Blood Biomarkers in Sports Medicine and Performance and the Future of Metabolomics
The field of sports medicine and performance has undergone an important transformation in the past years where the scientific approach is becoming increasingly more important for teams and athletes. Physical and physiological fitness, nutrition, fatigue a
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roduction The modern high-throughput bioanalytical platforms, in combination with computational capabilities for data analysis and interpretation, make it possible to quantify hundreds of metabolites in a single analysis. The two main areas of utilization in blood biomarkers are for performance and fitness as well as to monitor for overtraining. The intention of this chapter is to show the current methodologies used to monitor performance and training of competitive athletes where the use of metabolomics holds great future. The rapid emergence of metabolomics has enabled system-wide measurements of metabolites in various organisms. However, advances in the mechanistic understanding of metabolic networks remain limited, Angelo D’Alessandro (ed.), High-Throughput Metabolomics: Methods and Protocols, Methods in Molecular Biology, vol. 1978, https://doi.org/10.1007/978-1-4939-9236-2_26, © Springer Science+Business Media, LLC, part of Springer Nature 2019
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Iñigo San-Millán
as most metabolomics studies cannot routinely provide accurate metabolite identification, absolute quantification and flux measurement. Stable isotope labeling offers opportunities to overcome these limitations. Here we describe current approaches in the area of sports medicine and performance and provide examples of the significant impact that these studies have had on our understanding of cellular metabolism. Furthermore, we discuss recently developed software solutions for the analysis of stable isotope-labeled metabolomics data and propose the bioinformatics solutions that will pave the way for the broader application and optimal interpretation of system-scale labeling studies in metabolomics. 1.1 The Use of Blood Biomarkers to Assess Metabolic Fitness and Performance
There are not currently many biomarkers to assess metabolic fitness and performance. Because of its easy analysis and accessibility and because it is one of the most important signatures of cellular metabolism, lactate has been a preferred biomarker to assess physical and metabolic fitness. Lactate testing is probably the best method that we have to predict performance in endurance events [1, 2], it is probably the parameter that discriminates the most between different levels of athletic performance [3] (Fig. 1), and it can also be a very good parameter to prescribe exercise training zones and training programs for athletes [1, 4]. Lactate is the mandatory by-product of glucose oxidation (glycolysis). During glycolysis, lactic acid is formed, and it rapidly dissociates to lactate and a hydrogen ion (H+). For almost 50 years, the notion of lactate being a “waste product” as a result of anaerobic metabolism prevailed and was embedded in textbooks. However, the work done for the past 40 years by Dr. George Brooks from the University of California Berkeley has showed that lactate is not a waste product but a key regulator of different metabolic processes with hormone-like properties (“lacthormone”) [5–7] and even a master regulator in cancer as Brooks and I have proposed [8
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