ReviewSports medicine (Auckland, N.Z.)2003
Overtraining, excessive exercise, and altered immunity: is this a T helper-1 versus T helper-2 lymphocyte response?
Review in Sports medicine (Auckland, N.Z.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06295016 (Influence of Stressors and Recovery Regulation on the Super-compensation Effect of Endurance Athletes After High-intensity Intensive Training), which is not on this map. Cited by 71 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Influence of Stressors and Recovery Regulation on the Super-compensation Effect of Endurance Athletes After High-intensity Intensive Training
Who cites it
71 citing papers in PubMed, 247 citations in OpenAlex.
- Analysis of human neutrophil phenotypes as biomarker to monitor exercise-induced immune changes.Journal of leukocyte biology · 2021Trial
- The effect of L-theanine supplementation on the immune system of athletes exposed to strenuous physical exercise.Journal of the International Society of Sports Nutrition · 2019Trial
- The mediating role of healthy lifestyle in the association between higher socioeconomic status and an increased risk of allergic rhinitis: an analysis of NHANES.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Asthma in athletes: diagnostic challenges and management strategies.Current opinion in allergy and clinical immunology · 2026Review
- Exercise-induced effects on atherogenesis and tryptophan catabolism via the kynurenine pathway in an HIV-associated atherosclerosis mouse model.Experimental physiology · 2026Article
- Exercise, mitochondrial stress, and trained immunity: metabolic adaptation of innate immunity.Frontiers in immunology · 2026Review
- Exercise and tissue-resident memory T cells: from circulating numbers to spatial immune remodeling.Frontiers in immunology · 2026Review
- Context-dependent regulation of IL-6 in exercise and colorectal cancer cachexia.Frontiers in oncology · 2026Review
- Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation.Sports medicine and health science · 2025Review
- Associations of leisure-time and occupational physical activity with allergic rhinitis and chronic sinusitis in middle-aged adults: a population-based study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Physiology and Pathophysiology of Marathon Running: A narrative Review.Sports medicine - open · 2025Review
- Non-linear associations of total and leisure-time physical activity with chronic kidney disease: Findings from NHANES.PloS one · 2025Article
- The Role of Cardiac Troponin and Other Emerging Biomarkers Among Athletes and Beyond: Underlying Mechanisms, Differential Diagnosis, and Guide for Interpretation.Biomolecules · 2024Review
- Plant-Based Diet and Sports Performance.ACS omega · 2024Review
- Lung transcriptomics reveals the underlying mechanism by which aerobic training enhances pulmonary function in chronic obstructive pulmonary disease.BMC pulmonary medicine · 2024Article
- Retrospective study of COVID-19 experiences in elite multinational aquatic athletes.Scientific reports · 2023Article
- Skin Cancer Risk, Sun-Protection Knowledge and Behavior in Athletes-A Narrative Review.Cancers · 2023Review
- Differential Expression of Innate and Adaptive Immune Genes during Acute Physical Exercise in American Quarter Horses.Animals : an open access journal from MDPI · 2023Article
- Diagnosis and management of allergy and respiratory disorders in sport: An EAACI task force position paper.Allergy · 2022Article
- Heart Rate Variability-Based Subjective Physical Fatigue Assessment.Sensors (Basel, Switzerland) · 2022Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Overtraining syndrome (OTS) occurs where an athlete is training vigorously, yet performance deteriorates. One sign of OTS is suppressed immune function, with an increased incidence of upper respiratory tract infection (URTI). An increased incidence of URTIs is also associated with high volume/intensity training, as well as with excessive exercise (EE), such as a marathon, manifesting between 3-72 hours post-race. Presently, there is no encompassing theory to explain EE and altered immune competence. Recently, it has been conclusively established that T helper lymphocytes (T(H)), a crucial aspect of immune function, represent two distinct functional subsets: T(H)1 and T(H)2 lymphocytes. T(H)1 lymphocytes are associated with cell-mediated immunity (CMI) and the killing of intracellular pathogens, while T(H)2 lymphocytes are associated with humoral immunity and antibody production. When T(H)-precursor cells are activated, the balance is tipped in favour of one or the other. Furthermore, the most appropriate means of determining the T(H)-subset, is by the prevailing cytokine 'pattern'. This paper hypothesises that exercise-related immunosuppression is due to tissue trauma sustained during intense exercise, producing cytokines, which drive the development of a T(H)2 lymphocyte profile. A T(H)2 cell response results in simultaneous suppression of CMI, rendering the athlete susceptible to infection. Additionally, increased levels of circulating stress hormones (cortisol and catecholamines), as well as prostaglandin E(2), support up-regulation of T(H)2 lymphocytes. Marathon-related data are presented to support this hypothesis. It is concluded that an increased incidence of illness associated with OTS and in response to EE is not due to immunosuppression per se, but rather to an altered focus of immune function, with an up-regulation of humoral immunity and suppression of CMI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.