Continuous exercise induces airway epithelium damage while a matched-intensity and volume intermittent exercise does not

Combes, Adrien; Dekerle, Jeanne; Dumont, Xavier; Twomey, Rosie; Bernard, Alfred; Daussin, Frédéric N.; Bougault, Valérie

doi:10.1186/s12931-019-0978-1

Cited by 22 publications

(25 citation statements)

References 37 publications

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“…This threshold depends of course on the atmospheric conditions. It is interesting to note that similar results were previously obtained by Combes et al ( 2019 ) and Karamaoun et al ( 2019 ). These authors highlighted a deterioration of the epithelium of the bronchial region of the lungs above a ventilation rate of about 80 l min −1 when exercising continuously, due to the dehydration of the mucus.…”

Section: Resultssupporting

confidence: 90%

Comprehensive Analysis of Heat and Water Exchanges in the Human Lungs

et al. 2021

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This work presents a new mathematical model of the heat and water exchanges in the human lungs (newborn to adult). This model is based on a local description of the water and energy transports in both the lumen and the surrounding tissues, and is presented in a comprehensive, dimensionless framework with explicitly stated assumptions and a strong physiological background. The model is first used to analyze and quantify the key phenomena and dimensionless numbers governing these heat and water exchanges and then it is applied to an adult in various situations (varying atmospheric conditions, exercising…). The results highlight several interesting physiological elements. They show that the bronchial region of the lungs is able to condition the air in all the considered situations even if, sometimes, for instance when exercising, distal generations have to be involved. The model also shows that these distal generations are super-conditioners. Moreover, the results quantify the key role of the submucosal glands in mucus hydration. They also show that, during expiration, a significant cooling of the air and condensation of water occur along the respiratory tract as the vascularization of the tissues surrounding the airways is not able to maintain these tissues at body temperature during inspiration. Due to the interaction between several phenomena, it appears that the ratio of the amount of water returned to the mucosa during expiration to the amount extracted during inspiration is almost independent of the breathing conditions (around 33%). The results also show that, in acute situations, such as suffering from a pathology with airway dysfunction, when being intubated or when exercising above an intensity threshold, the heat and water exchanges in the lungs may be critical regarding mucus hydration. In proximal generations, the evaporation may overwhelm the ability of the submucosal glands to replenish the airway surface liquid with water. In some situations, the cooling of the mucosa may be very important; it can even become colder than the inspired air, due to evaporative cooling. Finally, the results show that breathing cold air can significantly increase the exchanges between the lungs and the environment, which can be critical regarding disease transmission.

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Section: Resultssupporting

confidence: 90%

Comprehensive Analysis of Heat and Water Exchanges in the Human Lungs

et al. 2021

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“…However, we did not ask about whether these sessions were intermittent or continuous. Two recent studies have highlighted that airway epithelial damage may be more pronounced during continuous work than interval work in healthy participants 23 and that participants with asthma can tolerate intermittent exercise better than moderate‐intensity continuous exercise 24 . Therefore, there may be some rationale for increased usage of HME during low‐intensity training; however, neither study was performed in a cold environment.…”

Section: Discussionmentioning

confidence: 99%

Usage of and attitudes toward heat‐ and moisture‐exchanging breathing devices among adolescent skiers

et al. 2020

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Heat-and moisture-exchanging breathing devices (HME) humidify and heat-inhaled air and prevent exercise-induced bronchoconstriction. HMEs have potential as primary preventers against airway damage and asthma induced by exercise in sub-zero temperatures. HME usage among athletes has not been previously investigated. This study surveyed the usage of and attitudes toward HMEs among elite skiers. We invited all 347 students from Swedish National Elite Sports Schools in cross-country skiing and biathlon to participate in a web-survey. The response rate was 55%, 53% were women, 30% had asthma, and 87% were cross-country skiers. Their mean (range) age was 17 (15-19) years. HMEs were used often or occasionally by 71% of respondents, while 68% reported respiratory symptoms while training in sub-zero temperatures. The most common temperature threshold for using HMEs was −15°C.Almost all participants believed that HMEs prevent airway problems induced by training in cold. The participants were motivated, and confident in succeeding, to increase their HME usage during exercise in −10°C or colder, if recommended. Swedish adolescent skiers commonly use HMEs and have positive attitudes toward increased HME usage. HMEs may constitute a simple and effective prevention strategy against airway symptoms and asthma among winter endurance athletes.

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“…Особенно это касается многочасовых АН [22][23][24]. Дополнительным условием здесь выступает физическая травма эпителия (бронхиального и альвеолярного) вследствие продолжительной гипервентиляции при неверно выстроенном тренировочном режиме [25]. По-видимому, все это имело место в тех литературных примерах, когда COVID-19 у тренированных к АН больных принимал тяжелые формы (кстати, из многочисленного отряда легкоатлетов-марафонцев отмечено всего 2 таких случая и еще 1 -среди профессиональных велосипедистов) [2,3].…”

Section: таблица 2 частота отдельных признаков* Covid-19 у больных аunclassified

COVID-19 in individuals adapted to aerobic exercise

Tretyakov

Захарченко

Ромасенко

et al. 2020

Pulʹmonologiâ (Mosk.)

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Analysis of COVID-19 features in individuals who regularly practice aerobic training. Methods. Asymptomatic persons and patients with COVID-19 older than 30 years, 293 people (180 men and 113 women), 214 of them – inhabitants of the Moscow region (the beginning of the sampling – 2nd decade of April 2020) and 79 – inhabitants of the Belgorod region (the beginning of the sampling – 2nd decade of May 2020), adapted (27 people 1st group) and unadapted (266 – control group) to aerobic training (AT). Computer tomography of the chest, RNA test for SARS-CoV-2 in smears from the nasopharynx-oropharynx, the clinical blood sample and level of antibodies to SARS-CoV-2 were studied. The criterion for adaptation to aerobic loads was considered compliance with the rules of the American Heart Association, 2008. Results. Adapted to AT individuals, in contrast to the control group, characterized with the prevalence of asymptomatic (p = 0.045) and absence of severe forms of COVID-19, limited cataral simptoms of the disease (p < 0.001), rare pneumonia with absence (1) or presence (2) of acute respiratory failure (p1 = 0,028; p2 = 0,034), along with lower prevalence of diseases, potentiating this infection (p = 0.03). Conclusion. Patients adapted to AT have less severe course of COVID-19.

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Continuous exercise induces airway epithelium damage while a matched-intensity and volume intermittent exercise does not

Cited by 22 publications

References 37 publications

Comprehensive Analysis of Heat and Water Exchanges in the Human Lungs

Comprehensive Analysis of Heat and Water Exchanges in the Human Lungs

Usage of and attitudes toward heat‐ and moisture‐exchanging breathing devices among adolescent skiers

COVID-19 in individuals adapted to aerobic exercise

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