mRNA and protein in the gastrocnemius muscle tissue significantly increased(P<0.01).Compared with the 1 h exercise group,the ATP content and IGF-1 protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+1 h exercise group significantly increased(P<0.05),while the CK and CK-MM contents significantly decreased(P<0.01).Compared with the 12 h exercise group,the D.officinale liquid+12 h exercise group showed a significant increase in ATP content(P<0.01),significant increases in IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue(P<0.01),and significant decreases in CK and CK-MM contents(P<0.01).Compared with the 24 h exercise group,the ATP content and IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+24 h exercise group significantly increased(P<0.01),while the CK and CK-MM contents significantly decreased(P<0.01).From the pathological tissue morphology of the gastrocnemius muscle in rats with EIMD treated with D.officinale,it could be concluded that the gastrocnemius muscle of each exercise group was significantly damaged,and the damage was significantly alleviated after administration of D.officinale liquid.[Conclusions]The effects and mechanism of D.officinale on prevention and treatment of EIMD in rats might be related to the promotion of IGF-1 mRNA and protein expression in injured tissues by reducing ATP energy consumption,CK-MM and CK activity.

Exercise-induced irisin in bone and systemic irisin administration reveal new regulatory mechanisms of bone metabolism

Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue （WAT） and uncoupling protein I （UCP1） expression, leading to an increase in total body energy expenditure by augmented UCPl-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo. In this study, we found that 2 weeks of voluntary wheel-running exercise induced high levels of FNDC5 messenger RNA as well as FNDC5/irisin protein expression in murine bone tissues. Increased immunoreactivity due to exercise-induced FNDC5/irisin expression was detected in different regions of exercised femoral bones, including growth plate, trabecular bone, cortical bone, articular cartilage, and bone-tendon interface. Exercise also increased expression of osteogenic markers in bone and that of UCP1 in WAT, and led to bodyweight loss. Irisin intraperitoneal （IP） administration resulted in increased trabecular and cortical bone thickness and osteoblasts numbers, and concurrently induced UCP1 expression in subcutaneous WAT. Lentiviral FNDC5 IP administration increased cortical bone thickness. In vitro studies in bone cells revealed irisin increases osteoblastogenesis and mineralization, and inhibits receptor activator of nuclear factor-kB ligand （RANKL）- induced osteoclastogenesis. Taken together, our findings show that voluntary exercise increases irisin production in bone, and that an increase in circulating irisin levels enhances osteogenesis in mice.

Single dose of intra-muscular platelet rich plasma reverses the increase in plasma iron levels in exercise-induced muscle damage:A pilot study

Background:Platelet rich plasma(PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury.However,the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage.The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise(exercise-induced muscle damage,EIMD).Methods:Moderately active male volunteers participated in this study and were assigned to a control group(control,n = 6) and PRP administration group(PRP,n = 6).The subjects performed exercise with a load of 80% one repetition maximum(1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached.The arms were treated with saline or autologous PRP post-24 h EIMD.Venous blood samples were obtained in the morning to establish a baseline value and 1–4 days post-exercise and were analyzed for serum ferritin,iron,iron binding capacity(IBC),creatinine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),and alanine aminotransferase(ALT).Results:The baseline levels of plasma iron,ferritin,IBC,CK,LDH,AST,and ALT were similar in both the control and PRP groups.However,24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period.Interestingly,PRP administration decreased plasma iron levels compared to the control on the second day post-exercise.Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin,CK,AST,ALT,or LDH.Conclusion:Acute exhaustive exercise increased muscle damage markers,including plasma iron,IBC,and ferritin levels,indicating muscle damage induced by exercise.PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage.

Real-time surface electromyography in Parkinson's disease patients during exercise-induced muscle fatigue

To explore the mechanisms underlying exercise-induced local muscle fatigue in patients with idiopathic Parkinson＇s disease （PD）,we used surface electromyography to record myoelectric signals from the tibialis anterior muscle during isometric contraction-induced fatigue until exhaustion.The results revealed no significant differences between patients with idiopathic PD and healthy controls in maximum voluntary contraction of the tibialis anterior muscle.The basic characteristics of surface electromyography were also similar between the two groups.The duration of isometric contraction at 50% maximum voluntary contraction was shortened in PD patients.In addition,PD patients exhibited a stronger increase in mean square amplitude,but a weaker decrease in median frequency and mean power frequency compared with healthy controls during isometric contraction.The skeletal muscles of PD patients revealed specificity of surface electromyography findings,indicating increased fatigability compared with healthy controls.

Exercise-induced anaphylaxis with an Ayurvedic drug as cofactor:A case report

BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showed a high degree of safety, it can act as cofactor of anaphylaxis, especially in condition at high risk, such as mast cell activation syndrome(MCAS). We reported this case to sensitize practitioners to investigate to the use of complementary and alternative medicine,in case of exercise-induced anaphylaxis(EIAn).CASE SUMMARY A 43-year-old woman, working as a dance teacher, developed urticaria after ingestion of rice, tuna and Shilajit, which did not respond to intramuscular corticosteroids. Subsequently, she developed dyspnoea and hypotension with loss of consciousness that arose 1 h after sexual activity. The patient did not refer personal history of atopy. Specific IgE for main food allergens resulted negative,with total IgE levels of 14 IU/L. Oral provocation test with Shilajit was not perfomed because the patient refused, but we performed prick-by-prick and patch test that resulted negative. Serum tryptase at the time of anaphylaxis was 20.6 μg/L that fell down to of 10.6 μg/L after therapy, but has remained at the high value after two days and during the follow-up. We performed an analysis of the c-KIT gene in peripheral blood, which was negative. We felt the diagnosis consistent with EIAn in a patient with a possible MCAS.CONCLUSION In Western countries the use of drugs from Ayurvedic medicine is more common than in the past. These substances can be cofactors of anaphylaxis in patients with risk factors.

EFFICACY OF ANTIHISTAMINE AGENTS ON MODEL FOR EXERCISE-INDUCED ASTHMA IN GUINEA PIGS

Objective To investigate the effects of antihistamine agents, loratadine and ketotifen, on the model of exercise-induced asthma in guinea pigs with lipopolysaccharide （LPS） and metyapone. Methods Nineteen guinea pigs were injected peritoneolly with LPS （ 1mg/kg, i. p. ） and metyapone （ 50mg/kg, i. p. ）. Then they were randomized into 3 groups. The control group （ n = 7） did not take any drug, ketotifen group （ n = 6） administered orally ketotifen （ Img·kg^-1· d^-1 ） and loratadine group （ n = 6） administered orally loratadine （ 2mg·kg^-1·d^-1 ） for 4 days. On thefifth day, lung resistance （RL） and dynamic compliance of respiratory system （Cdyn） of 3 groups were measured before and after exercise challenge. The total number of leukocytes in bronchoalveolar lavage fluid （BALF） from 3 groups was counted and differentiated cell type count was measured. Morphometric examination of the animal lungs was performed. Results In control group, RLincreased and Cdyn decreased significantly after exercise challenge. In ketotifen group and loratadine group with no change. There was a significant increase in the number of neutrophils, macrophages and eosinophils in BALF from control group. The infiltration of neutrophils in the bronchial mucosa was shown in control group in the morphometric study. Conclusion Loratadine and ketotifen can inhibit the exercise-induced bronchoconstriction in guinea pigs pretreated with LPS and metyrapone. Inhibiting the formation of inflammation in airway may be the therapeutic mechanism of these H-I receptor antagonists.

Exercise-Induced Bronchoconstriction Diagnostics:Impact of a Repeated Exercise Challenge Test

Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.

Effects of electroacupuncture on HPA axis in rats with exercise-induced immunosuppression

Objective To observe modulatory effects of electroacupuncture （EA） on hypothalamus-pituitary adrenal （HPA） axis, thymus-exponent （TE）, γ-IFN and interleukin-2 （IL-2） in rats with exercise-induced immunosuppression. Methods Forty-three SD rats were randomly, by using digits, divided into three groups： group A, B and C. Group A （n=10） was taken as a control group. Rats in group B （n=17） accepted intense swimming exercise for 150 min each time, 6 times each week for 8 weeks. Rats in group C （n=16） accepted EA intervention following each swimming since the second week of swimming exercise with the same duration and times as those in group B. The indices reflecting functional states of the HPA axis such as hypothalamic corticotropin releasing hormone （CRH）, plasma adrenocorticotropic hormone （ACTH）, corticosterone （CORT） etc. and changes in TE, serum γ-IFN, and IL-2 were determined. Results （1） Compared with group A, the values of ACTH and CORT in group B significantly increased （P〈0.01, P〈0.05）, but no significant differences were found in group C （both P〉0.05） though they were somewhat elevated. Compared with group A, CRH values increased by 85.14% in group B and decreased by 64.09% in group C, respectively, but both differences were without statistical significance （both P〉0.05）. Serum IL-2, γ-IFN and TE values in group B were significantly lower than those in group A（P〈0.05, P〈0.01 ）, among which γ-IFN decreased by 32.19%. The values of IL-2, γ-IFN and TE in group C tended to reduce but without significance, compared with group A. （2） Compared with group B, ACTH value in group C was very significantly lowered than that in group B （P〈0.01）, and CRH value was lower while CORT value was higher than those in group B but without significance （both P〉0.05）. The values of TE and γ-IFN in group C were significantly higher than those in group B （P〈0.01, P〈0.05）. Conclusion （1） Long-term of intense exercise induces accentuation of functions of the HPA axis and sustained high level of CORT, resulting in neuroendocrine disturbance and inhibition of immune functions. （2） EA provides favorable modulation on long-term of intense exercise-induced lowering of immune function and on the HPA axis.

Advances of studies on relieving of exercise-induced fatigue by transcutaneous electrical acupoint stimulation

The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminating free radical, regulating amino acid metabolism and retaining heart rate with transcutaneous electrical acupoint stimulation （TEAS）. Problems in the above researching field are generalized in this paper. For instance, the point selection is relatively simple; the selection of wave band, frequency and duration during the application of TEAS apparatus are not unified; and observation indices mainly remained in the aspect of biochemistry. It also prospects the future directions of TEAS relieving exercise-induced fatigue including selecting acupuncture point by differentiation of symptoms and signs, setting uniform standards for TEAS, and studying the mechanisms of TEAS relieving exercise-induced fatigue by testing gonadal axis, adrenal axis, gene and protein .

ew Diagnostic Criteria of Wheat-Dependent, Exercise-Induced Anaphylaxis in China

Background： Wheat-dependent, exercise-induced anaphylaxis （WDEIA） is an allergic reaction induced by intense exercise combined with wheat ingestion. The gold standard for diagnosis of WDEIA is a food exercise challenge： however, this test is unacceptable for Chinese WDEIA patients and unable to be approved by the Ethics Committee of Chinese hospitals due to substantial risk. There are no diagnostic criteria tbr Chinese WDEIA patients. The aim of present study was to propose new practical diagnosis criteria t＇or Chinese WDE1A patients. Methods： We prospectively included 283 clinically diagnosed WDEIA patients from January 1,2010 to June 30, 2014, and in tile meanwhile, three groups were enrolled which included 133 patients with the history of anaphylaxis induced by lbod other than wheat. 186 recurrent urticaria patients, and 94 healthy participants. Clinical comprehensive evaluation by allergists used as the reference gold standard, receiver operator characteristic （ROC） curves were plotted, areas under curve （AUC） tbr specific immunoglobin E （slgE） were compared to evaluate the diagnostic value of lgE specific to wheat, gluten, and 0）-5 gliadin. Patients were followed up by telephone questionnaire 1 year after diagnosis. Results： We reviewed 567 anaphylactic reactions in 283 WDEIA patients. Of these anaphylactic reactions, 415 （73.3%） reactions were potentially life-threatening anaphylaxis. Among the 567 anaphylactic reactions, 75% （425/567） occurred during exercise. The highest AUC （0.910） was observed for sIgE for gluten, followed by omega-5 gliadin （AUC 0.879）. Combined gluten- and co-5 gliadin-specific IgE testing provided sensitivity and specificity of 73.1% and 99.0%, respectively. During the 1-year follow-up period, repeat anaphylaxis was rare when patients observed strict avoidance of wheat products combined with exercise or other triggering agents. Conclusions： In this study, we proposed diagnostic criteria and management of WDEIA patients in China, Our present study suggested that confirmed anaphylactic reactions triggered by wheat with positive slgE to gluten and omega-5-gliadin may provide supportive evidence for clinicians to make WDEIA diagnosis without perforating a food exercise challenge.

Association between single nucleotide polymorphisms and wheat-dependent exercise-induced anaphylaxis in Chinese population

Background Wheat-dependent exercise-induced anaphylaxis （WDEIA） is a complex disease resulting from interaction of environmental and genetic factors. The aim of this study was to investigate the association of three single nucleotide polymorphisms （SNPs） （IL-4-C590T, IL-4RA A1727G and IL-10-A627C） with WDEIA. Methods SNP genotyping was conducted among the case subset composing 51 patients with WDEIA and four control subsets by sequencing DNA yielded from polymerase chain reaction （PCR）. Statistical analysis of genotype/allele＇s frequencies between cases and controls were carried out through Fisher＇s exact test with the software of SPSS16.0. Results For IL-4-C590T, there were statistically significant differences of genotype frequencies in case-control 1 （P=0.03） and case-control 4 （P=0.001） and statistically significant differences of allele frequencies in three case-control models （case-control 1：OR=4.27 （95% CI=1.40-13.07）, P=0.009; case-control 3：OR=1.99 （95% CI=1.13-3.50）, P=0.02; case-control 4：OR=2.39 （95% CI=1.49-3.84）, P=0.001）. All other association studies showed no statistically significant （P 〉0.05）. Conclusions IL-4-C590T may be related to the susceptibility of WDEIA, and the minor allele C might be a potential risk factor accounting for WDEIA. IL-4RA A1727G and IL-10-A627C might not be involved in the occurrence of WDEIA.

Effectiveness of Moxibustion for Exercise-Induced Fatigue——A Systematic Review for Randomized Controlled Trials

Objective：To review and assess the effect of single moxibustion for exercise-induced fatigue（EIF）.Methods：Computer-search for 8 medical databases and 5 clinical trail registries were conducted for randomized controlled trials（RCTs）,added with hand-search for 10 Chinese acupuncture-moxibustion journals and additional references.Data from included RCTs were pooled by RevMan5.1.Methodology quality of RCTs was judged by Cochrane Collaboration assessment tool while quality of primary outcomes was evaluated by GRADE3.2.Results：Five RCTs were finally included,all reported in small sample size with high risk of bias.Comparisons on single moxibustion and rest relief（without treatment） were studied.Six outcomes were reported,all favored moxibustion to rest relief for EIF.Primary outcomes showed as rating of perceived exertion（RPE） with mean difference（MD）=-0.49,95%confidence interval（CI）[-0.80,-0.19],800-m race performance with MD=^-2.21,95%CI[-3.57,-0.85],and Harvard Step Index（HSI） with MD=14.75,95%CI[8.35,21.15].Moreover,all primary outcomes as RPE,800-m race performance and HSI were rated low quality.Conclusions：Single moxibustion might be considered effective for EIF.However,due to small samples of included RCTs,high risk of bias among studies and poor quality of primary outcomes and subjects restricted to Chinese athletes only,these results present limitation,and should be taken with caution for practice.More large-size studies with rigorous design are warranted to further test effectiveness of moxibustion for EIF.

Effect of Moxibustion on Cardiac Remodeling and Myocardial Function in Rats with Exercise-Induced Fatigue

Objective:To explore the effect of moxibustion at Shenque(CV8)on myocardial structure and function in rats with exercise-induced fatigue.Methods:A 12-week treadmill training program was used to establish a rat model of exercise-induced fatigue.Fifty-six male SD rats removed six rats that did not reach the molding condition,Remaining rats were randomly divided into the following five groups:a normal group(n=10)that did not under go the exercise routine and were not treated,a control group(n=10)that did not under go the exercise routine,but received a mild dose of moxibustion at"Shenque"(CV 8)for 15 min,an untreated group(n=10)that received no treatment after exercise,a CV 8 group(n=10)that received a mild dose of moxibustion at"Shenque"(CV 8)for 15 min after exercise,a non-acupoint(tail)group(n=10)that received a mild dose of moxibustion at"non-acupoint"for 15 min after exercise.At one hour after the end of the 12-week training program,the left ventricular diastolic volume(LVDV),left ventricular systolic volume(LVSV),peak early diastolic mitral blood flow velocity(E),and peak late diastolic mitral blood flow velocity(A)were measured,and the E/A ratio were calculated.The serum myoglobin(Mb),creatine kinase-muscle/brain(CK-MB),and cardiac troponin-I(cTnI)levels were detected using an automatic biochemical analyzer.Results:When the values obtained before and after treatment were compared within the same groups,the LVDV,LVSV,E,and A were increased(P<0.05 or P<0.01),and the E/A were decreased(P<0.01)in the untreated group and the tail group.Regarding inter-group comparisons,the LVDV,LVSV,E,and A were increased(P<0.05 or P<0.01),and the E/A were decreased(P<0.01)in the untreated group and the tail group compared to the normal group and control group.Compared to the untreated group and the tail group,the LVDV,LVSV,E,and A were decreased(P<0.01)and the E/A were increased(P<0.01)in the CV 8 group.Compared to the normal group and the control group,the serum Mb,CK-MB,and cTnI levels were increased(P<0.01)in the untreated group and the tail group,and the serum Mb and CK-MB levels were also increased(P<0.01)in the CV 8 group.Compared to the untreated group and the tail group the serum Mb,CK-MB,and cTnI levels in the CV 8 group were decreased(P<0.01).Conclusions:Moxibustion at Shenque(CV8)can effectively prevent cardiac structural changes caused by exercise-induced fatigue and enhance heart function.This treatment does not have side effects in healthy rats and is a safe and effective technique..

High-intensity swimming alleviates nociception and neuroinflammation in a mouse model of chronic postischemia pain by activating the resolvin E1-chemerin receptor 23 axis in the spinal cord

Physical exe rcise effectively alleviates chronic pain associated with complex regional pain syndrome type-Ⅰ.However,the mechanism of exe rcise-induced analgesia has not been clarified.Recent studies have shown that the specialized pro-resolving lipid mediator resolvin E1 promotes relief of pathologic pain by binding to chemerin receptor 23 in the nervous system.However,whether the resolvin E1-chemerin receptor 23 axis is involved in exercise-induced analgesia in complex regional pain syndrome type-Ⅰ has not been demonstrated.In the present study,a mouse model of chronic post-ischemia pain was established to mimic complex regional pain syndrome type-Ⅰ and subjected to an intervention involving swimming at different intensities.Chronic pain was reduced only in mice that engaged in high-intensity swimming.The resolvin E1-chemerin receptor 23 axis was clearly downregulated in the spinal cord of mice with chronic pain,while high-intensity swimming restored expression of resolvin E1 and chemerin receptor 23.Finally,shRNA-mediated silencing of chemerin receptor 23in the spinal cord reve rsed the analgesic effect of high-intensity swimming exercise on chronic post-ischemic pain and the anti-inflammato ry pola rization of microglia in the dorsal horn of the spinal cord.These findings suggest that high-intensity swimming can decrease chronic pain via the endogenous resolvin E1-chemerin receptor 23 axis in the spinal cord.

Levels of Fine Particle Concentrations in Schools and Postexercise Pulmonary Function Disorders in Schoolchildren in Brazzaville

Context: Fine particles (PM2.5 and PM10) can accumulate in classrooms and in schoolyards located near urban roads. PM2.5 and PM10 can initiate, develop and exacerbate exercise-induced bronchospasm (EIB). This study aimed to assess the concentration levels of PM2.5 and PM10 in schools and to determine the rate of sensitivity to EIB among schoolchildren. Methods: A total of 128 students (67 girls and 61 boys) with an average age of 11 participated in this study. An ISAAC II questionnaire on respiratory symptoms was administered. PM2.5 and PM10 were measured. A 6-minute stress test was performed. Spirometry was performed. The ratio (I/O) of the concentrations of PM2.5 and PM10 recorded inside (I) the classrooms to those obtained outside (O) the classrooms was equal to 1 (I/O = 1). Results: The concentrations of PM2.5 and PM10 recorded inside the classrooms and those obtained outside the classrooms were higher than the values recommended by the WHO. 29 students out of 128 were diagnosed as sensitive to EIB [EIB (+)], i.e., a rate of sensitivity to EIB of 22.66%. A drop in postexercise PEF of 17.396% was observed among EIB (+) students. Conclusion: Schoolchildren in schools located near highways are exposed to high levels of PM2.5 and PM10 concentrations. Exposure to PM2.5 and PM10 played an important role in the initiation and exacerbation of exercise-induced bronchospasm in schoolchildren from schools located near highways. Effective programs for improving air quality in schools must be put in place to reduce the effects of particulate pollution on the respiratory health of school children.

Changes of 5-hydroxytryptamine and tryptophan hydroxylase expression in the ventral horn of spinal cord

Objective To investigate changes of 5-hydroxytryptamine （5-HT） and its synthesis rate-limiting enzyme tryp-tophan hydroxylase （TPH） in the ventral horn of spinal cord after exercise-induced fatigue, and to further discuss the mecha- nism of exercise-induced central fatigue at spinal level. Methods Sixteen healthy adult Wistar rats were randomly divided into 2 groups： exercise-induced fatigue group and control group. Immunohistochemical staining for 5-HT and TPH in the ventral horn were performed and analysized quantitatively. The mean optic densities of 5-HT and TPH positive fibers or terminals were measured by computerized image analyzer. Results Both 5-HT and TPH positive fibers/terminals decreased in the exercise-induced fatigue group. The immunohistochemical staining was weaker and the mean optic densities decreased obviously in the fatigue group compared with those in the control group （P 〈 0.05）. Conclusion 5-HT and TPH in the ventral horn of spinal cord might be involved in exercise-induced fatigue.

Triangle Characters of Electrocardiogram for Distinguishing States between Exercise and Relaxation

Will exercise-induced cardiovascular workload be monitored by Electrocardiogram (ECG) waveform morphology? The discrimination ability of ECG morphology from 30 subjects was tested for distinguishing states between exercise and relaxation in terms of side lengths, lengths of high lines, angles, perimeters and areas of triangle QRS and triangle T. As a result, 4 characters from triangle QRS had significant differences (t test, p<0.05) for over 85% of subjects in distinguishing between exercise states and relaxation states, which were: ratio of QR side length to RS side length in triangle QRS, angle S and angle Q, as well as the ratio between them. Moreover, ratio of angle S to angle Q had significant differences (t test, p<0.05) for all subjects. In conclusion, triangle characters in ECG could be used to distinguish exercise states from relaxation states.

Continuous positive airway pressure acutely increases exercise duration in children with severe therapy-resistant asthma:a randomized crossover trial

Background Lower exercise tolerance is an important component of asthma and the possible effects of non-invasive ven-tilation on exercise capacity in individuals with severe therapy-resistant asthma(STRA)are unknown.This study aimed to evaluate the immediate effect of continuous positive airway pressure(CPAP)on exercise tolerance in children with STRA.Methods We performed a controlled,randomized,crossover clinical trial including subjects aged 6 to 18 years old diagnosed with STRA.Clinical,anthropometric and lung function data were collected.The participants in the intervention group(IG)used CPAP(PEEP 10cmH2O and FiO20.21)for a period of 40 min.Subjects in the control group(CG)used CPAP with mini-mum PEEP at 1 cmH20 also for 40 min.Afterwards,subjects from both groups underwent cardiopulmonary exercise testing(CPET).After a 15-day washout period,on a subsequent visit,subjects participated in the opposite group to the initial one.Results Thirteen subjects with a mean age of 12.30±1.7 years were included.The variables of peak expiratory flow(PEF)and forced expiratory volume in the first second(FEV1)before using CPAP and after performing CPET did not show sig-nificant differences.Regarding CPET results,there was no significant difference(P=0.59)between groups at peak exercise for oxygen consumption—VO2(CG:33.4±6.3 and IG:34.5±5.9,mL kg^(-1)min^(-1)).However,the IG(12.4±2.1)presented a total test time(min)significantly(P=0.01)longer than the CG(11.5±1.3).Conclusion The results suggest that the use of CPAP before physical exercise increases exercise duration in children and adolescents with STRA.