Remote Ischemic Preconditioning Reduces Marathon-Induced Oxidative Stress and Decreases Liver and Heart Injury Markers in the Serum.

Jan Mieszkowski,Bartłomiej Niespodziński,Błaz∙Ej Stankiewicz,Ludmiła Daniłowicz-Szymanowicz,Andrzej Kochanowicz,Jędrzej Antosiewicz,Paulina Brzezińska,Katarzyna Sikorska,Andz∙Elika Borkowska

doi:10.3389/fphys.2021.731889

Abstract

Clinical studies continue to provide evidence of organ protection by remote ischemic preconditioning (RIPC). However, there is lack of insight into impact of RIPC on exercise-induce changes in human organs’ function. We here aimed to elucidate the effects of 10-day RIPC training on marathon-induced changes in the levels of serum markers of oxidative stress, and liver and heart damage. The study involved 18 male amateur runners taking part in a marathon. RIPC training was performed in the course of four cycles, by inflating and deflating a blood pressure cuff at 5-min intervals (RIPC group, n=10); the control group underwent sham training (n=8). The effects of RIPC on levels of oxidative stress, and liver and heart damage markers were investigated at rest after 10 consecutive days of training and after the marathon run. The 10-day RIPC training decreased the serum resting levels of C-reactive protein (CRP), alanine transaminase (ALT), γ-glutamyl transpeptidase (GGT), and malondialdehyde (MDA). After the marathon run, creatinine kinase MB (CK-MB), lactate dehydrogenase (LDH), cardiac troponin level (cTn), aspartate aminotransferase (AST), alkaline phosphatase (ALP), ALT, total bilirubin (BIL-T), and MDA levels were increased and arterial ketone body ratio (AKBR) levels were decreased in all participants. The changes were significantly diminished in the RIPC group compared with the control group. The GGT activity remained constant in the RIPC group but significantly increased in the control group after the marathon run. In conclusion, the study provides evidence for a protective effect of RIPC against liver and heart damage induced by strenuous exercise, such as the marathon.

Highlights

Prolonged strenuous running, e.g., a marathon run, induces a rise in the concentrations and/or activity of biomarkers that reflect physiological stress of the skeletal muscle, liver, heart, and some other tissues (Banfi et al, 2012)
The main goal of the current study was to evaluate the effects of 10-day remote ischemic preconditioning (RIPC) training on serum biomarkers of liver and heart damage induced by a marathon run
A similar effect of RIPC was observed on the levels of alanine transaminase (ALT), AST, and GGT activity, and BIL-T, the markers of liver damage

Summary

Introduction

E.g., a marathon run, induces a rise in the concentrations and/or activity of biomarkers that reflect physiological stress of the skeletal muscle, liver, heart, and some other tissues (Banfi et al, 2012). Oxidative stress is one of the processes associated with tissue damage. It can be induced by exercise, especially by prolonged forms of exercise, such as the marathon and its more demanding variations (Gomez-Cabrera et al, 2006; Kawamura and Muraoka, 2018). Changes in the concentration and/or activity of markers of heart and liver damage after a marathon run are transient and most return to the baseline after several days. While there is insufficient evidence to indicate any adverse effects of exercise on the heart (Kaleta-Duss et al, 2020) and liver (Lippi et al, 2011) of amateur marathon runners, further studies investigating the impact of strenuous exercise on the markers of heart and liver damage can give insight into the physiology of adaptation of these organs to a prolonged strenuous exercise

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