Sports Medicine

, Volume 47, Issue 7, pp 1389–1403 | Cite as

Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review

  • Washington Pires
  • Christiano E. Veneroso
  • Samuel P. Wanner
  • Diogo A. S. Pacheco
  • Gisele C. Vaz
  • Fabiano T. Amorim
  • Cajsa Tonoli
  • Danusa D. Soares
  • Cândido C. CoimbraEmail author
Systematic Review



Prolonged and strenuous physical exercise increases intestinal permeability, allowing luminal endotoxins to translocate through the intestinal barrier and reach the bloodstream. When recognized by the immune system, these endotoxins trigger a systemic inflammatory response that may affect physical performance and, in severe cases, induce heat stroke. However, it remains to be elucidated whether there is a relationship between the magnitude of exercise-induced hyperthermia and changes in intestinal permeability.


In this systematic review, we evaluated whether an exercise-induced increase in core body temperature (T Core) is associated with an exercise-induced increase in intestinal permeability.


The present systematic review screened the MEDLINE/PubMed and Web of Science databases in September 2016, without any date restrictions. Sixteen studies that were performed in healthy participants, presented original data, and measured both the exercise-induced changes in T Core and intestinal permeability were selected. These studies assessed intestinal permeability through the measurement of sugar levels in the urine and measurement of intestinal fatty acid binding protein or lipopolysaccharide levels in the blood.


Exercise increased both T Core and intestinal permeability in most of the 16 studies. In addition, a positive and strong correlation was observed between the two parameters (r = 0.793; p < 0.001), and a T Core exceeding 39 °C was always associated with augmented permeability.


The magnitude of exercise-induced hyperthermia is directly associated with the increase in intestinal permeability.


Lactulose Intestinal Permeability Bacterial Translocation Core Body Temperature Heat Stroke 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors acknowledge M.S. James Jeremy McCormick for reviewing the manuscript.

Compliance with Ethical Standards


Christiano Veneroso, Gisele Vaz, and Washington Pires are recipients of post-doctorate fellowships from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES/Brazil; AUX PE—PNPD—2251/2011), the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (PMPD/FAPEMIG; BPD-00674-14), and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; 168145/2014-6), respectively. Diogo Pacheco is a recipient of a Master’s fellowship from CAPES. Samuel P. Wanner (CNPq; 473737/2013-2) and Fabiano T. Amorim (CNPq; 404201/2013-0) have grants to investigate the association between thermoregulatory and inflammatory responses during physical exercise and heat stress and thermoregulatory responses in workers, respectively. The funding institutions had no role in the study design, data analysis, decision to publish, or preparation of the article.

Conflict of interest

Washington Pires, Christiano Veneroso, Samuel Wanner, Diogo Pacheco, Gisele Vaz, Fabiano Amorim, Cajsa Tonoli, Danusa Soares, and Cândido Coimbra declare that they have no conflicts of interest relevant to the content of this review.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Washington Pires
    • 1
    • 2
  • Christiano E. Veneroso
    • 3
  • Samuel P. Wanner
    • 3
  • Diogo A. S. Pacheco
    • 3
  • Gisele C. Vaz
    • 1
  • Fabiano T. Amorim
    • 4
    • 5
  • Cajsa Tonoli
    • 6
  • Danusa D. Soares
    • 3
  • Cândido C. Coimbra
    • 1
    • 3
    Email author
  1. 1.Department of Physiology and Biophysics, Institute of Biological SciencesUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Department of Physical Education, Institute of Life SciencesUniversidade Federal de Juiz de ForaGovernador ValadaresBrazil
  3. 3.Graduate Program in Sport Sciences, School of Physical Education, Physiotherapy and Occupational TherapyUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  4. 4.Department of Physical EducationUniversidade Federal dos Vales do Jequitinhonha e MucuriDiamantinaBrazil
  5. 5.Department of Health, Exercise Science and SportUniversity of New MexicoAlbuquerqueUSA
  6. 6.Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical TherapyVrije Universiteit BrusselBrusselsBelgium

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