Immune function and the swimmer: twenty-five years of enquiry at the AIS

Biography

Professor Peter Fricker is currently Consulting in Sports Medicine, Sports Science, Physical Activity and Health, and holds professorial appointments at Griffith University (Gold Coast) and Victoria University.

From 2005 to 2011 Professor Fricker was Director of the Australian Institute of Sport and for six months prior to his departure to Qatar he was Acting CEO of the Australian Sports Commission. He joined the AIS in 1981 as the AIS’s first sports physician, consulting from his own practice in Canberra. In 1983 he joined the AIS as staff medical officer. From that time until he was appointed Director he worked at the AIS as Head of Sports Science and

Sports Medicine, then as Deputy Director of the AIS.

He has also served as medical officer and medical director for Australian teams to six Commonwealth Games (1986-2006) and five Olympic Games (1988-2004). He serves on the Medical Commission of the Australian Olympic Committee, has served as Chair of the Medical Commission of the Australian Commonwealth Games Association, as a Member of the Australian Sports Drugs Medical Advisory Committee, a Member of the National Antidoping Research Committee, as advisor to the World Antidoping Agency (WADA) on antidoping research, and as a member of the AFL Research Committee, among other roles over many years.

He has edited and authored three text books and a book on fitness, and has published numerous papers on sports injuries, athlete health, and immunology and exercise in particular.

He was awarded the Medal of the Order of Australia in 1993, the Australian Sports Medal in 2001, the Citation for Distinguished Service to Sports Medicine by the Australasian College of Sports Physicians in 2010, and the Order of Merit of the Australian Olympic Committee in 2012.

Synopsis

Research on exercise and immune function has been conducted over more than two decades at the Australian Institute of Sport.

The initial (two part) question was why do our high performing athletes get sick when they train hard, and can we prevent such illness?

The AIS and its key partners from Hunter Institute of Immunology, the University of Canberra, and Griffith University embarked on understanding the behaviour of mucosal immune function, and focused much of the work initially on the tracking of Salivary IgA, which has been recognised as a very useful marker of immune status and at least a modest indicator of risk of upper respiratory illness.

Research also considered interventions on the premise that viruses were being reactivated in response to heavy training, which produced the symptoms and signs of illness, and a decrease in performance. Ebstein-Barr viruses were looked at, and antiviral prophylaxis was assessed.

Careful consideration was also being given to the causes of upper respiratory illness, and research methodology refined the assessment of illness for diagnosis, and quantification of workloads to compare the effects of training and of illness, and of recovery with or without interventions.

Research looked at whether athletes were more susceptible to illness than the non-exercising population, individual responses to training, and the associated risk of illness.

Similarly objective measures were necessary to document the impact illness might have on performance at key events.

Over time the research moved to consider the innate immune system, and the behaviour of the gut in this context. Much recent work has indicated a remarkably complex interplay of immune factors which involve the flora of the gut and the cellular mechanisms of the intestinal tract. Interleukins and cytokines, and their associated regulating factors, have come into the spotlight.

Interventions—notably probiotics—have been the most recent area of study in this context, with interesting results.