Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: A 5-year prospective follow-up study of 42 highly trained swimmers

Helenius, Ilkka; Rytilä, Paula; Sarna, Seppo; Lumme, Aki; Helenius, Mikko; Remes, Ville; Haahtela, Tari

doi:10.1067/mai.2002.124769

Cited by 130 publications

(143 citation statements)

References 24 publications

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“…Swimmers with exercise-induced bronchial symptoms had significantly higher sputum eosinophil counts than symptom-free swimmers (29). The inflammation may represent a form of repeated thermal, mechanical or osmotic airway trauma resulting in a healing or remodelling process, and seems to be directly associated with heavy training as discontinuing highlevel exercise has proved effective in reducing eosinophilic airway inflammation, as shown by a 5 years follow-up study of competitive swimmers (65). The athlete¢s inflammation (neutrophils over-represented) may explain, why indices for airway inflammation, BHR and symptoms have responded poorly to inhaled corticosteroids (69) or leukotriene antagonists (70) in the few controlled studies performed.…”

Section: Effects Of Heavy Exercisementioning

confidence: 95%

“…In young competitive skiers as compared with healthy somewhat older medical students, not particularly physically active, the skiers had lymphoid aggregates in their bronchi and signs of bronchial remodelling (tenascin) as demonstrated by bronchial biopsies in addition to increased responsiveness to cold air (5,64). A mixed type of eosinophilic and neutrophilic inflammation was found in elite swimmers (29,65), ice-hockey players (66) and cross-country skiers (64,67,68). Swimmers with exercise-induced bronchial symptoms had significantly higher sputum eosinophil counts than symptom-free swimmers (29).…”

Section: Effects Of Heavy Exercisementioning

confidence: 99%

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Exercise‐induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: Part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA²LEN

Carlsen

Anderson

Bjermer³

et al. 2008

Allergy

289

269

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Aims: To analyze the changes in the prevalence of asthma, bronchial hyperresponsiveness (BHR) and allergies in elite athletes over the past years, to review the specific pathogenetic features of these conditions and to make recommendations for their diagnosis. Methods: The Task Force reviewed present literature by searching Medline up to November 2006 for relevant papers by the search words: asthma, bronchial responsiveness, EIB, athletes and sports. Sign criteria were used to assess level of evidence and grades of recommendation.Results: The problems of sports-related asthma and allergy are outlined. Epidemiological evidence for an increased prevalence of asthma and BHR among competitive athletes, especially in endurance sports, is provided. The mechanisms for development of asthma and bronchial hyperresponsiveness in athletes are outlined. Criteria are given for the diagnosis of asthma and exercise induced asthma in the athlete. Conclusions: The prevalence of asthma and bronchial hyperresponsiveness is markedly increased in athletes, especially within endurance sports. Environmental factors often contribute. Recommendations for the diagnosis of asthma in athletes are outlined.

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Section: Effects Of Heavy Exercisementioning

confidence: 95%

Section: Effects Of Heavy Exercisementioning

confidence: 99%

Exercise‐induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: Part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA²LEN

Carlsen

Anderson

Bjermer³

et al. 2008

Allergy

289

269

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“…A study with competitive swimmers suggested that stopping high-level training decreases airway hyperresponsiveness (82). An experimental study with dogs showed that virtually all structural airway changes induced by repeated dry air challenges vanished after cessation of the challenges (73).…”

Section: Cold Air-provoked Long-term Responsesmentioning

confidence: 99%

Cold air-provoked respiratory symptoms: the mechanisms and management

Koskela

2007

International Journal of Circumpolar Health

185

137

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Objectives. To describe the mechanisms and management of cold air-provoked respiratory symptoms. Study design. A literature review. Methods. The review includes human epidemiological studies, human and animal experimental studies, as well as human studies about management of the cold air-provoked respiratory symptoms. Results. Cold air is unlikely to be a causal factor initiating respiratory diseases but a symptom trigger. In the present review, the airway responses beyond these symptoms were divided into three types. The short-term responses are those that develop within minutes in response to sudden cooling of the airways. Subjects with asthma or rhinitis are especially prone to these responses. The long-term responses are those that develop in response to repeated and longstanding cooling and drying of the airways, usually in endurance athletes. Finally, there are the physiological, reflex-mediated lower-airway responses to cooling of the skin or upper airways. Conclusions. The mechanisms beyond cold air-provoked respiratory symptoms vary considerably and mainly depend on the individual's susceptibility and the ventilation level during the cold exposure. An understanding of these mechanisms is essential for successful management of the symptoms. (Int J Circumpolar Health 2007; 66(2) [91][92][93][94][95][96][97][98][99][100]

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“…This has been attributed to airway inflammation and increased bronchial responsiveness induced by high-intensity long-term exercise, such as competitive swimming or long-distance running. Asthma symptoms may attenuate after discontinuing training and competition [14,15]. Atopy and type of sport appear to be the two major risk factors, with atopic long-distance runners having the highest risk of asthma compared to nonatopic non-athletes [16].…”

mentioning

confidence: 99%

Physical training does not increase allergic inflammation in asthmatic children

Moreira

Delgado²,

Haahtela³

et al. 2008

European Respiratory Journal

109

138

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The effects of a 3-month physical training programme on airway inflammation and clinical outcomes were studied in school-aged children with asthma.Subjects with persistent allergic asthma (aged 12.7¡3.4 yrs; n534) were randomly allocated into training and control groups. Exercise consisted of twice-weekly 50-min sessions for 12 weeks. Inflammation was assessed by levels of exhaled nitric oxide, blood eosinophils, eosinophil cationic protein, C-reactive protein, and total and mite-specific immunoglobulin (Ig)E. Lung volumes and bronchial responsiveness to methacholine were determined. The Paediatric Asthma Quality of Life Questionnaire and Paediatric Asthma Caregiver's Quality of Life Questionnaire were used to evaluate activity restrictions, symptoms and emotional stress. The efficacy of the training was assessed by accelerometry.Following the programme, the exercise group spent twice as much time as the controls undertaking moderate-to-vigorous activities. No differences in changes were seen between groups for asthma outcomes. However, total IgE decreased more in the exercise group, as did mite-specific IgE.Training did not increase inflammation in children with persistent asthma, and may have decreased both total and allergen-specific immunoglobulin E levels. It is concluded that there is no reason to discourage asthmatic children with controlled disease to exercise.

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Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: A 5-year prospective follow-up study of 42 highly trained swimmers

Cited by 130 publications

References 24 publications

Cold air-provoked respiratory symptoms: the mechanisms and management

Physical training does not increase allergic inflammation in asthmatic children

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