Glutamine and the effects of exhaustive exercise upon the immune response

1998 ◽  
Vol 76 (5) ◽  
pp. 524-532 ◽  
Author(s):  
Linda M Castell ◽  
Eric A Newsholme
Keyword(s):  
Immune Response ◽  
Respiratory Tract Infections ◽  
Opportunistic Infections ◽  
Exhaustive Exercise ◽  
Upper Respiratory Tract ◽  
High Incidence ◽  
Before And After ◽  
Prolonged Training ◽  
Upper Respiratory ◽  
Tract Infections

There is a high incidence of infections in athletes undergoing intense, prolonged training or participating in endurance races (e.g., the marathon), in particular, upper respiratory tract infections. Prolonged, exhaustive exercise can lower the plasma level of the amino acid, glutamine, which is an important fuel for some cells of the immune system and may have specific immunostimulatory effects. This could therefore be an important factor in the event of an impaired response of immune cells to opportunistic infections. The effects of feeding glutamine to sedentary individuals and to marathon and ultramarathon runners before and after prolonged, exhaustive exercise has been investigated in a series of studies that monitored the incidence of infections and some acute-phase response markers. Oral glutamine, compared with a placebo, appeared to have a beneficial effect on the incidence of infections reported by runners after a marathon.Key words: glutamine, endurance exercise, infections, immune response.

Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls

2019 ◽  
Vol 47 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Johannes C. Nossent ◽  
Warren Raymond ◽  
Helen Keen ◽  
David B. Preen ◽  
Charles A. Inderjeeth
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Serious Infection ◽  
Serious Infections ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Objective.Clinical data suggest that infections can trigger IgA vasculitis (IgAV), but longterm observations are lacking. We compared rates, types, and microorganisms for serious infection before and after diagnosis for children with IgAV and non-exposed controls.Methods.Using population-based administrative linked health datasets we estimated incidence rates (IR) for serious infection per 1000 person-months for patients with IgAV (n = 504, age 5 yrs, 59.1% males) and controls matched for age, sex, and year of presentation (n = 1281, age 6 yrs, 66% males). Time zero (T0) was the date of IgAV diagnosis or equivalent date in controls, lookback (median 38 mos) was the period prior to T0, and followup (median 239 mos) was the period after T0.Results.During lookback, prevalence of serious infection was similar in patients with IgAV and controls (11.5% vs 9.5%, respectively), but patients with IgAV had a higher rate of upper respiratory tract infections [incidence rate ratio (IRR) 1.79; 95% CI 1.39–2.31] with shorter time between first serious infection and T0 (27 vs 43 mos; p = 0.02). During followup, patients were at a constant increased risk for serious infections (IRR 1.46, 95% CI 1.35–1.58). These rates were higher during followup: sepsis (IRR 12.6), pneumonia (IRR 6.19), upper respiratory tract infections (IRR 2.36), and skin infections (IRR 1.85). There was little overlap between patients with serious infections in the lookback and followup periods.Conclusion.In patients with childhood IgAV there is an increased longterm risk for a broader spectrum of infections, which is unrelated to serious infections prior to diagnosis or treatment. This suggests disease-specific factors may have a lasting effect on immune competence in childhood IgAV.

THUR 178 Infections during grade 3/4 lymphopenia with cladribine tablets

2018 ◽  
Vol 89 (10) ◽  
pp. A23.3-A24
Author(s):  
Stuart Cook ◽  
Thomas Leist ◽  
Giancarlo Comi ◽  
Xavier Montalban ◽  
Elke Sylvester ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Opportunistic Infections ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Post Hoc Analysis ◽  
Upper Respiratory ◽  
Grade 3 ◽  
Tract Infections ◽  
Post Hoc

BackgroundIn CLARITY, cladribine tablets 3.5 mg/kg (CT3.5) demonstrated efficacy in relapsing MS patients. The most common AE was lymphopenia, reflecting cladribine’s mode of action. Integrated safety analysis showed infection incidence was not higher in patients receiving CT3.5 vs placebo, bar a small increase of herpes zoster (HZV).ObjectivePost-hoc analysis examined infectious AEs occurring concurrently with Grade 3/4 lymphopenia (G3/4) in CT3.5 treated patients.MethodsThe AE profile for CT3.5 during the periods of G3/4 was analysed. Adjusted-AE incidences per 100 patient years (Adj-AE/100PY) were calculated in a cohort of patients receiving CT3.5 monotherapy in clinical trials.ResultsData are presented as Adj-AE/100PY: G3/4 vs without G3/4. Adj-AE/100PY for any infections/infestations was 57.53 vs 24.50. Infections were similar between periods. ≥50% cases with G3/4 were easily-treatable upper- respiratory-tract infections (nasopharyngitis: 13.48 vs 5.24; upper-respiratory-tract infection: 9.67 vs 3.41; pharyngitis: 4.51 vs 0.73). HZV occurred in 4 patients with G3/4 (4.50 vs 0.73); cases were dermatomal and mild-to- moderate in severity. Single occurrences were reported for most infectious AEs. Opportunistic infections were single occurrences, not severe, serious or difficult-to-treat.ConclusionsG3/4 increased frequency of infections but did not affect the type of infectious AEs in CT3.5 treated patients. HZV profile was uncomplicated, consistent with findings of previous analyses.Disclaimerhttp://medpub-poster.merckgroup.com/ABN2018DISC_Grade34.pdf

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