Vitamin C Supplementation Attenuates the Increases in Circulating Cortisol, Adrenaline and Anti-Inflammatory Polypeptides Following Ultramarathon Running

The effects of vitamin C supplementation on the alterations in the circulating concentrations of cortisol, adrenaline, interleukin-10 (IL-10) and interleukin-1 receptor antagonist (IL-1Ra) which accompany ultramarathon running were measured using immuno-chemiluminescence, radioimmunoassay and ELISA procedures. Forty-five participants in the 1999 Comrades 90 km marathon were divided into equal groups (n = 15) receiving 500 mg/day Vit C (VC-500), 1500 mg/day Vit C (VC-1500) or placebo (P) for 7 days before the race, on the day of the race, and for 2 days following completion. Runners recorded dietary intake before, during and after the race and provided 35 ml blood samples 15 - 18 hrs before the race, immediately post-race, 24 hrs post race and 48 hrs post-race. Twenty-nine runners (VC-1500, n = 12; VC-500, n = 10; P, n = 7) complied with all study requirements. All post-race concentrations were adjusted for plasma volume changes. Analyses of dietary intakes and blood glucose and anti-oxidant status on the day preceding the race and the day of the race did not reveal that carbohydrate intake or plasma vitamins E and A were significant confounders in the study. Mean pre-race concentrations of serum vitamin C in VC-500 and VC-1500 groups (128 ± 31 and 153 ± 34 μmol/l) were significantly higher than in the P group (83 ± 39 μmol/l). Immediate post-race serum cortisol was significantly lower in the VC-1500 group (p < 0.05) than in P and VC-500 groups. When the data from VC-500 and P groups was combined (n = 17), immediate post-race plasma adrenaline, IL-10 and IL-1Ra concentrations were also significantly lower (p < 0.05) in the VC-1500 group. The study demonstrates an attenuation, albeit transient, of both the adrenal stress hormone and anti-inflammatory polypeptide response to prolonged exercise in runners who supplemented with 1500 mg vitamin C per day when compared to ≤ 500 mg per day.

Key words:

Vitamin C, ultramarathon runners, cortisol, adrenaline, interleukin-10, interleukin-1 receptor antagonist.

References

• 1 Attwood E C, Robey E D, Ross H, Bradley F, Kramer J J. Determination of platelet and leucocyte vitamin C and the levels found in normal subjects.  Clin Chim Acta. 1974;  54 95-105
• 2 Barnes P J, Adcock I. Anti-inflammatory actions of steroids: molecular mechanisms.  Trends Pharmacol Sci. 1993;  14 436-441
• 3 Barnes P J, Karin M. Nuclear factor kB - a pivotal transcription factor in chronic inflammatory diseases.  New Engl J Med. 1997;  336 1066-1071
• 4 Bieri J G, Tolliver T J, Catignani G L. Simultaneous determination of retinol and α-tocopherol in serum and plasma by liquid chromatography.  Clin Chem. 1983;  29 708-712
• 5 Borish F. IL-10: Evolving concepts.  J Allergy Clin Immunol. 1998;  101 293-297
• 6 Brites F D, Evelson P A, Christiansen M G, Nicol M F, Basilico M J, Wikinski R W. Soccer players under regular training show oxidative stress but an improved plasma antioxidant status.  Clin Sci. 1999;  96 381-385
• 7 De la Fuente M, Fernandez M D, Buegos M S, Soler A, Prieto A, Miquel J . Immune function in aged women is improved by ingestion of vitamins C and E.  Can J Physiol. 1998;  76 373-380
• 8 Dill D B, Costill D L. Calculation of percentage changes of blood, plasma and red cells in dehydration.  J App Physiol. 1974;  37 247-248
• 9 Ehrhart-Bornstein M, Hinson J P, Borstein S R, Scherbaum W A, Vinson G P. Intra-adrenal interactions in the regulation of adrenocortical steroidogenesis.  Endocrine Rev. 1998;  19 101-143
• 10 Gleeson M, Robertson J D, Maughan R J. Influence of exercise on ascorbic acid status in man.  Clin Sci. 1987;  73 501-505
• 11 Jones R B, Scatterlee D G, Cadd G G. Timidity in Japanese quail: Effects of vitamin C and divergent selection for adrenocortical response.  Physiology & Behaviour. 1999;  67 117-120
• 12 Keast D, Cameron K, Morton A R. Exercise and the immune response.  Sports Med. 1988;  5 248-267
• 13 Moore A R, Willoughby D A. The role of cAMP regulation in controlling inflammation.  Clin Exp Immunol. 1995;  101 387-389
• 14 Moser E K. Physiology and metabolism of ascorbic acid. In: Wenk C, Fenster R, Völker L (eds.) Ascorbic Acid in Domestic Animals: Proceedings of the Second Symposium. Basel<7LOC>; F. Hoffmann-La Roche 1992: 3-16
• 15 Nieman D C, Henson D A, Butterworth D E, Warren B J, Davis J M, Fagoaga O R, Nehlsen-Cannarella S L. Vitamin C supplementation fails to alter the immune response to 2.5 hours of running.  Int J Sports Med. 1997;  143 173-184
• 16 Nieman D C, Peters E M, Henson D A, Nevines E I, Thompson M M. Influence of Vitamin C supplementation on cytokine changes following an ultramarathon.  J Interferron & Cytokine Res. 2000;  20 1029-1035
• 17 Nussdorfer G G, Mazzochi G. Immune-endocrine interactions in the mammalian adrenal gland: facts and hypotheses.  Int Rev Cytol. 1998;  183 143-184
• 18 Pardue S L, Thaxton J P. Ascorbic acid and physiological stress. In: Wegger I, Tagwerker FJ, Moustgaard J (eds) Proceedings of Workshop on Ascorbic Acid in Domestic Animals. Copenhagen; The Royal Danish Agriculture Society 1984: 25-31
• 19 Pedersen B K, Ullum H. N K response to physical activity: possible mechanisms of action.  Med Sci Sports Exerc. 1994;  26 140-142
• 20 Peters E M, Anderson R, Theron A J. Attenuation of the increase in circulating cortisol and enhancement of the acute phase response in vitamin C-supplemented ultramarathon runners.  Int J Sports Med. 2001;  22 120-126
• 21 Peters E M, Goetzche J M, Grobbelaar B, Noakes T D. Vitamin C supplementation reduces the incidence of post-race symptoms of upper respiratory tract infection in ultradistance runners.  Am J Clin Nutr. 1993;  57 170-174
• 22 Peters E M, Goetzche J M, Joseph L E, Noakes T D. Vitamin C as effective as combinations of anti-oxidant nutrients in reducing symptoms of upper respiratory tract infections in ultramarathon runners.  S Afr J Sports Med. 1996;  4 23-27
• 23 Rahman I, MacNee W. Role of transcription factors in inflammatory lung diseases.  Thorax. 1998;  53 601-612
• 24 Satterlee D G. Ascorbic acid and physiological stress in poultry. In: Wenk G, Fenster R, Völker R (eds) Ascorbic Acid in Domestic Animals: Proceedings of the Second Symposium. Basel; Hoffmann-La Roche 1992: 43-59
• 25 Skinkai S, Watanabe S, Asai H, Shek P N. Cortisol response to exercise and post-exercise suppression of blood lymphocyte subset counts.  Int J Sports Med. 1996;  17 597-603
• 26 Stöckl J, Vetr H, Majdic O, Zlabinger G, Keuchler E, Knapp W. Human major group rhinoviruses downmodulate the accessory function of monocytes by inducing Il-10.  J Clin Invest. 1999;  104 957-965
• 27 Suzuki K, Totsuka M, Nakaji S, Yamada M, Kudoh S, Liu Q, Sugawara K, Yamaya K, Sato K. Endurance exercise causes interaction among stress hormones, cytokines, neutrophil dynamics, and muscle damage.  J Appl Physiol. 1999;  87 1360-1367
• 28 Van der Poll T, Coyle S M, Barbosa C C, Lowry S F. Epinephrine inhibits tumour necrosis factor -α and potentiates interleukin 10 production during human endoxemia.  J Clin Invest. 1996;  97 713-719
• 29 Weiss M, Schneider E M, Tarnow J, Mettler S, Krone M, Teschemacher A, Lemoine H. Is inhibition of oxygen radical production of neutrophils by sympathomimetics mediated via beta-2 adrenoreceptors?.  J Pharmacol Exp Therapeut . 1996;  278 1105-1113