Airway inflammation, bronchial hyperresponsiveness and asthma in elite ice hockey players

Abstract

Airway inflammation, bronchial hyperresponsiveness and asthma in elite ice hockey players. A. Lumme, T. Haahtela, J. Ö unap, P. Rytilä, Y. Obase, M. Helenius, V. Remes, I. Helenius. #ERS Journals Ltd 2003. ABSTRACT: There is little information of lower respiratory symptoms, bronchial hyperresponsiveness and airway inflammation in elite ice hockey players.A total of 88 highly trained ice hockey players and 47 control subjects were studied. All the subjects were subjected to skin-prick tests, resting spirometry examinations and histamine-challenge tests. Adequate induced sputum samples were obtained from 68 of the ice hockey players and from 18 symptom-free control subjects on a separate day.Bronchial hyperresponsiveness in a histamine-challenge test was found in 21 (24%) of the athletes and in five (11%) of the controls. Current asthma (current asthmatic symptoms and increased bronchial responsiveness) was observed in 13 (15%) of the athletes and in one (2%) of the control subjects. Total asthma (current asthma or previously physician-diagnosed asthma) occurred in 19 (22%) of the athletes and in two (4%) of the controls. Atopy, according to skin-prick tests, was observed in 51 (58%) of the athletes and 17 (36%) of the control subjects. The differential cell counts of eosinophils (2.6 versus 0.2%) and neutrophils (80.9 versus 29.9%) in the sputum samples of the ice hockey players were significantly higher than in those of the control subjects.Asthma is common in elite ice hockey players and they show signs of a mixed type of neutrophilic and eosinophilic airway inflammation. Inhalation of cold air associated with exposure to indoor pollutants during intensive training is a possible causative factor.

Airway responsiveness and inflammation in adolescent elite swimmers

“…8 In both ice hockey players and adult elite swimmers, sputum cell counts of neutrophils and eosinophils have been shown to be higher than in the control groups of randomly selected university students and laboratory staff. 9,16 Whereas adult elite athletes thus seem to have a special type of airway inflammation compared with healthy control subjects, this seems not to be the case for adolescent elite swimmers after 2 years of elite swimming.…”

“…[5][6][7] In addition, many elite athletes have airway inflammation, although the type of inflammation seems to vary between different types of sport. [8][9][10][11] It is likely that an increase in neutrophils is a consequence of endurance training and that increased eosinophils and lymphocytes are a result of exposure to environmental factors related to the different types of sport. 12 Swimming is one sport that has attracted attention; many children with childhood asthma were recommended to undertake swimming as their daily exercise because swimming was found to be less likely to lead to exercise-induced asthma.…”

Developing and Emerging Clinical Asthma Phenotypes

“…85 Elite athletes often have airway neutrophilic or eosinophilic airway inflammation, depending on the type of sport. [86][87][88] Clinical symptoms of exercise-induced asthma include wheezing, shortness of breath, dyspnea, cough, or chest tightness 5 to 10 minutes after exercise. The diagnosis is based on a 10% decrease in FEV 1 within 30 minutes after exercise in comparison with pre-exercise FEV 1 .…”

Asthma and the elite athlete: Summary of the International Olympic Committee's Consensus Conference, Lausanne, Switzerland, January 22-24, 2008

“…18,44,45 This may be a result of the presence of a more neutrophilic than eosinophilic airway inflammation in the athlete. [46][47][48][49] Criteria for good asthma control include no or minimal daytime symptoms, no limitations of activity, no nocturnal symptoms, no or minimal need for rescue medication, normal lung function, and no or mild infrequent exacerbations. Difficult-to-control asthma may be a result of an inadequate diagnosis, undertreatment (usually from underestimation of severity), poor adherence to the treatment, exacerbating factors such as allergen or pollutant exposures, or comorbidities, or a more severe phenotype of asthma that is less responsive to therapy.…”