Two distinct phenotypes of asthma in elite athletes identified by latent class analysis

Couto, Mariana; Stang, Julie; Horta, Luís; Stensrud, Trine; Severo, Mílton; Mowinckel, Petter; Silva, Diana; Delgado, Luís; Moreira, André; Carlsen, Kai‐Håkon

doi:10.3109/02770903.2015.1067321

Cited by 52 publications

(60 citation statements)

References 28 publications

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“…Both training in a cold air and swimming pool environment had been previously identified as risk factors for EIBw A and were recently confirmed . Another recent study evidenced that EIB was present in 60% of swimmers and 29% of cold‐weather athletes compared to only 17% of nonathlete controls .…”

Section: Development and Risk Factors For Eib In Athletesmentioning

confidence: 66%

“…Previously, the possibility of two different phenotypes among athletes has been suggested: the pattern of “classical asthma” characterized by early onset of asthma in childhood, bronchial hyper‐responsiveness (BHR) diagnosed by methacholine challenge, atopy and signs of eosinophilic airway inflammation; and another phenotype with onset of respiratory symptoms during sports career, BHR to eucapnic hyperventilation test (EVH) and a variable association with atopic markers and eosinophilic airway inflammation . More recently, using latent class analysis, Couto et al identified two distinct phenotypes of EIB in athletes: “atopic asthma” defined by the occurrence of allergic sensitization, increased levels of exhaled nitric oxide, rhinitis and other allergic comorbidities; and “sports asthma”, defined by the presence of exercise‐induced respiratory symptoms and BHR in the absence of allergic features. Of note, these two phenotypes match with the proposed definitions of EIB A and EIBw A .…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms of exercise‐induced bronchoconstriction in athletes: Current perspectives and future challenges

Couto

Kurowski

Moreira

et al. 2017

Allergy

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The evidence of exercise-induced bronchoconstriction (EIB) without asthma (EIBw A ) occurring in athletes led to speculate about different endotypes inducing respiratory symptoms within athletes. Classical postulated mechanisms for bronchial obstruction in this population include the osmotic and the thermal hypotheses. More recently, the presence of epithelial injury and inflammation in the airways of athletes was demonstrated. In addition, neuronal activation has been suggested as a potential modulator of bronchoconstriction. Investigation of these emerging mechanisms is of major importance as EIB is a significant problem for both recreational and competitive athletes and is the most common chronic condition among Olympic athletes, with obvious implications for their competing performance, health and quality of life. Hereby, we summarize the latest achievements in this area and identify the current gaps of knowledge so that future research heads toward better defining the etiologic factors and mechanisms involved in development of EIB in elite athletes as well as essential aspects to ultimately propose preventive and therapeutic measures. K E Y W O R D Sepithelial injury, neurogenic inflammation, osmotic, sports, thermal

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Section: Development and Risk Factors For Eib In Athletesmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Mechanisms of exercise‐induced bronchoconstriction in athletes: Current perspectives and future challenges

Couto

Kurowski

Moreira

et al. 2017

Allergy

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“…Both are endurance sports and thus associated with an increased risk of asthma; however, winter sports athletes may be at a greater risk because of the repeated and prolonged inhalation of cold, dry air. Others have also found that winter sport is a risk factor for the specific phenotype of sports asthma (27).…”

Section: Discussionmentioning

confidence: 99%

High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey

et al. 2020

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Objective: The prevalence of asthma among elite endurance athletes is high, but less is known about the incidence of asthma among athletes. The aim of this study was to examine the incidence rate of physician-diagnosed asthma among elite endurance athletes. Method: An annual postal questionnaire was sent to an open prospective cohort of elite endurance athletes between 2011 and 2015. Athletes from Swedish National teams, students at universities with elite sport partnership, and pupils at Swedish National elite sport schools, competing in cross-country skiing, biathlon, ski orienteering, or orienteering were invited (n ¼ 666). Incidence rate of physician-diagnosed asthma was calculated among those without asthma at baseline (n ¼ 449). Risk factors for incident physician-diagnosed asthma were identified using a multivariate logistic regression analysis. Results: Response rate was 88.7% (n ¼ 591) at baseline. The median age of participants was 17 (range 15-36) years at inclusion. The study population included 407 (69%) skiers and 184 (31%) orienteers. The prevalence of asthma at baseline was 23.9% (n ¼ 141). Incidence rate (95% confidence interval [CI]) of physician-diagnosed asthma was 61.2 (45.7-80.3) per 1,000 person-years. Risk factors (odds ratio [OR (95% CI)]) for incident physician-diagnosed asthma were family history of asthma (1.97 [1.04-3.68]), being a skier (3.01 [1.42-7.21]), and wheezing without having a cold (4.15 [1.81-9.26]). Conclusion: The incidence rate of physician-diagnosed asthma is high among Swedish elite endurance athletes. ARTICLE HISTORY

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“…The phenomenon of asthma and exercise‐induced bronchoconstriction and corresponding treatments within the athletic population has been a topic of considerable debate in the past . It appears established today that distinct phenotypes of asthma exist among elite athletes and that individuals of specific sport disciplines such as water and winter sports are significantly more often affected by exercise‐induced bronchoconstriction . Enabling asthmatic athletes’ to participate in elite sport while ensuring appropriate medical treatment with relevant β 2 ‐agonists is regulated by WADA, with regulations being frequently revisited and scrutinized with regards to effects of (non)permitted drug use on both the athletic performance as well as drug testing.…”

Section: Anabolic Agentsmentioning

confidence: 99%

Annual banned‐substance review: analytical approaches in human sports drug testing

Thevis

Kuuranne

Geyer

et al. 2017

Drug Testing and Analysis

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There has been an immense amount of visibility of doping issues on the international stage over the past 12 months with the complexity of doping controls reiterated on various occasions. Hence, analytical test methods continuously being updated, expanded, and improved to provide specific, sensitive, and comprehensive test results in line with the World Anti-Doping Agency's (WADA) 2016 Prohibited List represent one of several critical cornerstones of doping controls. This enterprise necessitates expediting the (combined) exploitation of newly generated information on novel and/or superior target analytes for sports drug testing assays, drug elimination profiles, alternative test matrices, and recent advances in instrumental developments. This paper is a continuation of the series of annual banned-substance reviews appraising the literature published between October 2015 and September 2016 concerning human sports drug testing in the context of WADA's 2016 Prohibited List. Copyright © 2016 John Wiley & Sons, Ltd.

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Two distinct phenotypes of asthma in elite athletes identified by latent class analysis

Cited by 52 publications

References 28 publications

Mechanisms of exercise‐induced bronchoconstriction in athletes: Current perspectives and future challenges

Mechanisms of exercise‐induced bronchoconstriction in athletes: Current perspectives and future challenges

High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey

Annual banned‐substance review: analytical approaches in human sports drug testing

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