Abstract
The active participation of skeletal muscles is a unique characteristic of exertional
heat stroke. Nevertheless, the only well-documented link between skeletal muscle activities
and exertional heat stroke pathophysiology is the extensive muscle damage (e. g.,
rhabdomyolysis) and subsequent leakage of intramuscular content into the circulation
of exertional heat stroke victims. Here, we will present and discuss rarely explored
roles of skeletal muscles in the context of exertional heat stroke pathophysiology
and recovery. This includes an overview of heat production that contributes to severe
hyperthermia and the synthesis and secretion of bioactive molecules, such as cytokines,
chemokines and acute phase proteins. These molecules can alter the overall inflammatory
status from pro- to anti-inflammatory, affecting other organ systems and influencing
recovery. The activation of innate immunity can determine whether a victim is ready
to return to physical activity or experiences a prolonged convalescence. We also provide
a brief discussion on whether heat acclimation can shift skeletal muscle secretory
phenotype to prevent or aid recovery from exertional heat stroke. We conclude that
skeletal muscles should be considered as a key organ system in exertional heat stroke
pathophysiology.
Key words
myopathy - illness - hyperthermia - immune response
