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To monitor individual mucosal immunity and identify potential risk factors of upper respiratory symptoms in elite swimmers over a competitive season. Eight-month longitudinal study, observing mucosal immunity, Epstein–Barr virus status, training loads and illness symptoms of elite international swimmers, leading into the Commonwealth Games 2018. Participants were fourteen elite swimmers (age ± standard deviation = 19.9 ± 0.8 years, height = 178.9 ± 6.3 cm, and mass = 75.0 ± 7.7 kg). Self-reported upper respiratory symptoms, training load and saliva samples were collected weekly. Venous blood samples were taken at study commencement to determine Epstein–Barr virus status. Throughout the study, 70 episodes of upper respiratory symptoms were recorded resulting in 34 days of missed training. Incidence (p = 0.001), severity (p = 0.022), and duration of upper respiratory symptoms (p = 0.001) were significantly higher during high training loads, compared to low. Eight swimmers (61 %) had evidence of past infection with Epstein–Barr virus, but this had no relationship with incidence, severity, or duration of upper respiratory symptoms (p > 0.05). Relative individual salivary immunoglobulin A concentration was 12 % lower when upper respiratory symptoms were present but was not statistically significant (p = 0.101). This study highlights the importance of individual athlete monitoring, to identify swimmers at increased illness risk. Identification of possible risk factors for upper respiratory symptoms, such as increased training load, may allow for modifications in training or other illness preventative strategies for elite swimmers. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated. Study Design Prospective cohort study. Setting A multicenter study involving 26 medical facilities in Japan. Methods Inclusion criteria were patients aged ≥18 years old with a confirmed COVID‐19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient‐reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID. Results Patients with high albumin, low C‐reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282‐6.526) for taste disorders and 3.534 (95% CI, 1.382‐9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores. Conclusion The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID‐19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID.

A pilot project was conducted to examine the health status and possible adverse health effects associated with seawater exposure (microbial water-quality indicators and phytoplankton abundance and their toxins) of surfers in Monterey Bay, Central California coastal waters. Forty-eight surfers enrolled in the study and completed an initial health background survey and weekly health surveys online using Survey Monkey. Descriptive statistics and generalized estimating equation, a regression technique, were used to identify longitudinal and correlated results. The surfers were predominately Caucasian, male, and physically active. They surfed approximately 4 h a week. Their average age was 34 years. The data indicated that the surfers were generally "healthy," with a low prevalence of diabetes, high cholesterol, and hypertension. Their most common health problems were allergies and asthma. During the study, 10% of the surfers reported gastrointestinal symptoms and 29% reported upper respiratory symptoms. This study suggests surfers were significantly more likely to report upper respiratory symptoms when they had a history of allergies, housemates with upper respiratory symptoms, and/or a history of previous adverse health symptoms while surfing during a "red tide" (an event often associated with the presence of phytoplankton toxins). Additionally, female surfers reported upper respiratory symptoms more than males.

A pilot project was conducted to examine the health status and possible adverse health effects associated with seawater exposure (microbial water-quality indicators and phytoplankton abundance and their toxins) of surfers in Monterey Bay, Central California coastal waters. Forty-eight surfers enrolled in the study and completed an initial health background survey and weekly health surveys online using Survey Monkey. Descriptive statistics and generalized estimating equation, a regression technique, were used to identify longitudinal and correlated results. The surfers were predominately Caucasian, male, and physically active. They surfed approximately 4 h a week. Their average age was 34 years. The data indicated that the surfers were generally "healthy," with a low prevalence of diabetes, high cholesterol, and hypertension. Their most common health problems were allergies and asthma. During the study, 10% of the surfers reported gastrointestinal symptoms and 29% reported upper respiratory symptoms. This study suggests surfers were significantly more likely to report upper respiratory symptoms when they had a history of allergies, housemates with upper respiratory symptoms, and/or a history of previous adverse health symptoms while surfing during a "red tide" (an event often associated with the presence of phytoplankton toxins). Additionally, female surfers reported upper respiratory symptoms more than males.

The study aimed to determine whether high-dose probiotic supplementation containing Lactobacillus casei (L. casei) for 7 consecutive days enhances salivary antimicrobial protein (S-AMP) responses to exertional-heat stress (EHS). Eight endurance-trained male volunteers (age 26 ± 6 years, nude body mass 70.2 ±8.8 kg, height 1.75 ± 0.05 m, VO2max 59 ± 5 ml⋅kg-1⋅min-1 [M ± SD]) completed a blinded randomized and counterbalanced crossover design. Oral supplementation of the probiotic beverage (PRO; L. casei x 1011 colony-forming units⋅day-1) or placebo (PLA) was consumed for 7 consecutive days before 2 hr running exercise at 60% VO2max in hot ambient conditions (34.0 °C and 32% RH). Body mass and unstimulated saliva and venous blood samples were collected at baseline (7 days before EHS), pre-EHS, post-EHS (1 hr, 2 hr, and 4 hr), and at 24 hr. Saliva samples were analyzed for salivary (S) IgA, α-amylase, lysozyme, and cortisol. Plasma samples were analyzed for plasma osmolality. Body mass and plasma osmolality did not differ between trials. Saliva flow rate remained relatively constant throughout the experimental design in PRO (overall M ±SD = 601 ± 284 µl/min) and PLA (557 ± 296 µl/min). PRO did not induce significant changes in resting S-AMP responses compared with PLA (p > .05). Increases in S-IgA, S-α-amylase, and S-cortisol responses, but not S-lysozyme responses, were observed after EHS (p < .05). No main effects of trial or Time x Trial interaction were observed for S-AMP and S-cortisol responses. Supplementation of a probiotic beverage containing L. casei for 7 days before EHS does not provide any further oral-respiratory mucosal immune protection, with respect to S-AMP, over PLA. [ABSTRACT FROM AUTHOR]

We investigated the health risks and benefits among surfers in Monterey Bay, Santa Cruz County, California, United States after seawater exposure. A total of 47 surfers enrolled and completed an online survey on the effect of the ocean environment on their well-being, physical and mental health, and provided their perspectives on ocean conservation. The majority of the surfers were white males, with a median age of 40 years, and a mean of 21 years surfing experience. Most of the participants spent over 5 h/week in the ocean. The most common health problems reported were adverse effects due to red tide exposure, surfer’s ear, back and neck problems, and allergies. A total of 41% reported upper respiratory symptoms, and 8% of the participants reported gastrointestinal symptoms. All participants reported that the ocean benefited their emotional health, and 45/47 (>96%) reported that the ocean increased their life satisfaction, happiness, and decreased their stress level. All participants reported being engaged in ocean stewardship. This study suggests surfers were significantly more likely to report upper respiratory symptoms when they had experienced adverse health effects while surfing during a “red tide” and during a bloom of the microscopic, single-celled phytoplankter, Akashiwo sanguinea.

Objective: This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated., Study Design: Prospective cohort study., Setting: A multicenter study involving 26 medical facilities in Japan., Methods: Inclusion criteria were patients aged ≥18 years old with a confirmed COVID-19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient-reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID., Results: Patients with high albumin, low C-reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282-6.526) for taste disorders and 3.534 (95% CI, 1.382-9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores., Conclusion: The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID-19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID., Competing Interests: None., (© 2024 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Competitive swimming requires high training load cycles including consecutive sessions with little recovery in between which may contribute to the onset of fatigue and eventually illness. We aimed to investigate immune changes over a 7-month swimming season. Fifty-four national and international level swimmers (25 females, 29 males), ranging from 13 to 20 years of age, were evaluated at rest at: M1 (beginning of the season), M2 (after the 1st macrocycle’s main competition), M3 (highest training load phase of the 2nd macrocycle) and M4 (after the 2nd macrocycle’s main competition) and grouped according to sex, competitive age-groups, or pubertal Tanner stages. Hemogram and the lymphocytes subsets were assessed by automatic cell counting and by flow cytometry, respectively. Self-reported Upper Respiratory Symptoms (URS) and training load were quantified. Although the values remained within the normal range reference, at M2, CD8+ decreased (M1 = 703 ± 245 vs. M2 = 665 ± 278 cell μL−1; p = 0.032) and total lymphocytes (TL, M1 = 2831 ± 734 vs. M2 = 2417 ± 714 cell μL−1; p = 0.007), CD3+ (M1 = 1974 ± 581 vs. M2 = 1672 ± 603 cell μL−1; p = 0.003), and CD4+ (M1 = 1102 ± 353 vs. M2 = 929 ± 329 cell μL−1; p = 0.002) decreased in youth. At M3, CD8+ remained below baseline (M3 = 622 ± 245 cell μL−1; p = 0.008), eosinophils (M1 = 0.30 ± 0.04 vs. M3 = 0.25 ± 0.03 109 L–1; p = 0.003) and CD16+56+ (M1 = 403 ± 184 vs. M3 = 339 ± 135 cell μL−1; p = 0.019) decreased, and TL, CD3+, and CD4+ recovered in youth. At M4, CD19+ were elevated (M1 = 403 ± 170 vs. M4 = 473 ± 151 cell μL−1; p = 0.022), CD16+56+ continued to decrease (M4 = 284 ± 131 cell μL−1; p < 0.001), eosinophils remained below baseline (M4 = 0.29 ± 0.05 109 L–1; p = 0.002) and CD8+ recovered; monocytes were also decreased in male seniors (M1 = 0.77 ± 0.22 vs. M4 = 0.57 ± 0.16 109 L–1; p = 0.031). The heaviest training load and higher frequency of URS episodes happened at M3. The swimming season induced a cumulative effect toward a decrease of the number of innate immune cells, while acquired immunity appeared to be more affected at the most intense period, recovering after tapering. Younger athletes were more susceptible at the beginning of the training season than older ones.

Competitive swimming requires high training load cycles including consecutive sessions with little recovery in between which may contribute to the onset of fatigue and eventually illness. We aimed to investigate immune changes over a 7-month swimming season. Fifty-four national and international level swimmers (25 females, 29 males), ranging from 13 to 20 years of age, were evaluated at rest at: M1 (beginning of the season), M2 (after the 1st macrocycle's main competition), M3 (highest training load phase of the 2nd macrocycle) and M4 (after the 2nd macrocycle's main competition) and grouped according to sex, competitive age-groups, or pubertal Tanner stages. Hemogram and the lymphocytes subsets were assessed by automatic cell counting and by flow cytometry, respectively. Self-reported Upper Respiratory Symptoms (URS) and training load were quantified. Although the values remained within the normal range reference, at M2, CD8+ decreased (M1 = 703 ± 245 vs. M2 = 665 ± 278 cell μL−1; p = 0.032) and total lymphocytes (TL, M1 = 2831 ± 734 vs. M2 = 2417 ± 714 cell μL−1; p = 0.007), CD3+ (M1 = 1974 ± 581 vs. M2 = 1672 ± 603 cell μL−1; p = 0.003), and CD4+ (M1 = 1102 ± 353 vs. M2 = 929 ± 329 cell μL−1; p = 0.002) decreased in youth. At M3, CD8+ remained below baseline (M3 = 622 ± 245 cell μL−1; p = 0.008), eosinophils (M1 = 0.30 ± 0.04 vs. M3 = 0.25 ± 0.03 109 L–1; p = 0.003) and CD16+56+ (M1 = 403 ± 184 vs. M3 = 339 ± 135 cell μL−1; p = 0.019) decreased, and TL, CD3+, and CD4+ recovered in youth. At M4, CD19+ were elevated (M1 = 403 ± 170 vs. M4 = 473 ± 151 cell μL−1; p = 0.022), CD16+56+ continued to decrease (M4 = 284 ± 131 cell μL−1; p < 0.001), eosinophils remained below baseline (M4 = 0.29 ± 0.05 109 L–1; p = 0.002) and CD8+ recovered; monocytes were also decreased in male seniors (M1 = 0.77 ± 0.22 vs. M4 = 0.57 ± 0.16 109 L–1; p = 0.031). The heaviest training load and higher frequency of URS episodes happened at M3. The swimming season induced a cumulative effect toward a decrease of the number of innate immune cells, while acquired immunity appeared to be more affected at the most intense period, recovering after tapering. Younger athletes were more susceptible at the beginning of the training season than older ones. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the effect of bovine colostrum (BC) on mucosal defense in the respiratory tracts of athletes and a nonexercising control group. Methods: An athlete cohort (ATH) of 25 (12 male, 13 female) elite swimmers (age 14-23 yr) and a control cohort (CON) of 28 (9M, 19F) students (age 18-27 yr) were randomly allocated in a double-blind manner to receive either 25 g BC (low-protein colostrum powder) or isocaloric placebo (PL) per day for 10 wk. Postprandial saliva samples were analyzed for immunoglobulins (A, G, and M) and osmolality at baseline, after 4 and 10 wk, and 2 wk postsupplementation. Blood samples were analyzed for immunoglobulins and C-reactive protein at baseline, after 5 and 10 wk, and 2 wk postsupplementation. Dietary intake was assessed by self-recorded dietary records. Upper respiratory tract symptoms (URS) and exercise were also self-recorded daily. Results: There was no significant time-related effect of the BC supplement on either saliva or plasma immunoglobulin levels for either cohort. After 4 wk supplementation fewer ATH/BC (25%) than ATH/PL participants (61%) reported URS incidents (p = .062). No significant difference occurred in URS reports in the control group. Conclusion: There was no measurable effect on immunoglobulin levels of consuming BC, which is in contrast to effects that have been reported previously in marathon runners, indicating that the effect of BC supplementation is not universal in all groups of athletes. Fewer athletes reported URS (although cause unknown) when consuming BC, which may be advantageous for training. [ABSTRACT FROM AUTHOR]

Secretory IgA in saliva (s-IgA) is a potential mucosal immune correlate of upper respiratory tract infection (URTI) status. Nutritional supplements may improve mucosal immunity, and could be beneficial to athletes who are at increased risk of URTI. In this study, 35 distance runners (15 female, 20 male, age 35 to 58 y) consumed a supplement of either bovine colostrum or placebo for 12 wk. Saliva samples were taken prior to training at baseline, monthly during supplementation, and 2 wk post supplementation. Median levels of s-IgA increased by 79% in the colostrum group after 12 wk intervention, and the time-dependent change from baseline value was significant (P = 0.0291). This significance was still apparent after adjusting for training volume and self-reporting of upper respiratory symptoms. This study has demonstrated increased s-IgA levels among a cohort of athletes following colostrum supplementation. While this result is statistically significant, its physiological interpretation must be viewed with caution due to the small numbers in this study and the large variability in s-IgA levels. [ABSTRACT FROM AUTHOR]

Objectives: Elite team-sport athletes are frequently exposed to stressors that have the potential to depress immunity and increase infection risk. Therefore, the purpose of this review is to describe how team-sport stressors impact upon immune responses, along with exploring whether alterations in these markers have the potential to predict upper respiratory tract illness symptoms.Design: Narrative review.Methods: Salivary secretory immunoglobulin A (SIgA) and T-cell markers have been shown to predict infection risk in individual endurance athletes. Papers discussing the impact of team-sport stressors on SIgA and T-cells were discussed in the review, studies discussing other aspects of immunity were excluded. Journal articles were sourced from PubMed, Web of science and Scopus. Key search terms included team-sport athletes, stressors, immunity, T-cells, cytokines, SIgA and upper respiratory illness.Results: Most team-sport stressors appear to increase risk for illness. An association between reduced SIgA and increased illness incidence has been demonstrated. Intensive training and competition periods have been shown to reduce SIgA, however, it is less clear how additional stressors including extreme environmental conditions, travel, psychological stress, sleep disturbance and poor nutrition affect immune responses.Conclusions: Monitoring SIgA may provide an assessment of a team-sport athletes risk status for developing upper respiratory tract symptoms, however there is currently not enough evidence to suggest SIgA alone can predict illness. Team-sport stressors challenge immunity and it is possible that the combination of stressors could have a compounding effect on immunodepression and infection risk. Given that illness can disrupt training and performance, further research is required to better elucidate how stressors individually and collectively influence immunity and illness. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate-vigorous exercise during 2 phases of the 4-week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% peak oxygen uptake for 45 min at 2 time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately postexercise, and 1 h postexercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26% (95% confidence limits (CI) 6-46) lower at postexercise compared with pre-exercise during the synthetic follicular phase ( p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8-30) lower at postexercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate-vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise. [ABSTRACT FROM AUTHOR]

Accumulating research identifies a role of psychological process, particularly negative affect, in the expression of airway nitric oxide (NO), yet directional associations tend to vary across methodologies and samples. Recent findings indicate higher social support to be associated with higher airway NO; however, consequences for respiratory infection remain unexplored. NO has a key role in the first line of epithelial defense against pathogens, thus, social support could unfold airway protective effects through enhanced production of NO. We therefore examined the associations among social support, negative affect, airway NO, and cold symptoms in a sample of undergraduate students. In this cross-sectional study, 637 participants completed questionnaires of social support, negative affect, medical history, and current cold symptoms followed by measurements of fractional exhaled NO (FE NO) to study airway NO during a semester period of relative low stress. Findings showed that greater social support was associated with higher FE NO and fewer cold symptoms, controlling for key covariates. Further analysis suggested an additional indirect effect of social support on FE NO through cold symptoms such that higher social support was related to lower cold symptoms, which were related to lower FE NO. These results, coupled with longitudinal findings in the previous research, suggest that social support can affect FE NO and cold symptoms through a complex pattern of direct and indirect effects. Overall, findings support the role of psychological processes – particularly social support - as relevant to FE NO and cold symptoms in young adults. • Greater social support was associated with higher levels of exhaled nitric oxide (FE NO). • Greater social support was also associated with fewer upper respiratory symptoms. • Greater symptoms of anxiety were associated with lower levels of FE NO. [ABSTRACT FROM AUTHOR]

Salivary antimicrobial protein (AMP) expression is a primary determinant of mucosal immunity. This expression can be altered by exercise. While salivary IgA has been extensively studied, less is known about Lysozyme (Lys) and Lactoferrin (Lac). Knowledge on how sex and menstrual phase affect mucosal immunity is also limited. The purpose of this study was to examine how sex, menstrual phase, and exercise impact IgA, Lys, and Lac expression. Men (n=9) and women (n=9) ran for 45 min at 75% VO2peak. Women were tested in the follicular and luteal phase. Saliva was collected pre-exercise, immediately post-exercise and 1 h postexercise. Pre-exercise, women had higher secretion rates of IgA compared to men (154±106 vs 85±44 μg/min) (p<0.05). Lac secretion rate increased with exercise in both sexes and remained above baseline 1 h after exercise in men (7460±4839 ng/min), but had returned to pre-exercise levels at 1 h post-exercise in women (5720±4661 ng/min) (time*sex interaction, p<0.05). Men had higher secretion rates of Lys (p<0.05) at each time point compared to women (Men pre-exercise: 31042±23132, post-exercise: 29521±13205, 1 h post-exercise: 41229±31270 ng/min vs Women pre-exercise: 11585±10367, post-exercise: 22719±19452, 1 h post-exercise: 17303±11419 ng/min). Both sexes increased the secretion rate of Lys and Lac with exercise, whereas IgA was unchanged. Menstrual phase did not affect IgA, Lys, or Lac and men and women did not differ in saliva flow rates. In conclusion, regularly menstruating women who are not taking hormonal contraceptives differently express AMPs compared to men. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the leukocyte subset counts, serum immunoglobulin A, performance and upper respiratory symptoms (URS), as well as their interrelationships, of well-trained cyclists for a 29-week training season using monitored loads. The season was divided into three phases: preparatory (nine weeks), first competitive phase (nine weeks) and second competitive phase (11 weeks). The sample consisted of eight well-trained cyclists, aged 18 ± 2 years. Immunological parameters and performance were evaluated during weeks 1 (baseline), 10 (early first competitive phase), 19 (early second competitive phase) and 29 (end of the second competitive phase). The training loads (volume x rating of perceived exertion) were monitored daily while the monitoring of URS was performed every 15 days using the WURSS-44 questionnaire. The data were analyzed using a one-way ANOVA and a Pearson correlation test with the significance level set at p = 0.05. No significant differences were found for training load, leukocyte subset counts or serum immunoglobulin A among the three phases. However, serum immunoglobulin A was 50.9% below the control group values. URS were significantly higher during the preparatory period, and there were significant correlations between URS and training load (strain) in the preparatory period (r = 0.72, p = 0.032) and second competitive phase (r = 0.73, p = 0.036). In conclusion, indicators of training load without a significant change throughout the season did not significantly affect immune parameters measured; however, the increase of strain can cause an increase of upper respiratory symptoms throughout the season, but without loss of performance. [ABSTRACT FROM AUTHOR]

Immune changes and increased susceptibility to infection are often reported in elite athletes. Infectious episodes can often impair training and performance with consequences for health and sporting success. This study monitored the occurrence of episodes of upper respiratory symptoms (URS) and the variation in circulating NK cells, CD56 and CD56 NK cells subpopulations, over a winter swimming season. Nineteen national elite swimmers and 11 non-athlete controls participated in this study. URS episodes were monitored using daily log books. Blood samples were taken at rest at four time points during the season: before the start of the season (t1-middle September), after 7 weeks of an initial period of gradually increasing training load (t2-early November), after 6 weeks of an intense training cycle (t3-late February) and 48 h after the main competition (t4-early April) and from the controls at three similar time points (t1-early November; t2-late February; t3-early April). In the swimmers, the occurrence of URS clustered around the periods of elevated training load (67 %). No URS were reported at equivalent time points in the non-athletes. Athletes showed a decrease in the percentage (t2 = 21 %; t3 = 27 %; t4 = 17 %) and absolute counts of circulating NK cells (t2 = 35 %; t3 = 22 %; t4 = 22 %), coinciding with the periods of increased training load, never recovering to the initial values observed at the start of the season. The reduction in the CD56 and an increase in the CD56 NK cell subpopulations were significant at t2 and t3 ( p < 0.05). Concomitant with the fall in values of NK cells, in athletes that shown more than three URS episodes, a moderate correlation ( r = 0.493; p = 0.036) was found between CD56/CD56 ratio and the number of URS episodes after the more demanding training phase (t3). At t3, a lower value of CD56 cell counts was found in the group who reported three or more URS episodes ( t = 2.239; p = 0.032). A progressive significant decrease in the expression of CD119, the receptor for IFN-γ, on the CD56 cells was found over the season and an elevation in Granzyme B expression was coincident with the more demanding training phases. Periods of highly demanding training seem to have a negative impact on innate immunity mediated by NK cell subsets, which could partially explain the higher frequency of URS observed during these training phases. [ABSTRACT FROM AUTHOR]

Abstract: Background: The prevalence of inlet patches and their association with other conditions of the gastrointestinal tract have been studied prospectively in tertiary care facilities; little is known about practice patterns in private outpatient clinics and endoscopy centres. Aims: To assess prevalence, demographic determinants, and associated clinicopathologic features of inlet patches in patients who had oesophagogastroduodenoscopy in outpatient settings throughout the United States. Methods: Retrospective analysis of the clinicopathologic records of 487,229 unique patients who had oesophagogastroduodenoscopy with biopsies between January 2008 and December 2010. Results: There were 870 patients with inlet patches with a prevalence of 0.18%. Significant associations included male gender (OR 1.68), dysphagia (OR 1.34), upper respiratory complaints (OR 2.81), globus (OR 5.39) Barrett oesophagus (OR 1.55), and adenocarcinomas arising in Barrett mucosa (OR 5.64). Conclusions: The prevalence of inlet patches in a tertiary care setting (0.18%) was considerably lower than reported in prospective studies (3.7% on average). Inlet patches were significantly associated with male gender, dysphagia, upper respiratory complaints, globus, Barrett mucosa, and adenocarcinomas arising in Barrett oesophagus. Further studies will be needed to determine if patients with inlet patches and Barrett mucosa benefit from increased surveillance. [Copyright &y& Elsevier]

Objectives: The aim of the study was to investigate whether the level of exhaled nitric oxide (eNO) provides a more sensitive measure to assess adverse pulmonary effects of air pollution than conventional lung function indices. Method: The non-selected cohort studied consisted of 68 children (aged 10–11 years) living in an urban environment. For 7 weeks respiratory complaints were reported daily by these children in a diary, and lung function measures and eNO levels were determined in the children once a week on days with various level of air pollution. Results: During the study the increase in the levels of the various air pollutants was positively associated with eNO (6% to 31% increase; P<0.05) but not with lung function measures. In contrast to the lung function measures, the prevalence of respiratory symptoms such as "sore throat", "runny nose", "having a cold", and "sick at home" were positively associated with the level of eNO measured in the following week. Conclusions: Though clinically very meaningful, functional pulmonary measures appear to be too course to detect relatively mild clinical symptoms in response to exposure to air pollution. In an epidemiological setting the increase in eNO may represent a more suitable measure to assess such adverse effects. [ABSTRACT FROM AUTHOR]

Introduction: Every March, dogsled drivers (mushers) compete in a 1569-km race across Alaska, involving physical exertion, mental exertion, and sleep deprivation for up to 2 wk. These factors may increase mushers' vulnerability to illness, making them a relevant study population for acute infection risk factors. Specifically, the influence of psychological factors on illness risk during prolonged physical exertion has rarely been investigated. The aim of this study was to examine the relationship between psychological characteristics, sleep deprivation, and illness incidence in Iditarod mushers., Methods: Fourteen mushers completed 4 psychological instruments to assess state and trait anxiety, resilience and perceived stress, and self-reported upper respiratory symptoms (URS) in the month before the race. Mushers self-reported sleep duration and URS during the race., Results: State and trait anxiety, resilience, and perceived stress did not differ between mushers with and without pre- and in-race URS (P>0.05). However, all mushers who reported in-race URS had reported URS ≤9 d before the race, and the onset of symptoms during the race typically occurred shortly after a rest period. Sleep duration was higher in mushers who reported in-race URS, both before (4.9±0.3 h, P=0.016) and during illness (5.9±1.3 h, P=0.006), vs mushers without in-race URS (3.4±0.8 h)., Conclusions: This study highlights recent illness, rest periods, and greater sleep requirements as potential risk factors for URS onset during a multiday endurance challenge, whereas psychological factors were not associated with URS., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)