Glucocorticoids improve high-intensity exercise performance in humans

Casuso, Rafael A.; Melskens, Lars; Bruhn, Thomas; Secher, Niels H.; Nordsborg, Nikolai Baastrup

doi:10.1007/s00421-013-2784-7

Cited by 31 publications

(44 citation statements)

References 26 publications

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“…The vast majority of literature on muscle GR signaling has focused on muscle wasting, a side effect of excessive or sustained GC exposure that is mediated, in part, by direct GR-dependent transactivation of genes that drive myocyte atrophy (e.g., Foxo3a, Gdf8/Myostatin, Fbxo32/Atrogin1; also known as atrogenes) (1,2). However, literature dating back to the 1930s, including the classic physiological studies from the laboratory of Dwight Ingle (3,4), have documented that moderate or transient exposure to GCs can enhance muscle performance and produce ergogenic effects in animals and humans (5)(6)(7)(8)(9)(10)(11)(12)(13). Consistent with this known physiological role of GCs in anticipatory metabolic adaptation, surreptitious GC ingestion is a well-known doping strategy used by elite endurance athletes, an act that has prompted disqualifications and has led to the universal banning of these drugs by sports regulatory agencies (14).…”

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confidence: 99%

Glucocorticoids enhance muscle endurance and ameliorate Duchenne muscular dystrophy through a defined metabolic program

Morrison‐Nozik

Anand

Zhu

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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Classic physiology studies dating to the 1930s demonstrate that moderate or transient glucocorticoid (GC) exposure improves muscle performance. The ergogenic properties of GCs are further evidenced by their surreptitious use as doping agents by endurance athletes and poorly understood efficacy in Duchenne muscular dystrophy (DMD), a genetic muscle-wasting disease. A defined molecular basis underlying these performance-enhancing properties of GCs in skeletal muscle remains obscure. Here, we demonstrate that ergogenic effects of GCs are mediated by direct induction of the metabolic transcription factor KLF15, defining a downstream pathway distinct from that resulting in GC-related muscle atrophy. Furthermore, we establish that KLF15 deficiency exacerbates dystrophic severity and muscle GC-KLF15 signaling mediates salutary therapeutic effects in the mdx mouse model of DMD. Thus, although glucocorticoid receptor (GR)-mediated transactivation is often associated with muscle atrophy and other adverse effects of pharmacologic GC administration, our data define a distinct GR-induced gene regulatory pathway that contributes to therapeutic effects of GCs in DMD through proergogenic metabolic programming.skeletal muscle metabolism | glucocorticoid | exercise | Duchenne muscular dystrophy | steroid hormone nuclear receptor

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confidence: 99%

Glucocorticoids enhance muscle endurance and ameliorate Duchenne muscular dystrophy through a defined metabolic program

Morrison‐Nozik

Anand

Zhu

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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“…In untrained men, one-legged knee-extensor exercise time to exhaustion was not affected by 5 days of dexamethasone [116]. In contrast, using a similar dosing scheme, another study found an increase in one-legged knee-extensor exercise time to exhaustion of 29%, and running distance in a certain type of maximal exercise test, namely 20-m shuttle-run test, of 19% [117]. Sprint performance over 30 m was not affected in this study.…”

Section: Resultsmentioning

confidence: 99%

Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects

Heuberger

Cohen

2018

Sports Med

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The World Anti-Doping Agency is responsible for maintaining a Prohibited List that describes the use of substances and methods that are prohibited for athletes. The list currently contains 23 substance classes, and an important reason for the existence of this list is to prevent unfair competition due to pharmacologically enhanced performance. The aim of this review was to give an overview of the available evidence for performance enhancement of these substance classes. We searched the scientific literature through PubMed for studies and reviews evaluating the effects of substance classes on performance. Findings from double-blind, randomized controlled trials were considered as evidence for (the absence of) effects if they were performed in trained subjects measuring relevant performance outcomes. Only 5 of 23 substance classes show evidence of having the ability to enhance actual sports performance, i.e. anabolic agents, β2-agonists, stimulants, glucocorticoids and β-blockers. One additional class, growth hormone, has similar evidence but only in untrained subjects. The observed effects all relate to strength or sprint performance (and accuracy for β-blockers); there are no studies showing positive effects on reliable markers of endurance performance. For 11 classes, no well-designed studies are available, and, for the remaining six classes, there is evidence of an absence of a positive effect. In conclusion, for the majority of substance classes, no convincing evidence for performance enhancement is available, while, for the remaining classes, the evidence is based on a total of only 266 subjects from 11 studies.

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“…Training associated with glucocorticoid treatment resulted in an 80% improvement in time‐to‐exhaustion performance after 1 week, as well as decreases in adrenocorticotrophic hormone, dehydroepiandrosterone, prolactin, growth hormone, and thyroid‐stimulating hormone, free testosterone, and increase in blood glucose concentration. Similarly, Casuso et al [59] assessed muscle function after a 5‐day ingestion period (twice/day) of either 2 mg of dexamethasone or placebo, but in a one‐legged kicking exercise, and whole‐body exercise performance, using 20‐m shuttle run and 30 m sprint tests. One‐leg kicking exercise time‐to‐exhaustion was longer and total running distance in the 20‐m shuttle run test was improved.…”

Section: Resultsmentioning

confidence: 99%

Analgesics and Sport Performance: Beyond the Pain‐Modulating Effects

Holgado

Hopker

Sanabria

et al. 2017

PM&R

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1Analgesics are widely used in sport to treat pain and inflammation associated with injury. However, there 2 is growing evidence that some athletes might be taking these substances in an attempt to enhance Introduction 18There is little doubt that when exercise is performed above certain intensities, or over a prolonged period 19 of time, it causes feeling of pain and discomfort. Sayings such as 'no pain, no gain' are often heard in 20 relation to both training and competition settings across a variety of different sports. Indeed, these 21 feelings of exercise-induced pain have been shown to have a negative effect on training and performance 22 [1]. As a consequence, there has been a trend for athletes from all levels and ages to use pharmacological 23 analgesics substances prior to training and competition up to 4-fold more than their age-matched general 24 population [2]. The general term analgesic covers a variety of different pharmacological substances, 25 including non-steroidal anti-inflammatory drugs (NSAIDs), non-opioid analgesic (such as paracetamol 26 2 and others), weak opioids (for example tramadol, codeine or morphine [3]) and orally administered or 27 injected glucorticosteroids [4,5]. Indeed, paracetamol and NSAIDs are one of the most recurrent groups 28 of pharmacological substances used by athletes ranging from 11 up to 92% [6,7]. For instance, it is 29 common for athletes with minor injuries to continue training and even competing, by treating their minor 30 health issues with analgesic [8]. 31The aforementioned negative association between pain and exercise capacity increases the likelihood of 32 analgesic use as a method to increase the level of performance during competition [5,9]. Furthermore, the 33 trends for more frequent use of analgesics in-competition vs. out-competition, use of more than one drug 34 at the same time, and administration of these medications at supratherapeutic dosages, all suggest athletes 35 may be using these analgesics as ergogenic aids [4,5]. Therefore, in contrast to the post-exercise use of 36 analgesics to accelerate recovery, there is potential for their prophylactic use as a potential performance 37 enhancing intervention. In comparison to what is known about the use of analgesics for treating sporting 38 injury [10,11], much less is known about their effects on exercise related physiology and performance 39 [12][13][14]. However, as analgesics exert a pharmacological action on key physiological systems related to 40 exercise performance, a theoretical rationale exists whereby these drugs could provide a significant 41 ergogenic effect. 42 Material and methods 43The aim of this manuscript was to review the literature and evaluate the evidence for the ergogenic effect 44 of analgesics, expected dosages, and potential side effects. A computer search of scientific databases 45 (PubMed, Web of Science, ScienceDirect and Scopus) was made for English language articles 46 investigating the use of analgesics in sport for all period of time up to September 2...

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Glucocorticoids improve high-intensity exercise performance in humans

Abstract: Short-term dexamethasone administration increases high-intensity one-legged kicking time to exhaustion and 20-m shuttle run performance, although sprint ability and the initial loss of muscular force generating capacity are similar after DEX and placebo.

Cited by 31 publications

References 26 publications

Glucocorticoids enhance muscle endurance and ameliorate Duchenne muscular dystrophy through a defined metabolic program

Glucocorticoids enhance muscle endurance and ameliorate Duchenne muscular dystrophy through a defined metabolic program

Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects

Analgesics and Sport Performance: Beyond the Pain‐Modulating Effects

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