Cellular integrative immune markers in elite athletes.

The integrative immune markers neutrophil-lymphocyte-ratio (NLR), platelet-lymphocyte-ratio (PLR) and systemic immune inflammation index (SII) have been established in clinical patient care. A transfer into elite athleticism may be beneficial for monitoring training and health. Blood samples of 195 healthy national Olympic-squad athletes were collected before a graded bicycle-ergometric exercise test until complete exhaustion. Measurements included white blood cells, lymphocytes and platelets, allowing for the calculation of the integrative immune markers. Correlations between athlete characteristics (sex, age, sporting discipline, training experience, training volume) and integrative immune marker-values were assessed. In a subgroup analysis a second blood sample was collected from 25 athletes 1 minute after the exercise test to assess its effect on the immune marker levels. An inverse correlation between peak power output and SII-level (Pearson correlation coefficient = -.270, p < .001) and NLR-level (Pearson correlation coefficient = -.249, p < .001) was found. Athletes with higher aerobic fitness had significantly lower values of SII and PLR compared to athletes with lower aerobic fitness. An elevated SII (p=.003) and a reduced PLR (p=.001) was documented as acute response to the exercise test. The integrative immune markers may be a promising tool for monitoring training and health in elite athletes.