Antibiotic Therapy and Athletes: Is the Mitochondrial Dysfunction the Real Achilles’ Heel?

Puccini, Valentina

doi:10.3390/sports10090131

Cited by 5 publications

(6 citation statements)

References 54 publications

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“…In this study, we showed that mice on standard diet with antibiotics had muscle weakness compared to mice on standard diet alone. Similar results were documented in athletes on antibiotics 39 . The study demonstrated that antibiotics could influence colon health and should not be used during UC immunotherapy.…”

Section: Discussionsupporting

confidence: 88%

Diet effects on colonic health influence the efficacy of Bin1 mAb immunotherapy for ulcerative colitis

Thomas

Dilbarov

Kelly

et al. 2023

Sci Rep

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Ulcerative colitis (UC) is an idiopathic disease of the large intestine linked to high fat-high protein diets, a dysbiotic microbiome, and a metabolome linked to diet and/or aberrant circadian rhythms associated with poor sleeping patterns. Understanding diet-affected factors that negatively influence colonic health may offer new insights into how to prevent UC and enhance the efficacy of UC immunotherapy. In this preclinical study, we found that standard or high fiber diets in mice positively influenced their colonic health, whereas a high fat-high protein diet negatively influenced colonic health, consistent with clinical findings. Animals fed a high fat/high protein diet experienced obesity and a reduced colon length, illustrating a phenotype we suggest calling peinosis [hunger-like-condition; Greek, peina: hunger; osis: condition], as marked by a lack of nutrient energy remaining in fecal pellets. Notably, a high fat/high protein diet also led to signs of muscle weakness that could not be explained fully by weight gain. In contrast, mice on a high fiber diet ranked highest compared to other diets in terms of colon length and lack of muscle weakness. That said, mice on a high fiber diet were more prone to UC and toxic responses to immunotherapy, consistent with clinical observations. Recent studies have suggested that a standard diet may be needed to support the efficacy of immunotherapeutic drugs used to prevent and treat UC. Here we observed that protection against UC by Bin1 mAb, a passive UC immunotherapy that acts by coordinately enforcing intestinal barrier function, protecting enteric neurons, and normalizing the microbiome, was associated with increased colonic levels of healthful short-chain fatty acids (SCFA), particularly butyric acid and propionic acid, which help enforce intestinal barrier function. This work offers a preclinical platform to investigate how diet affects UC immunotherapy and the potential of dietary SCFA supplements to enhance it. Further, it suggests that the beneficial effects of passive immunotherapy by Bin1 mAb in UC treatment may be mediated to some extent by promoting increased levels of healthful SCFA.

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Section: Discussionsupporting

confidence: 88%

Diet effects on colonic health influence the efficacy of Bin1 mAb immunotherapy for ulcerative colitis

Thomas

Dilbarov

Kelly

et al. 2023

Sci Rep

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“…In order not to miss their training schedule and to maintain athletic performance, athletes are more prone to consuming antibiotics in comparison to the general population [ 42 , 43 ]; therefore, the rise in AMR may significantly impact the selection of antibiotics. Studies have shown that intensive exercise for long durations increases the risk of upper respiratory tract infection, frequently necessitating the use of antimicrobial agents [ 42 , 44 ], and that drug choice may be influenced by the presence of MRSA in the upper respiratory tract (although the mentioned pathogen rarely causes respiratory infections per se).…”

Section: Implications Of Antimicrobial Resistance For Antibiotic Trea...mentioning

confidence: 99%

“…Antibiotics can be classified performance-wise as bactericidal or bacteriostatic, as well as chemically into groups of beta-lactams, aminoglycosides, tetracyclines, fluoroquinolones, macrolides, carbapenems and trimethoprim (among others) [ 42 ]. Although generally considered safe, antibiotics as a group of many classes of drugs with a common therapeutic goal share their burden of unwanted effects being manifested on the human body [ 43 , 45 , 46 ].…”

Section: Implications Of Antimicrobial Resistance For Antibiotic Trea...mentioning

confidence: 99%

“…Broad-spectrum antibiotics are often used in order to cover a wider range of infections caused by both Gram-positive and Gram-negative bacteria, and are more commonly used when faced with the issue of AMR. As mentioned before [ 42 , 46 ], fluoroquinolones are commonly associated with an increased risk (i.e., three to six times) of developing inflammation of tendons and Achilles tendon rupture [ 56 ]. The other factors that contribute to Achilles tendon rupture during the use of fluoroquinolones include age over 60, male gender, renal disease, physical activity and concomitant steroid use [ 46 , 57 , 58 ].…”

Section: Implications Of Antimicrobial Resistance For Antibiotic Trea...mentioning

confidence: 99%

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Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes’ Health and Avenues for Collaborative Public Health Action

Ožegić,

Bedenić,

Sternak

et al. 2024

Antibiotics

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Antimicrobial resistance (AMR) poses a global threat, leading to increased mortality and necessitating urgent action—however, its impact on athletes and the world of sports has hitherto been neglected. Sports environments (including athletic and aquatic) exhibit high levels of microbial contamination, potentially contributing to the spread of resistant microorganisms during physical activities. Moreover, the literature suggests that travel for sports events may lead to changes in athletes’ gut microbiomes and potentially impact their antibiotic resistance profiles, raising questions about the broader implications for individual and public/global health. The prevalence of Staphylococcus aureus (S. aureus) among athletes (particularly those engaged in contact or collision sports) ranges between 22.4% and 68.6%, with MRSA strains being isolated in up to 34.9% of tested individuals. Factors such as training frequency, equipment sharing, delayed post-training showers, and a history of certain medical conditions are linked to higher colonization rates. Moreover, MRSA outbreaks have been documented in sports teams previously, highlighting the importance of implementing preventive measures and hygiene protocols in athletic settings. In light of the growing threat of AMR, there is a critical need for evidence-based treatment guidelines tailored to athletes’ unique physiological demands to ensure responsible antibiotic use and mitigate potential health risks. While various initiatives—such as incorporating AMR awareness into major sporting events—aim to leverage the broad audience of sports to communicate the importance of addressing AMR, proactive measures (including improved AMR surveillance during large sporting events) will be indispensable for enhancing preparedness and safeguarding both athletes’ and the general public’s health. This narrative review thoroughly assesses the existing literature on AMR and antibiotic usage in the context of sports, aiming to illuminate areas where information may be lacking and underscoring the significance of promoting global awareness about AMR through sports.

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“…It could also potentially be useful in classification of athletes' use of pharmaceuticals. Various studies have examined the use of pharmaceuticals in sports ( 8 – 10 ), within different sport disciplines ( 11 – 13 ), nationalities ( 14 , 15 ), age groups ( 16 ), during major sports events ( 14 , 17 , 18 ) or with focus on specific pharmacological classes, e.g., analgesics ( 19 – 21 ), antibiotics ( 22 , 23 ), anti-asthmatics ( 24 ), allergy medication ( 25 ) and decongestants ( 26 ). A challenge with the existing literature is the use of different methodologies to map and study the use of pharmaceuticals, making comparisons difficult.…”

Section: Introductionmentioning

confidence: 99%

Use of pharmaceuticals amongst athletes tested by Anti-Doping Norway in a five-year period

Gjelstad,

Herlofsen,

Bjerke

et al. 2023

Front. Sports Act. Living

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IntroductionThe aim of the study was to map the use of pharmaceuticals by Norwegian athletes registered on doping control forms (DCFs) in a five-year period to examine general and some class specific use of pharmaceuticals across sports and athlete levels.MethodAnonymous data from DCFs collected in 2015-2019 were manually entered into a database using the Anatomical Therapeutic Chemical (ATC) system for classification of the pharmaceuticals. Variables entered were year of control, gender, age group, athlete level, sport, test type, nationality, and pharmaceuticals (and dietary supplements) used.ResultsPain killers in the ATC groups M01 A (Nonsteroidal anti-inflammatory drugs - NSAIDs) and N02 B (other analgesics), and anti-asthmatics in ATC groups R03 A and R03 B were the most frequently used pharmaceuticals. National level athletes reported more use of pharmaceuticals (1.4 ± 1.7 pharmaceuticals per form) than recreational level athletes (0.9 ± 1.2). The highest proportion of DCFs containing information about at least one pharmaceutical were found in speed skating (79.1%), alpine skiing (74.0%), rowing (72.4%) and cross-country skiing (71.7%). Painkillers were most frequently used in muscular endurance sports (30.4% and 21.2 % for M01A and N02 B, respectively) and ball and team sports (17.9% and 17.0%). Use of hypnotics was reported from ice-hockey players and alpine skiers in around 8% of the cases.CoclusionUse of anti-asthmatics was most often reported amongst athletes specially exposed to cold, chemicals and heavy endurance training. Athletes in specialized sports requiring high levels of strength and/or endurance reported a higher use of pharmaceuticals out-of-competition compared to in-competition, while there was no such difference in complex sports, such as team, gymnastic, aiming and combat sports.

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Antibiotic Therapy and Athletes: Is the Mitochondrial Dysfunction the Real Achilles’ Heel?

Cited by 5 publications

References 54 publications

Diet effects on colonic health influence the efficacy of Bin1 mAb immunotherapy for ulcerative colitis

Diet effects on colonic health influence the efficacy of Bin1 mAb immunotherapy for ulcerative colitis

Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes’ Health and Avenues for Collaborative Public Health Action

Use of pharmaceuticals amongst athletes tested by Anti-Doping Norway in a five-year period

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