Herbsttagung Programm & Abstracts - Deutsche Gesellschaft für ...

Angiopoietin-2, circulating cell-free mitochondrial DNA (ccf mtDNA) and
markers of inflammation are increased in collapsed marathon runners
R.H. Hübner 1 , J.M. Doehn 1, B. Gutbier 1 , A.K. Neuhauss 1 , K. Fischer 1 , L. Brechtel 2 , M. Kruell 2 , J.
Lock 2 , N. Suttorp 1 , S. Hippenstiel 1 , M. Witzenrath 1
1 Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité –
Universitätsmedizin Berlin, Germany; 2 SCC Running Events GmbH, Berlin, Germany
Rationale: Exercise induced collapse (EIC) after running a (half) marathon is the most common cause
for emergency treatment at running events. Systemic inflammation has been observed in marathon
runners. However, the trigger for inflammation in intensity exercise is not unknown. Mitochondrial DNA
(mtDNA) is released after cellular injury and acts as damage-associated molecular pattern (DAMP)
that activates innate immunity. Angiopoietin (ANG)-2 is a contributor to endothelial permeability,
whereas ANG-1 supports endothelial quiescence. We hypothesized that running a (half) marathon
evokes liberation of mtDNA and/or ANG2, which contributes to EIC.
Methods: We examined 18 healthy runners before, immediately following and 24 hours after the
Berlin marathon 2010 and compared results of clinical examination and blood analysis with 30
collapsed runners of the Berlin marathon 2009 and 2010 and the Berlin half marathon 2010. Collapsed
runners were divided into runners with mild symptoms (n=22) or with serve symptoms (n=8).
Inflammatory markers, ccf mtDNA, and ANG-1 and -2 were analyzed in serum samples by qPCR or
ELISA.
Results: White blood cells, CRP, IL-6, ccf mtDNA, ANG-2 and ANG2/ANG-1 ratio were increased in
healthy runners after marathon as compared to screening. Levels of ccf mtDNA and ANG-2 correlated
with inflammatory markers. ANG-2 and ANG-2/ANG-1 ratio showed higher increase in collapsed
runners with severe symptoms as compared to collapsed runners with mild symptoms, or to healthy
runners.
Conclusion: Serum mtDNA and ANG-2 were increased after running a marathon in healthy runners,
and even higher ANG-2 levels were observed in collapsed runners with severe symptoms after a (half)
marathon. Further studies are warranted to provide evidence for a possible causal relationship
between running, elevated mtDNA, increased ANG-2, capillary leak syndrome and EIC.
32