Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Brazil; Departamento de Química, Diretoria de Sistemas de Armas da Marinha, Marinha do Brazil, Brazil; Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil.
Departamento de Corridas, Universidade Federal do Rio de Janeiro, Escola de Educação Física, Brazil.
Neuromuscul Disord. 2021 Jul;31(7):583-595. doi: 10.1016/j.nmd.2021.04.007. Epub 2021 May 6.
Exertional rhabdomyolysis may occur when an individual is subjected to strenuous physical exercise. It is occasionally associated with myoglobinuria (i.e. "cola-colored" urine) alongside muscle pain and weakness. The pathophysiology of exertional rhabdomyolysis involves striated muscle damage and the release of cellular components into extracellular fluid and bloodstream. This can cause acute renal failure, electrolyte abnormalities, arrhythmias and potentially death. Exertional rhabdomyolysis is observed in high-performance athletes who are subjected to intense, repetitive and/or prolonged exercise but is also observed in untrained individuals and highly trained or elite groups of military personnel. Several risk factors have been reported to increase the likelihood of the condition in athletes, including: viral infection, drug and alcohol abuse, exercise in intensely hot and humid environments, genetic polymorphisms (e.g. sickle cell trait and McArdle disease) and epigenetic modifications. This article reviews several of these risk factors and proposes screening protocols to identify individual susceptibility to exertional rhabdomyolysis as well as the relevance of proteomics for the evaluation of potential biomarkers of muscle damage.
当个体进行剧烈的体力活动时，可能会发生运动性横纹肌溶解症。它偶尔与肌红蛋白尿（即“可乐色”尿液）、肌肉疼痛和无力有关。运动性横纹肌溶解症的病理生理学涉及横纹肌损伤和细胞成分释放到细胞外液和血液中。这可能导致急性肾衰竭、电解质异常、心律失常，甚至死亡。运动性横纹肌溶解症在高强度、重复和/或长时间运动的高性能运动员中观察到，但在未经训练的个体以及高度训练或精英军事人员中也观察到。据报道，有几个风险因素会增加运动员患病的可能性，包括：病毒感染、药物和酒精滥用、在炎热潮湿的环境中运动、遗传多态性（例如镰状细胞特征和 McArdle 病）和表观遗传修饰。本文综述了其中的一些风险因素，并提出了筛选方案，以确定个体对运动性横纹肌溶解症的易感性，以及蛋白质组学在评估肌肉损伤潜在生物标志物方面的相关性。
