Rj. Shephard et Pn. Shek, ACUTE AND CHRONIC OVER-EXERTION - DO DEPRESSED IMMUNE-RESPONSES PROVIDE USEFUL MARKERS, International journal of sports medicine, 19(3), 1998, pp. 159-171
There are ethical objections to inducing cumulative muscle damage and
associated decrements of performance deliberately in a healthy athlete
. Available data on acute and chronic over-exertion thus include the c
hanges of immune response observed following a single bout of exhausti
ng exercise, sequential observations made on top-level competitors as
they approach peak training periods, and longitudinal laboratory studi
es of heavy (but not necessarily damaging) bouts of training. In all t
hree of these situations, subclinical muscle damage initiates an acute
inflammatory response, with a resulting deterioration in physical per
formance. Although much smaller in degree and shorter in duration, the
associated changes in immune function are similar to those seen in se
psis. There have been major advances in immunological technique over t
he past decade, and significant changes in a number of elements of the
immune response can be identified in athletes during periods of heavy
training. The most promising immunological marker of excessive traini
ng seems a decrease in salivary IgA concentration. However, no single
change occurs with sufficient consistency to identify the individual c
ompetitor who is at risk of overtraining. Mechanisms can be conceived
that convert a sequence of excessive training bouts into an acute and
then a chronic inflammatory process, but the syndrome of overtraining
has a complex overlay of biological and psychological influences. It r
emains more easily detected by decreases in physical performance and a
lterations in mood state than by changes in immune function.