Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0424 Oslo, Norway.
Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
Cells. 2021 Aug 25;10(9):2193. doi: 10.3390/cells10092193.
Elevated levels of gut leakage markers have been shown after strenuous exercise in healthy individuals. Any association between a temporary increase in these markers and the presence of coronary artery disease (CAD) is unknown. We therefore aimed to explore circulating gut leakage markers in response to a bout of strenuous exercise in patients with symptoms of CAD. Patients referred to exercise stress testing due to symptoms of CAD were included ( = 287). A maximal exercise ECG stress test was performed and venous blood samples were drawn at rest and within five minutes after, for analysis of soluble cluster of differentiation 14 (sCD14), lipopolysaccharide-binding protein (LBP), intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide (LPS) and gene expression of toll-like receptor 4 (TLR4) in circulating leukocytes. Patients then underwent coronary angiography. LPS, LBP and sCD14 increased significantly after strenuous exercise in patients with symptoms of CAD, suggesting that even short bouts of vigorous exercise are associated with gut leakage. The gene expression of TLR4 decreased significantly after exercise, possibly as a negative feedback to the increase in LPS. There were no differences in exercise-induced changes between the groups of CAD, suggesting gut leakage to be independent of the presence of CAD.
在健康个体中剧烈运动后，肠道渗漏标志物水平升高。这些标志物的暂时性增加与冠状动脉疾病（CAD）之间的任何关联尚不清楚。因此，我们旨在探讨 CAD 症状患者剧烈运动时循环肠道渗漏标志物的变化。因 CAD 症状而接受运动应激测试的患者被纳入研究（n=287）。进行最大运动心电图应激测试，并在休息时和运动后 5 分钟内抽取静脉血样，以分析可溶性分化簇 14（sCD14）、脂多糖结合蛋白（LBP）、肠脂肪酸结合蛋白（I-FABP）、脂多糖（LPS）和循环白细胞中 toll 样受体 4（TLR4）的基因表达。然后患者接受冠状动脉造影。CAD 症状患者剧烈运动后 LPS、LBP 和 sCD14 显著增加，表明即使是短暂的剧烈运动也与肠道渗漏有关。运动后 TLR4 的基因表达显著下降，可能是对 LPS 增加的负反馈。CAD 组之间运动诱导的变化无差异，表明肠道渗漏与 CAD 的存在无关。
