Effect of Ibuprofen on Markers of Acute Kidney Injury, Intestinal Injury, and Endotoxemia after Running in the Heat.

PURPOSE To test the hypothesis that ibuprofen ingestion exacerbates markers of acute kidney injury (AKI), gastrointestinal (GI) injury, and endotoxemia after running in the heat. METHODS Using a randomized double-blind crossover design, eleven physically active individuals (six women) ingested 600 mg of ibuprofen or placebo 12- and one-hour prior to running one-hour in a heated chamber (35 °C, 20%-60% R.H.) at an intensity of 60% V̇O2peak. Blood and urine samples were collected pre-, post-, and one-hour post-exercise to assess cytokines and markers of AKI, GI injury, and endotoxemia. RESULTS One hour of running in the heat increased markers of AKI (urinary product of IGFBP7•TIMP2 [Placebo: ∆ 1.8 ± 0.8 log10(ng/ml)2/1000, Ibuprofen: ∆ 1.8 ± 0.9 log10(ng/ml)2/1000], urinary NGAL, and serum cystatin C), GI damage (I-FABP [Placebo: ∆ 631 ± 446 pg/ml, Ibuprofen: ∆ 576 ± 455 pg/ml]), and inflammatory cytokines (TNFα [Placebo: ∆ 5.2 ± 3.5 pg/ml, Ibuprofen: ∆ 6.2 ± 4.9 pg/ml], IL-6, IL-10, and MCP-1), but these changes were not exacerbated by ibuprofen ingestion. There were effects of time (p < 0.001) and condition (p = 0.03) for serum IL-8, with greater concentrations in the ibuprofen (pre: 11.4 ± 5.1 pg/mL, post: 15.5 ± 7.3 pg/ml) trials than placebo (pre: 9.7 ± 4.2 pg/mL, post: 11.7 ± 5.4 pg/mL). There were no effects of time or condition on markers of endotoxemia (LBP [Placebo: ∆ -1.2 ± 3.2 μg/ml, Ibuprofen: ∆ 1.0 ± 1.6 μg/ml], sCD14). CONCLUSIONS These findings indicate that ibuprofen ingestion does not worsen intestinal or renal injury experienced during one hour of exercise in the heat, but increases pro-inflammatory IL-8.