Special considerations for adolescent athletic and asthmatic patients

Exercise-Induced Bronchoconstriction Among Adolescent Athletes With Asthma: A Systematic Review

Exercise-induced bronchoconstriction (EIB) is a concern that frequently affects athletes and regular exercisers. The main objective of this systematic review is to study recently published literature that evaluated the risk of EIB among adolescent athletes with asthma. PubMed, Web of Science, Science Direct, EBSCO, SCOPUS, Wiley, and Cochrane Library were searched. Study articles were screened by title and abstract using Rayyan QCRI then a full-text assessment was implemented. A total of ten studies with 3129 adolescent athletic subjects were included in this review. The prevalence of EIB ranged from 2.1% to 61%. Most studies have demonstrated that athletes in their adolescence suffer from EIB, which requires regular management. Two studies have reported that low-income communities and humidity levels are risk factors for EIB. We found that EIB is frequent among adolescent athletes. The prevalence varies between countries due to different social and environmental factors.

Exercise-Induced Bronchoconstriction in Children: A Comparison between Athletes and Non-Athletes

Exercise-induced bronchoconstriction (EIB) is a dysfunction of the respiratory tract consisting of transient airflow obstruction. This study is a retrospective analysis of two prospective studies concerning EIB symptoms in two adolescent populations. Our study group included 400 non-athletes and 101 athletes. Due to the similarity of indoor exercise conditions, an analysis was performed on the basis of where training took place. The study aims to assess the EIB prevalence in the following groups of adolescent children: non-athletes and athletes. In "indoor" athletes, the EIB prevalence was 22.4%. Among non-athletes, EIB was diagnosed in 10.2% (p = 0.007). A history of asthma was found in 6.5% of non-athletes and 29.3% of indoor athletes (p < 0.001). The incidence of EIB without asthma was higher in indoor athletes (14.6%) than in non-athletes (9.9%). Athletes achieved higher mean values in forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF), and maximum expiratory flow rate at 25% (MEF₂₅) parameters. In the group of non-athletes, higher results were observed in forced expiratory volume in one second % of vital capacity (FEV₁%VC), MEF₅₀, and MEF₇₅. The findings of the study present the complexity of the EIB diagnosis among children training in an indoor environment.

Exercise-induced bronchoconstriction, temperature regulation and the role of heat shock proteins in non-asthmatic recreational marathon and half-marathon runners

Exercise is the most common trigger of bronchospasm. Heat shock protein (HSP) expression was linked to asthmatic patients. The prevalence and pathophysiology of exercise-induced bronchoconstriction (EIB) in non-professional non-asthmatic runners is unknown. We sought to investigate the frequency of EIB and cytokine changes in non-professional non-asthmatic marathon and half marathoners with and without EIB. Testing was performed before the marathon (baseline), immediately post-marathon at the finish area (peak), and 2–7 days after the marathon (recovery): immunosorbent assays for measurement of HSP70, blood count analysis, spirometry and temperature measurements. We experienced a decline in FEV1 of ≥10% in 35.29% of marathon and 22.22% of half marathon runners. Runners with EIB had significantly higher HSP70 serum concentrations at baseline than those without EIB (987.4 ± 1486.7 vs. 655.6 ± 1073.9; p = 0.014). Marathoners with EIB had significantly increased WBC before participating in the competition (7.4 ± 1.7 vs. 6.0 ± 1.5; p = 0.021). After recovery we found increased HSP70 serum concentrations in marathoners with EIB compared to those without (2539.2 ± 1692.5 vs. 1237.2 ± 835.2; p = 0.032), WBC (7.6 ± 1.8 vs. 6.4 ± 1.6; p = 0.048) and PLT (273.0 ± 43.0 vs 237.2 ± 48.3; p = 0.040). At all measured skin sites skin temperatures in runners were significantly lower immediately after participating in the competition when compared to temperature before the race (skin temperature baseline vs. peak: abdominal: 33.1 ± 0.2 vs. 30.0 ± 0.4; p < 0.001; upper arm: 31.6 ± 0.2 vs. 29.4 ± 0.3; p < 0.001; upper leg: 30.7 ± 0.3 vs. 29.4 ± 0.2; p = 0.014; lower leg: 30.6 ± 1.0 vs. 30.2 ± 1.5; p = 0.007). We found a higher than expected number of non-professional athletes with EIB. HSP70 serum concentrations and elevated WBC could indicate a predisposition to EIB.