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. 2019 Sep 16;50(1):103–127. doi: 10.1007/s40279-019-01181-y

Table 4.

Characteristics of the included studies and relevant outcomes

Study Participants Exercise protocol Sample Biomarker Technique Findings
Møller et al. [34] 12 Healthy subjects (7 males and 5 females); MA ± SD = 26.1 ± 4.9 y/o Maximal bicycle exercise (VO2-max test) under normal conditions and at 4559 m (high-altitude hypoxia) for 3 days Lymphocytes SBs,FPG-s s, ENDO III-s s Comet assay Increased SBs at hypoxia on all 3 days; ENDO III-s s increased on day 3 at hypoxia; FPG-s s remained unchanged
Fogarty et al. [66] 10 Healthy males; MA ± SD = 23 ± 4 y/o Treadmill test to exhaustion Lymphocytes Tail DNA (%) Comet assay DNA damage increased 63% (p < 0.05) after exercise compared to rest
Sardas et al. [55] 12 Male rowers (MA ± SD = 22 ± 3.8 y/o) and 11 PE students (MA ± SD = 21.8 ± 3.8 y/o) Three-staged exercise test on a rowing (rowers) and bicycle ergometer (PE students) Lymphocytes Tail DNA (%) Comet assay DNA damage was increased 24 h post exercise compared to pre-exercise in both rowers and PE students but overall pre- and post-exercise damage was significantly higher in rowers compared to PE students
Reichhold et al. [47]a 28 Male triathletes; MA ± SD = 32.7 ± 6.3 y/o Ironman triathlon (3.8 km swim, 180 km cycle, 42 km run) Lymphocytes Tail DNA (%) Comet assay

The % of SBs decreased significantly immediately post-race, then increased 1 d post-race and declined again 5 d after the race

Between days 5 and 19 post-race the levels of strand breaks decreased further below initial levels

Hartmann et al. [70] 2 Males (20 and 30 y/o) and 1 female (32 y/o) Treadmill test to exhaustion White blood cells DNA migration (μm) Comet assay No increase in DNA migration was seen immediately after the test but a significant increase in DNA migration was found after 6, 24 and 48 h.
Liu et al. [38] 8 Males athletes; MA ± SD = 21.35 ± 1.04 Treadmill exercise to exhaustion Peripheral blood cells Tail length; Olive tail moment Comet assay Compared to before exercise, both tail length and olive tail moment significantly rose after exercise (p < 0.001)
Inoue et al. [56] 9 Swimmers (MA ± SD = 20.1 ± 1.2 y/o) and 9 distance runners (MA ± SD = 20.9 ± 2.1 y/o) 1500 m for 90 min (swimmers) and 15 km distance running for 70 min (runners) Lymphocytes 8-OHdG HPLC 8-OHdG decreased significantly after swimming, but no significant change was observed after running
Sacheck et al. [62] 8 Young (MA ± SD = 25.4 ± 2.2 y/o) and 8 older (MA ± SD = 69.3 ± 3.5 y/o) Downhill running on a treadmill for 45 min at 75% VO2-max Leukocytes 8-OHdG HPLC No change in 8-OHdG 24 h post-exercise
Revan [61] 14 Healthy males; MA ± SEM = 22.3 ± 0.5 y/o Incremental exercise test to exhaustion on a cycle ergometer Plasma 8-OHdG Cayman ELISA Kit No significant difference in 8-OHdG levels before and after exercise
Tanimura et al. [54] 8 Young untrained (MA ± SD = 23.8 ± 3.2 y/o) and 8 endurance-trained (MA ± SD = 21.1 ± 3.7 y/o) men Cycling at 75% VO2-max 1 h daily for three consecutive days Lymphocytes Tail DNA (%) Comet assay DNA damage at day 4 was significantly greater than that at day 1 in both groups
Saritaş et al. [63] 22 Healthy trained men; MA ± SEM = 21.45 ± 0.43 y/o 12 min run test Serum 8-OHdG ELISA Kit 8–OHdG levels were not different between the time periods (before exercise, immediately after exercise and 24 h after the exercise) (p > 0.05)
Mastaloudis et al. [51] 5 Males (MA ± SEM = 39 ± 8 y/o) and 5 females (MA ± SEM = 35 ± 4 y/o) 50 km ultramarathon Leukocytes Tail DNA (%) Comet assay On average, in both placebo and experimental groups, DNA damage increased at mid-race but returned to baseline values by the end of the race
Harms-Ringdahl et al. [50] 15 Healthy untrained males and females (7 females and 8 males; MA ± SD = 30.5 ± 6.9 y/o 20 min cycling at 80% of maximum heart rate Serum 8-OHdG ELISA Kit Levels of 8-OHdG increased 42% after the exercise
Hartmann et al. [69] 3 Male and 3 female athletes (aged between 21-33 y/o) Short-distance triathlon competition (1.5 km swimming, 40 km cycling, 10 km running) Lymphocytes Tail moment (DNA migration) Comet assay Increase in DNA migration was seen at 24 h post-exercise, whereas at 48 h the values were lower compared to 24 h but higher than the pre-exercise values. At 72 h, the maximum increase in DNA migration was found and baseline values were still elevated after 120 h
Fogarty et al. [67] 12 Healthy males; MA ± SD = 23 ± 4 y/o) Bike test at 40,70 and 100% of VO2-max Leukocytes Tail length Comet assay Increase in DNA damage observed at moderate (70% VO2max) and high-intensity exercise (100% VO2max) compared to rest
Tanimura et al. [74] 15 Healthy sedentary males; MA ± SD = 23.7 ± 1.1 y/o Cycling at 75% VO2-max for 1 h Lymphocytes Tail DNA (%) Comet assay There was increased DNA damage at 3 h post-exercise compared to pre-exercise (p < 0.05)
Paik et al. [72] 10 Healthy males; MA ± SD = 25.6 ± 0.8 y/o Treadmill run to exhaustion at 80% VO2-max Lymphocytes Tail DNA (%), tail length, tail moment Comet assay There was increased DNA damage measured just prior to the termination of exercise compared to pre-exercise (p < 0.05)
Ryu et al. [40] 30 Male runners, 10 in each group; 10 km group (MA ± SD = 36.5 ± 10.9 y/o), 21 km group (MA ± SD = 45.0 ± 7.8 y/o), 45 km group (MA ± SD = 37.9 ± 13.6 y/o) 3 different marathon distances: 10 km,21 km and 45 km Lymphocytes Tail DNA (%), tail length, tail moment Comet assay Compared to rest and recovery, tail moment was significantly higher in all groups. Also, at 45 km tail moment was found to be higher a post-exercise compared to the 10 km and 21 km (p < 0.05). No differences in DNA in tail (%) or tail length was observed
Itoh et al. [60] 8 Untrained males; MA ± SD = 21.8 ± 2.1 y/o 10 km run Plasma 8-OHdG ELISA kit Decreased plasma 8-OHdG levels both immediately and 1 h after the 10-km run compared to resting values (p < 0.05)
Tsai et al. [75] 14 Male runners (median age 21, range 20–24 y/o) 42 km marathon race Peripheral blood mononuclear cells Tail DNA (%), FPG-s s, ENDO III-s s Comet assay SBs increased on day 1; increased levels of FPG-s s were observed immediately and 24 h (day 1) after the race; ENDO III-s s levels also increased immediately post-exercise and on day 7
Bloomer et al. [59] 11 & 6 Aerobically trained men and women; MA ± SD = 23.3 ± 5.2 y/o Treadmill run for 30 min at 80% VO2-max Plasma 8-OHdG ELISA Kit No significant difference was observed in 8-OHdG levels before and after exercise
Turner et al. [76] 9 Healthy men; MA ± SD = 46.1 ± 5.3 y/o 233 km ultraendurance race Peripheral blood mononuclear cells Tail DNA (%), FPG Comet assay Increased SBs immediately and 24 h after the race, compared to baseline (p < 0.01); an increase in FPG-dependent oxidative DNA damage was also observed immediately after the race (p < 0.05)
Peters et al. [73] 8 Male athletes; MA ± SD = 34.2 ± 2.44 y/o 2.5-h treadmill run at 75% VO2-max Lymphocytes Tail length/DNA migration (μm) Comet assay There was no significant increase in DNA strand breaks before and after the exercise (p > 0.05)
Zhang et al. [78] 11 Healthy male students aged between 18–20 y/o Bicycle exercise to exhaustion White blood cells Tail length/DNA migration (mm) Comet assay Significantly increased DNA migration at 6 h and 24 h compared to pre-exercise (p < 0.01)
Wagner et al. [77] 42 Male athletes; MA ± SD = 35.3 ± 7 y/o Ironman triathlon (3.8-km swimming, 180 km cycling and 42.2-km running) Lymphocytes SBs, Tail DNA (%), ENDO III-s s, FPG-s s Comet assay SBs decreased post-race; DNA migration increased 1 day post-race due to SBs (p < 0.01), then 5 days post-race returned to pre-race levels and decreased further to below the initial levels 19 days post-race (p < 0.01)
Sato et al. [64] 15 Male subjects aged 19–29 y/o (7 physically active and 8 sedentary) 50% VO2-max of cycle ergometer exercise for 30 min Leukocytes 8-OHdG HPLC No change in physically active subjects but decreased in sedentary subjects
Hartmann et al. [68] 8 Healthy men (29-34 y/o) Treadmill run to exhaustion White blood cells Tail moment Comet assay Increase in DNA damage was seen 24 h after the run (mean increase = 35.3 ± 8.3%)
Shi et al. [57] 5 Healthy males (aged 22–38 y/o) Exercise on a cycle ergometer at 50% VO2-max for 10.5 ± 1.3 min Leukocytes 8-OHdG HPLC After aerobic exercise, no significant change in leukocyte 8OHdG level was seen. (However, a significant increase was detected in samples taken 24 h after anaerobic exercise)
Davison et al. [65] 7 Healthy males; MA ± SD = 22.3 ± 4.1 y/o Treadmill test to exhaustion Peripheral blood mononuclear cells Tail moment Comet assay An increase in DNA damage was observed after exercise
Asami et al. [36]a 23 Healthy males aged 19-50 y/o (10 untrained and 13 trained) Maximal cycling exercise Leukocytes 8-OHdG HPLC A significant decrease in 8-OHdG levels was observed in the untrained subjects only (p < 0.05)
Briviba et al. [49] 10 Subjects for half-marathon (5 males and 5 females; MA ± SD = 43 ± 9 y/o) and 12 subjects for marathon (2 males and 10 females; MA ± SD = 45 ± 10 y/o) Half-marathon (21.1 km) and a marathon (42.195 km) Lymphocytes Tail DNA (%), FPG-s s and ENDO III-s s Comet assay No significant changes in the levels of DNA strand breaks in lymphocytes after either race. However, a significant difference was found in the % of ENDO III s in the tail after both races (p < 0.05), whereas the % of FPG-s s was slightly increased but not significantly (p > 0.05)
Pittaluga et al. [53] 7 Females; MA ± SD = 68.1 ± 2.7 y/o Exhaustive bout on a cycle ergometer Serum 8-OHdG HPLC No significant difference in 8-OHdG levels before and after exercise
Niess et al. [39] 5 UT and 6 TR Treadmill run test to exhaustion Leukocytes Tail moment/DNA migration(μm) Comet assay An increase in DNA migration from 2.31 ± 0.20 (TR) and 2.22 ± 0.16 (UT) at rest to 2.65 ± 0.30 (TR) and 3.00 ± 0.41 tail moment (UT) was observed 24 h after exercise
Niess et al. [71] 12 Male runners; MA ± SD = 27.3 ± 4.1 y/o Half-marathon (21.1 km) Leukocytes DNA migration (μm) Comet assay DNA migration rose significantly 24 h after the race, compared to rest (p < 0.01)
Williamson et al. [80] 10 Recreationally males; MA ± SD = 22 ± 2 y/o Treadmill test to exhaustion Peripheral blood mononuclear cells Tail DNA (%) Comet assay Tail intensity was increased by 18.2% post-exercise (p < 0.05)
Orlando et al. [48]a 21 Rugby male athletes; MA ± SD = 26 ± 5 y/o 40 min run at 85% of maximum heart rate Peripheral blood mononuclear cells Tail DNA (%) Comet assay No significances of DNA damage were observed after the exercise bout
Meihua et al. [58] 10 Male athletes; MA ± SD = 21.1 ± 1.13 y/o VO2-max (Bruce protocol) Peripheral blood cells and plasma DNA damage index and 8-OHdG Comet assay and HPLC Exercise increased DNA damage index as measured by comet assay; plasma 8-OHdG levels also increased following exhaustive exercise (p < 0.01)
Roh et al. [37]a 10 Male college athletes; MA ± SD = 18.8 ± 0.8 y/o 1 h run at 75% of heart rate reserve Lymphocytes Tail DNA (%) Comet assay DNA tail (%) increased following exercise (p < 0.05)
Kim et al. [79] 11 Amateur male triathletes; MA ± SD = 37.9 ± 6.2 y/o 2 triathlon races (O2 and Olympic courses) Lymphocytes Tail DNA (%) Comet assay In the Olympic course, DNA tail intensity (%) increased after match and decreased after 3 and 6 days of recovery; In the O2 course, tail (%) decreased after match, increased after 3 days, and decreased after 6 days of recovery (p < 0.01)

SBs strand breaks, FPG-s s formamidopyrimidine glycosylase-sensitive sites, ENDO III-s s endonuclease III-sensitive sites, 8-OHdG 8-hydroxy-2′–deoxyguanosine, MA mean age, SD standard deviation, HPLC high-performance liquid chromatography, ELISA enzyme-linked immunosorbent assay, PE physical education, VO2-max maximum rate of oxygen consumption; untrained, UT trained, TR, y/o years old

anot included in meta-analyses