Immune Function in Sport and Exercise

302 GLOSSARY processes, that each comprise less than monocyte Type of white blood cell 0.001% of total-body mass and are that can ingest and destroy foreign needed in quantities of less than 100 material and initiate the acquired mg per day. Among the 14 trace immune response. Precursor of tissue elements are iron, zinc, copper, macrophage. chromium and selenium. monosaccharide A simple sugar that micronutrients Organic vitamins and cannot be hydrolysed to smaller units inorganic minerals that must be (e.g. glucose, fructose and galactose). consumed in relatively small amounts in the diet to maintain health. mRNA Messenger ribonucleic acid. min (minute) Unit of time; 60 MTT 3-(4,5-dimethlythiazol-2-yl)-2,5- seconds. diphenyltetrazolium bromide; a yellow compound used in assays of lympho- mineral An inorganic element found cyte proliferation. in nature, although the term is usually reserved for those elements that are mucosa Layer of cells lining the solid. In nutrition, the term mineral is mouth, nasal passages, airways and usually used to classify those dietary gut that present a barrier to pathogen elements essential to life processes. entry into the body. Examples are calcium and iron. myoglobin A protein that functions mitochondrion Oval or spherical as an intracellular respiratory pigment organelle containing the enzymes of that is capable of binding oxygen and the tricarboxylic acid cycle and elec- only releasing it at very low partial tron transport chain. Site of oxidative pressures. phosphorylation (resynthesis of ATP involving the use of oxygen). neurotransmitters Endogenous signalling molecules that transfer mitogen Chemical that can stimulate information from one nerve ending to lymphocytes to proliferate (undergo the next. rapid cell divisions). neutrophil Type of white blood cell mitosis A type of cell division in that can ingest and destroy foreign which each of the two daughter cells material. Very important as a first line receives exactly the same number of of defence against bacteria. chromosomes present in the nucleus of the parent cell. NH2 Amino group. NH4+ Ammonium ion. mL Millilitre. NIDDM Non-insulin-dependent diabetes mellitus. mole The amount of a chemical compound whose mass in grams is nitrogen balance A dietary state in equivalent to its molecular weight, the which the input and output of nitro- sum of the atomic weights of its gen is balanced so that the body nei- constituent atoms. ther gains nor loses tissue protein. molecule An aggregation of at least NK (natural killer) cell A type of two atoms of the same or different lymphocyte important in eliminating elements held together by special viral infections and preventing cancer. forces (covalent bonds) and having a precise chemical formula (e.g. O2, NKCA Natural killer cytotoxic C6H12O6). activity. The ability of NK cells to monoclonal antibody A specific destroy virally infected cells and antibody derived from a single B cell tumour cells. clone. N/L ratio Ratio of neutrophils to lymphocytes in the blood.

Glossary 303 NO Nitric oxide. production of reactive oxygen species NO● Nitric oxide radical. (ROS) by phagocytes following their activation. non-essential amino acids Amino acids that can be synthesized in the PAMP (pathogen-associated molecular body. pattern) Molecules that are common- ly expressed by microorganisms that noradrenaline Catecholamine hor- are not expressed by host cells. mone and the neurotransmitter of most of the sympathetic nervous sys- pathogen Microorganism that can tem (of so-called adrenergic neurons). cause symptoms of disease. Also known as norepinephrine. PBMC Peripheral blood mononuclear norepinephrine See noradrenaline. cells which includes all lymphocytes and monocytes but excludes granulo- nutraceutical A nutrient that may cytes. function as a pharmaceutical (drug) when taken in certain quantities. PBS Phosphate-buffered saline. nutrient Substance found in food PE R-phycoerythrin; a fluorescent that provides energy or promotes marker used in flow cytometry. growth and repair of tissues. PEM (protein energy malnutrition) nutrition The total of the processes Inadequate intake of dietary protein of ingestion, digestion, absorption and and energy. metabolism of food and the subse- quent assimilation of nutrient materi- peptide Small compound formed by als into the tissues. the bonding of two or more amino acids. Larger chains of linked amino O2 Oxygen molecule. acids are called polypeptides or O2- ● (superoxide radical) A highly proteins. reactive free radical. PerCP Peridinin chlorophyll; a fluo- obesity An excessive accumulation of rescent marker used in flow cytometry. body fat. Usually reserved for those individuals who are 20% or more perforin Molecule produced by NK above the average weight for their size. cells and cytotoxic T cells that forms a pore in the membrane of target cells OH Hydroxyl group. leading to lysis and cell death. OH ● (hydroxyl radical) A highly PGE2 Prostaglandin E2. reactive free radical. pH A measure of acidity/alkalinity. opsonin A molecule that enhances pH = −log10[H+]. phagocytosis by promoting adhesion PHA (phytohaemagglutinin) A plant of the antigen to the phagocyte. lectin that acts as a T cell mitogen. osmosis The diffusion of water phagocyte Leukocyte capable of molecules from the lesser to the ingesting and digesting microorgan- greater concentration of solute isms. (dissolved substance) when two solutions are separated by a phagocytosis Process of ingestion of membrane that selectively prevents the bacteria, virus or cell debris by cells passage of solute molecules but is such as neutrophils and macrophages permeable to water molecules. (phago = eat; cyte = cell). OTS Overtraining syndrome. phenotype The appearance or physi- ological characteristic of an individual oxidative (or respiratory) burst that results from the interaction of the Increased oxygen consumption and genotype and the environment.

304 GLOSSARY phospholipids Fats containing a polysaccharide Polymers of (arbitrar- phosphate group that on hydrolysis ily) more than about 10 monosaccha- yield fatty acids, glycerol, and a ride residues linked glycosidically in nitrogenous compound. Lecithin is an branched or unbranched chains. example. Phospholipids are important Examples include starch and glycogen. components of membranes. POMS Profile of mood state PIgR (poly-Ig receptor) A receptor questionnaire. molecule that specifically binds dimer- ic secretory IgA and transports it postabsorptive state The period after across the mucosal epithelial cells. a meal has been absorbed from the gastrointestinal tract. plasma The liquid portion of the blood in which the blood cells are sus- power Work performed per unit of pended. Typically accounts for 55–60% time. of the total blood volume. Differs from serum in that it contains fibrinogen, precursor A substance from which the clot-forming protein. another, usually more active or mature, substance is formed. plasma cell Terminally differentiated B lymphocyte that secretes large prohormones A protein hormone amounts of antibody. before processing to remove parts of its sequence and thus make it active. PMA (phorbol myristate acetate) A chemical that directly stimulates pro- prostaglandins Lipids derived from tein kinase C, a key component of the the PUFA arachidonic acid that intracellular signalling cascade that increase vascular permeability, results in increased gene expression sensitize pain receptors, initiate fever and production of cytokines. It is also and stimulate or inhibit immune used as a stimulator of oxidative burst responses. activity in neutrophils and monocytes. prosthetic group A coenzyme that is PMN Polymorphonuclear cells, tightly bound to an enzyme. which principally refers to neutrophils. protease An enzyme that catalyses PMT Photomultiplier tube. the digestion or cleavage of proteins. pokeweed mitogen (PWM) A plant protein Biological macromolecules lectin that is a T-cell-dependent B cell composed of a chain of covalently mitogen. linked amino acids. Proteins may have structural or functional roles. polymorphonuclear Refers to the irregularly shaped nucleus of some proteolytic Breakdown of protein cells (e.g. neutrophils). into peptides and amino acids. polypeptide A peptide that, upon PRR (pattern recognition receptors) hydrolysis, yields more than two Receptors on APCs and phagocytes amino acids. that recognize PAMPs. polyphenols A large class of PUFA (polyunsaturated fatty acid) naturally occurring compounds that Fatty acid that contains more than one include the flavonoids, flavonols, carbon–carbon double bond. flavonones and anthocyanidins. These compounds contain a number of pyrogen A substance that causes phenolic hydroxyl (-OH) groups body temperature to elevated, as in attached to ring structures, which fever, and be regulated at a higher set confers them with powerful point. antioxidant activity. Ra (rate of appearance) Usually refers to the rate at which a substance enters the blood circulation.

Glossary 305 RBC Red blood cell (erythrocyte). sarcoplasmic reticulum An elaborate bag-like membranous structure found Rd (rate of disappearance) Usually within a muscle cell. Its interconnect- refers to the rate at which a substance ing membranous tubules lie in the leaves the blood circulation. narrow spaces between the myofibrils, surrounding and running parallel to RDA (recommended daily allowance) them. Recommended intake of a particular nutrient that meets the needs of nearly SD (standard deviation) A measure all (97%) healthy individuals of similar of variability about the mean; 68% of age and gender. The RDAs are estab- the population is within 1 standard lished by the Food and Nutrition deviation above and below the mean, Boards of the National Academy of and about 95% of the population is Sciences (USA). within 2 standard deviations of the mean. reperfusion Restoration of the blood supply to a tissue or organ. SE (standard error) A measure of variability about the mean. rhIL-6 Recombinant human inter- leukin-6. serum Fluid left after blood has clotted. RIA Radioimmunoassay. SI Stimulation index; lymphocyte ribosome Very small organelle proliferation expressed as ratio of composed of protein and RNA that is mitogen-stimulated proliferation rate either free in the cytoplasm or to unstimulated proliferation rate. attached to the membranes of the endoplasmic reticulum of a cell. The s-IgA Salivary immunoglobulin A. site of protein synthesis. SOD Superoxide dismutase. RNA Ribonucleic acid. solute A substance dissolved in a RNI (recommended nutrient intake) solvent liquid such as water. Defined as the level of intake required to meet the known nutritional needs solvent A liquid medium in which of more than 97.5% of healthy persons. particles can dissolve. In the UK the RNI is very similar to the original RDA. stable isotope An isotope is a specif- ic form of a chemical element. It dif- ROS (reactive oxygen species) fers from atoms of other forms Collective name for free radicals and (isotopes) of the same element in the other highly reactive molecules number of neutrons in its nucleus. derived from molecular oxygen. ROS ‘Stable’ refers to the fact that the iso- include superoxide radical (●O2−), tope is not radioactive, in contrast to hydroxyl radical (●OH−), hydrogen some other types of isotope. peroxide (H2O2), and perchlorous acid (HOCl). starch A carbohydrate made of multi- ple units of glucose attached together s (second) A unit of time. by bonds that can be broken down by human digestion processes. Starch is sarcolemma The cell membrane of a also known as a complex carbohydrate. muscle fibre. steroid A complex molecule derived sarcomere The smallest contractile from the lipid cholesterol containing unit or segment of a muscle fibre and four interlocking carbon rings. defined as the region between two Z lines. submaximal exercise Exercise at an intensity below that which elicits the sarcoplasm The cytoplasm or intra- maximal oxygen uptake. cellular fluid within a muscle fibre.

306 GLOSSARY supramaximal exercise Exercise at a transcription The process by which high intensity above that which would RNA polymerase produces single- elicit the maximal oxygen uptake. stranded RNA complementary to one strand of the DNA. Syst`eme Internationale (SI) International Unit System, a world- translation The process by which wide agreed uniform system of units. ribosomes and tRNA decipher the genetic code in mRNA in order to TBARS (thiobarbituric acid-reactive synthesize a specific polypeptide or substances) Stable compounds protein. produced as a consequence of free radical actions on lipid structures, Treg T regulatory lymphocyte. which are commonly used as a measure of oxidative stress. UK United Kingdom. Tc T cytotoxic lymphocyte; effector UPS Unexplained underperformance cell of cell-mediated immunity. syndrome (also known as overtraining syndrome). TCR (T cell receptor) Antigen recep- tor present on surface of T lympho- urea End product of protein metabo- cytes that recognizes fragments of lism. Chemical formula: CO(NH2)2. antigenic peptides presented by MHC uric acid A crystalline body, present class II proteins on APCs. in small quantity in the urine of man and most mammals. It is a breakdown testosterone The male sex hormone product of nucleic acids. responsible for male secondary sex characteristics at puberty. It has urine Fluid produced in the kidney anabolic and androgenic effects. and excreted from the body. Contains urea, ammonia, and other metabolic TGF Transforming growth factor; an wastes. inhibitory cytokine produced by T regulatory cells. URTI Upper respiratory tract infec- tions like colds and flu. Th T helper lymphocyte. USA United States of America. thymus The lymphoid gland located in the chest where lymphocytes vegan Vegetarian who eats no animal differentiate into immunocompetent products. T cells. vegetarian One whose food is of tissue An organized association of vegetable or plant origin. similar cells that perform a common function (e.g. muscle tissue). vitamin An organic substance neces- sary in small amounts for the normal TLR (Toll-like receptor) Family of metabolic functioning of the body. evolutionarily conserved PRRs present Must be present in the diet because the on APCs and phagocytes that detect body cannot synthesize it (or cannot PAMPs and initiate the acquired synthesize an adequate amount of it). immune response to pathogens. vitamin B1 Thiamine. TNF (tumour necrosis factor) A vitamin B2 Riboflavin. cytokine that promotes inflammation. vitamin B6 Pyridoxine. vitamin B12 Cyanocobalamin. trafficking (of leukocytes) vitamin C Ascorbic acid. Movements of leukocytes into or out of the circulation. vitamin D Cholecalciferol, the prod- uct of irradiation of 7-dehydrocholes- tocopherol Vitamin E. The most bio- terol found in the skin. logically active alcohol in vitamin E is α-tocopherol.

Glossary 307 vitamin E Alpha-tocopherol. W (watt) Unit of power or work rate (J/s). vitamin K Menoquinone. water The universal solvent of life Vmax Maximal velocity of an enzy- (H2O). The body is composed of 60% matic reaction when substrate concen- water. tration is not limiting. V˙O2 Rate of oxygen uptake. WBC White blood cell (leukocyte). V˙O2max Maximal oxygen uptake. Important cells of the immune system The highest rate of oxygen consump- that defend the body against invading tion by the body that can be deter- microorganisms. mined in an incremental exercise test to exhaustion. WHO World Health Organization. w.w. Wet weight.

309 Index Note: Bold page numbers indicate glossary entries. acidosis, 291 T cell cytokine production and, 97 metabolic see metabolic acidosis β-adrenoceptors acquired (adaptive/specific) immunity, acute exercise and, 96–7 18–19, 24–9, 291 leukocyte demargination and, 71, 72 acute exercise and, 91–113 overtraining and, 129 chronic exercise and, 116–24 adrenocorticotrophic hormone (ACTH), components, 16 decision-making in, modulation, 27 291 general mechanism, 29–35, 91–2 overtraining and, 129 innate immunity and, interactions, 18–19, age and immune function, 37–8 see also children; elderly 19, 22 agranulocytes see mononuclear cells overtraining and, 126–8 AIDS see HIV infection ACTH see adrenocorticotrophic hormone air travel, 261 acute exercise, 67–113 alcohol consumption and vaccine efficacy, acquired immunity and, 91–113 glutamine levels and, 173 233–4 innate immunity and see innate altitude, high, 154–5 amino acids, 172–7, 291 immunity in special populations branched-chain, 176–7, 292 cAMP, 293 children, 281–2 HIV-infected individuals, 271 lymphocyte numbers and, 97 older people, 275–6 neutrophil adherence and, 72 see also heavy (exhaustive/intensive/ analgesics (pain-killers), 263 anorexia athletica, 164, 292 strenuous) exercise anorexia nervosa, 292 acute-phase proteins, 18, 20, 291 Antarctic personnel, upper respiratory adaptive immunity see acquired tract infections, 154 immunity antibiotics, 263 adhesion molecules, cell-surface, 71–2, antibody see immunoglobulin antigen(s), 292 96, 97 children in football practice, 282 intradermal, skin test response see skin adrenal gland see test response hypothalamic–pituitary–adrenal memory (immunological) with see axis; sympatheticoadrenal- memory medullary axis adrenaline (epinephrine), 291, 295 presentation, 24–6 leukocyte demargination and, 71, 72 recognition/receptors, 27, 27–9 leukocyte numbers and, 71, 83, 96, 97 in hot conditions, 146 B cells, 30 plasma levels, in hot vs cold water, transport/processing/removal, 26–7, 147, 150 30–1, 224–5 see also vaccination antigen–antibody complexes, 30–1

310 INDEX antigen–MHC complexes, 24, 25, 32 reduction, 162 antigen-presenting cells, 24–6 ‘sports’ drinks, 255, 257 cytokine responses to ingestion, 214, 216 naive T cells and, 33–5 IL-6, 209 anti-inflammatory cytokines, 206 and prevention of underperformance dietary carbohydrate and, 166 syndrome, 135 IL-6 and, 212 carboxyfluorescein succinamidyl anti-inflammatory drugs, 263 antimicrobial soluble factors, 20–1 ester, 62 antioxidants, 292 cardiology see heart vitamins as, 186–90 caregivers, psychological stress affecting antiviral drug, Epstein–Barr virus, 263–4 apoptosis, 292 antibody response to influenza lymphocyte, 98 vaccination, 227, 228–9 arachidonate metabolites see eicosanoids amelioration, 237 ascorbic acid see vitamin C β-carotene, 190, 293 astronauts, 155–6 catecholamines, 293 autoimmune disease, 40 and acute exercise, 96–7 leukocyte demargination and, B cells, 27–9 71–2 counts, monitoring, 251 CD proteins, 293 differentiation into plasma cells see lymphocytes, 23 plasma cells in flow cytometry, 52–5 exercise-related numbers, 95–6 CD3-expressing (T) cells in hot conditions, 149 acute exercise effects, 102 functions/characteristics, 23 in flow cytometry, 52–5 production, 26 in heating psychological stress and numbers exercising subjects, 146, 147, 149 of, 223 passive subjects, 142 CD4+ (helper) T cells, 23, 33–5, 91–2 bacteria acute exercise effects, 93–5, 102, 103 commensal see microflora mitogen stimulation and, 101, 105 upper respiratory tract infection, 263 antigen presentation to, 25 B cell activation by antigens and the basophils, characteristics/functions, 17 role of, 30 β-carotene, 190, 293 in cell-mediated immunity, 32 biopsy, 293 in flow cytometry, differentiation from other T cell types, 52–5 muscle, IL-6 mRNA and protein, 211 in HIV-infected individuals, training punch, psychological stress effects on effects, 273–4 in hot conditions with exercise, 146, 147, wound healing, 232–3 149 blood in overtrained athletes, 126 Th1/Th2-type see Th1/Th2 cells tests, 248–53 CD4+/CD8+ ratio, 251 costs, 252–3 acute exercise effects, 94 sample collection/preparation, 47–9 in hot conditions in passive subjects, 142 volume (plasma volume) monitoring, 251 acute exercise effects, 99 in overtrained athletes, 126 endurance exercise effects, 250 in professional footballers over course of competitive season, bone marrow, 26, 28 123–4 branched-chain amino acids, 176–7, 292 CD8+ (cytotoxic and suppressor) brief exercise see acute exercise T cells/lymphocytes, 23, 27, 32 acute exercise effects, 93–5, 102, 103 C-reactive protein, 20, 294 mitogen stimulation and, 101, 105 callisthenics in flow cytometry older people, 278, 279 and upper respiratory tract infection risk and, 4, 278 carbohydrate (CHO), dietary, 165–9, 293 availability, 164, 165–9 exercise and, 165–9, 171, 255

Index 311 CD8+ (cytotoxic and suppressor) moderate exercise and, 5–6 T cells/lymphocytes (Contd) seasonal variation, 5, 6 zinc supplementation and, 194–5 activity assessment, 60 cold environments, 151–4 differentiation from other T cell types, exercise, 153–4, 259, 261 colony-stimulating factor (CSF), 294 52–5 granulocyte-, 143 in hot conditions with exercise, 146, 147, commensal bacteria see microflora competitive season, immune changes over 149 IFN-[gamma] production, 94–5, 102, course, 122–4 complement system, 18, 20–1, 294 103, 217 CD14+ monocytes neutrophil function and, 83 conjugate vaccination, psychological stress flow cytometry, 48 IL-6 expression, 82 effects on antibody response to, 229–30 flow cytometry studies, 58–9 cooling see cold environments Toll–like receptor expression, 80 copper, 197–8 CD25 (IL-2 receptor)-expressing cells deficiency, 191, 197–8 acute exercise effects, 101 excess, 191 flow cytometry, 56 role, 191 CD45RO and RA-expressing T cells sources and recommended acute exercise effects, 101 intake, 193 in professional footballers over course corticosteroids (glucocorticoids) neutrophilia and, 74 of competitive season, 123 in overtraining, chronic elevation, 131–2 CD54 and children, 282 cortisol, 294 CD69-expressing cells hydration status and, 164–5 hyperthermia and, 143, 147, 150 acute exercise effects, 101 leukocyte numbers and, 83 flow cytometry, 56 lymphocytes, 96, 97, 99–100 cell(s), immune see immune cells neutrophils, 74 cell-mediated immunity (delayed-type overtraining and, 129, 131–2, 257 prolonged exercise and, 174 hypersensitivity), 32, 293, 295 IL-6 and, 212 acute exercise effects, 100–5 psychological stress and, 235 humoral immunity vs, regulation, T cell cytokine production and, 97 costs, blood tests, 252–3 33–5 cough medication, 263 measurement in response to creatine kinase, 293–4 activity intradermal application of antigen, monitoring, 252 63 normal, 248 spacetravel and, 155–6 cross-sectional studies of exercise training, in underperformance syndrome, 117 and increased incidence CSF see colony-stimulating factor of infection, 131 culture, cell see in vitro tests cell surface molecules on leukocytes see cyclic AMP see AMP adhesion molecules; CD antigens cycling chemotaxis, 293 carbohydrate intake during, 168, 169 monocyte, flow cytometry, 60 in cold conditions, immune function neutrophil, 76 and, 153–4 flow cytometry, 60 competitive season of, 122–3 children, 281–3 in hot conditions chilling see cold environments leukocyte counts and, 146, 147, chronic fatigue in underperformance 148, 149 syndrome, 132–4 leukocyte function and, 150 clonal expansion of lymphocytes, 29 cobalamin see vitamin B12 cobalt, 198 cognitive behavioural stress management, 237–8 cold, common heavy exercise and, 8, 11 medication, 262–4

312 INDEX cytokines, 18, 205–20 inadequate see malnutrition anti-inflammatory see anti-inflammatory macronutrients, 161–81, 301 cytokines management, 255, 257–8, 264 definition, 205, 294 micronutrients see micronutrients in females, 38 underperformance syndrome and, 135 iron handling, 195 dihydrorhodamine, oxidative burst leukocyte production of, 215–17 Th1/Th2 cells see subheading below activity assessment, 59 in overtrained athletes 3-(4,5-dimethylthiazol-2-yl)-2, chronic fatigue and, 132 Th1/Th2 cells producing, 5-diphenyltetrazolium bromide 131, 132 (MTT), 61–2, 302 pro-inflammatory, 206 doping laws and medications, 263 prolonged exercise effects see heavy drinks, ‘sports’, 255, 257 exercise drugs, upper respiratory tract infections, receptors, flow cytometry of cells 262–4 expressing, 56 duration of exercise and innate immunity, secretion activated by exercise, 206 84 Th1/Th2 CD4+ cells producing, 33–4, see also endurance exercise 212, 215, 216–17 acute exercise effects, 97, 101–2 EBV (Epstein–Barr virus), 262, 295 flow cytometry studies, 57–9 Echinacea purpurea, 199–200, 264 overtraining effects, 131, 132 eicosanoids, 295 stress hormone effects, 97 Toll-like receptors and, 80 production types, 18 dietary fatty acids and, 170 wound healing and, 233 by neutrophils and monocytes, 59 see also specific cytokines elastase, neutrophil cytotoxic activity, 294 acute exercise and, 77–8 of natural killer cells see natural killer exercise in hot conditions and, 148, 149 cells elderly, immune function, 37–8, 274–81 cytotoxic T cells see CD8+ T cells exercise effects, 274–81 Daily Analyses of Life Demands in ELISA, 49–50, 295 Athletes (DALDA), 130, 259, elite athletes 260, 294 acute increase in training load, 118 DCs see dendritic cells in course of competitive season, 122–4 defence psychological stress, 258–9 endothelium, vascular, leukocyte adherence chemical and cellular see immune system (and its reduction) to, 71, 72, 76 endotoxin see lipopolysaccharide commensal bacteria in, 36 endurance exercise/events (prolonged physical/structural, 19, 20 degranulation, 294 exercise) neutrophil, 77–9 glutamine levels and, 173–4 iron levels and, 195–6, 196 carbohydrate intake and, 168 leukocytosis, 68–9 dehydration, 164–5 older people, 279 plasma volume expansion, 250 haematocrit in, 249–50 upper respiratory tract infection risk delayed-type hypersensitivity see cell- and, 8–12 mediated immunity vitamin C and, 187–9 dendritic cells (DCs), 21, 294 see also ironman; long-distance running; antigen presentation by, 24 marathon; triathletes; Th1/Th2 balance and, 33 ultramarathon diabetes, 285, 294 energy, 295 diet and nutrition, 39, 161–203, 255, 257–8, deficits/supply crises, 164–5 IL-6 response in muscle to, 209, 210 303 glucose as source of, 165, 211 availability of nutrients, 162–4 restriction programme in obese women, 284

Index 313 environment (as factors affecting fluorine, 198 immunity), 37–40, 259–61 folic acid/folate, 296 extreme, 139–60 blood levels management, 259–61 assessment, 249 normal values, 248 enzyme-linked immunosorbant assay, 49–50, 295 deficiency, 185 excess, 185 eosinophils, 295 role, 185 characteristics/functions, 17 football monitoring of values, 252 children, 282 normal values, 248 professional players epinephrine see adrenaline competitive season effects, 123–4 Epstein–Barr virus, 262, 295 upper respiratory tract infection, 10 erythrocyte (red blood cell), 296 foreign material, recognition, 23–4 see also antigen count, 248, 249 free radicals see reactive oxygen species evolutionary reasons for exercise-induced gastrointestinal tract, 297 leukocytosis, 72 commensal bacteria see microflora ex vivo tests see in vitro tests extreme environments see environment gender blood values, 248 fat (lipid), 296, 300 immunity and, 38 dietary, 169–71 metabolism, and IL–6, 212 geometric mean fluorescence intensity, 59 glucocorticoids see corticosteroids fatigue, chronic, in underperformance glucose syndrome, 132–4 blood, 165 fatty acids, 170, 296 as energy source, 165, 211 essential, 296 hepatic production and IL-6, 211–12 polyunsaturated see polyunsaturated glutamine, 172–6, 297 fatty acids branched-chain amino acid females supplements and levels of, athlete triad (syndrome), 296 176–7 blood values, 248 exercise and, 173–4 immune function, 38 overtraining, 128–9, 130–1, 174 supplementation, 175, 176, 258 ferritin, 296 glycogen, 296 serum muscle, IL-6 and prolonged exercise monitoring, 249 and, 209–11 normal values, 248 granulocyte characteristics/functions, 17 granulocyte-CSF and hyperthermia, 143 fever, severe cold, 263 gravity, normal, leukocytosis in astronauts ‘fight or flight’ response, 72 returning to, 155, 156 fitness and innate immunity, 84 growth hormone and hyperthermia, flow cytometry, 47, 48–9, 50–62 142–3, 147 guidelines on minimizing risk of, immune cell functional testing, 55–62 253–64 lymphocyte subset assessment, 52–5 gut, commensal bacteria see microflora principles/technical aspects, 51–2 flu see influenza haem iron, 196 fluid status see hydration status haematocrit (packed cell volume), fluorescein isothiocyanate (FITC) in flow 249–50, 297 cytometry normal, 248 LPS-stimulated IL-6 production by haemodynamic factors, leukocyte monocytes, 58 demargination, 69–71 lymphocyte subtype differentiation, 53, haemoglobin, 298 54, 55 concentration, 248, 249 fluorescent markers in flow cytometry LPS-stimulated IL-6 production by monocytes, 58–9 lymphocyte proliferation, 62 lymphocyte subtype differentiation, 53–5

314 INDEX half-ironman event, immune function hyperthermia, 141, 298 following event, 11–12 leukocyte responses, 142–3, 147–8 haptoglobulin, 20 hypothalamic–pituitary–adrenal axis health behaviour and immune system, (under stress), 141, 234, 235 233–4 overtraining, 129 heart hypothermia (core temperature output, and leukocyte demargination, 70 (<36˚), 151 rate, indicating overtraining, 257 leukocyte function in, 152 heat (hot conditions), 141–51 hypoxia at altitude, 155 exercise in, 145–51, 259–61 passive heat stress, 142–5 ICAM-1 and children, 282 heavy chains of Ig, 30–1 immune cells, 16 heavy (exhaustive/intensive/strenuous) functional tests via flow cytometry, exercise or training 55–62 cytokine responses, 119–20, innate, 16, 19 213–14, 215–17 acute exercise effects on function, IL-6 production, 206, 207, 75–83 208–11, 212 sample collection and preparation for glutamine levels and, 173 testing, 47–9 immune responses (other than immune deficiency/depression cytokines), 40, 117–24 diet/nutrition-related, 39 upper respiratory tract infection risk, carbohydrate content, 166–9 fat content, 170, 171 8–12, 46, 116, 119, 217 protein content, 172 see also acute exercise; overtraining glutamine depletion and, 130–1, 175, helper (CD4+; Th) T cells see CD4+ T cells 175–6 hepatic function see liver in intensified training, 118 hepatitis B vaccination, psychological in overtrained athletes, causes, 130–5 stress effects on antibody response immune system (and its to, 225–7, 235, 236 function/response), 15–43 amelioration, 236–7 herbal supplements, 199–200 acquired immunity see acquired high altitude, 154–5 immunity exercise at, 154–5, 259, 261 histocompatibility proteins see major activation by endogenous danger histocompatibility complex signals, 35 HIV infection/AIDS, 270–4 malnutrition and, 39 acute exercise and see acute exercise HLA see major histocompatibility assessment/monitoring of function and complex hormones, 298 activity, 45–65 as overtraining markers, 129 sample collection and preparation, sex see sex steroids stress see stress hormones 47–9 hot conditions see heat assessment/monitoring of status in humoral immunity, 29–31 acute exercise effects, 105–10 athletes, 248–53 cell-mediated immunity vs, regulation, underperformance syndrome onset 33–5 hydration status, 164–5 and, 125–30, 257 haematocrit indicating, 249–50 components, 16–18 hydrochlorous acid (HOCl) production, 21–2, 298 cellular see immune cells acute exercise and, 79 soluble, 16, 16–17, 18 hydrogen peroxide (H2O2) production, 21 factors affecting, 37–40 acute exercise and, 79 heavy exercise and, 10–12 hygiene, good practice, 261–2 innate immunity see innate immunity intensified training and see heavy (exhaustive/intensive/strenuous) exercise moderate exercise and, 6–7 mucosal, 35–6 overtraining and see overtraining overview, 15–16, 91–2

Index 315 immune system (and its post-exercise ‘open-window’, 131 function/response) (Contd) lymphocytopenia and, 98–9 psychological stress and, interaction psychological stress and, 221–3 between, 223–4 respiratory see respiratory tract mechanisms of, 233–6 infections wound healing and, 231, 232 in special populations, risk, 269–89 immunodeficiency/depression see training during period of, 264 vitamin C and, 186, 188 immune deficiency/depression white blood cell elevated count in, 250 immunoglobulin(s) (antibodies), 26, 29–31, inflammatory disease, 40 inflammatory response system, triggers, 133 292 influenza (flu) medication, 262–4 classes, 29, 31 influenza (flu) vaccination, antibody cycling in heat and production of, response to 150 older people, 280 in ELISA, 49–50 psychological stress effects, 227–9, 230 flow cytometry studies of production, amelioration, 237 60 injury (trauma; damage), tissue mucosal, 36 muscle damage and IL-6, 207–8 acute exercise effects, 107–9 in overtraining, 131–2 serum, acute exercise effects, 106–7 see also wound healing structure, 30–1 innate (natural/non-specific) immunity, vaccination-associated response see 18, 19–24, 67–89 vaccination acquired immunity and, interactions, immunoglobulin A, 29, 31, 36 18–19, 19, 22 mucosal secretion, 36, 37 acute exercise effects, 67–89 acute exercise effects, 107–9 immune cell function, 75–83 salivary see salivary IgA chronic exercise and, 117–24 serum, acute exercise effects, 106 components in, 16, 19 upper respiratory tract infection and duration of exercise and, 84 fitness of subject and, 84 moderate exercise and, 7 intensity of exercise and, 84 immunoglobulin D, 29 mediators of change, 83–4 immunoglobulin E, 29 overtraining and, 126–8 immunoglobulin G, 29, 31 intensity of exercise/training high/heavy see heavy exercise; salivary, acute exercise effects, 109 serum, acute exercise effects, 106 overtraining immunoglobulin M, 29, 31 immunity and effects of, 255–6 salivary see salivary IgM serum, acute exercise effects, 106 innate, 84 immunostimulants, dietary, 199–200, 264 older people, 277, 279 immunosuppressive mechanisms, mild to moderate see mild to moderate mucosal, 36 exercise/exercise training in vitro (cell culture) tests of immune interferon-␥ (IFN-␥), T cells producing response, 46, 55–62 acute exercise effects, 94–5, 102, 103 comments on, 63–4 in vivo tests of immune response, 46, heating effects in passive subjects, 144 intensified/prolonged exercise, 119–20, 62–3 comments on, 63–4 121, 217 infection, 253–64 interleukin-1, 18 glutamine depletion and risk of, 174, heating effects (passive subjects) on 175 mononuclear cell production of, 144 guidelines on minimizing risk of, wound healing and, 233 253–64 interleukin-1 receptor antagonist (IL-1ra) good hygiene practice, 262 immune responses, 19 and prolonged exercise, 214 factors affecting, 37 interleukin-1β, 213, 214 iron and, 195, 199 interleukin-2, 18 malnutrition reducing resistance to, 39

316 INDEX interleukin-2 (Contd) differential, 72–3 receptors, cells expressing see CD25 elevated see leukocytosis T cells producing in hot conditions acute exercise effects, 95, 102 heating effects in passive subjects, 144 exercising subjects, 146–8 passive subjects, 142–3 interleukin-4, T cells producing, acute monitoring, 250–2 exercise effects, 102, 103 normal values, 248 in overtrained athletes, 126–7 interleukin-6, 18, 206–13 in recovery from exercise see recovery biological roles, 211–13 leukocytosis (high WBC count), 300 hyperthermia and, 143 astronauts on return to earth, 155, 156 monocyte production of, 216 exercise-induced, 68–75 LPS-stimulated see lipopolysaccharide cold conditions and, 152 post-exercise, 83–4, 98 delayed (in prolonged exercise), prolonged exercise effects, 206, 207, 208–11, 212 68–9 underperformance syndrome delayed (in recovery from brief and, 132–3 intense exercise), 68, 73, 74–5 interleukin-8, 213, 214 dietary carbohydrate and, 166 intracellular adhesion molecule-1 and hot conditions and, 146–7 mechanisms, 69–72, 75 children, 282 in illness, 250 iron, 20, 195–7 in passive subjects in hot conditions, deficiency, 191, 195–6, 199, 249 142–3 excess (incl. megadoses), 191, 197 see also specific types of leukocytes role, 191 lifestyle in older people, 278 sources and recommended intake, light chains of Ig, 30–1 lipid see fat 193, 249 lipopolysaccharide (LPS; endotoxin), vitamin C affecting absorption, and effects of exercise, 196, 249 57, 215, 300 ironman event, half-, immune function IL-6 production by monocytes stimulated by, 80, 82, 216 following, 11–12 flow cytometry studies, 58–9 TNF-α production (by monocytes) J chain of IgA, 36, 37 stimulated by, 212–13, 216 J-shaped curve of exercise and infection liver glucose production and IL–6, 211–12 risk, 2–4, 8, 12, 115–6 leukocyte demargination, 71 long-distance/prolonged running, IL-6 keyhole limpet haemocyanin (KHL), kinetics, 208 225, 300 see also marathon; ultramarathon longitudinal studies of exercise training, lactate, blood, overtrained subjects, 257 116–17, 117 laser in flow cytometry, 51, 52 LPS see lipopolysaccharide leukocyte(s) (white blood cells), 16, 250, lung leukocyte margination/ 300, 307 demargination, 70 functions (and characteristics) in ventilation rate, 98 lymph nodes, 26 general, 17 lymphocytes, 23, 26–9, 301 functions in cold conditions apoptosis, 98 differentiation from other cell types in exercising subjects, 153 flow cytometry, 51, 53 passive subjects, 152–3 functions (in general), 17, 23 functions in hot conditions heating effects in passive subjects, 144 exercising subjects, 148–51 mitogen-stimulated see mitogen- passive subjects, 143–5 stimulated lymphocytes marginated, 69–70, 301 demargination, 70–1, 79 remargination in recovery from exercise, 73 see also specific types leukocyte counts, 17, 250–2 in cold conditions, passive subjects, 152

Index 317 lymphocytes (Contd) manganese, 198 numbers/counts, 92–100 sources and recommended intake, 193 abnormal see lymphocytopenia; lymphocytosis marathon runners monitoring, 251–2 cortisol levels and delayed leukocytosis, normal, 248 74 proliferation dietary carbohydrate intake, 167–8 acute exercise effects, 102–5 upper respiratory tract infections, in cold conditions in passive subjects, 8, 9, 10 152, 153 see also ironman; ultramarathon flow cytometric assessment, 60–2 glutamine depletion in overtraining medical support, 262 and its effects on, 130 medications, upper respiratory tract in hot conditions in exercising subjects, 150 infections, 262–4 intensified training effects, 119, 121 memory, immunological (incl. memory older people in training, 278, 279 psychological stress and, 224 cells), 26, 29, 32–3, 301 types/subsets, 23 professional footballers over differentiation of various, in flow cytometry, 52–5 competitive season, 123–4 see also B cell; natural killer cell; men, blood values, 248 T cell meningococcal A+C vaccination, see also neutrophil/lymphocyte ratio psychological stress effects on lymphocytopenia, post-exercise, antibody response to, 230 74, 92, 100 menstrual cycle, 38 metabolic acidosis, 301 mechanisms and interpretation, 96–9 diet-induced, 174 lymphocytosis metabolic effects of IL-6, 211–12 MHC see major histocompatibility exercise-induced, 92–100 complex heat and, 146, 147 microflora (commensal bacteria), gut (in mechanisms and interpretation, host defence), 36 96–9 probiotics and, 200 micronutrients, 183–208, 257–8, 302 in passive subjects in hot deficiencies (in general), 39 conditions, 142 avoidance, 185 in low-fat diet, 171 lymphoid organs/tissues, 26 see also minerals; vitamins mild to moderate exercise/exercise macrominerals, 191, 301 training, 117 macronutrients, 161–81, 301 cross-sectional and longitudinal studies, macrophages, 80, 301 117 innate immunity and, 84 general characteristics/functions, older people, 276–81 17, 26 upper respiratory tract infection risk, 2–8, 116 wound healing and, 231 military training, 118–20 see also monocytes minerals, 191–9, 302 magnesium, 197 deficiency risk-related sports, 199 deficiency, 191, 197 macro-, 191, 301 excess, 191 recommended intakes, 193, 198–9 role, 191, 197 trace, 191–9 sources and recommended intake, 193 mitogen-stimulated lymphocytes magnetic cell sorter, 47–8 heating effects in passive subjects, major histocompatibility complex (MHC; 144 plasma cell Ig production, acute exercise HLA), 301 effects, 106 antigen interactions, 24, 25, 32 T cells see mitogen-stimulated T cells males, blood values, 248 training effects malnutrition (under- and overnutrition – intensified, 119, 121 in older people, 277, 278, 279 primarily under-), 39, 162–4 immune deficiency due to see immune deficiency

318 INDEX mitogen-stimulated T cells children, 282 acute exercise effects, 101, 105 flow cytometric assessment, 60 older people, 276 heating effects in exercising flow cytometric studies, 61–2 subjects, 150–1 moderate exercise see mild to moderate heating effects in passive subjects, 144 exercise intense exercise and, 80–3 moderate exercise and, 6–7 monocytes, 80, 302 obese women, 283–4, 284 acute exercise effects, 80 elevated levels and proliferation, 61 chemotaxis, 60 in acute exercise, 72–3, 93, 103–4 cytokine production, 216 in children, 281–2 IL-6 see interleukin-6 in cold conditions in passive subjects, eicosanoid production, 59 elevated counts (monocytosis), 72, 252 152 delayed (post-exercise), 74 in hot conditions in cyclists, in hot conditions with exercise, 146, 147, 148 147, 149 flow cytometry, 51, 53, 59–60 HIV-infected individuals, training functional studies, 59–60 function/characteristics (in general), 17, effects, 271–2 21 monitoring of levels, 251 heating effects in passive subjects, older people, training effects, 277, 279 144–5 neuroendocrine system in psychological intensified training effects, 120 monitoring of numbers, 252 stress, 234–6 normal values, 248 neutrophil(s), 75–9, 83, 250–1, 302 oxidative burst see oxidative burst phagocytosis see phagocytosis adherence to endothelium, 72, 76 Toll-like receptor expression and carbohydrate intake and, 168 function, 80 chemotaxis see chemotaxis see also CD14+ monocytes; macrophages degranulation see degranulation eicosanoid production, 59 mononuclear cells (agranulocytes) elevated (neutrophilia), 72 characteristics/functions, 17 peripheral blood see peripheral blood delayed (post-exercise), 74, 75 mononuclear cells in hot conditions with exercise, 146, mood state see psychological 147, 148 questionnaires; stress, flow cytometry, 51, 53, 59–60 psychological functional studies, 59–60 mountain sickness, acute, 155, 261 functions (in general), 17, 21 MTT assay (lymphocyte proliferation), acute exercise effects, 75–9 61–2, 302 heating effects in exercising subjects, mucosal immunity, 35–6 148–9 Igs in see immunoglobulin heating effects in passive subjects, muscle (skeletal), 207–11 143 cold exposure evoking contractions, 151 intensified training effects, 119, 121 exercise-induced damage, 207–8 overtrained athletes, 127–8 IL-6 and, 207–11 trained older people, 278 myeloperoxidase monitoring of levels, 250–1 acute exercise and, 77–8 normal values, 248 exercise in hot conditions and, 148 oxidative burst see oxidative burst myocarditis, viral, 11 phagocytosis see phagocytosis neutrophil/lymphocyte ratio, overtrained natural immunity see innate immunity natural killer (NK) cells, 19, 20, 22–3, athletes, 126 NK cells see natural killer cells 80–3, 302 non-specific immunity see innate cytotoxic/cytolytic activity (NKCA), immunity 23, 302 noradrenaline (norepinephrine), 303 lymphocyte numbers and, 96 plasma levels in cycling in hot vs cold water, 147, 150 nutrition see diet

Index 319 obesity, 283–5 acute exercise effects in older people, 276 oestrogen, 38 training effects in older people, 277, 278, older people see elderly omega-3 PUFAs, 170, 171 279 opsonin and opsonization, 31, 303 pituitary hormones (and stressors), 141 oral tolerance, 36 overtraining/over-reaching, 40, 117–21, overtraining, 129 plasma cells, 29–30, 303 124–32 glutamine and, 130–1, 174 Igs of see immunoglobulin markers/signs of, 125–30, 256–7 in mucosal defence, 36 syndrome of see underperformance production (from B cells), 25–6 pneumococcal vaccination, psychological syndrome overweight persons, 283–5 stress effects on antibody response oxidative burst (generation of reactive to, 229 polyunsaturated fatty acids (PUFAs), 304 oxygen species), 21–2, 303 omega-3, 170, 171 monocytes pregnancy, 38 probiotics, 200 acute exercise effects, 80 Profile of Mood States (POMS), 130, 259 flow cytometry, 59–60 progesterone, 38 intensified training effects, 120 prolonged exercise see endurance exercise neutrophils prostaglandins, 304 acute exercise effects, 77, 79 and dietary fatty acids, 170 flow cytometry, 59–60 protein, dietary, 172 intensified training effects, 119, 121 pro-vitamin A (β-carotene), 190, 292 overtrained athletes, 127–8 psychological questionnaires, 259 overtraining and, 129–30, 135 packed cell volume see haematocrit psychological stress see stress pain-killers, 263 psychological therapies in stress, 236–8 pathogen-associated molecular patterns punch biopsy, psychological stress effects on wound healing, 232–3 (PAMPs), 23–4, 25, 57, 303 pyrexia (fever), severe cold, 263 pattern-recognition receptors (PRRs), pyridoxine see vitamin B6 24, 304 reactive oxygen species (oxygen free peridin chlorophyll (PerCP) in flow radicals), 296–7, 305 cytometry, 303 in oxidative burst see oxidative burst lymphocyte subtype differentiation vitamin scavengers (=antioxidants), from, 53, 54, 55 186–90 peripheral blood mononuclear cells recovery from exercise/training (PBMCs), 303 leukocyte counts, 73 sample collection and preparation, 47, 48 delayed leukocytosis, 68, 73, 74–5 peripheral vasoconstriction, cold lymphocytopenia, 74, 92 exposure, 151 sufficient time (between sessions) for, phagocytes, 21–2, 303 reducing risk of underperformance syndrome, 134 killing process in, 22, 79 phagocytosis, 21, 22, 25, 303 see also rest red blood cell see erythrocyte monocytes, 80 resistance training, older people, 280–1 flow cytometry, 59 respiratory burst see oxidative burst respiratory tract infections, upper, 1–14, 46 neutrophils, 76–7 flow cytometry, 59 altitude-related risk of, 155 trained older people, 278 cooling-related risk of, 151, 154 exercise-related risk of, 253–4 photomultiplier tube in flow cytometry, 54 R-phycoerythrin (PE) in flow cytometry, 303 heavy/intensified exercise, 8–12, 46, 116, 119, 217 LPS-stimulated IL-6 production by monocytes, 58 J-shaped curve, 2–4, 8, 12, 115–6 moderate exercise, 2–8, 116 lymphocyte subtype differentiation from, 53, 54, 55 phytohaemagglutinin (PHA)-stimulated T cell proliferation

320 INDEX respiratory tract infections, upper (Contd) sources and recommended intake, 193 obese women in training, 283–4, sex (gender) and immunity, 38 284 sex steroids/hormones, 38 older people in training, 278 overtraining, 119, 174 overtrained athletes, 129 vitamin C supplementation of shivering thermogenesis, 151, 263 ultramarathon runners affecting, short-term exercise see acute exercise 188 skeletal muscle see muscle skin test response to antigens (delayed- medication, 262–4 training with, 264 type hypersensitivity response), 63 zinc and, 194–5 HIV-infected individuals, 272 rest (as part of exercise/training trained older people, 279–80 sleep and stress and the immune programme), 124 sufficient, 255 system, 234 soccer see football reducing risk of underperformance spaceflight, 155–6 syndrome, 134, 135 specific immunity see acquired retinol see vitamin A immunity rhinovirus and moderate exercise, 5–6 spleen, leukocyte demargination, 71 rhodamine, oxidative burst activity Staphylococcus aureus, ear/nose/skin, assessment, 59 post-exercise colony counts, 254 rubella vaccination, psychological stress steroids see corticosteroids; sex steroids strenuous exercise see heavy effects on antibody response stress to, 229 running physical (± psychological), 140–1 in hot conditions in military training, 118 leukocyte counts and, 146 underperformance syndrome neutrophil function and, 148–9 triggered by, 133 long-distance see long-distance running; marathon; ultramarathon psychological, 39, 221–45, 258–9 amelioration, and its effects, 236–8 salivary IgA, 36, 253 immune function see immune acute exercise effects, 107–9 system infection and questionnaires indicating see in elite swimmers over competitive psychological questionnaires season, 122 sources and symptoms of, in Daily upper respiratory tract infection, and Analyses of Life Demands in moderate exercise, 7 Athletes, 260 intensified training effects, 118–20 vaccination response in see monitoring, 253 vaccination overtraining effects, 128 wound healing see wound healing psychological stress and, 39 stress hormones salivary IgG, acute exercise effects, 109 and acquired immunity, 96–7 salivary IgM factors affecting, 256 extreme environments, 147, 150 acute exercise effects, 109 glucose availability, 162 monitoring, 253 overtraining, 131–2 season(s) prolonged exercise, 174 competitive, immune changes over and innate immunity, 83 course, 122–4 superoxide anion/radical production, of year 21, 303 and older people in training, 279 acute exercise and, 79 upper respiratory tract infections suppressor T cells see CD8+ T cells swimmers, elite, over course of varying with, 5, 6 selenium, 198 competitive season, 122 sympathetic nervous system deficiency, 191, 198 excess, 191 cold exposure and, 151 role, 191 psychological stress and, 234, 236

Index 321 sympatheticoadrenal-medullary axis, thymus-dependent vaccination, stress and, 141 psychological stress effects on antibody response to, 224, 225–9 heat, 147 compared with thymus-independent T cell(s)/lymphocytes, 27–9, 32 vaccinations, 230 activation, acute exercise effects, 100–1 thymus-independent vaccination, antigen presentation to, 24, 25 psychological stress effects on functions (in general), 23 antibody response to, 229 IFN-[gamma] production see interferon- [gamma] compared with thymus-dependent numbers see T cell numbers vaccinations, 230 production, 26 proliferation see T cell proliferation tissue injury in overtraining, 131–2 subtypes TNF-α see tumour necrosis factor-α cytotoxic and suppressor see CD8+ T α-tocopherol see vitamin E cells tolerance, mucosally-induced, 36 differentiation in flow cytometry, Toll-like receptors, 24, 306 52–5 helper see CD4+ T cells; Th1/Th2 cells monocyte, acute exercise effects, 80 suppressor, 23 trace nutrients see micronutrients training T cell numbers, 251–2 acute exercise effects, 93–5 chronic effects on immune function, older people, 275–6 116–24 cold conditions in passive subjects, 152 factors minimizing infection risk, 255–6 hot conditions heavy see heavy (exhaustive/intensive/ exercising subjects, 146, 147, 149 passive subjects, 142 strenuous) exercise or training; monitoring, 251–2 overtraining overtrained athletes, 126 with infection, 264 psychological stress and, 223 in special populations HIV-infected seasonal, professional footballers, 123 individuals, 271–4 children, 282 T cell proliferation obese people, 283–5 acute exercise effects, 102–5 older people, 276–81 older people, 276 transferrin, 20, 195 flow cytometric assessment, 60–2 trauma see injury in hot conditions in exercising triathletes subjects, 150 intensified training by, 118 training effects in older people, 277 post-event immune function, 11–12 tumour necrosis factor-α (TNF-α), 18 temperature LPS and see lipopolysaccharide body see fever; hyperthermia; hypothermia ultramarathon runners and vitamin C environmental extremes, 141–54 requirements, 187–8, 188 Th1/Th2 cells, 33–5 underperformance syndrome, balance, 33–5 unexplained, 124–6, 306 acute exercise effects, 94–5 overtraining effects, 131, 132 immunodepression in, causes, 130–5 cytokine production see cytokines markers (monitoring) for onset, 125–30, flow cytometry studies, 57–9 256–7 thermal stress, 141–54 reducing risk of development, 134–5 thermogenesis, shivering, 151, 263 symptoms, 125 [3H]-thymidine, lymphocyte proliferation URTI see respiratory tract infections studies, 61–2 vaccination (immunization) thymus, 26, 28, 306 antibody response to, 224–30 HIV-infected individuals, 280 immunology, 224–5 measurement, 62–3 psychological stress affecting, 224–30, 233–4, 235, 236

322 INDEX vaccination (Contd) iron absorption affected by, 196, 249 psychological stress affecting, role, 185, 186–7 amelioration of, 236–7 supplementation, 187–9 benefits, 255, 262 in common cold, 264 valacyclovir (Valtrex), Epstein–Barr vitamin E (α-tocopherol), 171, 185, 189–90, virus, 263 306 vascular endothelium, leukocyte deficiency, 185, 189–90 excess, 185 adherence (and its reduction) to, 71, 72, 76 with megadoses, 186 vasoconstriction, peripheral, cold role, 185 exposure, 151 ventilation rate, lung, 98 walking, brisk viral infections (respiratory tract), 263, older people, 278, 279 263–4 and upper respiratory tract infection cold-causing see cold, common risk, 4, 278 vitamin(s) (in general), 184–90, 258, 306 antioxidant, 186–90 water status see hydration megadoses/oversupplementation, 186, weight, body 190, 258 recommended intakes, 190–1, 258 excessive, 283–5 vitamin A (retinol), 171, 190 low, 164 deficiency, 185, 190 white blood cells see leukocytes and specific excess, 185 with megadoses, 186 types of leukocytes role, 185 women see females vitamin B6 (pyridoxine) wound healing, 230–3 deficiency and excess, 185 role, 185 immunology, 231, 233 vitamin B12 (cobalamin), 185, 190 psychological stress effects, 230–3 blood levels assessment, 249 interventions reducing, 237 normal values, 248 deficiency, 185, 190 zinc, 192–5 excess, 185 deficiency, 191, 193–4 role, 185 monitoring, 249 vitamin C (ascorbic acid), 186–9, 292 role, 191, 192–3 deficiency, 185, 187 sources and recommended intake, 193 excess, 185 supplementation, 194–5 with common cold, 264 excess (incl. megadoses), 191, 194–5