Alterations in acute-phase reactants (CRP, rheumatoid factor, complement, Factor B, and immune complexes) following an ultramarathon

Objectives. The human body initiates an acute phase response (APR) in response to a wide range of homeostatic disturbances. This complex series of reactions serves to activate repair processes and prevent ongoing tissue damage. An important aspect of the APR is the de novo synthesis of acute phase proteins (APP), many of which have not been thoroughly investigated. Main outcome measures. Alterations in CRP (C-reactive protein), C1est, C3, C4, C6, rheumatoid factor (RF) and Factor B were determined before and after an ultramarathon. Data were analysed using a one-way analysis of variance comparing values to pre-exercise levels. Significance was set at p < 0.05. Design. Venepunctures were performed on athletes participating in an ultramarathon (90 km) 24 hours before, immediately post-exercise (IPE), and 3h, 24h and 72h after the race. Serum was stored at –80°C until analysed. CRP levels in serum were assessed using the N Latex CRP kit. The levels of circulating immune complexes (CIC) were determined using particle-enhanced nephelometry. Complement proteins C1est, C3, C4 and RF were measured using laser nephelometry. C6 and Factor B were determined by radial immunodiffusion. Results. CRP was significantly elevated IPE (58%), 3h post (77%), 24h post (87%) and 72h post (69%). Pre-race CRP levels were above the normative range (5.10 ± 3.08 mg/l), C6 was significantly elevated (p < 0.05) at 24h post (7.8%) and 72h post (8.8%) exercise. Factor B was significantly elevated (p < 0.05) at 72h post exercise (12.8%). RF was significantly elevated at 72h post exercise (6.7%). Conclusion. Significant increases in selected acutephase reactants occur several days after the exercise event. In addition, as indicated by elevated resting levels of CRP, the athletes began the race with some degree of inflammation, presumably as a result of the cumulative training and racing mileage in preparation for the ultramarathon.