Mucosal Immunity and Self-Reported Upper Respiratory Symptoms in a Cohort of Premier League Academy Soccer Players

Introduction The measurement of a number of salivary biomarkers has become common place in Premier League Soccer teams, in an attempt to monitor responses to training, competition, lifestyle factors and stress. The purpose of this paper was to analyse markers of mucosal immunity through the second half of a competitive season in a cohort of Premier League Academy players. Methods A total of 256 saliva samples were taken during routine monitoring of a cohort 16 players in the under-18 age group of an English Premier League club Academy. Morning saliva samples were collected weekly over a period of 17 weeks between the christmas break and the end of the competitive season. The IgA concentration of the samples was determined using an IPRO Point of Care device and the remaining sample was sent to a remote laboratory for the subsequent determination of IgG and alpha-amylase (sAA) by ELISA. On any occasion that players perceived upper respiratory symptoms (URS) a WURSS questionnaire was completed and extra saliva samples (115) taken each day until symptoms had ceased. Results IgA, IgG and sAA were highly variable between subjects (with CV 57.6, 81.4 and 59.5% respectively) and within subjects (48.5, 65.9, and 46.4%) through the 17 week period. Weekly group mean (±SD) IgA ranged from 114.1 (57.5) to 318.4 (176) μg/ml, IgG from 27.4 (23.7) to 61.7 ( 30.5) μg/ml and sAA from 191.9 (100.7) to 370.6 (203) μg/ml, but no significant differences were seen due to the high individual variability. During the 17 week study period 26 incidences of URS were reported by 15 of the players and were monitored using WURSS and subsequent saliva testing. A drop in IgA by more than 40% from individual healthy mean values, within two weeks of each URS episode, was seen in 14 of the 26 episodes. A drop in IgA/sAA ratio by more than 40% of individual healthy mean values, within two weeks of each URS episode, was seen in 19 of the 26 episodes. However, using the same individualised criteria for IgA and IgA/sAA ratio there were 28 and 38 samples, respectively, where such drops did not lead to URS, with several such occurences seen within the same individuals. In cases where URS were reported, subsequent IgA during perceived symptoms was seen to rise 40% above individual healthy mean levels in 15 of the 26 episodes. Conclusion Salivary markers of mucosal immunity, particularly IgA and sAA when expressed as percentages of healthy baseline norms have good potential for predicting self-reported URS in this cohort of elite under 18 soccer players. Rather than remain suppressed through symptoms, these markers were often then seen to rise by more than 40%. Creation of individual profiles of such salivary markers seems warranted for purposes of monitoring

Investigating The Use of a Point Of Care Salivary IgG Test In The Sporting Environment

Introduction The use of salivary diagnostics within the sporting community has gathered momentum in recent years; with the identification of hormone levels to assist in the optimisation of workloads, or antibody levels to assess individual recovery status and potential immune suppression. Immediate feedback for coaching and support staff via a Point of Care (POC) test would give a significant time advantage over standard laboratory techniques, which often reveal data to sporting squads only days later. This paper assesses a new POC product developed by Ipro for the rapid determination of salivary IgG in comparison to standard laboratory ELISA determination. Methods A total of 45 saliva samples were taken from a cohort of English Premier League Senior and Academy soccer players (22.4 ±7.2 yrs) using IPRO OFC collection kits. The samples were taken during routine monitoring: before training sessions. The same samples were assessed immediately on a POC Lateral Flow Device (LFD) to determine salivary IgG concentrations and then taken to a laboratory for subsequent analysis via ELISA within 4 hours of collection. The measurement range for ELISA was 1.75 - 105 μg/ml and POC test 1.6 - 120 μg/ml. Results Four samples exceded maximum values on both platforms and were excluded from the analysis. The remaining salivary IgG concentrations measured via ELISA ranged from 7.26 - 57.54 μg/ml and with the LFD from 2.26 - 51.81 μg/ml, with the mean difference 7.90 μg/ml. The relationship between the salivary IgG values obtained using the ELISA and POC test was represented by the formula: y = 0.8305x – 3.8109, with R2 0.8107. Conclusion The POC test used in the sporting environment showed good agreement with the ELISA method for the determination of salivary IgG. Given the quick data turnaround and efficiency in terms of cost, it represents a suitable alternative method for use in sports teams

Influence of a montmorency cherry juice blend on indices of exercise-induced stress and upper respiratory tract symptoms following marathon running—a pilot investigation

Background: Prolonged exercise, such as marathon running, has been associated with an increase in respiratory mucosal inflammation. The aim of this pilot study was to examine the effects of Montmorency cherry juice on markers of stress, immunity and inflammation following a Marathon. Methods: Twenty recreational Marathon runners consumed either cherry juice (CJ) or placebo (PL) before and after a Marathon race. Markers of mucosal immunity secretory immunoglobulin A (sIgA), immunoglobulin G (IgG), salivary cortisol, inflammation (CRP) and self-reported incidence and severity of upper respiratory tract symptoms (URTS) were measured before and following the race. Results: All variables except secretory IgA and IgG concentrations in saliva showed a significant time effect (P < 0.01). Serum CRP showed a significant interaction and treatment effect (P < 0.01). The CRP increase at 24 and 48 h post-Marathon was lower (P < 0.01) in the CJ group compared to PL group. Mucosal immunity and salivary cortisol showed no interaction effect or treatment effect. The incidence and severity of URTS was significantly greater than baseline at 24 h and 48 h following the race in the PL group and was also greater than the CJ group (P < 0.05). No URTS were reported in the CJ group whereas 50 % of runners in the PL group reported URTS at 24 h and 48 h post-Marathon. Conclusions: This is the first study that provides encouraging evidence of the potential role of Montmorency cherries in reducing the development of URTS post-Marathon possibly caused by exercise-induced hyperventilation trauma, and/or other infectious and non-infectious factors