Cellular Integrative Immune Markers in Elite Athletes

Abstract The integrative immune markers neutrophil-lymphocyte-ratio (NLR) , platelet-lymphocyte-ratio (PLR) and systemic immune inflammation index (SII) are established markers in clinical patient care. Adoption of these markers in elite athletics might prove beneficial for monitoring training and health. Blood samples of 195 healthy national Olympic squad athletes were collected before a graded bicycle-ergometric exercise test until complete exhaustion. Measurements included white blood cells, lymphocytes and platelets, allowing for the calculation of the integrative immune markers. Correlations between athlete characteristics (sex, age, sporting discipline, training experience, training volume) and integrative immune marker-values were assessed. In a subgroup analysis a second blood sample was collected from 25 athletes at 1 minute after exercise test to assess its effect on the immune marker levels. An inverse correlation between peak power output and SII-level (Pearson correlation coefficient=−.270, p<.001) and NLR-level (Pearson correlation coefficient=−.249, p<.001) was found. Athletes with higher aerobic fitness had significantly lower values of SII and PLR compared to athletes with lower aerobic fitness. An elevated SII (p=.003) and a reduced PLR (p=.001) was documented as acute response to the exercise test. The integrative immune markers might be a promising tool for monitoring training and health in elite athletes.

[1]  Abraham Weizman,et al.  Neutrophil to-lymphocyte and platelet-to-lymphocyte ratios as biomarkers for suicidal behavior in children and adolescents with depression or anxiety treated with selective serotonin reuptake inhibitors , 2022, Brain, Behavior, and Immunity.

[2]  E. Çakıcı,et al.  An Assessment on the Effectiveness of the Immature Granulocyte Percentage in Predicting Internal Organ Involvement Among Children With Henoch-Schönlein Purpura , 2021, Journal of pediatric hematology/oncology.

[3]  K. Shirai,et al.  Baseline systemic inflammatory immune index may predict overall survival and progression-free survival in patients with non-small cell lung cancer patients on immune checkpoint inhibitors. , 2021 .

[4]  J. Zacher,et al.  Transferring clinically established immune inflammation markers into exercise physiology: focus on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index , 2021, European Journal of Applied Physiology.

[5]  E. Kızıltunç,et al.  Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease , 2021, Angiology.

[6]  Katrina Hinde,et al.  Wearable Devices Suitable for Monitoring Twenty Four Hour Heart Rate Variability in Military Populations , 2021, Sensors.

[7]  Yibin Wang,et al.  The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19 , 2021, Cell Metabolism.

[8]  A. Yorulmaz,et al.  Systemic Immune-Inflammation Index (SII) Predicts Increased Severity in Psoriasis and Psoriatic Arthritis , 2020, Current health sciences journal.

[9]  J. Kool,et al.  High-intensity interval training reduces neutrophil-to-lymphocyte ratio in persons with multiple sclerosis during inpatient rehabilitation , 2020, Multiple sclerosis.

[10]  Xu Wang,et al.  Reference intervals of systemic immune-inflammation index, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume to platelet ratio, mean platelet volume and red blood cell distribution width-standard deviation in healthy Han adults in Wuhan region in central China , 2020, Scandinavian journal of clinical and laboratory investigation.

[11]  Alan J. Metcalfe,et al.  Cellular immune response to acute exercise: Comparison of endurance and resistance exercise , 2020, European journal of haematology.

[12]  W. Bloch,et al.  Acute Impact of Recovery on the Restoration of Cellular Immunological Homeostasis , 2019, International Journal of Sports Medicine.

[13]  F. Cadegiani,et al.  Basal Hormones and Biochemical Markers as Predictors of Overtraining Syndrome in Male Athletes: The EROS-BASAL Study. , 2019, Journal of athletic training.

[14]  W. Bloch,et al.  Aqua cycling for immunological recovery after intensive, eccentric exercise , 2019, European Journal of Applied Physiology.

[15]  H. Goyal,et al.  Normal Reference Intervals of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, Lymphocyte-To-Monocyte Ratio, and Systemic Immune Inflammation Index in Healthy Adults: a Large Multi-Center Study from Western China. , 2019, Clinical laboratory.

[16]  H. Ullum,et al.  The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis , 2018, Multiple sclerosis journal - experimental, translational and clinical.

[17]  B. Stricker,et al.  Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study , 2018, Scientific Reports.

[18]  Na Young Kim,et al.  Reference values of neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, platelet-lymphocyte ratio, and mean platelet volume in healthy adults in South Korea , 2018, Medicine.

[19]  R. Duffield,et al.  Can Sleep Be Used as an Indicator of Overreaching and Overtraining in Athletes? , 2018, Front. Physiol..

[20]  F. He,et al.  Determinant roles of gender and age on SII, PLR, NLR, LMR and MLR and their reference intervals defining in Henan, China: A posteriori and big‐data‐based , 2018, Journal of clinical laboratory analysis.

[21]  O. Timur,et al.  Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer , 2017, Endocrine regulations.

[22]  Paul Martin,et al.  Inflammation and metabolism in tissue repair and regeneration , 2017, Science.

[23]  Kiyoshi Ichihara,et al.  A global multicenter study on reference values: 1. Assessment of methods for derivation and comparison of reference intervals. , 2017, Clinica chimica acta; international journal of clinical chemistry.

[24]  Ji-Feng Feng,et al.  Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus , 2017, Medicine.

[25]  M. Hallek,et al.  Physical exercise modulates the homeostasis of human regulatory T cells. , 2016, The Journal of allergy and clinical immunology.

[26]  S. Sammito,et al.  Correlation between the results of three physical fitness tests (endurance, strength, speed) and the output measured during a bicycle ergometer test in a cohort of military servicemen , 2016, Military Medical Research.

[27]  B. Sjödin,et al.  Immunological changes in human skeletal muscle and blood after eccentric exercise and multiple biopsies , 2000, The Journal of physiology.

[28]  Peter Schjerling,et al.  Pro‐ and anti‐inflammatory cytokine balance in strenuous exercise in humans , 1999, The Journal of physiology.

[29]  A. Lucia,et al.  Overtraining parameters in special military units. , 1998, Aviation, space, and environmental medicine.

[30]  J. Mitchell,et al.  Exercise-induced muscle damage: effect on circulating leukocyte and lymphocyte subsets. , 1995, Medicine and science in sports and exercise.

[31]  S. Incir.  Can Immature Granulocyte Count and Hemogram Indices be Good Predictors of Urinary Tract Infections in Children? , 2021 .

[32]  R. Záhorec.  Neutrophil-to-lymphocyte ratio, past, present and future perspectives. , 2021, Bratislavske lekarske listy.

[33]  D. Germolec,et al.  Markers of inflammation. , 2010, Methods in molecular biology.