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Immune function in Swedish élite orienteers.

A Lannergård1, J Fohlman, L Wesslén

  • 1Department of Medical Sciences, Section of Infectious Diseases, Uppsala University Hospital, Sweden.

Scandinavian Journal of Medicine & Science in Sports
|November 7, 2001
PubMed
Summary

Sudden unexpected death (SUD) in elite male orienteers was linked to myocarditis. However, immune screening revealed no significant dysfunction, suggesting other factors may contribute to this cardiac risk.

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Area of Science:

  • Cardiology
  • Immunology
  • Sports Medicine

Background:

  • An elevated incidence of sudden unexpected death (SUD) was observed in young male Swedish elite orienteers between 1979-1992.
  • Autopsies revealed subacute-to-chronic myocarditis in 75% of cases, with Chlamydia pneumoniae suspected as a potential causative agent.

Purpose of the Study:

  • To investigate potential immune dysfunction contributing to myocarditis and SUD in elite orienteers.
  • To compare the immune profiles of elite orienteers with a control group of highly trained athletes.

Main Methods:

  • Immunologic screening was performed on 119 elite orienteers and 36 control athletes.
  • Tests included immunoglobulin levels, complement activation, lymphocyte subsets, and cytokine analysis (IL-1 beta, IL-6, TNF-alpha, IFN-gamma).

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  • Soluble adhesion molecules (sELAM-1, sICAM-1) and soluble IL-2 receptor-alpha were also measured.

    • Main Results:

    • No significant differences in most immune parameters were found between orienteers and controls, apart from two cases of C3-deficiency and one of IgA-deficiency.
    • Interferon-gamma (IFN-gamma) levels were significantly higher in controls than in orienteers.
    • Orienteers exhibited elevated levels of soluble E-selectin ligand-1 (sELAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1).

    Conclusions:

    • The study did not identify any specific immunologic disturbances that could explain the increased susceptibility to myocarditis and SUD in elite orienteers.
    • While Chlamydia pneumoniae was suspected, the observed immune profiles do not support a widespread immune dysfunction as the primary cause.
    • Further research is needed to elucidate the underlying mechanisms of sudden unexpected death in this athletic population.