Adaptive response triggered by the repeated SCUBA diving is reflected in cardiovascular, muscular, and immune biomarkers

Abstract

It has been shown that one recreational SCUBA (rSCUBA) diving session is sufficient to cause changes in plasma level of cardiovascular (CV) and muscular biomarkers. To explore whether repetitive rSCUBA diving triggers an adaptive response of the CV, muscular, and immune system, we measured the cardiac damage (NT-proBNP, hs-TnI, and CK-MB), muscle damage (myoglobin (Mb), galectin-3, CK, and LDH), vascular endothelial activation (ET-1 and VEGF), and inflammatory (leukocyte count (Lkc), CRP, and IL-6) biomarkers. A longitudinal intervention study included divers (N = 14) who conducted one dive per week over 5 weeks at the depth of 20-30 m for 30 min after a non-dive period of 5 months. The blood samples were collected before and after the first, third, and fifth dives and specific biomarkers were measured in plasma or serum by the standard laboratory methods. The concentrations of the majority of measured biomarkers increased after every single dive; the exception was ET-1 concentration that decreased. The cumulative effect of five dives has been reflected in diminishing changes in hs-TnI, Mb, galectin-3, ET-1, VEGF, and IL-6 levels, and more pronounced increases in NT-proBNP and hs-CRP levels. The median values of all measured biomarkers in all time points, except Mb, remained within the corresponding reference range. Repeatedly performed rSCUBA diving activates an adaptive response of the CV, muscular, and immune system that is reflected in changes in the specific biomarker concentration.

Keywords: IL-6; NT-proBNP; SCUBA diving; endothelin-1; galectin-3; myoglobin.

FIGURE 1

Study design and blood collection time points

FIGURE 2

The effect of SCUBA diving on leukocyte count (a), C‐reactive protein (b), and interleukin‐6 (c) presented as Dots plot (all data) with corresponding median value and IQR ranges. PRE‐DIVE 1, 3, and 5—measuring points immediately before the first, third, and fifth dives. POST‐DIVE 1, 3, and 5—measuring points immediately after the first, third, and fifth dives. Differences between pre‐ and corresponding post‐dive values of every performed dive were tested with Wilcoxon singed‐rank test (p < 0.05), while differences between all pre‐ and all post‐dive values were tested with Friedman ANOVA test and Dunn's post‐hoc test. *Significance values have been adjusted by the Bonferroni correction for multiple tests. URL—upper reference level

FIGURE 3

The effect of SCUBA diving on creatine kinase myocardial band (a), high‐sensitivity troponin I (b), N‐ terminal prohormone of brain natriuretic peptide (c), and high‐sensitivity C‐reactive protein (d) presented as Dots plot (all data) with corresponding median value and IQR ranges. PRE‐DIVE 1, 3, and 5—measuring points immediately before the first, third, and fifth dives. POST‐DIVE 1, 3, and 5—measuring points immediately after the first, third, and fifth dives. Differences between pre‐ and corresponding post‐dive values of every performed dive were tested with Wilcoxon singed‐rank test (p < 0.05), while differences between all pre‐ and all post‐dive values were tested with Friedman ANOVA test and Dunn's post‐hoc test. *Significance values have been adjusted by the Bonferroni correction for multiple tests. URL—upper reference level

FIGURE 4

The effect of SCUBA diving on creatine kinase (a), lactate dehydrogenase (b), myoglobin (c), and galectin‐3 (d) presented as Dots plot (all data) with corresponding median value and IQR ranges. PRE‐DIVE 1, 3, and 5—measuring points immediately before the first, third, and fifth dives. POST‐DIVE 1, 3, and 5—measuring points immediately after the first, third, and fifth dives. Differences between pre‐ and corresponding post‐dive values of every performed dive were tested with Wilcoxon singed‐rank test (p < 0.05), while differences between all pre‐ and all post‐dive values were tested with Friedman ANOVA test and Dunn's post‐hoc test. *Significance values have been adjusted by the Bonferroni correction for multiple tests. URL—upper reference level

FIGURE 5

The effect of SCUBA diving on vascular endothelial growth factor (a) and endothelin‐1 (b) presented as Dots plot (all data) with corresponding median value and IQR ranges. PRE‐DIVE 1, 3, and 5—measuring points immediately before the first, third, and fifth dives. POST‐DIVE 1, 3, and 5—measuring points immediately after the first, third, and fifth dives. Differences between pre‐ and corresponding post‐dive values of every performed dive were tested with Wilcoxon singed‐rank test (p < 0.05), while differences between all pre‐ and all post‐dive values were tested with Friedman ANOVA test and Dunn's post‐hoc test. *Significance values have been adjusted by the Bonferroni correction for multiple tests. URL—upper reference level