5 replies to this topic

[maxwatt]

Brain Behav Immun. 2006 Nov;20(6):578-84. Epub 2006 Mar 22.
Comment in:
Brain Behav Immun. 2007 May;21(4):514; author reply 515.
Ibuprofen use, endotoxemia, inflammation, and plasma cytokines during ultramarathon competition.

Nieman DC, Henson DA, Dumke CL, Oley K, McAnulty SR, Davis JM, Murphy EA, Utter AC, Lind RH, McAnulty LS, Morrow JD.
Department of Health, Leisure, and Exercise Science, Fischer Hamilton/Nycom Biochemistry Laboratory, Appalachian State University, Boone, NC 28608, USA. niemandc@appstate.edu
The primary purpose of this study was to measure the influence of ibuprofen use during the 160-km Western States Endurance Run on endotoxemia, inflammation, and plasma cytokines. Subjects included 29 ultramarathoners who consumed 600 and 1200 mg ibuprofen the day before and on race day, respectively, and 25 controls that competed in the race but avoided ibuprofen and all other medications. Blood and urine samples were collected the morning prior to and immediately following the race, and subjects recorded muscle soreness during the week following the race using a 10-point Likert scale (DOMS). Race time (25.8+/-.6 and 25.6+/-.8 h, respectively) and ratings of perceived exertion (RPE, 6-20 scale) (14.6+/-.4 and 14.5+/-.2, respectively) did not differ significantly between ibuprofen users and nonusers. Ibuprofen use compared to nonuse was linked to a smaller increase in urine creatinine (P=.038), higher plasma levels of lipopolysaccharide (group effect, P=.042), and greater increases (pre-to-post race) in serum C-reactive protein and plasma cytokine levels for interleukin (IL)-6, IL-10, IL-8, IL-1 ra, granulocyte colony-stimulating factor, monocyte chemotactic protein 1, and macrophage inflammatory protein 1 beta, but not tumor necrosis factor alpha. Post-race DOMS and serum creatine kinase levels did not differ significantly between ibuprofen users and nonusers (20,621+/-3565 and 13,886+/-3068 microcal/L, respectively, P=.163). In conclusion, ibuprofen use compared to nonuse by athletes competing in a 160-km race did not alter muscle damage or soreness, and was related to elevated indicators of endotoxemia and inflammation.
PMID: 16554145

This probably applies to other NSAIDs too, including aspirin. ?

Edited by maxwatt, 02 September 2009 - 01:29 PM.

[niner]

This probably applies to other NSAIDs too, including aspirin. ?

Seems like a reasonable assumption, but a 160km race? Wow, this is so far out of the realm of normal exertion for mere mortals such as ourselves, that I have to wonder if we can take anything from this. It might be better to look at how we feel using NSAIDS with our more typical workouts. The blood chemistry did go in the wrong direction with the ibuprofen group. It does make you wonder.

[Shepard]

Ha, I'm supposed to be doing the Western States run next year if I kept a bet I made with a friend a few years back. Since we didn't do the Boston run this year to qualify, I'm hoping the death of one Olympic lifter won't be part of the 2010 run.

[James Cain]

Anti-inflammatories can be useful for preventing inflammation associated with low-level exercise. Any muscular contraction will use inflammatory molecules to signal a cascade of events to alter nutrient utilizatino and repair mechanisms, though at the lower intensities there is little muscle damage. Running 160km results in a comparatively exaggerated inflammatory response as above, but also results in actual muscle and structural (e.g., bone and vascular) damage. I agree that the amount over exercise totally overshot any anti-inflammatory effect of the ibuprofen, but another thing to consider is that if the initial inflammatory response (a necessary response for proper adaptation) is blunted by the ibuprofen then their might be a sort of overcompensation by the body, or maybe a lack of initial repair that lead to more damage. So the take-home message might be to not take anti-inflammatories after major physical insults, but they're good for small things like a single exercise session or banging your shin on the coffee table?

[nowayout]

Anti-inflammatories can be useful for preventing inflammation associated with low-level exercise. Any muscular contraction will use inflammatory molecules to signal a cascade of events to alter nutrient utilizatino and repair mechanisms, though at the lower intensities there is little muscle damage. Running 160km results in a comparatively exaggerated inflammatory response as above, but also results in actual muscle and structural (e.g., bone and vascular) damage. I agree that the amount over exercise totally overshot any anti-inflammatory effect of the ibuprofen, but another thing to consider is that if the initial inflammatory response (a necessary response for proper adaptation) is blunted by the ibuprofen then their might be a sort of overcompensation by the body, or maybe a lack of initial repair that lead to more damage. So the take-home message might be to not take anti-inflammatories after major physical insults, but they're good for small things like a single exercise session or banging your shin on the coffee table?

Don't you think a single exercise session also needs the repair mechanisms to be triggered? If you exercise enough in a session to produce a perceived need for ibuprofen, there is obviously enough damage to need some repair.

[James Cain]

Don't you think a single exercise session also needs the repair mechanisms to be triggered? If you exercise enough in a session to produce a perceived need for ibuprofen, there is obviously enough damage to need some repair.

I was suggesting that the repair mechanisms may be partially dependent on inflammatory signalling. Perhaps the adaptive response to moderate intensity is dependent more on inflammatory signalling and low-grade muscle damage that would be overcome by using NSAIDs, but that high-intensity/volume exercise would provide such a large muscular damage and inflammatory response that the effect of the NSAIDs are overcome. But this latter scenario may require a full adaptive response but be only blunted (not completely supressed) by the Ibuprofen such that the inflammation and adaptive response would overcompensate, which is what was seen in the study results.

I'm just offering ideas as to why running a 160km race while taking Ibuprofen would result in greater inflammation than without Ibuprofen. Though if I had to hedge my bets I'd say that because the muscular damage experienced during exercise is partially dependent on nutrient availability, and that nutrient transfer and fuel utilization is altered during exercise by inflammatory signalling (i.e., IL-6 and IL-2 and their downstream targets) then taking Ibuprofen might have altered fuel usage in a way that lead to non-optimal muscular contraction and mitrochondrial function, thus ending with a greater muscular damage and thus a greater later immune and adaptive response. Since the size of this effect would be "dose-dependent" with the running, then running more would show greater results, and moderate exercise sessions may not be long enough to make this effect noticeable.