Skip to main content
Erschienen in: European Journal of Applied Physiology 5/2011

01.05.2011 | Original Article

Myocardial tolerance to ischemia–reperfusion injury, training intensity and cessation

verfasst von: Fabio Esposito, Raffaella Ronchi, Giuseppina Milano, Vittoria Margonato, Simona Di Tullio, Marina Marini, Arsenio Veicsteinas, Michele Samaja

Erschienen in: European Journal of Applied Physiology | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Training has been shown to induce cardioprotection. The mechanisms involved remain still poorly understood. Aims of the study were to examine the relevance of training intensity on myocardial protection against ischemia/reperfusion (I/R) injury, and to which extent the beneficial effects persist after training cessation in rats. Sprague-Dawley rats trained at either low (60% \( {\dot{{V}}\text{O}}_{2\max } \)) or high (80% \( {\dot{{V}}\text{O}}_{2\max } \)) intensity for 10 weeks. An additional group of highly trained rats was detrained for 4 weeks. Untrained rats served as controls. At the end of treatment, rats of all groups were split into two subgroups. In the former, rats underwent left anterior descending artery (LAD) ligature for 30 min, followed by 90-min reperfusion, with subsequent measurement of the infarct size. In the latter, biopsies were taken to measure heat-shock proteins (HSP) 70/72, vascular endothelial growth factor (VEGF) protein levels, and superoxide dismutase (SOD) activity. Training reduced infarct size proportionally to training intensity. With detraining, infarct size increased compared to highly trained rats, maintaining some cardioprotection with respect to controls. Cardioprotection was proportional to training intensity and related to HSP70/72 upregulation and Mn-SOD activity. The relationship with Mn-SOD was lost with detraining. VEGF protein expression was not affected by either training or detraining. Stress proteins and antioxidant defenses might be involved in the beneficial effects of long-term training as a function of training intensity, while HSP70 may be one of the factors accounting for the partial persistence of myocardial protection against I/R injury in detrained rats.
Literatur
Zurück zum Zitat Armstrong RB, Laughlin MH, Rome L, Taylor CR (1983) Metabolism of rats running up and down an incline. J Appl Physiol 55:518–521PubMed Armstrong RB, Laughlin MH, Rome L, Taylor CR (1983) Metabolism of rats running up and down an incline. J Appl Physiol 55:518–521PubMed
Zurück zum Zitat Benjamin I, Christians E (2002) Exercise, estrogen, and ischemic cardioprotection by heat shock protein 70. Circ Res 90:833–835PubMedCrossRef Benjamin I, Christians E (2002) Exercise, estrogen, and ischemic cardioprotection by heat shock protein 70. Circ Res 90:833–835PubMedCrossRef
Zurück zum Zitat Boluyt MO, Brevick JL, Rogers DS, Randall MJ, Scalia AF, Li ZB (2006) Changes in the rat heart proteome induced by exercise training: increased abundance of heat shock protein hsp20. Proteomics 6:3154–3169PubMedCrossRef Boluyt MO, Brevick JL, Rogers DS, Randall MJ, Scalia AF, Li ZB (2006) Changes in the rat heart proteome induced by exercise training: increased abundance of heat shock protein hsp20. Proteomics 6:3154–3169PubMedCrossRef
Zurück zum Zitat Brixius K, Schoenberger S, Ladage D, Knigge H, Falkowski G, Hellmich M, Graf C, Latsch J, Montie GL, Prede GL, Bloch W (2008) Long-term endurance exercise decreases antiangiogenic endostatin signalling in overweight men aged 50–60 years. Br J Sports Med 42:126–129 (discussion 129)PubMedCrossRef Brixius K, Schoenberger S, Ladage D, Knigge H, Falkowski G, Hellmich M, Graf C, Latsch J, Montie GL, Prede GL, Bloch W (2008) Long-term endurance exercise decreases antiangiogenic endostatin signalling in overweight men aged 50–60 years. Br J Sports Med 42:126–129 (discussion 129)PubMedCrossRef
Zurück zum Zitat Brown MD (2003) Exercise and coronary vascular remodelling in the healthy heart. Exp Physiol 88:645–658PubMedCrossRef Brown MD (2003) Exercise and coronary vascular remodelling in the healthy heart. Exp Physiol 88:645–658PubMedCrossRef
Zurück zum Zitat Brown DA, Moore RL (2007) Perspectives in innate and acquired cardioprotection: cardioprotection acquired through exercise. J Appl Physiol 103:1894–1899PubMedCrossRef Brown DA, Moore RL (2007) Perspectives in innate and acquired cardioprotection: cardioprotection acquired through exercise. J Appl Physiol 103:1894–1899PubMedCrossRef
Zurück zum Zitat Chicco AJ, Johnson MS, Armstrong CJ, Lynch JM, Gardner RT, Fasen GS, Gillenwater CP, Moore RL (2007) Sex-specific and exercise-acquired cardioprotection is abolished by sarcolemmal KATP channel blockade in the rat heart. Am J Physiol Heart Circ Physiol 292:H2432–H2437PubMedCrossRef Chicco AJ, Johnson MS, Armstrong CJ, Lynch JM, Gardner RT, Fasen GS, Gillenwater CP, Moore RL (2007) Sex-specific and exercise-acquired cardioprotection is abolished by sarcolemmal KATP channel blockade in the rat heart. Am J Physiol Heart Circ Physiol 292:H2432–H2437PubMedCrossRef
Zurück zum Zitat Demirel HA, Powers SK, Zergeroglu MA, Shanely RA, Hamilton K, Coombes J, Naito H (2001) Short-term exercise improves myocardial tolerance to in vivo ischemia-reperfusion in the rat. J Appl Physiol 91:2205–2212PubMed Demirel HA, Powers SK, Zergeroglu MA, Shanely RA, Hamilton K, Coombes J, Naito H (2001) Short-term exercise improves myocardial tolerance to in vivo ischemia-reperfusion in the rat. J Appl Physiol 91:2205–2212PubMed
Zurück zum Zitat Demirel HA, Hamilton KL, Shanely RA, Tumer N, Koroly MJ, Powers SK (2003) Age and attenuation of exercise-induced myocardial HSP72 accumulation. Am J Physiol Heart Circ Physiol 285:H1609–H1615PubMed Demirel HA, Hamilton KL, Shanely RA, Tumer N, Koroly MJ, Powers SK (2003) Age and attenuation of exercise-induced myocardial HSP72 accumulation. Am J Physiol Heart Circ Physiol 285:H1609–H1615PubMed
Zurück zum Zitat Dickson EW, Hogrefe CP, Ludwig PS, Ackermann LW, Stoll LL, Denning GM (2008) Exercise enhances myocardial ischemic tolerance via an opioid receptor-dependent mechanism. Am J Physiol Heart Circ Physiol 294:H402–H408PubMedCrossRef Dickson EW, Hogrefe CP, Ludwig PS, Ackermann LW, Stoll LL, Denning GM (2008) Exercise enhances myocardial ischemic tolerance via an opioid receptor-dependent mechanism. Am J Physiol Heart Circ Physiol 294:H402–H408PubMedCrossRef
Zurück zum Zitat French JP, Hamilton KL, Quindry JC, Lee Y, Upchurch PA, Powers SK (2008) Exercise-induced protection against myocardial apoptosis and necrosis: MnSOD, calcium-handling proteins, and calpain. FASEB J 22:2862–2871PubMedCrossRef French JP, Hamilton KL, Quindry JC, Lee Y, Upchurch PA, Powers SK (2008) Exercise-induced protection against myocardial apoptosis and necrosis: MnSOD, calcium-handling proteins, and calpain. FASEB J 22:2862–2871PubMedCrossRef
Zurück zum Zitat Hamilton KL, Powers SK, Sugiura T, Kim S, Lennon S, Tumer N, Mehta JL (2001) Short-term exercise training can improve myocardial tolerance to I/R without elevation in heat shock proteins. Am J Physiol Heart Circ Physiol 281:H1346–H1352PubMed Hamilton KL, Powers SK, Sugiura T, Kim S, Lennon S, Tumer N, Mehta JL (2001) Short-term exercise training can improve myocardial tolerance to I/R without elevation in heat shock proteins. Am J Physiol Heart Circ Physiol 281:H1346–H1352PubMed
Zurück zum Zitat Hamilton KL, Staib JL, Phillips T, Hess A, Lennon SL, Powers SK (2003) Exercise, antioxidants, and HSP72: protection against myocardial ischemia/reperfusion. Free Radic Biol Med 34:800–809PubMedCrossRef Hamilton KL, Staib JL, Phillips T, Hess A, Lennon SL, Powers SK (2003) Exercise, antioxidants, and HSP72: protection against myocardial ischemia/reperfusion. Free Radic Biol Med 34:800–809PubMedCrossRef
Zurück zum Zitat Harris MB, Starnes JW (2001) Effects of body temperature during exercise training on myocardial adaptations. Am J Physiol Heart Circ Physiol 280:H2271–H2280PubMed Harris MB, Starnes JW (2001) Effects of body temperature during exercise training on myocardial adaptations. Am J Physiol Heart Circ Physiol 280:H2271–H2280PubMed
Zurück zum Zitat Husain K (2004) Physical conditioning modulates rat cardiac vascular endothelial growth factor gene expression in nitric oxide-deficient hypertension. Biochem Biophys Res Commun 320:1169–1174PubMedCrossRef Husain K (2004) Physical conditioning modulates rat cardiac vascular endothelial growth factor gene expression in nitric oxide-deficient hypertension. Biochem Biophys Res Commun 320:1169–1174PubMedCrossRef
Zurück zum Zitat Kavazis AN, McClung JM, Hood DA, Powers SK (2008) Exercise induces a cardiac mitochondrial phenotype that resists apoptotic stimuli. Am J Physiol Heart Circ Physiol 294:H928–H935PubMedCrossRef Kavazis AN, McClung JM, Hood DA, Powers SK (2008) Exercise induces a cardiac mitochondrial phenotype that resists apoptotic stimuli. Am J Physiol Heart Circ Physiol 294:H928–H935PubMedCrossRef
Zurück zum Zitat Kemi OJ, Haram PM, Loennechen JP, Osnes JB, Skomedal T, Wisloff U, Ellingsen O (2005) Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function. Cardiovasc Res 67:161–172PubMedCrossRef Kemi OJ, Haram PM, Loennechen JP, Osnes JB, Skomedal T, Wisloff U, Ellingsen O (2005) Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function. Cardiovasc Res 67:161–172PubMedCrossRef
Zurück zum Zitat Laughlin MH, Oltman CL, Bowles DK (1998) Exercise training-induced adaptations in the coronary circulation. Med Sci Sports Exerc 30:352–360PubMedCrossRef Laughlin MH, Oltman CL, Bowles DK (1998) Exercise training-induced adaptations in the coronary circulation. Med Sci Sports Exerc 30:352–360PubMedCrossRef
Zurück zum Zitat Lennon SL, Quindry J, Hamilton KL, French J, Staib J, Mehta JL, Powers SK (2004a) Loss of exercise-induced cardioprotection after cessation of exercise. J Appl Physiol 96:1299–1305PubMedCrossRef Lennon SL, Quindry J, Hamilton KL, French J, Staib J, Mehta JL, Powers SK (2004a) Loss of exercise-induced cardioprotection after cessation of exercise. J Appl Physiol 96:1299–1305PubMedCrossRef
Zurück zum Zitat Lennon SL, Quindry JC, French JP, Kim S, Mehta JL, Powers SK (2004b) Exercise and myocardial tolerance to ischaemia-reperfusion. Acta Physiol Scand 182:161–169PubMedCrossRef Lennon SL, Quindry JC, French JP, Kim S, Mehta JL, Powers SK (2004b) Exercise and myocardial tolerance to ischaemia-reperfusion. Acta Physiol Scand 182:161–169PubMedCrossRef
Zurück zum Zitat Liu J, Yeo H, Overvik-Douki E, Hagen T, Doniger S, Chu D, Brooks G, Ames B (2000) Chronically and acutely exercised rats: biomarkers of oxidative stress and endogenous antioxidants. J Appl Physiol 89:21–28 Liu J, Yeo H, Overvik-Douki E, Hagen T, Doniger S, Chu D, Brooks G, Ames B (2000) Chronically and acutely exercised rats: biomarkers of oxidative stress and endogenous antioxidants. J Appl Physiol 89:21–28
Zurück zum Zitat Marini M, Frabetti F, Musiani D, Franceschi C (1996) Oxygen radicals induce stress proteins and tolerance to oxidative stress in human lymphocytes. Int J Radiat Biol 70(3):337–350 Marini M, Frabetti F, Musiani D, Franceschi C (1996) Oxygen radicals induce stress proteins and tolerance to oxidative stress in human lymphocytes. Int J Radiat Biol 70(3):337–350
Zurück zum Zitat Marini M, Lapalombella R, Margonato V, Ronchi R, Samaja M, Scapin C, Gorza L, Maraldi T, Carinci P, Ventura C, Veicsteinas A (2007) Mild exercise training, cardioprotection and stress genes profile. Eur J Appl Physiol 99:503–510PubMedCrossRef Marini M, Lapalombella R, Margonato V, Ronchi R, Samaja M, Scapin C, Gorza L, Maraldi T, Carinci P, Ventura C, Veicsteinas A (2007) Mild exercise training, cardioprotection and stress genes profile. Eur J Appl Physiol 99:503–510PubMedCrossRef
Zurück zum Zitat Marini M, Falcieri E, Margonato V, Trere D, Lapalombella R, di Tullio S, Marchionni C, Burattini S, Samaja M, Esposito F, Veicsteinas A (2008) Partial persistence of exercise-induced myocardial angiogenesis following 4-week detraining in the rat. Histochem Cell Biol 129:479–487PubMedCrossRef Marini M, Falcieri E, Margonato V, Trere D, Lapalombella R, di Tullio S, Marchionni C, Burattini S, Samaja M, Esposito F, Veicsteinas A (2008) Partial persistence of exercise-induced myocardial angiogenesis following 4-week detraining in the rat. Histochem Cell Biol 129:479–487PubMedCrossRef
Zurück zum Zitat Melling CW, Thorp DB, Milne KJ, Noble EG (2009) Myocardial Hsp70 phosphorylation and PKC-mediated cardioprotection following exercise. Cell Stress Chaperones 14:141–150PubMedCrossRef Melling CW, Thorp DB, Milne KJ, Noble EG (2009) Myocardial Hsp70 phosphorylation and PKC-mediated cardioprotection following exercise. Cell Stress Chaperones 14:141–150PubMedCrossRef
Zurück zum Zitat Moien-Afshari F, Ghosh S, Elmi S, Rahman MM, Sallam N, Khazaei M, Kieffer TJ, Brownsey RW, Laher I (2008) Exercise restores endothelial function independently of weight loss or hyperglycaemic status in db/db mice. Diabetologia 51:1327–1337PubMedCrossRef Moien-Afshari F, Ghosh S, Elmi S, Rahman MM, Sallam N, Khazaei M, Kieffer TJ, Brownsey RW, Laher I (2008) Exercise restores endothelial function independently of weight loss or hyperglycaemic status in db/db mice. Diabetologia 51:1327–1337PubMedCrossRef
Zurück zum Zitat Pantos C, Malliopoulou V, Mourouzis I, Thempeyioti A, Paizis I, Dimopoulos A, Saranteas T, Xinaris C, Cokkinos DV (2006) Hyperthyroid hearts display a phenotype of cardioprotection against ischemic stress: a possible involvement of heat shock protein 70. Horm Metab Res 38:308–313PubMedCrossRef Pantos C, Malliopoulou V, Mourouzis I, Thempeyioti A, Paizis I, Dimopoulos A, Saranteas T, Xinaris C, Cokkinos DV (2006) Hyperthyroid hearts display a phenotype of cardioprotection against ischemic stress: a possible involvement of heat shock protein 70. Horm Metab Res 38:308–313PubMedCrossRef
Zurück zum Zitat Paroo Z, Haist JV, Karmazyn M, Noble EG (2002) Exercise improves postischemic cardiac function in males but not females: consequences of a novel sex-specific heat shock protein 70 response. Circ Res 90:911–917PubMedCrossRef Paroo Z, Haist JV, Karmazyn M, Noble EG (2002) Exercise improves postischemic cardiac function in males but not females: consequences of a novel sex-specific heat shock protein 70 response. Circ Res 90:911–917PubMedCrossRef
Zurück zum Zitat Powers SK, Lennon SL, Quindry J, Mehta JL (2002) Exercise and cardioprotection. Curr Opin Cardiol 17:495–502PubMedCrossRef Powers SK, Lennon SL, Quindry J, Mehta JL (2002) Exercise and cardioprotection. Curr Opin Cardiol 17:495–502PubMedCrossRef
Zurück zum Zitat Powers SK, Quindry JC, Kavazis AN (2008) Exercise-induced cardioprotection against myocardial ischemia-reperfusion injury. Free Radic Biol Med 44:193–201PubMedCrossRef Powers SK, Quindry JC, Kavazis AN (2008) Exercise-induced cardioprotection against myocardial ischemia-reperfusion injury. Free Radic Biol Med 44:193–201PubMedCrossRef
Zurück zum Zitat Quindry J, French J, Hamilton K, Lee Y, Mehta JL, Powers S (2005) Exercise training provides cardioprotection against ischemia-reperfusion induced apoptosis in young and old animals. Exp Gerontol 40:416–425PubMedCrossRef Quindry J, French J, Hamilton K, Lee Y, Mehta JL, Powers S (2005) Exercise training provides cardioprotection against ischemia-reperfusion induced apoptosis in young and old animals. Exp Gerontol 40:416–425PubMedCrossRef
Zurück zum Zitat Quindry JC, Hamilton KL, French JP, Lee Y, Murlasits Z, Tumer N, Powers SK (2007) Exercise-induced HSP-72 elevation and cardioprotection against infarct and apoptosis. J Appl Physiol 103:1056–1062PubMedCrossRef Quindry JC, Hamilton KL, French JP, Lee Y, Murlasits Z, Tumer N, Powers SK (2007) Exercise-induced HSP-72 elevation and cardioprotection against infarct and apoptosis. J Appl Physiol 103:1056–1062PubMedCrossRef
Zurück zum Zitat Staib JL, Quindry JC, French JP, Criswell DS, Powers SK (2007) Increased temperature, not cardiac load, activates heat shock transcription factor 1 and heat shock protein 72 expression in the heart. Am J Physiol Regul Integr Comp Physiol 292:R432–R439PubMedCrossRef Staib JL, Quindry JC, French JP, Criswell DS, Powers SK (2007) Increased temperature, not cardiac load, activates heat shock transcription factor 1 and heat shock protein 72 expression in the heart. Am J Physiol Regul Integr Comp Physiol 292:R432–R439PubMedCrossRef
Zurück zum Zitat Starnes JW, Taylor RP, Park Y (2003) Exercise improves postischemic function in aging hearts. Am J Physiol Heart Circ Physiol 285:H347–H351PubMed Starnes JW, Taylor RP, Park Y (2003) Exercise improves postischemic function in aging hearts. Am J Physiol Heart Circ Physiol 285:H347–H351PubMed
Zurück zum Zitat Starnes JW, Barnes BD, Olsen ME (2007) Exercise training decreases rat heart mitochondria free radical generation but does not prevent Ca2+-induced dysfunction. J Appl Physiol 102:1793–1798PubMedCrossRef Starnes JW, Barnes BD, Olsen ME (2007) Exercise training decreases rat heart mitochondria free radical generation but does not prevent Ca2+-induced dysfunction. J Appl Physiol 102:1793–1798PubMedCrossRef
Zurück zum Zitat Tarricone E, Scapin C, Vitadello M, Esposito F, Margonato V, Milano G, Samaja M, Gorza L (2008) Cellular distribution of Hsp70 expression in rat skeletal muscles. Effects of moderate exercise training and chronic hypoxia. Cell Stress Chaperones 13:483–495PubMedCrossRef Tarricone E, Scapin C, Vitadello M, Esposito F, Margonato V, Milano G, Samaja M, Gorza L (2008) Cellular distribution of Hsp70 expression in rat skeletal muscles. Effects of moderate exercise training and chronic hypoxia. Cell Stress Chaperones 13:483–495PubMedCrossRef
Zurück zum Zitat Taylor R, Harris M, Starnes J (1999) Acute exercise can improve cardiprotection without increasing heat shock protein content. Am J Physiol 276:H1098–H1102PubMed Taylor R, Harris M, Starnes J (1999) Acute exercise can improve cardiprotection without increasing heat shock protein content. Am J Physiol 276:H1098–H1102PubMed
Zurück zum Zitat Taylor RP, Ciccolo JT, Starnes JW (2003) Effect of exercise training on the ability of the rat heart to tolerate hydrogen peroxide. Cardiovasc Res 58:575–581PubMedCrossRef Taylor RP, Ciccolo JT, Starnes JW (2003) Effect of exercise training on the ability of the rat heart to tolerate hydrogen peroxide. Cardiovasc Res 58:575–581PubMedCrossRef
Zurück zum Zitat Testa U, Pannitteri G, Condorelli GL (2008) Vascular endothelial growth factors in cardiovascular medicine. J Cardiovasc Med (Hagerstown) 9:1190–1221CrossRef Testa U, Pannitteri G, Condorelli GL (2008) Vascular endothelial growth factors in cardiovascular medicine. J Cardiovasc Med (Hagerstown) 9:1190–1221CrossRef
Zurück zum Zitat Yamashita N, Hoshida S, Otsu K, Asahi M, Kuzuya T, Hori M (1999) Exercise provides direct biphasic cardioprotection via manganese superoxide dismutase activation. J Exp Med 189:1699–1706PubMedCrossRef Yamashita N, Hoshida S, Otsu K, Asahi M, Kuzuya T, Hori M (1999) Exercise provides direct biphasic cardioprotection via manganese superoxide dismutase activation. J Exp Med 189:1699–1706PubMedCrossRef
Zurück zum Zitat Zhang KR, Liu HT, Zhang HF, Zhang QJ, Li QX, Yu QJ, Guo WY, Wang HC, Gao F (2007) Long-term aerobic exercise protects the heart against ischemia/reperfusion injury via PI3 kinase-dependent and Akt-mediated mechanism. Apoptosis 12:1579–1588PubMedCrossRef Zhang KR, Liu HT, Zhang HF, Zhang QJ, Li QX, Yu QJ, Guo WY, Wang HC, Gao F (2007) Long-term aerobic exercise protects the heart against ischemia/reperfusion injury via PI3 kinase-dependent and Akt-mediated mechanism. Apoptosis 12:1579–1588PubMedCrossRef
Metadaten
Titel
Myocardial tolerance to ischemia–reperfusion injury, training intensity and cessation
verfasst von
Fabio Esposito
Raffaella Ronchi
Giuseppina Milano
Vittoria Margonato
Simona Di Tullio
Marina Marini
Arsenio Veicsteinas
Michele Samaja
Publikationsdatum
01.05.2011
Verlag
Springer-Verlag
Erschienen in
European Journal of Applied Physiology / Ausgabe 5/2011
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-010-1707-0

Weitere Artikel der Ausgabe 5/2011

European Journal of Applied Physiology 5/2011 Zur Ausgabe

Neu im Fachgebiet Arbeitsmedizin

Elterliches Belastungserleben, Unaufmerksamkeits‑/Hyperaktivitätssymptome und elternberichtete ADHS bei Kindern und Jugendlichen: Ergebnisse aus der KiGGS-Studie

Open Access ADHS Leitthema

Die Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) ist eine der häufigsten psychischen Störungen im Kindes- und Jugendalter [ 1 ]. In Deutschland beträgt die Prävalenz einer elternberichteten ADHS-Diagnose bei Kindern und Jugendlichen 4,4 % …

Substanzkonsum und Nutzung von sozialen Medien, Computerspielen und Glücksspielen unter Auszubildenden an beruflichen Schulen

Open Access Leitthema

Die Begrenzung von Schäden durch Substanzkonsum und andere abhängige Verhaltensweisen von Jugendlichen und jungen Erwachsenen ist ein wichtiges Anliegen der öffentlichen Gesundheit. Der Übergang von der Adoleszenz zum jungen Erwachsenenalter ist …

Berufsbelastung und Stressbewältigung von weiblichen und männlichen Auszubildenden

Leitthema

In der Öffentlichkeit wird die berufliche Ausbildung oftmals unter ökonomischen Gesichtspunkten diskutiert: Mit den geburtenstarken Jahrgängen gehen erfahrene Fachkräfte in Rente und von nachfolgenden Generationen rücken zu wenige Arbeitskräfte …

Rauschtrinken in der frühen Adoleszenz

COVID-19 Leitthema

Alkohol ist in Deutschland die mit Abstand am häufigsten konsumierte psychoaktive Substanz. Mehr als 2 Drittel aller Erwachsenen im Alter von 18 bis 64 Jahren (70,5 %) hat 2021 in den letzten 30 Tagen Alkohol konsumiert [ 1 ]. Von diesen …