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Klain A, Giovannini M, Pecoraro L, Barni S, Mori F, Liotti L, Mastrorilli C, Saretta F, Castagnoli R, Arasi S, Caminiti L, Gelsomino M, Indolfi C, Del Giudice MM, Novembre E. Exercise-induced bronchoconstriction, allergy and sports in children. Ital J Pediatr 2024; 50:47. [PMID: 38475842 DOI: 10.1186/s13052-024-01594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 03/14/2024] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.
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Affiliation(s)
- Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy.
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
- Department of Health Sciences, University of Florence, 50139, Florence, Italy
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126, Verona, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Lucia Liotti
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, 60123, Ancona, Italy
| | - Carla Mastrorilli
- Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, 70126, Bari, Italy
| | - Francesca Saretta
- Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100, Udine, Italy
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Stefania Arasi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - Lucia Caminiti
- Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98124, Messina, Italy
| | - Mariannita Gelsomino
- Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS, Catholic University of the Sacred Heart, 00168, Rome, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Elio Novembre
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
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Zaccarin M, Zanni S, Gallè F, Protano C, Valeriani F, Liguori G, Romano Spica V, Vitali M. Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study. TOXICS 2022; 10:toxics10120759. [PMID: 36548592 PMCID: PMC9784475 DOI: 10.3390/toxics10120759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 05/14/2023]
Abstract
This study investigates the prevalence of respiratory symptoms and the training factors possibly associated with them in a sample of young Italian competitive swimmers. A questionnaire about training information and symptoms was administered to participants during the winter and summer 2021 training seasons. In total, 396 athletes took part in the study. In the winter training subgroup (n = 197), we found significant associations between increasing training hours per session and the presence of nasal congestion/rhinorrhoea (OR = 3.10; p = 0.039) and cough (OR = 3.48; p = 0.015). Total training hours per week were significantly associated with nasal congestion/rhinorrhoea (OR = 1.12; p = 0.010). In the summer group (n = 199), the same factors were not associated with respiratory symptoms. Having an allergy was significantly related to nasal congestion/rhinorrhea in both the logistic models (model 1 OR = 2.69, p = 0.013; model 2 OR = 2.70, p = 0.012), while having asthma significantly increased the risk of coughing (OR = 3.24, p = 0.033). The kind of environment (indoor or outdoor facilities) did not affect the studied symptoms either in summer or winter. Further investigations are needed to better understand the mechanisms involved in the development of respiratory symptoms in swimmers, particularly on how inflammation and remodelling develop and which environmental conditions can favour these processes.
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Affiliation(s)
- Matteo Zaccarin
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Zanni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Federica Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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