Exercise-induced bronchoconstriction in elite or endurance athletes:

Atchley, Taylor J.; Smith, Douglas B.

doi:10.1016/j.anai.2020.01.023

Cited by 20 publications

(40 citation statements)

References 80 publications

(120 reference statements)

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“…The suggested pathogenesis of this cold- and dry air-induced bronchoconstriction in the healthy subjects is a hyperosmotic shift of the extracellular fluid in the airway mucosa. This would then via airway epithelial injury directly stimulate of afferent C-fiber nerve endings and immediate local release of neuropeptides or stimulate cell shrinkage and release of mediators that trigger bronchial smooth muscle contraction, vascular leakage, and edema (Atchley and Smith 2020 ). The HME might have attenuated this response by increasing the temperature and humidity of the inhaled air and protecting the lower facial area and thus facial cooling, thus reducing both potential triggers.…”

Section: Discussionmentioning

confidence: 99%

“…Further proposed mechanisms in the pathogenesis of EIB in athletes are airway epithelial injury, airway inflammation, and oxidative stress (Atchley and Smith 2020 ). Exercise in cold, dry air has been shown to increase urine CC16 concentrations to a greater extent than exercise in warm, humid air (Bolger et al 2011 ), indicating increased airway epithelial damage in colder climates.…”

Section: Introductionmentioning

confidence: 99%

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A breathing mask attenuates acute airway responses to exercise in sub-zero environment in healthy subjects

et al. 2022

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Purpose Cold air exposure is associated with increased respiratory morbidity and mortality. Repeated inhalation of cold and dry air is considered the cause of the high prevalence of asthma among winter endurance athletes. This study assessed whether a heat- and moisture-exchanging breathing device (HME) attenuates airway responses to high-intensity exercise in sub-zero temperatures among healthy subjects. Methods Using a randomized cross-over design, 23 healthy trained participants performed a 30-min warm-up followed by a 4-min maximal, self-paced running time trial in − 15 °C, with and without HME. Lung function was assessed pre- and immediately post-trials. Club cell protein (CC-16), 8-isoprostane, and cytokine concentrations were measured in plasma and urine pre- and 60 min post trials. Symptoms were assessed prior to, during, and immediately after each trial in the chamber. Results HME use attenuated the decrease in forced expiratory volume in 1 s (FEV1) post trials (∆FEV1: mean (SD) HME − 0.5 (1.9) % vs. no-HME − 2.7 (2.7) %, p = 0.002). HME also substantially attenuated the median relative increase in plasma-CC16 concentrations (with HME + 27% (interquartile range 9–38) vs no-HME + 121% (55–162), p < 0.001) and reduced airway and general symptom intensity, compared to the trial without HME. No significant changes between trials were detected in urine CC16, 8-isoprostane, or cytokine concentrations. Conclusion The HME attenuated acute airway responses induced by moderate-to-maximal-intensity exercise in − 15 °C in healthy subjects. Further studies are needed to examine whether this HMEs could constitute primary prevention against asthma in winter endurance athletes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A breathing mask attenuates acute airway responses to exercise in sub-zero environment in healthy subjects

et al. 2022

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“…A high incidence of EIB was noted during the skyscraper stair race that was negatively associated with exercise performance. Therefore, EIB deserves more attention among active population undertaking intense exercise training and may require more careful management [ 14 , 17 , 18 ] to reduce the symptoms, improve fitness, and ensure continued sports and/or active leisure time participation of the affected individuals.…”

Section: Discussionmentioning

confidence: 99%

High Incidence of Bronchospastic Response to a Stair Climbing Exercise

Venckūnas¹,

Balsys²

2021

Cureus

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Background While it is increasingly recognized that exercise-induced bronchoconstriction (EIB) affects a substantial proportion of sport participants, the relation of EIB incidence and severity to the type and intensity of exertion remains under-investigated. The aim of this study was to establish the incidence and severity of EIB during a stair race, a highly demanding all-out effort exercise. We hypothesized that a large proportion of participants would develop EIB to this particular high-intensity competition, and that among the predisposing factors, severity of EIB would depend on the level of exertion. Methodology In this study, screening for EIB was conducted during the official competitive race to a 114-m skyscraper held during the late spring in a city center of approximately 0.5 million residents. Healthy active men (n = 26; age = 32.0 ± 7.0 years) volunteering for the study from the field of the race were included. Allergy Questionnaire for Athletes was completed, and responses of expiratory capacity (forced expiratory volume in the first second, FEV1) and blood lactate were measured by portable digital devices. Results On average, FEV1 dropped by 10.5 ± 5.6% after the exercise. In 11 (approximately 42.5%) participants, FEV1 drop was >10%, indicative of clinical EIB. While age, anthropometry, training experience, allergy history, baseline FEV1, and post-exercise lactate did not differ in responders versus non-responders, those with FEV1 decrement of >10% were slower in the race. Conclusions Due to very high incidence of EIB observed in active men performing a maximal-effort task and negative association of EIB with competitive performance, the condition of these individuals undertaking regular intense exercise deserves more attention.

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“…This process triggers the release of inflammatory mediators, causing smooth muscle contraction and airway oedema. Cold air is another proposed mechanism, triggering an initial constriction of the bronchial micro vessels during exercise followed by hyperaemia when no longer exposed to cold air [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Underlying lung disease and exposure to terrestrial moderate and high altitude: personalised risk assessment

2022

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Once reserved for the fittest, worldwide altitude travel has become increasingly accessible for ageing and less fit people. As a result, more and more individuals with varying degrees of respiratory conditions wish to travel to altitude destinations. Exposure to a hypobaric hypoxic environment at altitude challenges the human body and leads to a series of physiological adaptive mechanisms. These changes, as well as general altitude related risks have been well described in healthy individuals. However, limited data are available on the risks faced by patients with pre-existing lung disease. A comprehensive literature search was conducted. First, we aimed in this review to evaluate health risks of moderate and high terrestrial altitude travel by patients with pre-existing lung disease, including chronic obstructive pulmonary disease, sleep apnoea syndrome, asthma, bullous or cystic lung disease, pulmonary hypertension and interstitial lung disease. Second, we seek to summarise for each underlying lung disease, a personalized pre-travel assessment as well as measures to prevent, monitor and mitigate worsening of underlying respiratory disease during travel.

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Exercise-induced bronchoconstriction in elite or endurance athletes:

Cited by 20 publications

References 80 publications

A breathing mask attenuates acute airway responses to exercise in sub-zero environment in healthy subjects

A breathing mask attenuates acute airway responses to exercise in sub-zero environment in healthy subjects

High Incidence of Bronchospastic Response to a Stair Climbing Exercise

Underlying lung disease and exposure to terrestrial moderate and high altitude: personalised risk assessment

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