Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review
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SYSTEMATIC REVIEW
Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review Washington Pires1,2 • Christiano E. Veneroso3 • Samuel P. Wanner3 Diogo A. S. Pacheco3 • Gisele C. Vaz1 • Fabiano T. Amorim4,5 • Cajsa Tonoli6 • Danusa D. Soares3 • Caˆndido C. Coimbra1,3
•
Published online: 10 December 2016 Ó Springer International Publishing Switzerland 2016
Abstract Background Prolonged and strenuous physical exercise increases intestinal permeability, allowing luminal endotoxins to translocate through the intestinal barrier and reach the bloodstream. When recognized by the immune system, these endotoxins trigger a systemic inflammatory response that may affect physical performance and, in severe cases, induce heat stroke. However, it remains to be elucidated whether there is a relationship between the magnitude of exercise-induced hyperthermia and changes in intestinal permeability.
W. Pires and C. E. Veneroso contributed equally to this work. & Caˆndido C. Coimbra [email protected] 1
Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, 6627 Avenida Antoˆnio Carlos, Belo Horizonte, Minas Gerais 31270-901, Brazil
2
Department of Physical Education, Institute of Life Sciences, Universidade Federal de Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
3
Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
4
Department of Physical Education, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
5
Department of Health, Exercise Science and Sport, University of New Mexico, Albuquerque, New Mexico, USA
6
Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
Objective In this systematic review, we evaluated whether an exercise-induced increase in core body temperature (TCore) is associated with an exercise-induced increase in intestinal permeability. Methods The present systematic review screened the MEDLINE/PubMed and Web of Science databases in September 2016, without any date restrictions. Sixteen studies that were performed in healthy participants, presented original data, and measured both the exercise-induced changes in TCore and intestinal permeability were selected. These studies assessed intestinal permeability through the measurement of sugar levels in the urine and measurement of intestinal fatty acid binding protein or lipopolysaccharide levels in the blood. Results Exercise increased both TCore and intestinal permeability in most of the 16 studies. In addition, a positive and strong correlation was observed between the two parameters (r = 0.793; p\0.001), and a TCore exceeding 39 °C was always associated with augmented permeability. Conclusion The magnitude of exercise-induced hyperthermia is directly associated with the increase in int
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