Lindsey Bryndan, Shaul Yosef, Martin Joel
Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, United States of America.
Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Virginia, United States of America.
PLoS One. 2025 Apr 29;20(4):e0321223. doi: 10.1371/journal.pone.0321223. eCollection 2025.
Tactical athletes must maintain high levels of physical and cognitive readiness to handle the rigorous demands of their roles. They frequently encounter acute stressors like sleep deprivation, muscle fatigue, dehydration, and harsh environmental conditions, which can impair their readiness and increase the risk of mission failure. Given the challenging conditions these athletes face, there is a vital need for non-invasive, rapidly deployable point-of-care assessments to effectively measure the impact of these stressors on their operational readiness. Salivary biomarkers are promising in this regard, as they reflect physiological changes due to stress. This systematic review aims to investigate salivary markers as potential indicators for readiness, specifically focusing on their sensitivity to acute stressors like sleep deprivation, dehydration, environmental factors, and muscle fatigue. A search was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines (PROSPERO; registration #: CRD42022370388). The primary inclusion criteria were the use of a quantitative analysis to assess salivary biomarkers changes in response to acute stressors. Risk of bias and methodological quality were evaluated with the modified Downs and Black checklist. Hormonal salivary biomarkers were the most commonly studied biomarkers. Muscle damage and fatigue were the most frequently studied acute stressors, followed by sleep deprivation, multiple stressors, dehydration, and environmental. Biomarkers such as creatine kinase, aspartate aminotransferase, uric acid, cortisol, testosterone, and the testosterone to cortisol ratio were indicative of muscle damage. Dehydration influenced osmolality, total protein, flow rate, and chloride ion concentrations. Sleep deprivation affected proteins, peptides, and alpha-amylase levels. Environmental stressors, such as hypoxia and cold temperatures, altered cortisol, pH, dehydroepiandrosterone-sulfate (DHEA-s), and salivary IgA levels. The current body of research highlights that various salivary biomarkers react to acute stressors, and proteomic panels appear promising for predicting physical and cognitive outcomes relevant to the operational readiness of tactical athletes.
战术运动员必须保持高水平的身体和认知准备状态，以应对其角色所带来的严格要求。他们经常面临急性应激源，如睡眠剥夺、肌肉疲劳、脱水和恶劣的环境条件，这些都会损害他们的准备状态，并增加任务失败的风险。鉴于这些运动员所面临的具有挑战性的条件，迫切需要非侵入性、可快速部署的即时护理评估，以有效衡量这些应激源对其作战准备状态的影响。唾液生物标志物在这方面很有前景，因为它们反映了压力引起的生理变化。本系统评价旨在研究唾液标志物作为准备状态的潜在指标，特别关注其对睡眠剥夺、脱水、环境因素和肌肉疲劳等急性应激源的敏感性。使用系统评价和元分析的首选报告项目（PRISMA）指南进行了检索（PROSPERO；注册号：CRD42022370388）。主要纳入标准是使用定量分析来评估唾液生物标志物对急性应激源的反应变化。使用改良的唐斯和布莱克清单评估偏倚风险和方法学质量。激素唾液生物标志物是研究最广泛的生物标志物。肌肉损伤和疲劳是研究最频繁的急性应激源，其次是睡眠剥夺、多重应激源、脱水和环境因素。肌酸激酶、天冬氨酸转氨酶、尿酸、皮质醇、睾酮以及睾酮与皮质醇的比值等生物标志物表明存在肌肉损伤。脱水影响渗透压、总蛋白、流速和氯离子浓度。睡眠剥夺影响蛋白质、肽和α-淀粉酶水平。环境应激源，如缺氧和低温，会改变皮质醇、pH值、硫酸脱氢表雄酮（DHEA-s）和唾液免疫球蛋白A水平。当前的研究表明，各种唾液生物标志物对急性应激源有反应，蛋白质组学分析对于预测与战术运动员作战准备状态相关的身体和认知结果似乎很有前景。
