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Exercise-induced increases in NT-proBNP are not related to the exercise-induced immune response
  1. J Scharhag1,
  2. T Meyer1,3,
  3. M Auracher1,
  4. M Müller2,
  5. M Herrmann1,2,
  6. H Gabriel4,
  7. W Herrmann2,
  8. W Kindermann1
  1. 1
    Institute of Sports and Preventive Medicine, University of Saarland, Saarbrücken, Gemany
  2. 2
    Department of Clinical Chemistry/Central Laboratory, University of Saarland, Saarbrücken/Homburg, Germany
  3. 3
    Institute of Sports Medicine, University of Paderborn, Germany
  4. 4
    Department of Sports Medicine, Friedrich-Schiller-University, Jena, Germany
  1. Dr J Scharhag, Institute of Sports and Preventive Medicine, Campus, Building B 8.2, University of Saarland, 66123 Saarbrücken, Germany; j.scharhag{at}


Objective: To investigate if the exercise-induced immune response contributes to the exercise-induced increase in brain natriuretic peptide (BNP) in healthy athletes. This has previously been speculated, as elevated concentrations of BNP or N-terminal pro brain natriuretic peptide (NT-proBNP) in cardiovascular patients were found to be related to immune reactions and elevations in inflammatory cytokines such as interleukin 6 (IL-6).

Methods: Stored serum samples were analysed for NT-proBNP concentrations of 14 healthy endurance athletes (mean age: 25 (SD 5) years; VO2peak 67 (SD 6) ml/min/kg), who had been examined previously for exercise-induced immune reactions and their dependence on carbohydrate supplementation (6 or 12% carbohydrate vs placebo beverages) after three bouts of 4 h cycling at a given workload of 70% of the individual anaerobic threshold. Venous blood samples were taken before, immediately after, and 1 h and 1 day after exercise. Leucocyte subpopulations were determined immediately after blood sampling by flow cytometry. Serum samples for posterior analysis of C-reactive protein (CRP), IL-6, cortisol and NT-proBNP were stored at −80°C.

Results: The exercise-induced increases in NT-proBNP (p<0.001) were not related to the exercise-induced immune response, although exercise induced marked (CHOS-dependent) increases in IL-6, CRP, cortisol, leucocytes, neutrophils, monocytes and natural killer cells.

Conclusion: It is unlikely that the exercise-induced increases in NT-proBNP or BNP in healthy athletes are caused by the exercise-induced immune response. Therefore, exercise-induced increases in NT-proBNP or BNP in healthy athletes have to be differentiated from increases in cardiovascular patients with systemic inflammation.

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  • Competing interests: None.

  • Funding: The study was supported by a grant from and approved by the board and the ethics committee of the National Institute of Sports Science of Germany (Bundesinstitut für Sportwissenschaft: VF 0407/01/11/99-2000), Bonn, Germany.