Cell Stress and Chaperones

, Volume 20, Issue 1, pp 3–13 | Cite as

Effects of allopurinol on exercise-induced muscle damage: new therapeutic approaches?

  • F. Sanchis-Gomar
  • H. Pareja-Galeano
  • C. Perez-Quilis
  • A. Santos-Lozano
  • C. Fiuza-Luces
  • N. Garatachea
  • G. Lippi
  • A. Lucia
Mini Review

Abstract

Intensive muscular activity can trigger oxidative stress, and free radicals may hence be generated by working skeletal muscle. The role of the enzyme xanthine oxidase as a generating source of free radicals is well documented and therefore is involved in the skeletal muscle damage as well as in the potential transient cardiovascular damage induced by high-intensity physical exercise. Allopurinol is a purine hypoxanthine-based structural analog and a well-known inhibitor of xanthine oxidase. The administration of the xanthine oxidase inhibitor allopurinol may hence be regarded as promising, safe, and an economic strategy to decrease transient skeletal muscle damage (as well as heart damage, when occurring) in top-level athletes when administered before a competition or a particularly high-intensity training session. Although continuous administration of allopurinol in high-level athletes is not recommended due to its possible role in hampering training-induced adaptations, the drug might be useful in non-athletes. Exertional rhabdomyolysis is the most common form of rhabdomyolysis and affects individuals participating in a type of intense exercise to which they are not accustomed. This condition can cause exercise-related myoglobinuria, thus increasing the risk of acute renal failure and is also associated with sickle cell trait. In this manuscript, we have reviewed the recent evidence about the effects of allopurinol on exercise-induced muscle damage. More research is needed to determine whether allopurinol may be useful for preventing not only exertional rhabdomyolysis and acute renal damage but also skeletal muscle wasting in critical illness as well as in immobilized, bedridden, sarcopenic or cachectic patients.

Keywords

Xanthine oxidase Free radicals Muscle injury Rhabdomyolysis Sarcopenia Cachexy 

Abbreviations

ADM

Adrenomedullin

ALT

Alanine aminotransferase

AST

Aspartate aminotransferase

ATP

Adenosine triphosphate

CK

Creatine kinase

CK-MB

Creatine kinase, myocardic isoenzyme

CoP

Copeptin

CRP

C-reactive protein

FRs

Free radicals

GDF15

Growth differentiation factor 15

GGT

Gamma glutamyltransferase

HSP

Heat-shock protein

HO

Heme oxygenase

Hs-TnT

Highly sensitive troponin T

IL-6

Interleukin-6

IMP

Inositol monophosphate

LDH

Lactate dehydrogenase

MDA

Malondialdehyde

MR-proADM

Midregional part of proadrenomedullin

Myo

Myoglobin

NAD

Nicotinamide adenine dinucleotide

OS

Oxidative stress

PCT

Procalcitonin

PlGF

Placental growth factor

ROS

Reactive oxygen species

suPAR

Soluble urokinase plasminogen activator receptor

sVEGFR-1/sFLT-1

Vascular endothelial growth factor receptor-1

VEGF

Vascular endothelial growth factor

XDH

Xanthine dehydrogenase

XO

Xanthine oxidase

XOR

Xanthine oxide-reductase

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Copyright information

© Cell Stress Society International 2014

Authors and Affiliations

  • F. Sanchis-Gomar
    • 1
    • 2
  • H. Pareja-Galeano
    • 1
    • 2
  • C. Perez-Quilis
    • 3
  • A. Santos-Lozano
    • 4
    • 5
  • C. Fiuza-Luces
    • 5
    • 6
  • N. Garatachea
    • 5
    • 7
  • G. Lippi
    • 8
  • A. Lucia
    • 5
    • 6
  1. 1.Department of PhysiologyUniversity of ValenciaValenciaSpain
  2. 2.Fundación Investigación Hospital Clínico Universitario/INCLIVAValenciaSpain
  3. 3.University Research Institute “Dr. Viña Giner”, Molecular and Mitochondrial MedicineCatholic University of Valencia “San Vicente Mártir”ValenciaSpain
  4. 4.Department of Biomedical SciencesUniversity of LeónLeónSpain
  5. 5.Research Institute of Hospital 12 de Octubre (“i + 12”)MadridSpain
  6. 6.European UniversityMadridSpain
  7. 7.University of ZaragozaHuescaSpain
  8. 8.Laboratory of Clinical Chemistry and HematologyAcademic Hospital of ParmaParmaItaly

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