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Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon.
- Source :
-
PloS one [PLoS One] 2022 Feb 17; Vol. 17 (2), pp. e0263873. Date of Electronic Publication: 2022 Feb 17 (Print Publication: 2022). - Publication Year :
- 2022
-
Abstract
- Background: Medical personnel may find it challenging to distinguish severe Exertional Heat Illness (EHI), with attendant risks of organ-injury and longer-term sequalae, from lesser forms of incapacity associated with strenuous physical exertion. Early evidence for injury at point-of-incapacity could aid the development and application of targeted interventions to improve outcomes. We aimed to investigate whether biomarker surrogates for end-organ damage sampled at point-of-care (POC) could discriminate EHI versus successful marathon performance.<br />Methods: Eight runners diagnosed as EHI cases upon reception to medical treatment facilities and 30 successful finishers of the same cool weather marathon (ambient temperature 8 rising to 12 ºC) were recruited. Emerging clinical markers associated with injury affecting the brain (neuron specific enolase, NSE; S100 calcium-binding protein B, S100β) and renal system (cystatin C, cysC; kidney-injury molecule-1, KIM-1; neutrophil gelatinase-associated lipocalin, NGAL), plus copeptin as a surrogate for fluid-regulatory stress, were sampled in blood upon marathon collapse/completion, as well as beforehand at rest (successful finishers only).<br />Results: Versus successful finishers, EHI showed significantly higher NSE (10.33 [6.37, 20.00] vs. 3.17 [2.71, 3.92] ug.L-1, P<0.0001), cysC (1.48 [1.10, 1.67] vs. 1.10 [0.95, 1.21] mg.L-1, P = 0.0092) and copeptin (339.4 [77.0, 943] vs. 18.7 [7.1, 67.9] pmol.L-1, P = 0.0050). Discrimination of EHI by ROC (Area-Under-the-Curve) showed performance that was outstanding for NSE (0.97, P<0.0001) and excellent for copeptin (AUC = 0.83, P = 0.0066).<br />Conclusions: As novel biomarker candidates for EHI outcomes in cool-weather endurance exercise, early elevations in NSE and copeptin provided sufficient discrimination to suggest utility at point-of-incapacity. Further investigation is warranted in patients exposed to greater thermal insult, followed up over a more extended period.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Acute Kidney Injury epidemiology
Acute Kidney Injury metabolism
Adolescent
Adult
Brain Injuries epidemiology
Brain Injuries metabolism
Case-Control Studies
Diagnosis, Differential
Female
Heat Stress Disorders epidemiology
Heat Stress Disorders metabolism
Humans
Male
Middle Aged
Physical Exertion
ROC Curve
United Kingdom epidemiology
Weather
Young Adult
Acute Kidney Injury diagnosis
Biomarkers metabolism
Brain Injuries diagnosis
Cold Temperature
Heat Stress Disorders diagnosis
Marathon Running injuries
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 17
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 35176088
- Full Text :
- https://doi.org/10.1371/journal.pone.0263873