Document Detail

Mechanisms of asthma in Olympic athletes--practical implications.
MedLine Citation:
PMID:  18445185     Owner:  NLM     Status:  MEDLINE    
Athletes' symptoms may only occur in extreme conditions, which are far from normal. Exercise may increase ventilation up to 200 l/min for short periods in speed and power athletes, and for longer periods in endurance athletes such as swimmers and cross-country skiers. Increasing proportions of young athletes are atopic, i.e. they show signs of IgE-mediated allergy which is, along with the sport event (endurance sport), a major risk factor for asthma and respiratory symptoms. Mechanisms in the etiology and clinical phenotypes vary between disciplines and individuals, and it may be an oversimplification to discuss athlete's asthma as a distinct and unambiguous disease. Nevertheless, the experience on Finnish Olympic athletes suggests at least two different clinical phenotypes, which may reflect different underlying mechanisms. The pattern of 'classical asthma' is characterized by early onset childhood asthma, methacholine responsiveness, atopy and signs of eosinophilic airway inflammation, reflected by increased exhaled nitric oxide levels. Another distinct phenotype includes late onset symptoms (during sports career), bronchial responsiveness to eucapnic hyperventilation test, but not necessarily to inhaled methacholine, and a variable association with atopic markers and nitric oxide. A mixed type of eosinophilic and neutrophilic airway inflammation seems to affect especially swimmers, ice-hockey players, and cross-country skiers. The inflammation may represent a multifactorial trauma, in which both allergic and irritant mechanisms play a role. There is a significant problem of both under- and overdiagnosing asthma in athletes and the need for objective testing is emphasized. Follow-up studies are needed to assess the temporal relationship between asthma and competitive sporting, taking better into account individual disposition, environmental factors (exposure), intensity of training and potential confounders.
T Haahtela; P Malmberg; A Moreira
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Allergy     Volume:  63     ISSN:  1398-9995     ISO Abbreviation:  Allergy     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-04-30     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  685-94     Citation Subset:  IM    
Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
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MeSH Terms
Allergens / immunology
Anti-Asthmatic Agents / therapeutic use
Asthma* / diagnosis,  drug therapy,  immunology,  physiopathology
Autonomic Nervous System / physiopathology
Bronchial Provocation Tests
Hyperventilation / physiopathology
Inflammation / immunology
Skin Tests
Swimming Pools
Reg. No./Substance:
0/Allergens; 0/Anti-Asthmatic Agents

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