Immune system physiology

Often, before an important fight a boxer is isolated from his usual environment in an attempt to enhance his focus by minimizing distractions. The additional benefit of the seclusion is that it minimizes exposure to potential infectious agents that could jeopardize his or her health before an important fight. Vigorous physical exertion produces alterations in the body’s ability to fight infection.1 The circulatory system stimulates the changes in the immune system on several levels affecting the skin cells, upper respiratory tract mucosa, lung, peritoneal cavity, and muscles. Exercise-induced stress affects the natural killer cells, neutrophils, and macrophages. Changes occur by influencing stress hormones, cytokine concentration, body temperature, blood flow, and hydration. The result is immune dysfunction lasting 3 to 72 hours. This dysfunction provides organisms a window of opportunity to increase the risk of subclinical and clinical infection.1, 2 The overall effect appears to be modified by the degree of stress.3 There is an increased risk associated with heavy training, whereas moderate training has been associated with a reduction in upper respiratory tract infection (URTI) incidence. The risk of infection can also be amplified by the additional factors related to severe mental stress, sleep deprivation, and weight loss when a fighter has to make the necessary weight for an event.4

Hydration is a critical element for the body’s immune system and there is evidence to suggest that dehydration can predispose an individual to developing a fever.5 In addition to being in optimal physical and mental condition, a boxer must make the weight stipulated by his division for the event. Because fat and muscle cannot be reduced quickly, dehydration becomes the main tool for losing a few pounds. The process can occur over a few months, weeks, days and, unfortunately, hours. Steam baths, plastic suits, laxatives, vomiting, and expectoration are used individually or in combination to achieve the desired weight loss. This activity can produce a potentially dangerous situation in regard to the boxer’s susceptibility to infection. The mucosal layer of the oral pharynx is one of the first lines of protection from an invading organism. Exposure from the acidic contents of the stomach that occurs during induced vomiting directly compromises this barrier. In addition, diminishing the volume of saliva will also deplete the quantity of immunoglobulin A available to protect the oral and respiratory tract. Further volume depletion by the other methods can increase the heart rate and induce stress during a time when the boxer is relatively inactive. This stress can influence the body’s ability to fight infection.

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Diet and nutrition can play a role in counteracting some of the detrimental effects of exercise on the immune system. Water is the life blood of an active boxer during training and competition. Water is essential for providing the necessary hydration during exercise. Unfortunately, it contains none of the calories, proteins, or electrolytes necessary to enhance immune system function. Ingestion of carbohydrate beverages during intense and prolonged exercise seems effective in mitigating exercise-induced immune suppression.6 In addition, protein intake can increase insulin levels, optimize glycogen resynthesis, and enhance protein production necessary to fight infection.7 The use of some supplements such as quercetin also have the potential to lessen the magnitude of exercise-induced perturbations in immune function and reduce the risk of URTIs.8 Quercetin is found in onions, blueberries, curly kale, hot peppers, tea, and broccoli. Not only is quercetin a powerful antioxidant but it seems to also exert antipathogenic activity against a variety of viruses and bacteria. Other supplements such as vitamins E and C have not shown meaningful effects on exercise-induced inflammation, muscle damage, increases in plasma cytokines, and immune perturbations.9, 10

In total, the physiologic effects of training seem to be more of a benefit then detriment because most conditioned athletes do not appear to experience any infectious diseases at a greater prevalence than the general population.

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