Biomarkers After Sporting Incapacitation Study (BASIS)

• Research type

  Research Study

• Full title

  Biomarkers After Sporting Incapacitation Study

• IRAS ID

  247967

• Contact name

  Neil Hill

• Contact email

  n.hill@imperial.ac.uk

• Sponsor organisation

  Imperial College London

• Duration of Study in the UK

  1 years, 1 months, 6 days

• Research summary

  Research Summary
  We wish to characterise the biochemical response to collapse associated with endurance exercise and define the roles of biomarkers relating to heat injury detection, diagnosis, monitoring, classification, prognosis and treatment. This will form a basis for future interventional studies to improve outcome from exertional heat stroke and other illnesses associated with physical activity.

  We intend to collect the following information:
  1. in (n= up to 20) collapsed runners - in addition to usual clinical information collected as part of routine medical care in the marathon medical tent, (e.g. rectal temperature, blood pressure, heart rate, etc) blood samples will be taken at the following time-points: (1) T=0; as close to the time of collapse as feasible; (2) T+1 hour; (3) T+4-6 hours and (4) T+24 hrs. Samples will be separated and frozen on site for subsequent assay. A post-race urine sample will be collected if available. Transthoracic echocardiography will be performed in the marathon medical tent on all participants with the aim of performing serial studies (as close to the point of collapse as possible, at 1 hour, ± 4 to 6 hours). A structured questionnaire will be administered by telephone 2 to 4 weeks after the event to participants who collapsed

  2. in (n= 20) 'successful finisher' controls - blood samples will be taken at the following time-points: (1) ‘pre-race’ (at race registration the day before the marathon); (2) T=0; as close to the time of successful completion of event as feasible; (3) T+1 hour; (4) T+4-6 hours and (5) T+24 hrs. Samples will be separated and frozen on site for subsequent assay. A pre- and post-race urine sample will be collected from all subjects when available.
  Transthoracic echocardiography will be performed with the aim of performing serial studies (as close to completion as feasible and if logistically possible at 1 hour and ± 4 to 6 hours).

  Differences in serum sodium, creatinine, urea and markers of physiological stress including novel biomarkers NGAL, KIM-1, copeptin, S100β, NSE, LPS and I-FABP between cases and controls will be examined and further related to clinical outcome, severity of EHI, and markers of organ dysfunction including AKI, encephalopathy and gut permeability. These results will also be related to the echocardiographic features present upon becoming incapacitated (EHI cases) or completing the event (healthy controls) and to the responses to a structured questionnaire administered by telephone to EHI cases only.

  Summary of Results
  People who collapsed with environmental heat injury during a cool weather marathon had higher levels of neuron specific enolase and copeptin comapred with successful finishers. These biomarkers may be useful as point-of-collapse markers in the future. Also, collapsed runners had higher levels of mast cell tryptase which dilates blood vessels and they has lower blood pressure suggesting that release of tryptase may be part of the mechanism of runner collapse.

• REC name

  London - South East Research Ethics Committee

• REC reference

  19/LO/0340

• Date of REC Opinion

  29 Mar 2019

• REC opinion

  Favourable Opinion