Imperial College London
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DrNeilHill

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Senior Lecturer
 
 
 
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n.hill

 
 
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Location

 

East WingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stacey:2022:10.1371/journal.pone.0263873,
author = {Stacey, MJ and Hill, N and Parsons, I and Wallace, J and Taylor, N and Grimaldi, R and Shah, N and Marshall, A and House, C and O'Hara, J and Brett, S and Woods, DR},
doi = {10.1371/journal.pone.0263873},
journal = {PLoS One},
title = {Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon},
url = {http://dx.doi.org/10.1371/journal.pone.0263873},
volume = {17},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Medical personnel may find it challenging to distinguish severe Exertional Heat Illness (EHI), with attendant risks of organ-injury and longer-term sequalae, from lesser forms of incapacity associated with strenuous physical exertion. Early evidence for injury at point-of-incapacity could aid the development and application of targeted interventions to improve outcomes. We aimed to investigate whether biomarker surrogates for end-organ damage sampled at point-of-care (POC) could discriminate EHI versus successful marathon performance.Methods:Eight runners diagnosed as EHI cases upon reception to medical treatment facilities and 30 successful finishers of the same cool weather marathon (ambient temperature 8 rising to 12 ºC) were recruited. Emerging clinical markers associated with injury affecting the brain (neuron specific enolase, NSE; S100 calcium-binding protein B, S100β) and renal system (cystatin C, cysC; kidney-injury molecule-1, KIM-1; neutrophil gelatinase-associated lipocalin, NGAL), plus copeptin as a surrogate for fluid-regulatory stress, were sampled in blood upon marathon collapse/completion, as well as beforehand at rest (successful finishers only).Results:Versus successful finishers, EHI showed significantly higher NSE (10.33 [6.37, 20.00] vs. 3.17 [2.71, 3.92] ug.L-1, P<0.0001), cysC (1.48 [1.10, 1.67] vs. 1.10 [0.95, 1.21] mg.L-1, P = 0.0092) and copeptin (339.4 [77.0, 943] vs. 18.7 [7.1, 67.9] pmol.L-1, P = 0.0050). Discrimination of EHI by ROC (Area-Under-the-Curve) showed performance that was outstanding for NSE (0.97, P<0.0001) and excellent for copeptin (AUC = 0.83, P = 0.0066).Conclusions:As novel biomarker candidates for EHI outcomes in cool-weather endurance exercise, early elevations in NSE and copeptin provided sufficient discrimination to suggest utility at point-of-incapacity. Further investigation is warranted in patients exposed to greater thermal insult, followed up over a more extended period.
AU  - Stacey,MJ
AU  - Hill,N
AU  - Parsons,I
AU  - Wallace,J
AU  - Taylor,N
AU  - Grimaldi,R
AU  - Shah,N
AU  - Marshall,A
AU  - House,C
AU  - O'Hara,J
AU  - Brett,S
AU  - Woods,DR
DO  - 10.1371/journal.pone.0263873
PY  - 2022///
SN  - 1932-6203
TI  - Relative changes in brain and kidney biomarkers with Exertional Heat Illness during a cool weather marathon
T2  - PLoS One
UR  - http://dx.doi.org/10.1371/journal.pone.0263873
UR  - http://hdl.handle.net/10044/1/95052
VL  - 17
ER  -
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