Editor-in-Chief: L. Bruce Gladden, PhD, FACSM
ISSN: 0195-9131
Online ISSN: 1530-0315
Frequency: 12 issues / year
Ranking: 6/81 in Sports Sciences
Impact Factor: 4.041
News & Views from the Editor-in-Chief

This month I am highlighting two stimulating studies on quite different topics, one on the underlying mechanisms of exercise-induced muscle injury, and the second on the responses of an elite endurance athlete to maintained training during chemotherapy for cancer.

Exhaustive exercise promotes muscle injury including lesions in the myofiber structure; however, the underlying mechanisms remain poorly understood. It has been reported that neutrophil infiltration into the injured skeletal muscle occurs in various experimental models of muscle damage and that neutrophil count and migratory activity are also increased in the blood after exhaustive exercise. However, direct demonstration in muscle tissue is difficult in human studies. In this month's MSSE®, Kawanishi et al. examined the role of neutrophils in exercise-induced myofiber injury and muscle inflammation using a mouse model of neutrophil depletion. Their results indicate that myofiber injury and neutrophil infiltration into the muscle are elevated after exhaustive exercise; however, myofiber injury after exhaustive exercise can be attenuated by blocking neutrophil infiltration. They conclude that neutrophils contribute to muscle injury in the initial step by inducing macrophage infiltration and subsequent cytokine production.

In this month's second highlight by Savage et al., we get first-hand knowledge of the VO2peak and training regimen of an extremely active recreational athlete over a 32-month period while she received anthracycline-based therapy, surgery, radiotherapy, Herceptin, and breast reconstruction for locally advanced HER2+ breast cancer. In the report, the 39-year-old woman, determined to maintain her "competitive edge," maintained a high volume of activity only limited by periodic surgeries. While the volume far exceeded recommended guidelines for a sedentary woman, it was at or below her daily exercise training volume prior to cancer diagnosis. The main recommendations provided to her were to: 1) avoid high-intensity training (>80% of peak heart rate) while receiving an anthracycline, 2) maintain volume at or below her base volume, and 3) adapt her training days based on her response to chemotherapy (e.g., nausea). As expected, she had a lower VO2peak secondary to alterations in her training, most pronounced after completing chemotherapy. However, unlike most women with cancer, this elite athlete did recover her pretreatment  VO2peak due to her persistence, realistic training regimen, and optimal communication among oncologists, cardiologists, and exercise physiologists. Given the importance of fitness on survival in breast cancer patients, this current case report can serve to inspire and motivate both sedentary and highly active women as they recover their fitness and their lives.


L. Bruce Gladden


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