The breathless adolescent asthmatic athlete

Kh, Carlsen

doi:10.1183/09031936.00068510

Cited by 33 publications

(22 citation statements)

References 71 publications

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“…It has been confirmed by practical experiments arising from Norwegian competitive endurance athletes that revealed that they respond particularly well and with a higher reversibility to inhaled ipratropium bromide than to inhaled beta2-agonists. 29 Our study has important limitations. First, the reduced number of subjects included, which may prevent the study from reaching statistical significance; however, they were all elite swimmers.…”

Section: Discussionmentioning

confidence: 93%

Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers

Couto

Silva

Santos

et al. 2015

Revista Portuguesa de Pneumologia (English Edition)

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Background: Dysautonomia has been independently associated with training and exerciseinduced bronchoconstriction. In addition, neurogenic airway inflammation was recently associated with swimmers-asthma. We aimed to assess the relation between autonomic nervous system and airway responsiveness of asthmatic elite swimmers. Methods: Twenty-seven elite swimmers, 11 of whom had asthma, were enrolled in this exploratory cross-sectional study. All performed spirometry with bronchodilation, skin prick tests and methacholine challenge according to the guidelines. Pupillometry was performed using PLR-200 TM Pupillometer. One pupil light response curve for each eye was recorded and the mean values of pupil's maximal and minimal diameters, percentage of constriction, average and maximum constriction velocities (parasympathetic parameters), dilation velocity, and total time to recover 75% of the initial size (sympathetic parameters) were used for analysis. Asthma was defined using IOC-MC criteria; subjects were divided into airway hyperesponsiveness (AHR) severity according to methacholine PD 20 in: no AHR, borderline, mild, moderate and severe AHR. Differences for pupillary parameters between groups and after categorization by AHR severity were assessed using SPSS 20.0 (p ≤ 0.05). In individuals with clinically relevant AHR, correlation between PD 20 and pupillary parameters was investigated with Spearman's correlation test. Results: No statistically significant differences were observed between asthmatic and nonasthmatic swimmers regarding parasympathetic parameters. When stratified by AHR, maximal and minimal diameters and percentage of constriction were significantly lower among those with severe AHR. Among swimmers with clinically relevant AHR (n = 18), PD 20 correlated with parasympathetic activity: maximal (r = 0.67, p = 0.002) and minimal diameters (r = 0.75, p < 0.001), percentage of constriction (r = −0.59, p = 0.011) and latency (r = 0.490, p = 0.039).Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers 23 Conclusions: No significant differences were observed between asthmatic and non-asthmatic swimmers regarding parasympathetic parameters, but among those with relevant AHR an association was found. Although limited by the sample size, these findings support the relation between dysautonomia and AHR in asthmatic swimmers.

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Section: Discussionmentioning

confidence: 93%

Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers

Couto

Silva

Santos

et al. 2015

Revista Portuguesa de Pneumologia (English Edition)

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“…Exercise-induced asthma (EIA) is found in 8%–10% of healthy school-aged children and 35% in children with asthma 25. Furthermore, the degree of EIA in children seems to depend on exercise intensity.…”

Section: Epidemiology Of Asthma and Eib In Athletes And Adolescent Atmentioning

confidence: 99%

“…Carlsen describes two phenotypes of asthma in athletes; the first includes athletes who have had asthma from early childhood, often accompanied by allergic symptoms, the second describes those athletes expressing acute asthmatic symptoms triggered by the exercise stimulus itself 25. Although in the second group, traditional asthmatic symptoms may not be obvious, but subjects experience coughing and the release of mucus only after exercise or over prolonged periods of time.…”

Section: Epidemiology Of Asthma and Eib In Athletes And Adolescent Atmentioning

confidence: 99%

Special considerations for adolescent athletic and asthmatic patients

Wuestenfeld¹,

Wolfarth²

2013

OAJSM

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Asthma is defined as a chronic inflammatory disorder of the airways with bronchial hyperresponsiveness and variable bronchoconstriction, and is one of the most common diseases in childhood and adolescence. Exercise-induced asthma-like symptoms and asthma are also frequently seen in highly trained athletes. Exercise-induced asthma (EIA) and exercise-induced bronchoconstriction (EIB) are found in 8%–10% of healthy school-aged children and in 35% of children with asthma. Highly increased ventilation, inhalation of cold, dry air and air pollutants (eg, chlorine) are thought to be important triggers for EIA and EIB. EIA is often experienced concurrently with vocal cord dysfunction, which needs to be considered during the differential diagnosis. The pharmacological treatment of EIA is similar to the treatment of asthma in nonexercising adolescents. The therapy is based on anti-inflammatory drugs (eg, inhaled glucocorticosteroids) and bronchodilators (eg, β2-agonists). The treatment of EIB is comparable to the treatment of EIA and leukotriene modifiers offer a new and promising treatment option, particularly in EIB. Generally, athletes may not use β2-agonists according to the prohibited list of the World Anti-Doping Agency (WADA). However, the WADA list contains specific β2-agonistic substances that are permitted to be used by inhalation.

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“…This phenotype develops after years of intensive training within endurance sports, most often in cross‐country skiers and swimmers. The causative pathogenic mechanisms are thought to be airway’s epithelial damage owing to regularly repeated increased ventilation during training and competition, usually combined with exposure to an environmental agent, like cold air inhalation for cross‐country skiers, and organic chlorine products for competitive swimmers (46). It has been reported that mechanisms may involve epithelial damage (47), disturbed repair owing to the regularly occurring trauma to the airways, following airways inflammation and an increased parasympathetic activity in the airways (44).…”

Section: Exercise‐induced Asthma and Other Exercise‐induced Respiratomentioning

confidence: 99%

Allergy and sports in children

Giacco

Carlsen

Toit

2012

Pediatric Allergy Immunology

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Physical activity is beneficial for children with positive outcomes for mental and physical well-being. Allergic conditions unique to the sporting arena may serve as an impediment to participation in physical activity for allergic children. A common example is exercise-induced asthma; less common activity-related allergic conditions include food-dependent exercise-induced anaphylaxis, exercise-induced anaphylaxis, and exercise-induced urticaria. Allergic children may also be at risk of allergic reactions when exposed to allergens that are more commonly found in the sports environment, e.g., latex, sports drinks, and medications such as NSAIDs. Recent advances in our understanding of the patho-physiological and immunologic mechanisms that may account for these conditions have facilitated more effective and safer management strategies. There are also important immunologic lessons to be learnt with respect to specific physical factors that may result in diminished allergen tolerance; indeed, these lessons may facilitate safer allergen desensitisation regimens. The role of the immune system in exercise-induced immunoallergic syndromes, clinical aspects, and diagnostic and therapeutic approaches are discussed in this review.

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The breathless adolescent asthmatic athlete

Cited by 33 publications

References 71 publications

Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers

Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers

Special considerations for adolescent athletic and asthmatic patients

Allergy and sports in children

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