Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools

Mechanisms of asthma development in elite athletes

“…showed that adolescent cross-country skiers (ski-gymnasts) during one competitive winter season developed signs of inflammation (lymphoid follicles and deposition of tenascin) in their bronchial biopsies independent of being asthmatics or not. Recently, these findings in bronchial biopsies from cross-country skiers was confirmed by similar findings in swimmers [32].…”

Is there a potential link between indoor chlorinated pool environment and airway remodeling/inflammation in swimmers?

“…We recently obtained bronchial biopsies in 23 competitive swimmers during a period of rest, without intense training, to assess baseline airway inflammatory and structural (remodeling) changes, in comparison with ten control and ten asthmatic subjects [6]. We observed similar inflammatory and remodeling changes in swimmers' airways as those described in mild asthmatic subjects, although the former had a more intense mucin production.…”

Advances in adult asthma diagnosis and treatment in 2012: Potential therapeutics and gene-environment interactions

“…62 Competitive swimmers who swim in chlorinated pools have increased risk of airway responsiveness to methacholine and exercise-induced bronchospasm and of having inflammatory and remodeling changes on bronchial biopsy. 36 A meta-analysis found discontinuing LABA therapy in adults with asthma controlled by combination ICSs and LABAs was associated with a decrease in asthma quality of life and asthma control and fewer symptom-free days. 73 A pooled analysis of clinical trials found no association between omalizumab treatment and risk of malignancy.…”

“…In a very different consideration of the environment, Bougault et al 36 investigate the environment of swimmers. Their concern is that high and sustained levels of ventilation required by athletes causes dehydration and mechanical stress on the airways.…”