ECSS 2005, Belgrade, Serbia Post Race Rectal HGH

ACE, ACtN3, AMPDI

1 allele of ACE = endurance

D allele of ACE = Sprint

Some studies show assoc

1 acele of ACE overrepresented in SA Ironman - Collins et al Medicine Sci Sport Medicine

suggested this ACE gene other gene with close prox of ACE gene on chromosone 17q23 may encode for a protein directly involved w t athlete phenotype

Growth Hormone (GH1) gene -    17q 24 2 -    encodes for family of GH -    anterior pituity -    IGF-1

Is growth H involved?

GH, little or no beneficial effect on GH on health indivs -    but GH might phys role in carotic metab and enhance tissue repair post ex

ex induced GH secretion stimulates -    swet secretion -    heat XXX through sweat -    influ heat loss during ex

GH1 gene

155 subjects 104 post rectal 55 control subj – no ultra XXX blood sample and geoXXX

triathlete group significance older than control

significance dif in post-ran rectal temp for gh1 genotype

Conclusion -    GH1 not assoc w endurance performance -    Unlikely that any of t genes are aassoc w performance

But temp lower for TT athletes

Exchange Symposium, Fri 5pm

Chair: Emin Eren (TUR)

Sport, Medicine and Scie hist roots -    MEDICINE: fundamental o    Disease – injury o    Healing + prevention

Medicine is sci of diagnosis, treating, and preventing disease

Hist  backg -    priest – magic – physician -    men-nefer -    Met – Sunu – Metsunu = medicine

Medicine and Magic

Ancient Greek

From magic and religion to secular practice Need to understand physics Study of matter and energy -    metaphysics

science -    latin – scientic – knowledge of something -    scive – to know (disting) -    scindere – to cut/divide -    sci – systematic

Is medicine a sci discipline? -    clinical medicine yes -    medicine as ‘art’ of healing using sci method -    ‘doctor’ = teacher

3 pillers of medicine - Claudius Galen – father of sport medicine

Sport Medicine progs around Europe not UK

What is sports medicine -    therapeutic -    team doctor -    sports physician 1904 germany -    dept 1911 dresden -    congress 1912 -    uni course 1919 -    journal 1924 -    institute 1945 prague

scope of sport medicine -    sci, moral, legal, health issues -    enhance qual of life

sci and sport -    ancient

hist of sport sci -    rise of physiology links -    Pierre-Jean Cabani (1757-1808) -    AV Hill -    Edward Muybridge – motion photo -    Ergometry 1790

Sci in Coaching

Coaching – art of sci to better performance

Conclusion

Stimulants – human

Scope -    sport sci – pushing limits -    sport medicine – protecting within limits

brotherhood not rivalry

Pres 2

Fabi Pigouazi

Sport medicine – from biological to clinical

Founded FIMS 1928, 19 feb -    2nd Olympic winter games

IOC MC 1967

Essentials of sport medicine

Ex as essential

ME: ethics in sport medicine at the time?

Ex as component of health -    ex for prevention – treatment, education

specialists -    athlete, coach, team physician, physio – need good relationship

Future development -    sport performance will increase -    av life span will rise -    sport medicine widely used

ME: wat formal structures protect integrity of physican decision making?

ME: ECSS needs a session on science communication

Biol limit of life

115 yrs - goal of 3rd millennium is inc quant and qual of life

heed to change ‘value of soc’

WHO – health definition

Lifestyle changes

Principles of wellness

State of sm in Euro -    euro won 50% of medal sin Athens

Gene doping -    Problem: lack of control of gene expression

FIMS – 200,000 physicians

Vassilis Klissourus

Unifying Sport Medicine and Sport Science: Paradigm of Sport Genetics

Goals – sci – push limit -    medicine-protect

but ultimate goal of both is to optimise human performance

there is no division between sci and medicine challenges

1.    grasp interplay between genes and enviro 2.    bioethic problem of genetic enhancement

Physio Basis of Records -    athlete v non-athlete difference = former learned to close gap between phsych and physio -    drives closer to limits (AV Hill 1925)

Sport Performance Determinant

Phenotype variation -normal distrib - what is relative power of genes and enviro in development of phenotype

2 stages 1. measured genotype 2. unmeasured

JAP, 1971, 31: 338, 344 -    Klissourus twin study -    Max aerobic power -    Almost identifical for twin -    93% heritability -    all genes for VO2Max

Max aerobic for non and identifcal twins -    supp hyp that gen is important for VO2 max

Perth Genetic Analysis

Maes et al JAP, 28 1479, 1996 Genetic and Envirol Sources of Variation in Vo2peak in 105….

Twin research -heritability estimate - conclude genes dominate - for max aerobic power -for max aerobic cap

But phenotype not predetermined or unchangeable -    training changes -    genes not like switches

Reserch direction -    to what extent can modify phenotype? -    A genotype intention modified? -    How genetic is process I change? -    perXX and cognitive?

Klissourus, Interest J Sport Medicine, 2002 Genes and Olympic Performance -    interpret difference were not significance, except for personality (behav)

Behaviour Determines Performance

Identify specific genes -    got to find t many genes relationship to partic att state

Walfarth, et al Medicine Sci Sport Ex, Jan 2005 -    T uHuman Gene Map for Performance Phenotype -    ACE – but siXXX

ME: Include co-presenters on Website of abstracts

Nanga Parbut – 8125m Climbing Beyond the Limits Peter Bartsch JAP 63 752-757, 1987 Bender PR, JAP 1989, 66, 2733 -    ventilation increases over 2wks at a given altitude

1m of o2 of blood -    decrease of plasma vol -    inc of EPO

inc of capillary of fibre

M. Redge West and West, High Alt Physio and Medicine, Chapman and Hall

Calbet AJP 184,304-16, 2003

Performance gets better -    Fulco, JAP in press -    But VO2max decreases, stable

Cenbelli 1889 cited in High Alt Medicine and Physio (Ward, Miledge and West) 2000

1% decrese per 100m over 1500m

Calbet, Am J Physio 284, R302-16, 2003 -    no eeffect because

above 500m -    reduced inoXXX uptake -    24% en deficient at 6452 -    Westertop JAP 1994 -    40% @ 5300-8800m -    Westertop JAP 1993 -    43% during OE11 -    Rose, JAP 1988, find deficit not t issue

Anholm, Am Rev Respir Dis 1992 -    breaking pattern at everest

Sutton JAP, 1988 -    Work on cap of everest

Cognitive function remains impaired 1yr after expedition

RB Huey, JAMA 284, 181, 2000

Mie

Thomas Scasz 1973, 115

Medicine and magic -    formerly when religion was strong and sci weak, men mistook magic for medicine, now when sci is strong and religion weak, men mistake medicine for magic

2 assumpt - sport has relationship lack of governance elite sport susceptible to enhancement

Borgmann – t Baconian/Cartesian project -    man goal dominance of nature – athleteic 1984: 36)

Brown-snout.com/cycling/misc

Ex Dict Sport Sci and Medicine, 1994, 29-30

Biotech – instrum structure -    neither good nor bad -    depend on use

Cuttler et al 1998 – nontherap use of HGC

Kass classif of biomed technology -    control of death and life -    irrelevant except: astr: genetic selection -    Control of H potentialities -    Control of h achievements

Elite sport involves/needs suffering

Medicine not about PERFORMANCE ENHANCING, but sports

Juengst – getting back to normal - telos of med

appeal to normality is problematic in elite sport

Boorse 1997 -    abnormal enhanced health?

Normally as constructed or enhanced

Wollheim, 1984, XIV -    without psych, normality is t name for a ill-defined and tortousuly effXX achievement

3 conceptions of norm

1.    BST 2.    Social construct 3.    Psych/psychoanalyt

Sports medicine need to disting between these ideas -    problem in principle -    can we choose?

Tim Noakes – dis H view of lactate paraxoc

Poster -    detect blood doping through comparison of change in RBC and reticulocyte count

cardiac regenerative capacity -    stem cells

new view of how heart responds to injury

a heart is significance myocyte regeneration - new myocyte formuation

post London

apoptosis – prog cell death necrosis – through injury

why only slow fibres affected -    presence of phosophic -    not present in fast twitch