Serum concentrations of C reactive protein, α1 antitrypsin, and complement (C3, C4, C1 esterase inhibitor) before and during the Vuelta a Espana

Objectives: To determine serum concentrations of proinflammatory ( C reactive protein, complement C3 and C4) and anti-inflammatory (alpha(1) antitrypsin, C1 esterase inhibitor (C1-INH)) acute phase proteins in elite cyclists before and during a three week cycle tour. Methods: Seventeen professional cyclists participating in the Vuelta a Espana volunteered for the study. Their mean (SD) physical characteristics were: age 28 ( 1) years; height 1.7 (0.06) m; weight 65 ( 7) kg; body fat 7.6 (0.8)%; VO(2)MAX 75.3 (2.3) ml/ kg/min. Venepuncture was performed on each subject 24 hours before the tour began (T0), on day 11 ( the first rest day; T1) and day 21 ( the second to last stage of the tour; T2). Samples at T1 and T2 were taken about 17 hours after the previous stage. Analysis of variance was used to determine changes over time. Where significance was found, a Tukey post hoc test was performed. Results: C reactive protein concentrations were consistently within the normal range, although there was a 228%, non-significant increase at T1. C3 concentrations fell within the normal range at all times assessed. C4 concentrations before the race were within the normal range and were significantly increased 10 days ( T1) into the race. C1-INH concentrations did not change significantly throughout the race. a1 Antitrypsin concentration before the race was at the lower end of the normal range and was only significantly raised at T2. Conclusions: Although not as pronounced as those reported in marathon/ultramarathon runners, elite cyclists participating in a three week cycle tour experienced increases in selected proinflammatory and anti-inflammatory acute phase proteins, indicating an acute phase/inflammatory response. It is tenable that the increase in alpha1 antitrypsin and C1-INH (anti-inflammatory mediators) at T2 served to attenuate the acute phase/inflammatory response. The lower than normal resting concentrations of the acute phase proteins supports the notion that chronic aerobic exercise induces an anti-inflammatory state.