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Hyperventilation- and Exercise-Induced Asthma
In 10 elite athletes with exercise-induced bronchoconstriction and 10 elite athletes without exercise-induced bronchoconstriction, Mickleborough and coworkers
did a randomized, double-blind crossover study of fish-oil capsules (containing n-3 polyunsaturated fatty acids: eicosapentaenoic acid and docohexaenoic acid). The fish-oil diet had no effect on pulmonary function before exercise in either group or after exercise in the control group. At 15 minutes after exercise, the decrease in FEV1 was less in subjects receiving the fish-oil diet, 3%, than in subjects receiving placebo, 14.5%, or a normal diet, 17.3%. Compared with the other groups, subjects receiving the fish-oil diet had decreased levels of leukotriene E4, 9 , 11ß-prostaglandin F2, leukotriene B4, tumor necrosis factor-, and interleukin-1ß. The authors conclude that a fish oil diet suppresses exercise-induced bronchoconstriction and the effect appears to be mediated by lessening of inflammation. An editorial commentary by Sadeh and Israel
accompanies this article.
Eucapnic voluntary hyperpnea has been recommended for identifying exercise-induced bronchoconstriction, but it requires relatively complex equipment. The validity of an osmotic aerosol, mannitol, as a surrogate was assessed by Holzer and coworkers
in 50 elite summer sport athletes, 27 of whom had been previously diagnosed as having asthma. Twenty-five subjects had a positive response to eucapnic voluntary hyperpnea (mean fall in FEV1, 25%), 26 subjects had a positive response to mannitol, and 24 subjects had positive responses to both challenges. When compared against eucapnic voluntary hyperpnea as a reference standard, inhalation of mannitol had a sensitivity of 96% and a specificity of 92%. The authors conclude that the response to inhaled mannitol is both sensitive and specific for detecting the response to eucapnic voluntary hyperpnea in elite swimmers.
To determine whether variables measured from exhaled condensates are influenced by presence or absence of a nose clip, Vass and coworkers
studied 25 healthy volunteers and 8 patients with allergic rhinitis. The volume of condensate was higher when subjects inhaled and exhaled through the mouth (with a nose clip) than when they inhaled through the nose and exhaled through the mouth (without nose clip): 2,321 versus 1,746 µl. Levels of adenosine, ammonia, and thromboxane B2 were equivalent by the two routes in both healthy subjects and patients with rhinitis. The authors conclude that use of a nose clip results in an exhaled condensate of greater volume, but it does not influence the level of inflammatory mediators.
In a pulmonary perspective, Boulet
discusses asymptomatic airway hyperresponsiveness.
Citations 1-5 of 5 total displayed.
Airway Narrowing in Athletes: A Different Kettle of Fish?
- Jonathan Sadeh and Elliot Israel
Am. J. Respir. Crit. Care Med. 168: 1146-1147.
[Full text]
Fish Oil Supplementation Reduces Severity of Exercise-induced Bronchoconstriction in Elite Athletes
- Timothy D. Mickleborough, Rachael L. Murray, Alina A. Ionescu, and Martin R. Lindley
Am. J. Respir. Crit. Care Med. 168: 1181 -1189. First published online as doi:10.1164/rccm.200303-373OC
[Abstract]
[Full text]
Comparison of Nasal and Oral Inhalation during Exhaled Breath Condensate Collection
- Géza Vass, Éva Huszár, Erzsébet Barát, Márta Valyon, Domonkos Kiss, István Pénzes, Mónika Augusztinovicz, and Ildikó Horváth
Am. J. Respir. Crit. Care Med. 167: 850 -855. First published online as doi:10.1164/rccm.200207-716BC
[Abstract]
[Full text]
Mannitol as a Challenge Test to Identify Exercise-induced Bronchoconstriction in Elite Athletes
- Karen Holzer, Sandra D. Anderson, Hak-Kim Chan, and Jo Douglass
Am. J. Respir. Crit. Care Med. 167: 534 -537. First published online as doi:10.1164/rccm.200208-916OC
[Abstract]
[Full text]
Asymptomatic Airway Hyperresponsiveness: A Curiosity or an Opportunity to Prevent Asthma?
- Louis-Philippe Boulet
Am. J. Respir. Crit. Care Med. 167: 371-378.
[Full text]
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