On the mechanisms of stress-induced human spleen contraction: training for a higher blood oxygen-carrying capacity

Despite its comparatively limited size in humans, spleen has been shown able to expel red-blood cells in the circulation and thus augment blood oxygen-carrying capacity under certain physiologic conditions. In the present state-of-the-art review, the short- and long-term regulation of spleen volume will be discussed. With regards to the physiological mechanism underlying spleen contraction, sympathetic activation stands as the prime contributor to the response. A dose-dependent relationship between specific interventions of apnea, exercise and hypoxia (imposed separately or in combination) and spleen contraction alleges to the trainability of the spleen organ. The trainability of the spleen is further substantiated by virtue of cross-sectional and longitudinal studies reporting robust increases in both organ volume at rest and subsequent spleen contraction. Alternative ways to assess the relationship between hematologic gains and the magnitude of spleen contraction (i.e., the reduction of spleen volume) will be presented herein. In extension of changes in the conventional measures of hemoglobin concentration and hematocrit, assessment of hemoglobin mass and total blood volume using the (safe, low-cost and time-efficient) CO-rebreathing technique could deepen scientific knowledge on the efficiency of human spleen contraction.