endurance sports
消炎剤を予防的に使用した場合の科学的研究は少ない。アスリートは消化器系統と心臓血管系、および、骨格筋肉系、腎臓の副作用の潜在的なリスクを考慮すべきである。
Phys Sportsmed. 2010 Apr;38(1):132-8. doi: 10.3810/psm.2010.04.1770.
Prophylactic use of NSAIDs by athletes: a risk/benefit assessment.
Abstract
Athletes often seek artificial means to gain advantage and prolong participation when competing. This often involves taking naturally occurring or chemically synthesized compounds. The World Anti-Doping Agency does not prohibit the use of nonsteroidal anti-inflammatory drugs (NSAIDs) because these agents are not performance enhancing, and their analgesic and anti-inflammatory effects are at best performance enabling. Consequently, athletes have relatively unrestricted access to NSAIDs, which are readily available as over-the-counter drugs. However, concern has been raised on athletes' prophylactic use of these agents. Data from many sporting fields have consistently demonstrated that many individuals self-administer NSAIDs prior to athletic participation to prevent pain and inflammation before it occurs. However, scientific evidence for this approach is currently lacking, and athletes should be aware of the potential risks in using NSAIDs as a prophylactic agent. These agents are not benign, and can produce significant side effects, including gastrointestinal and cardiovascular conditions, as well as musculoskeletal and renal side effects. The latter side effects appear paradoxical to the rationale for prophylactic use of NSAIDs. This article discusses current observations regarding athlete use of NSAIDs, and the possible benefits and potential risks of their use.
不慣れな激しい練習をすると、消炎剤は筋肉の外とう細胞を傷つけるようだ。
J Appl Physiol (1985). 2009 Nov;107(5):1600-11. doi: 10.1152/japplphysiol.00707.2009. Epub 2009 Aug 27.
Local NSAID infusion inhibits satellite cell proliferation in human skeletal muscle after eccentric exercise.
Mikkelsen UR1, Langberg H, Helmark IC, Skovgaard D, Andersen LL, Kjaer M, Mackey AL.
Abstract
Despite the widespread consumption of nonsteroidal anti-inflammatory drugs (NSAIDs), the influence of these drugs on muscle satellite cells is not fully understood. The aim of the present study was to investigate the effect of a local NSAID infusion on satellite cells after unaccustomed eccentric exercise in vivo in human skeletal muscle. Eight young healthy males performed 200 maximal eccentric contractions with each leg. An NSAID was infused via a microdialysis catheter into the vastus lateralis muscle of one leg (NSAID leg) before, during, and for 4.5 h after exercise, with the other leg working as a control (unblocked leg). Muscle biopsies were collected before and 8 days after exercise. Changes in satellite cells and inflammatory cell numbers were investigated by immunohistochemistry. Satellite cells were identified using antibodies against neural cell adhesion molecule and Pax7. The number of Pax7(+) cells per myofiber was increased by 96% on day 8 after exercise in the unblocked leg (0.14 +/- 0.04, mean +/- SE) compared with the prevalue (0.07 +/- 0.02, P < 0.05), whereas the number of Pax7(+) cells was unchanged in the leg muscles exposed to the NSAID (0.07 +/- 0.01). The number of inflammatory cells (CD68(+) or CD16(+) cells) was not significantly increased in either of the legs 8 days after exercise and was unaffected by the NSAID. The main finding in the present study was that the NSAID infusion for 7.5 h during the exercise day suppressed the exercise-induced increase in the number of satellite cells 8 days after exercise. These results suggest that NSAIDs negatively affect satellite cell activity after unaccustomed eccentric exercise.
６０名のウルトラマラソンランナーでの研究。タンパク質カルボニルは、非ステロイド系抗炎症薬のユーザーは非使用者対して有意に高かった。ウルトラマラソンなどでの抗炎症剤の使用には注意が必要である。
Int J Sports Med. 2007 Nov;28(11):909-15. Epub 2007 May 31.
Effect of NSAID on muscle injury and oxidative stress.
McAnulty S1, McAnulty L, Nieman D, Morrow J, Dumke C, Henson D.
Abstract
Indirect markers of muscle damage and delayed onset muscle soreness were examined and correlated to changes in oxidative stress, plasma antioxidant potential, and use or nonuse of non-steroidal anti-inflammatory drugs in 60 ultra-marathoners following the Western States EnduranceRun. Blood was collected prior to and immediately following the race and analyzed for muscle damage by creatine phosphokinase and oxidative stress by F (2)-isoprostanes, protein carbonyls, and lipid hydroperoxides and antioxidant potential by the ferric reducing ability of plasma. Subjects recorded delayed onset muscle soreness during the week following the race. Lipid hydroperoxide concentrations were unchanged, but F (2)-isoprostanes, protein carbonyls, ferric reducing ability of plasma, creatine phosphokinase, and delayed onset muscle soreness increased significantly postrace. Protein carbonyls were significantly higher postrace in nonsteroidal anti-inflammatory drug users versus nonusers (p < 0.05). However, there was no difference between users and non-users for all other markers. Postrace creatine phosphokinase concentrations were not correlated with oxidative stress markers but were correlated with changes in delayed onset muscle soreness. Based upon these findings, caution should be used when consuming nonsteroidal anti-inflammatory drugs during ultra distance events.
アメリカでは非ステロイド系抗炎症薬がよく用いられる。服用者のうち30～50%に消化器系統の副作用が見られる。
Curr Sports Med Rep. 2002 Apr;1(2):107-15.
Athletes, nonsteroidal anti-inflammatory drugs, coxibs, and the gastrointestinal tract.
Shoor S1.
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common self-administered and prescribed drugs taken in the United States. From 30% to 50% of those using these medications experience some degree of gastrointestinal (GI) side effect. Independent of NSAID use, a majority of athletes suffer GI symptoms, most of which has been documented in endurance athletes. Studies of NSAID use in patients with chronic osteo- and rheumatoid arthritis have defined a set of factors that can identify those who are at higher risk of serious GI events. Using such a model, clinicians can choose either to discontinue NSAID use, or prescribe a lower-risk NSAID or coxib (rofecoxib, celecoxib), prophylaxis with misoprostol, or proton pump inhibitor. Coxibs have been designed to decrease GI ulceration and bleeding by selective inhibition of cyclooxygenase-2, and offer an option for patients at high risk of GI hemorrhage. There are data suggesting that rofecoxib may be associated with an increased risk of myocardial infarction, and until further data are available, caution should be used when considering its prescription to patients at high risk of cardiovascular events.
Ther Umsch. 2001 Apr;58(4):226-31.
[Misuse of drugs in recreational sports].
[Article in German]
Mahler N1.
Abstract
The extent of drug abuse in mass sport is only poorly documented. Studies about drug abuse investigated only the prohibited substances according to the Olympic movement antidoping code. So for instance about the use of anabolic androgenic steroids (AAS) by school children or young students. But only few investigations point to the drug abuse in mass sport regarding the easily accessible over-the-counter drugs of the class of nonsteroidal anti-inflammatory drugs (NSAID). These drugs permit an athlete to compete at his normal level of performance despite injuries or pain. However, the masking of pain may exacerbate the injury. Precautions should be taken to prevent the unwarranted or unmonitored use of anti-inflammatory agents during treatment of sport injuries. The abuse may be extensive since most people consider over-the-counterdrugs, such as aspirin and ibuprofen, harmless. Studies in Switzerland among endurance athletes in mass sport examining the use of medications before an event showed a prevalence between 5 and 10% of NSAID. Even if this seems a small number, further investigations should focus on the use of medications among different age groups and preventive information to abstain from the use of certain medication for competitors in mass sport should be worked out.