We can imagine that football clubs might soon be asking their costly football players to take allopurinol, a medicine for gout. Our prediction comes after reading an article that physiologists at the University of Valencia teaching hospital will soon publish in the Scandinavian Journal of Medicine & Science in Sports. According to the Spanish researchers, a standard dose of allopurinol protects footballers’ heart muscles during a match.
Some professional footballers are worth millions. As clubs invest so much money in their players, it’s inevitable that injured players represent a heavy financial burden to the sport and society. Estimates made in 2000 put the figure at round seventy million dollars a year.
In 2003 the Spanish researchers published the results of a study they made of Tour de France cyclists in JAMA. [JAMA. 2003 May 21;289(19):2503-4.] These showed that administration of substances that inhibit the enzyme xanthine-oxidoreductase could protect athletes against injury. Allopurinol is one of these substances.
During exercise xanthine-oxidoreductase converts hypoxanthine is into xanthine first, and then into uric acid.
During this process aggressive molecules, such as superoxide, are released. These molecules can cause damage to the muscles and the heart, and increase the chance of injury or heart disease occurring. Allopurinol and its metabolite oxypurinol inhibit this process by inhibiting xanthine-oxidoreductase.
Because gout episodes are the result of excess uric acid in the blood, doctors use allopurinol as a medicine for gout. It has relatively few side effects and is not on the doping list.
Allopurinol helps prevent football injuries
By the way, there are natural alternatives for allopurinol. Phytate – in supplement form it goes by the name of inositol-hexakisphosphate – inhibits xanthine-oxidoreductase too [Life Sci. 2004 Feb 13;74(13):1691-700.], as do the flavonoids baicalein [structural formula shown here], wogonin and baicalin. [Anticancer Res. 1993 Nov-Dec;13(6A):2165-70.] These are found in extracts of plants such as Scutellaria baicalensis [which you may know as Skullcap].
The researchers performed an experiment, funded by the EU, on 12 male football players, all of whom played a match in the Spanish Football League. Half of the players were given a placebo four hours before the match, the other half were given 300 mg allopurinol. Just before the match and 12 hours afterwards the researchers analysed the players’ blood.
The effects of allopurinol were most visible after the match. The researchers found considerably less creatine-kinase [CK], lactate dehydrogenase [LDH] and myoglobin in the players that had been given allopurinol than those that had been given a placebo. CK, LDH and myoglobin are markers for muscle damage.
Markers for damage to the heart muscle are high sensitive troponinT [Hs TnT] and myocardial-kinase [CK-MB]. Allopurinol inhibited the rise in these two markers after the match too.
A classic marker for free-radical damage is the concentration of malondialdehyde in the blood. The effect of allopurinol on this marker doesn’t look like much, but it was statistically significant.
“Because allopurinol is such a safe drug, the possibility could be considered that players could be given allopurinol to prevent cardiac and skeletal muscle damage”, the researchers conclude. “The fact that professional players in the last decade have started playing three games a week (as opposed to earlier when they only played one every weekend) gives more strength to the preventive action of allopurinol for these individuals.”
Allopurinol prevents cardiac and skeletal muscle damage in professional soccer players.
Xanthine oxidase (XO), a free radical-generating enzyme, is involved in tissue damage produced during exhaustive exercise. Our aim was to test whether allopurinol, a powerful inhibitor of XO, may be effective in preventing exercise-induced tissue damage in soccer players. Twelve soccer players were randomized into two experimental groups. One received allopurinol, before a match of the premier Spanish Football League, and the other placebo. Allopurinol prevented the exercise-induced increase in all the markers of skeletal muscle damage analyzed: creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and myoglobin. Creatine kinase-MB isoenzyme and highly sensitive troponin T, specific biomarkers of myocardial injury, increased significantly in the placebo but not in the allopurinol-treated group after the football match. We also found that the exercise-induced lipid peroxidation, as reflected by malondialdehyde measurements, was prevented after allopurinol administration. However, inhibition of XO did not prevent the increment in the activity of alanine aminotransferase found after the match. No changes in the serum gamma glutamyltransferase activity was found after the match on either the placebo and the allopurinol groups. These two enzymes were determined as biomarkers of liver injury. Allopurinol represents an effective and inexpensive pharmacological agent to prevent tissue damage in soccer players.
PMID: 24690021 [PubMed – as supplied by publisher]