Expression of Cytokines Excreted in the Urine in the Different Phases of the Menstrual Cycle in Female Soccer Players


Introduction: it is accepted that menstruation has many features of inflammatory process. In menstruation, the complex events involving the inflammatory process lead the final tissue breakdown and bleeding; and they are orchestrated by specific molecular pathways, as well as hormones such as progesterone and estradiol. The aim of this study was to evaluate the expression of cytokines excreted in the urine in both phases of the menstrual cycle in female football players in the city of São Paulo. Methods: 42 female football players were evaluated, with an average age of 18.95 years (SD: 2.77) with regular menstrual cycle for at least 2 years and without use of contraceptive hormone therapy; regular physical activity 5 times a week for 2 hours a day. Both, the study protocol and consent form had been approved by the UNIFESP-EPM Ethics Committee (nº1604/10). The urine was collected at 4 moments: before the game (pré) and after the game (post) and in the two phases of the menstrual cycle: luteal and follicular; and stored at - 80°C degrees. The cytokines IL-15 and TNF-alfa were quantified by Elisa method. Statistics: the values were represented in medians and quartiles and compared through Wilcoxon test. The value of excretion of cytokines was standardized by urinary osmolarity for better homogeneity of samples. Results: the analysis of urine samples showed an increase of interleukin IL-15 after the game (post) when compared to values before the game (pré) in the follicular phase (p < 0.01) as well as in the luteal phase (p < 0.003). Additionally, we observed an increase of TNF-alfa after the game (post) when compared with values before the game (pré) in the follicular phase (p < 0.001). Conclusion: our results of TNF-alfa may be associated to inflammatory cascade related to reproductive tract, which is regulated by cyclic form by the sex steroids and were an increase of NFkB induces the production of pro-inflammatory cytokines. In this way, during the luteal phase the athlete has an inflammatory condition and the physical activity is not enough to promote an additional increase of this cytokine. Otherwise the results of IL-15 suggests that this cytokine has a key role in normal pregnancy, is still elevated after the game probably due to its importance as a mechanism of protection of pregnancy and that even the effort of the game is not sufficient to alter this physiologic process.

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