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Exerc Immunol Rev. 2000;6:5-42.

Mucosal immune responses and risk of respiratory illness in elite athletes.

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  • 1Hunter Immunology Unit, Hunter Area Pathology Service, Royal Newcastle Hospital, Australia.


This review focuses on studies of mucosal immunity in elite athletes and specifically addresses the role of mucosal immunity in respiratory illness and associations with the intensity, volume, and duration of exercise. Habitual exercise at an intense level can cause suppression of mucosal immune parameters. Salivary IgA and IgM concentrations decline immediately after a bout of intense exercise and usually recover within 24 hours. Training at an intense level can result in a chronic suppression of mucosal immunoglobulin levels. The degree of suppression is associated with the intensity of the exercise and the duration or volume of the training. Low levels of salivary IgM and IgA, particularly the IgA1 subclass are associated with an increased risk of respiratory illness. Monitoring mucosal immune parameters during critical training periods and establishing personal profiles for individual athletes may provide an assessment of the risk status of an athlete for URTI and allow effective management by the athlete and coach. The nature of the respiratory illnesses in some elite athletes is still uncertain. Recent data indicate viral reactivation may be a significant cause of the respiratory symptoms. Despite suppression of mucosal immune parameters, elite athletes are capable of normal responses to novel oral vaccinations, indicating that mucosal immune mechanisms are intact.

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