Exercise induced bronchoconstriction and asthma in elite athletes

Exercise induced bronchoconstriction (EIB), is described as a condition ofairway obstruction triggered by intense physical activity in individuals with increasedbronchial hyperreactiviy. We aimed to compare the frequency of EIB in healthycontrol group and elite athletes and to evaluate the relationship between bronchialhyperreactivity, bronchial inflammation and atopy.Thirty students between the age of.18 to 30 of Celal Bayar University Schoolof Physical Training and Sports who exercise more than 12 hours a week.4 monthsprior to the study (athletes group) and thirty cases between the age of.18 to 30 whoexercise less than 2 hours a week (control group) were included in the study. Aquestionnaire related with respiratory symptoms developing in daily life and maximalexercise, exercise bronchoprovocation test (EBT) and methacholinebronchoprovocation tests (MBT) were performed. Exhaled nitric oxide (NO) levelswere measured and skin prick tests with common 20 aeroallergens were done.Mean age, gender, smoking history, FEV1, FVC, FEV1/FVC and PEF valuesof the control and the athletes group were not found statistically significant different(p>0,05).EBT was found to be positive in 4 of the athletes (13,3%), but no positiveresponse to the exercise test was determined in the control group. This differencebetween the athletes and the control group was not statistically significant (p>0,05).Thirteen (43,3%) of the athletes and 1 of the control group (3,3%) were MBTpositive. MBT was statistically significant more positive in the athletes group than thecontrol group (p=0,000).Bronchial hyperreactivity was accepted to be positive if one of MBT or EBTwas found to be positive. Sixteen (53,3%) athletes (n=15 methacholine, n=1methacholine and exercise), and 1(3,3%) in the control group (n=1 methacholine)were positive for bronchial hyperreactivity (BHR+). The difference between theathletes and the control group was statistically significant (p=0,000). BHR + and BHR- athletes and control group showed no statistically significant difference according togender, atopy history, family history of atopy, skin prick tests and smoking historywhen compared with each other (p>0,05). BHR + and BHR- athletes?s exercisesymptom score was statistically significant different than the control group (p=0,048).Exhaled NO levels were found 22,6±10,1 and 22,3±10.1 in the athletes andthe control group respectively, this difference was not statistically significant (p>0,05).BHR+ and BHR- athletes and the control group did not show any statisticallysignificant difference (p>0,05).Skin prick test results demonstrated 6 (20,0%) positives in the athletes groupand 3 (10,0%) in the control group, but there was not statistically significantdifference between the two groups (p=0,05). 77,8% of the study populationdescribing allergic diseases had a positive skin prick test, while 94,1% of the caseswith no allergic diseases had a negative skin prick test. Mean NO levels of atopypositive cases with skin prick test (9 cases) were 30,0±10,0 and mean NO levels ofatopy negative cases with skin prick test (51 cases) were 21,0±18,0, the differencebetween the two groups were not statistically significant (p>0,05).We concluded that athletes with symptoms related with exercise should beevaluated for EIB carefully, should be investigated for bronchial hyperreactivity withEBT and MBT for the diagnosis, and as the risk of EIB is increased, atopic athletesshould be screened more fussily, and also exhaled NO measurement is not asuitable method of evaluating bronchial hyper reactivity.