Exercise-Induced Bronchoconstriction in Children

Abstract

Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5–15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children.

School Nurses on the Front Lines of Healthcare: Emergencies Associated With Sport and Physical Activities (Part 3): Shortness of Breath in a Pediatric Athlete During a Track Event

“…EIB, also known as exercise-induced asthma (EIA), describes airway narrowing that occurs during exercise (Klain et al, 2022). EIB can occur in individuals with or without a diagnosis of asthma or reactive airway disease.…”

An Overview on the Primary Factors That Contribute to Non-Allergic Asthma in Children

“…The first crucial distinction to be made is between exercise-induced asthma (EIA) and exercise-induced bronchoconstriction (EIB). Bronchial hyperactivity and persistent inflammation are the hallmarks of the genuine pathology known as EIA; on the contrary, the temporary airway restriction known as EIB may also be present in non-asthmatic patients [ 28 ]. EIB is presented in 52.5% of children with asthma [ 29 , 30 ] and it occurs in 8.6–12% of healthy children aged 7–17 years [ 31 ], EIA is triggered by cold and dry air during exercise, causing dehydration of the airways mucosa, resulting in increased osmolarity, contraction of bronchial smooth muscle, and an influx of eosinophils and mast cells that release inflammatory mediators (leukotrienes, histamine, IL-8, tryptase, and prostaglandins) [ 32 ].…”

“…EIB is presented in 52.5% of children with asthma [ 29 , 30 ] and it occurs in 8.6–12% of healthy children aged 7–17 years [ 31 ], EIA is triggered by cold and dry air during exercise, causing dehydration of the airways mucosa, resulting in increased osmolarity, contraction of bronchial smooth muscle, and an influx of eosinophils and mast cells that release inflammatory mediators (leukotrienes, histamine, IL-8, tryptase, and prostaglandins) [ 32 ]. These signalling molecules lead to an increase in smooth muscle contraction, mucus formation, microvascular permeability, and sensory nerve activation of the airways, which is the main cause of bronchoconstriction and airway oedema [ 28 , 33 , 34 ]. Recent studies report correlations of bronchospasm with eosinophils [ 35 ], eosinophil cationic protein (ECP) [ 36 ], lipoxin A4 [ 37 ], phospholipase A2 [ 38 ], and endothelin-1 [ 39 , 40 ].…”