Hypoventilation, Normobaric Hypoxia, Normoxia
Conditions
Keywords
HIF1a, HLA-G, Repeated sprint, Inflammation, covid-19, immune system, athletes
Brief summary
COVID-19 has significantly impacted sports globally, with event postponements, training disruptions, and wide-ranging concerns. SARS-CoV-2 infection can result in hyperinflammation and cardiopulmonary changes, with hypoxia as an aggravating sign. Hypoxia triggers complex immunometabolic mechanisms, including activation of HIF-1α and induction of HLA-G expression. Hypoxia training protocols benefit aerobic capacity and sports performance, with potential immunological impact. Studying immunometabolic markers in this context can improve athletic preparation and athletes' general health.
Detailed description
Covid-19, caused by SARS-CoV-2, can progress to pulmonary hyperinflammation and cardiopulmonary changes, with hypoxia being one of the main signs of worsening. In hypoxia, there is activation of HIF-1 that induces the expression of HLA-G, an immuno-tolerogenic molecule that inhibits the hyperinflammatory response. Hypoxia training protocols can promote cardiopulmonary benefits and increase the expression of anti-inflammatory cytokines, HIF-1 and HLA-G. Immunometabolic markers have the potential to be used in the prevention, diagnosis, and treatment of diseases with inflammatory mechanisms. The objective of this study is to evaluate the influence of physical training protocols in hypoxic, normobaric, and hypobaric environments, on the immune, and metabolic response and cardiopulmonary behavior in athletes post covid-19, to identify potential biomarkers and better clarify the impact of exercise on immunometabolism post-covid-19. The study will consist of a randomized and controlled intervention, with training using different normobaric hypoxic methods; and an observational study at natural altitude (hypobaric hypoxia). In the normobaric hypoxia trial, participants will be divided into a control group that will carry out a training plan of repeated sprints in normoxia; and two other groups that will perform the same training sessions in normobaric hypoxia and with low lung volume voluntary hypoventilation. In the observational study with hypobaric hypoxia, high-performance resistance athletes will be recruited, who will comply with the training plan proposed by the team's coach at altitude. Cardiorespiratory, immunometabolic, neuromuscular, and autonomic fatigue, hematological indicators, plasma levels of lipid mediators, sHLA-G and cytokines, and the expression of HIF-1α in leukocyte cells will be evaluated. The analysis of the effect of the training methods will be carried out by ANOVA for repeated measures (parametric or non-parametric), or means comparison tests for paired samples (t or Wilcoxon) after evaluating the assumptions and the identification of associations between variables will be carried out by Binomial Logistic Regression Analysis.
Interventions
OTHERRepeated sprint
* Duration of the study: 8 weeks of participation. * Each repeated sprint training protocol: 2 training sessions per week for 4 weeks. * Collection sessions: 3 collection sessions will be carried out: before the start of the training protocol - T0; at the end of the protocol, in week 4 - T1; and late, 4 weeks after the end of the protocol, in week 8 - T2. * Training sessions: will be carried out on an ergometer and will consist of 3 sets of 5 sprints of 10s all-out with 20s of rest between sprints, and 5 minutes of rest between sets.
Sponsors
University of Sao Paulo
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Faculdade de Motricidade Humana
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* more than 5 years of training experience in an resistance modality; * participates in national or international championships regularly; * athletes convalescing from covid-19, at least 30 days after diagnosis and/or hospital discharge; * manifested mild to severe symptoms; * vaccinated or not against SARS-CoV-2; * antigen self-test for SARS-CoV-2 negative.
Exclusion criteria
* athletes who have had an acclimatization experience or exposure to altitude lasting more than 10 days in the last 6 months; * contain signs or symptoms of acute covid-19; * present a positive SARS-CoV-2 antigen self-test; * pregnant or postpartum women; * use anti-inflammatory or immunosuppressive medications.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak force | Before, just after and 4 weeks after the training program | Isometric mid thigh pull |
| Plasma levels of eicosanoids, endocannabinoids, steroid hormones, sphingolipids, ceramides and other glycerophospholipids | Before, just after and 4 weeks after the training program | Mass Spectrometry (LC-MS/MS) |
| Hematological indicators (hematocrit, hemoglobin and cell count) | Before, just after and 4 weeks after the training program | Blood count |
| Ventilatory thresholds and maximum oxygen consumption | Before, just after and 4 weeks after the training program | mL/kg·min |
| Blood lactate concentrations | Before, just after and 4 weeks after the training program | mmol.L-1 |
| Muscle oximetry | Before, just after and 4 weeks after the training program | Near-infrared spectroscopy (NIRS) |
| Hypoxia Inducible Factor 1 alpha (HIF-1a) | Before, just after and 4 weeks after the training program | Flow cytometry for PBMCs |
| Human Leukocyte Antigen-G (HLA-G) | Before, just after and 4 weeks after the training program | ELISA |
| Cytokines (TNF-α, IL-1β, IL-6, IL-10, IL-8 and IFN-γ) | Before, just after and 4 weeks after the training program | ELISA |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Arterial oxygen saturation | Throughout the training program, 4 weeks | oxymetry (%) |
| Subjective perception of effort | Throughout the training program, 4 weeks | Adapted Borg scale |
| Blood pressure, heart rate and temperature | Before, just after and 4 weeks after the training program | Values at rest mmHg, bpm and ºC |
| Anthropometric assessments and body composition | Before, just after and 4 weeks after the training program | height (m), body mass (kg), fat free mass (kg), fat mass (kg) |
| Heart rate | Throughout the training program, 4 weeks | maximum values during the training sessions (bpm) |
Countries
Portugal
Contacts
Primary ContactCristina Monteiro, PhD
Backup ContactJoana Reis, PhD
Outcome results
None listed