Creatine supplement is one of the most popular nutritional supplements and has various metabolic functions and sports medicine applications. It increases muscle mass and can decrease muscular inflammation.  Creatine is considered a nutritional supplement and is synthesized from three amino acids: arginine, glycine, and methionine. It can be produced endogenously by the liver and kidneys or ingested from exogenous sources such as meat and fish. It increases muscle mass and can decrease muscular inflammation. Some studies have suggested a beneficial role of creatine supplementation on chronic pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis. It is worth noting that asthma prevalence is high among athletes, and many of these individuals may be taking creatine. However, the effects of creatine supplementation on chronic pulmonary diseases of allergic origin have not been investigated.

Creatine is a precursor molecule for adenosine triphosphate, which is the primary substrate for intracellular energy generation. Cells take creatine from the bloodstream through a creatine transporter and store it as free creatine and phosphorylated form, creatine phosphate. Previous studies demonstrated that creatine supplementation increases the intracellular content of free creatine and creatine phosphate.

Asthma is a chronic inflammatory disease with a high prevalence in the general population, around 10%. Among professional and nonprofessional athletes, the estimated prevalence of asthma is even higher, ranging from 3% to 50%, depending on the sports training environment and the presence of atopy. Among adolescents, one of the largest groups of sports supplements consumers, asthma prevalence can be as high as 30%. Many of these athletes and adolescents are probably taking creatine. However, the effects of creatine supplementation on this population remain unknown.

In an experimental study done by Vieira and colleagues, for the first time, the effects of 32 days of oral creatine supplementation on lung inflammatory response were evaluated in a model of chronic allergic lung inflammation in sensitized mice. The results showed creatine supplementation exacerbated allergic inflammation, airway responsiveness, and remodeling in sensitized mice.  These were characterized respectively by: a significant increase in the density of eosinophils in Bronchoalveolar lavage fluid (BALF) and airway walls; a significant increase in hyperresponsiveness; and a significant increase in the volume proportion of elastic and collagen fibers and smooth muscle thickness.

The British Medical Journal (BMJ) published an article in 2005 on creatine supplementation during pulmonary rehabilitation in COPD. They stated that creatine supplementation increases fat-free mass, peripheral muscle strength and endurance, and health status, but not exercise capacity. Creatine may constitute a new ergogenic treatment in COPD.

Taking into account that the uses of creatine in sports medicine are based not only on its effects on muscle mass gain but also on its muscular anti-inflammatory action, and also considering its beneficial role on chronic obstructive pulmonary diseases, it can be concluded that creatine could also have some beneficial effect on chronic pulmonary inflammatory diseases of allergic origin, such as asthma. Furthermore, since professional and nonprofessional athletes with asthma might be using creatine supplementation, we believe it is crucial to investigate creatine’s effects in this population.

References:

1. J P Fuld, L P Kilduff, J A Neder, Y Pitsiladis, M E J Lean, S A Ward, M M Cotton (2005). Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease, British Medical Journal (BMJ).
2. Rodolfo P. Vieira , Anna Cecília S. Duarte , Renata C. Claudino , Adenir Perini , Ângela B. G. Santos , Henrique T. Moriya , Fernanda M. Arantes-Costa , Mílton A. Martins , Celso R. F. Carvalho , and Marisa Dolhnikoff (2007). Creatine Supplementation Exacerbates Allergic Lung Inflammation and Airway Remodeling in Mice, American Journal of Respiratory cell and Molecular Biology, Volume 37 Issue 6.
3. T L Griffiths, D Proud (2005), Creatine supplementation as an exercise performance enhancer for patients with COPD? An idea to run with, British Medical Journal (BMJ)