Asthma in Elite Athletes: Pathogenesis, Diagnosis, Differential Diagnoses, and Treatment

Abstract

Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective measurements, such as the eucapnic voluntary hyperpnea test or exercise test. When considering that not all respiratory symptoms are due to asthma, other diagnoses should be considered. Certain regulations apply to elite athletes who require asthma medication for asthma. Knowledge of these regulations is essential when treating elite athletes. This article is aimed at physicians who diagnose and treat athletes with respiratory symptoms. It focuses on the pathogenesis of asthma and exercise-induced bronchoconstriction in elite athletes and how the diagnosis can be made. Furthermore, treatment of elite athletes with asthma, anti-doping regulations, and differential diagnoses such as exercise-induced laryngomalacia are discussed.

Dietary cucurbitacin E reduces high-strength altitude training induced oxidative stress, inflammation and immunosuppression

“…Previous reports have shown that certain immunosuppressive substances can be produced in the serum of athletes after high-intensitive exercise (Pedersen et al 2011, Sato et al 2016. In this study, we also found that incubating human and mouse lymphocytes with stress serum of rats (after 4-weeks altitude training) can significantly reduce transformation efficiencies, and serum from cynomolgus monkeys also has similar effects on the transformation of rat and mouse lymphocytes.…”

Moderate Exercise Enhances the Production of Interferon-γ and Interleukin-12 in Peripheral Blood Mononuclear Cells

“…The clinical reported effects of moderate exercise on the immune system differ from that of excessive physical exercise. Short moderate exercise is correlated with reduced incidence of respiratory infections and asthma (56), while excessive amount of exercise is considered a major risk factor for allergic disorders (78). The molecular mechanism underling these differences in disease susceptibility based on exercise intensity are not clearly understood.…”

Increased Circulating Anti-inflammatory Cells in Marathon-trained Runners

“…Compared to a sedentary lifestyle, exercise in moderate amounts can reduce the incidence of upper respiratory tract infections (URTI) [17], reduce symptoms associated with allergies [6], and decrease the risk of developing asthma [8]. On the other hand, excessive amounts of exercise are associated with an increased the incidence of URTI [13], increased activity of inflammatorybased diseases [24], and an increased incidence of asthma [21]. This relationship between activity level and incidence/activity of disease is known as the J-shaped curve [9].…”