Waśkiewicz Zbigniew, Mukhambet Zhassyn, Azerbayev Daulet, Bondarev Sergei
Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland.
Department of Sport Education and Coaching, Academy of Physical Education and Mass Sport, Astana 010000, Kazakhstan.
Int J Mol Sci. 2025 Jun 30;26(13):6317. doi: 10.3390/ijms26136317.
Ultramarathon running elicits a profound inflammatory response, characterized by significant increases in interleukin-6 (IL-6) and C-reactive protein (CRP), with comparatively modest changes in tumor necrosis factor-alpha (TNF-α). We reviewed approximately 80 field studies of ultramarathon events (distances >42.2 km) that measured IL-6, CRP, and TNF-α before and after races. IL-6 typically spiked immediately post-race-often rising dozens or even thousands of times above baseline-then rapidly declined, usually returning to near baseline within 24-48 h. CRP, an acute-phase protein, exhibited a slower, sustained elevation, peaking 24-72 h after race completion and remaining above baseline for 2-3 days before gradually returning to normal. TNF-α responses were variable: some studies reported small but significant post-race increases (roughly 1.2-1.7-fold above baseline), while others found no significant change in circulating TNF-α despite the extreme effort. Longer race durations and distances generally correlated with higher peak IL-6 and CRP levels. Experienced ultramarathon runners tended to exhibit attenuated inflammatory responses compared with less-trained individuals, and anti-inflammatory cytokines (e.g., IL-10) increased in tandem with IL-6 in well-trained athletes, helping to mitigate TNF-α elevations. In total, 28 studies were included in the final synthesis, and their quality was assessed using the Newcastle-Ottawa Scale. Visual synthesis tools, including a PRISMA flowchart and time course plots, are provided to enhance the narrative's interpretability. In summary, ultramarathon running elicits a robust systemic inflammatory response with distinct temporal patterns for IL-6, CRP, and TNF-α. These findings have important implications for athlete recovery, monitoring, and understanding the physiological limits of the inflammatory response to extreme endurance stress.
超级马拉松跑步会引发强烈的炎症反应，其特征是白细胞介素-6（IL-6）和C反应蛋白（CRP）显著增加，而肿瘤坏死因子-α（TNF-α）的变化相对较小。我们回顾了约80项关于超级马拉松赛事（距离>42.2公里）的实地研究，这些研究测量了比赛前后的IL-6、CRP和TNF-α。IL-6通常在赛后立即飙升——常常升至比基线水平高出几十倍甚至数千倍——然后迅速下降，通常在24 - 48小时内恢复到接近基线水平。CRP作为一种急性期蛋白，呈现出较慢的持续升高，在比赛结束后24 - 72小时达到峰值，并在高于基线水平2 - 3天后逐渐恢复正常。TNF-α的反应各不相同：一些研究报告赛后有小幅但显著的增加（比基线水平高出约1.2 - 1.7倍），而另一些研究发现，尽管付出了极大努力，循环中的TNF-α并无显著变化。更长的比赛时长和距离通常与更高的IL-6和CRP峰值水平相关。与训练较少的个体相比，经验丰富的超级马拉松跑者往往表现出较弱的炎症反应，并且在训练有素的运动员中，抗炎细胞因子（如IL-10）与IL-6同步增加，有助于减轻TNF-α的升高。最终的综合分析共纳入了28项研究，并使用纽卡斯尔-渥太华量表对其质量进行了评估。还提供了包括PRISMA流程图和时间进程图在内的可视化综合工具，以增强叙述的可解释性。总之，超级马拉松跑步会引发强烈的全身炎症反应，IL-6、CRP和TNF-α呈现出不同的时间模式。这些发现对运动员的恢复、监测以及理解极端耐力压力下炎症反应的生理极限具有重要意义。
