Direct and Cross Effects of Adaptation to Systemic Hyperthermia: Impact on Quality of Life, Neurohormonal and Psychophysiological Human Status
Condition: Hypoxia, Altitude; Exercise Tolerance; Metabolic Disturbance; Quality of Life
MeSH terms: Altitude Sickness; Hypoxia; Hyperthermia; Fever
Study type: Interventional

Summary: 
      Life expectancy and quality of human life are important indicator of the sustainable
      development of the society. At the same time, the physical, functional, emotional and
      psychological components of the of the quality of life evaluation are subjected to be
      evaluated objectively and corrected using modern medical and socio-psychological methods.
      According to a fair number of experts, the arsenal of means for functional rehabilitation and
      health promotion is limited, and its expansion is only possible on the basis of the
      principles of adaptation medicine and their translation from experimental research into
      specific preventive and health-promoting technologies.

      The study is aimed at the development in molecular-endocrine, neuro-visceral and
      psychophysiological complex mechanisms of human long-term adaptation to systemic modern
      heating device-based hyperthermia for the development of medical technology focused on
      optimization in physical functioning, neuro-autonomic regulation, psycho-emotional status and
      stress- resistance as objective characteristics of humans' quality of life in working age.

      The novelty of the project is the disclosure of key mechanisms of adaptational direct and
      cross-effects to the prolonged systemic individually dosed hyperthermia underlying the
      optimization of stress-resistance, psycho-physiological status and exercise tolerance of
      practically healthy persons and leading to an increase in the subjectively perceived quality
      of life.

      The discovery of the mechanisms of hyperthermically induced neuroplasticity (in terms of the
      dynamics of oxidative stress, heat shock proteins and the brain derived neurotrophic factor)
      will also have a scientific significance, which in the long term prospectives may play a role
      in the development of technics for the prevention and rehabilitation of age-associated
      neuro-degenerative processes and diseases.
    

Detailed description: 
      Hyperthermic Fitness Treatment (HFT) is proved in many applied and clinical trials to be a
      helpful tool for enhancing thermal acclimation, physical tolerance and endurance, improving
      cardiovascular dysfunctions, normalizing metabolic status and body weight in patients with
      chronic non-infectious diseases and in aged healthy individuals. Clinical effects of
      hyperthermia acclimation or repeated sauna's sessions were investigated in series of
      well-designed placebo-controlled studies at different cohorts of Bronchial Asthma (BA),
      Chronic Obstructive Pulmonary Disease (COPD), Cardiovascular Disease (CVD) Metabolic Syndrome
      and Obesity (MS-O) patients, qualified professional sportsmen and healthy volunteers.

      Effects of sauna bathing and hyperthermic treatments (acclimation to systemic, whole body
      dosed hyperthermia, which leads to core temperature increase on 2,0-2,5oC) are accurately
      described in well-controlled medical studies, performed by experienced researchers imposing
      different protocols (from 1 session lasting 15-20 min, daily 1 week up to 2 sessions per day,
      3 weeks).

      The generalized result of the most trials suggests adaptation to hyperthermia (sauna bathing
      sessions) is accompanied by a multi-faceted molecular, cellular, organic and systemic,
      organismic responses - by progressively increased resistance to thermal stressors, increased
      bronchial conductivity and pulmonary ventilation, sweating; stimulated activation of
      neuro-humoral and cardiovascular systems, boosted microcirculation and, as a consequence,
      providing more efficient transport and utilization of O2 by body tissues, resulting in
      increase of exercise tolerance, physical activity, normalization of appetite, balancing
      thermogenesis and heat release.

      Mechanisms underlying the described clinical effects are partially connected with increased
      production of some neurotransmitters, hormones and peptides, among them - Brain derived
      neurotropic factor (BDNF), Somatotropin (Human Growth Hormone - HGH), Heat Shock Proteins
      family as cell signaling pathways inducers etc.

      In spite of difference in study design, protocols, and hyperthermic mashines - devices, it is
      safe to make the conclusion that periodic individually adapted hyperthermic sessions are
      capable to induce haematological, neuro-humoral, cardiorespiratory and antioxidant adaptation
      to provide pathogenetic treatment and rehabilitation of patients with chronic non-infectious
      diseases.

      Enhanced stress resistance and improved oxygen transfer/utilization are basic mechanisms
      whereby the organism increases its resistance to any physical and environmental stressors and
      to variety of pathogenic factors.

      The described Hyperthermic Fitness Treatment (HFT) method is safe, has no significant
      complications or adverse side effects and is generally very well tolerated by sportsmen,
      healthy persons and different clinical patients' groups.
    

Intervention name(s): Hyperthermic Fitness Treatment (HFT); Placebo Hyperthermic Fitness Treatment; Physical Examination; Assessment of Cardiorespiratory Fitness; Autonomic Balance, Orthostatic and Hypoxic tolerance; Psychological Testing; Measurement of Blood Markers
Intervention type(s): Device; Device; Other; Other; Other; Other; Other
Intervention description(s): The Hyperthermic Fitness Treatment uses Alfa Basic capsule, an ergonomic camera in which a participant may take a lying position and undergo hyperthermia procedures (infrared heating with intracapsule temperature increase up to 80 degrees C◦), the head being outside the camera blown by cool air with a built-in ventilator. HFT is comparable to dry sauna bathing. Core body temperatures will be raised to 37.5-38.5°C◦. Recommended duration of one HFT session is 40 min. All the HFT group participants while undergoing sessions in the Cocoon will be dressed in bathing suits.; Attenuated heating with less heat set (20-30 degrees C◦). This results in no increase of core body temperature. The participant will still feel heat and will see similar lighting and hear similar sounds as those occurring during actual HFT, and will be in the capsule for the same period of time.; Resting hearth rate (HR), Systolic and Diastolic blood pressure (SBP and DBP) values are measured twice in supine position using an automatic tonometer after 5 min of rest.
Body mass (BM) and height are measured to calculate Body Mass Index. Body composition is assessed with the use of portable body-impedance-meter for the whole body impedance-analysis.
Body core temperature, Blood pressure (BP) and Heart rate (HR) are measured before and right after each session. Arterial oxygen saturation (SpO2) and HR is monitored continuously by the use of a pulse oximeter, attached to the index fingertip of non dominant hand.; An assessment of exercise tolerance and cardiorespiratory fitness (ET, CRF) is carried out with the use of Cardiopulmonary Exercise Test - CPET). Testing is carried out using a gas analyzer and an Intertrack treadmill. Evaluation of gas exchange parameters conducted according to a given program - Cardiopulmonary load testing.; Evaluation of Autonomic balance is assesed using Heart Rate Variability (HRV) analysis. The HRV test relies on a 5-min RR interval (time in milliseconds between two R waves of the electrocardiogram complex) recorded at rest for 5 min supine (SU) followed of 5 min resting time. Measurement of the interval duration between two R waves of the cardiac electrical activity are performed with a HR monitor.
Orthostatic tolerance is assessed after ANS balance assessment by HRV analysis to continue RR intervals registration for 3 min after participant was asked to stand up taking a vertical position near the couch.
The individual sensitivity to hypoxia is determined by conducting a 10-minute hypoxic test (HT) - breathing through a facial mask by a gas mixture with 11% of O2, with minute-by-minute monitoring of HR and hemoglobin saturation by oxygen (SaO2). Arterial blood pressure is recorded before and after HT.; Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), which is a self-completed quantity of health-related QoL.
Participants are asked to complete the Pittsburgh Sleep Quality Index (PSQI), a retrospective self-report measure assessing their quality of sleep during the last three weeks preceding the study.
Anxiety level is estimated by using State and Trait Anxiety Scales (SA and TA) developed by Ch. Spielberger
Subjective Ratings of Thermosensation and Pain.Participants rate their comfort, thermosensation, and pain by fixing results in visual-analogous scale (VAS) while passing each of HFT treatment.; Periferal venous blood (10 ml) sumples of the fastest (overnight fast) study subjects are withdrawn by a qualified laboratory technician via aseptic technique from the antecubital vein in the sitting position, using sterile needles and are collected. Serum BDNF, HGH, HSPs (60, 70, 90) concentrations are determined.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: Adaptation; Systemic hyperthermia; Quality of life; Neuro-visceral interactions; Preventive medical technologies; Personalized approach; Neuroplasticity; Brain derived neurotrophic factor; Irisin; Heat Shock proteins