Document Detail

Airway inflammation and upper respiratory tract infection in athletes: is there a link?
MedLine Citation:
PMID:  18198657     Owner:  NLM     Status:  MEDLINE    
Upper Respiratory Tract Infection (URTI) is regarded as the most common medical condition affecting both highly trained and elite athletes, in particular those participating in endurance events. The causes of these disturbances, also occurring during training, remain unclear. Viruses such as rhinovirus, adenovirus and para-influenza virus are frequently reported as the source of URTI. However, in a few comprehensive laboratory and epidemiological studies which reported at least a 30% incidence of URTI, no identifiable pathogens were either reported or studied. A recent, longitudinal study investigated symptomatology and pathogenic etiology in sedentary controls, recreational and elite athletes. The highest incidence of URTI occurred in elite athletes. However; only 11 out of 37 illness episodes overall had pathogenic origins, and most of the unidentified upper respiratory illnesses were shorter in duration and less severe than infectious ones. This concept of inflammation without infection in athletes is quite new and leads us to consider other explanatory pathophysiological conditions. Increases in airway neutrophils, eosinophils and lymphocytes have been described under resting conditions in endurance sports, swimmers and cross-country skiers. These inflammatory patterns may be due to pollutants or chlorine-related compounds in swimmers. After intense exercise similar airways cellular profiles have been reported, with a high amount of bronchial epithelial cells. This increase in airway inflammatory cells in athletes can result from a hyperventilation-induced increase in airway osmolarity stimulating bronchial epithelial cells to release chemotactic factors. Fortunately, in most cases, these inflammatory cells express rather low level of adhesion molecules, explaining why airway inflammation may appear blunted in athletes despite numerous inflammatory cellular elements. However it can be hypothesized that a transient loss of control of this local inflammation, due to various external physico-chemical strains, might occur. This might account for some of the unidentified upper respiratory illnesses.
Stéphane Bermon
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Exercise immunology review     Volume:  13     ISSN:  1077-5552     ISO Abbreviation:  Exerc Immunol Rev     Publication Date:  2007  
Date Detail:
Created Date:  2008-01-17     Completed Date:  2008-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505535     Medline TA:  Exerc Immunol Rev     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  6-14     Citation Subset:  IM    
Institut Monégasque de Médecine et Chirurgie du Sport, 11 avenue d'Ostende, 98000 Monaco.
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MeSH Terms
Environmental Exposure
Respiratory Function Tests
Respiratory System / immunology*,  pathology
Respiratory Tract Infections / immunology*,  pathology

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