Ischemic preconditioning modulates the acute post-exercise inflammatory, angiogenic, and neurotrophic response in endurance runners

This randomized, double-blind, sham-controlled trial examined whether a 21-day ischemic preconditioning (IPC) intervention modifies acute inflammatory, angiogenic, and neurotrophic responses to intense endurance exercise in competitive male long-distance runners. Forty runners were allocated to IPC (n = 20) or SHAM (n = 20), and 35 completed the study. Each participant performed a 20 × 400 m interval running test before and after the intervention, with blood collected before exercise, immediately after exercise, and 24 h post-exercise. Before the intervention, the running trial induced significant time-dependent increases in all inflammatory biomarkers and in all angiogenic and neurotrophic markers. After the intervention, IPC was associated with higher post-exercise IL-10 and IL-15 responses than SHAM, with peak between-group differences of 27% and 35%, respectively. Significant group × time interactions were also observed for BDNF and sAPPα; only SHAM showed a significant post-exercise BDNF increase, whereas sAPPα increased more strongly in IPC. In addition, ANG and NGF concentrations were overall 17% and 16% higher, respectively, in IPC than in SHAM. These findings indicate that repeated IPC modulates selected acute molecular responses to intense endurance exercise in a marker-specific manner, although the underlying mechanisms require further investigation.Registry: ClinicalTrials.gov, TRN: NCT05412888, Registration date: 09/06/2022.