Gut Leakage Markers in Response to Strenuous Exercise in Patients with Suspected Coronary Artery Disease.

Susanne Kristine Aune,Ragnhild Helseth,Joanna Cwikiel,Ingebjørg Seljeflot,Marius Trøseid,Svein Solheim,Arnljot Flaa,Ayodeji Awoyemi,Harald Arnesen

doi:10.3390/cells10092193

Susanne Kristine Aune, Ragnhild Helseth + Show 7 more

Open Access

https://doi.org/10.3390/cells10092193

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Journal: Cells	Publication Date: Aug 25, 2021
Citations: 6	License type: CC BY 4.0

Affiliation: Oslo University Hospital, University of Oslo

Abstract

Elevated levels of gut leakage markers have been shown after strenuous exercise in healthy individuals. Any association between a temporary increase in these markers and the presence of coronary artery disease (CAD) is unknown. We therefore aimed to explore circulating gut leakage markers in response to a bout of strenuous exercise in patients with symptoms of CAD. Patients referred to exercise stress testing due to symptoms of CAD were included (n = 287). A maximal exercise ECG stress test was performed and venous blood samples were drawn at rest and within five minutes after, for analysis of soluble cluster of differentiation 14 (sCD14), lipopolysaccharide-binding protein (LBP), intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide (LPS) and gene expression of toll-like receptor 4 (TLR4) in circulating leukocytes. Patients then underwent coronary angiography. LPS, LBP and sCD14 increased significantly after strenuous exercise in patients with symptoms of CAD, suggesting that even short bouts of vigorous exercise are associated with gut leakage. The gene expression of TLR4 decreased significantly after exercise, possibly as a negative feedback to the increase in LPS. There were no differences in exercise-induced changes between the groups of CAD, suggesting gut leakage to be independent of the presence of CAD.

Highlights

Published: 25 August 2021Regular physical activity is associated with reduced risk for cardiovascular disease (CVD) [1,2]
toll-like receptor 4 (TLR4) expression on leucocytes was the TLR4 complex, we investigated whether TLR4 expression on leucocytes was alaltered
The main findings of the present study were that most of the investigated gut leakage markers increased immediately after strenuous exercise in patients with symptoms of coronary artery disease (CAD), indicating that even short bouts of vigorous activity are associated with gut leakage

Summary

Introduction

Regular physical activity is associated with reduced risk for cardiovascular disease (CVD) [1,2]. Regular endurance exercise has been shown to reduce biomarkers associated with chronic, vascular inflammation and the development of atherosclerosis such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and C-reactive protein (CRP) [3]. Regular exercise has been shown to beneficially alter the composition and quality of the gut microbiota, preventing gut dysbiosis and reducing circulating gut leakage markers [4,5]. Gut microbiota alterations have in several studies been linked to cardiometabolic risk factors and presence of CVD [6]. As opposed to regular exercise, is associated with elevated risk for coronary events, especially in individuals with pre-existing CAD [1,7]. Established underlying mechanisms are suggested to include increased arterial wall sheer stress, coronary artery spasms, increased flexing of the coronary arteries causing plaque disruption, as well as systemic changes such as increased thrombogenicity and platelet activation [8]

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