University of Oulu

Niemelä et al. Sports Medicine - Open (2016) 2:21 DOI 10.1186/s40798-016-0045-0

Acute changes in inflammatory biomarker levels in recreational runners participating in a marathon or half-marathon

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Author: Niemelä, Markus1; Kangastupa, Päivikki2,3; Niemelä, Onni2,3;
Organizations: 1Department of Surgery, Oulu University Hospital, Oulu, Finland
2Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital
3University of Tampere, Seinäjoki, Finland
4Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Springer Nature, 2016
Publish Date: 2018-02-15


Background: Strenuous physical activity activates the participant’s immune responses; however, few studies exist, observing exercise-induced simultaneous changes in mediators of inflammation.

Methods: We examined individual responses in soluble urokinase-type plasminogen activator receptor (suPAR), a marker of immune activation, soluble endocytic receptor for haptoglobin-hemoglobin complexes (CD163), a marker of monocyte-macrophage activation, C-reactive protein (CRP), and pro- and anti-inflammatory cytokines from blood samples drawn at baseline, at 3- and 48-h post-races from recreational runners who successfully completed the marathon (199 ± 8 min, n = 4) or half-marathon (132 ± 4 min, n = 4) run. For comparisons, biomarkers reflecting muscle, heart, kidney, and liver functions were measured.

Results: Significant 3-h post-race increases occurred in levels of suPAR (p < 0.01), CD163 (p < 0.05), white blood cells (p < 0.001), pro-inflammatory cytokines, interleukin-6 (IL-6) (p < 0.001), IL-8 (p < 0.05), and anti-inflammatory cytokine IL-10 (p < 0.05), whereas tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) remained relatively stable. Full-marathon running lead to more pronounced increases in suPAR, CD163, IL-8, and IL-10 than half-marathon running. In addition, 3-h post-race increases of all these parameters correlated significantly with changes in serum TNF-α and cortisol. The 48-h levels of serum suPAR and both pro- and anti-inflammatory cytokines had decreased to baseline levels, whereas CRP, a marker of acute phase response, increased in those with the most prominent IL-6 and IL-10 elevations in their preceding samples. The highest suPAR, CRP, IL-6, TNF-α, IL-10, and cortisol levels were noted in the individual with the most severe post-race fatigue.

Conclusions: Prolonged running increases mediators of inflammation in an exercise-dose-dependent manner which should be considered in the assessment of health status of physically active individuals after recent acute bouts of strenuous exercise.

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Series: Sports medicine - open
ISSN: 2199-1170
ISSN-E: 2198-9761
ISSN-L: 2199-1170
Volume: 2
Article number: 21
DOI: 10.1186/s40798-016-0045-0
Type of Publication: A1 Journal article – refereed
Field of Science: 315 Sport and fitness sciences
Copyright information: © 2016 Niemelä et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.