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How does exercise cause asthma attacks?

Sandra D Anderson1

  • 1Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. sandya@med.usyd.edu.au

Current Opinion in Allergy and Clinical Immunology
|March 1, 2006
PubMed
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Airway dehydration during exercise triggers inflammatory mediator release, contributing to exercise-induced bronchoconstriction. Mast cells and epithelial injury play key roles, highlighting the need to measure airway responses in asthma patients.

Area of Science:

  • Respiratory Medicine
  • Exercise Physiology
  • Immunology

Background:

  • Evaporative water loss from airway surfaces is the primary stimulus for exercise-induced bronchoconstriction (EIB).
  • The severity of EIB is closely linked to the recruitment and involvement of peripheral airways.
  • Epithelial injury and plasma exudation are potential contributors to EIB pathogenesis, particularly in athletes.

Purpose of the Study:

  • To underscore the role of airway dehydration in triggering EIB.
  • To highlight the significance of peripheral airway involvement in EIB severity.
  • To draw attention to epithelial injury and plasma exudation as contributing factors in EIB.

Main Methods:

  • Measurement of inflammatory mediators (histamine, cysteinyl leukotrienes, adenosine) in induced sputum and exhaled air condensate.

Related Experiment Videos

  • Assessment of mediator concentration changes following pharmacological intervention (loratadine and montelukast).
  • Gene expression analysis of the 5-lipoxygenase pathway in response to exercise in healthy subjects.

    • Main Results:

    • Inflammatory mediators are released into airways during exercise, quantifiable via sputum induction and exhaled air condensate.
    • Combined administration of loratadine and montelukast effectively reduced mediator concentrations.
    • Exercise stimulates the upregulation of genes involved in the 5-lipoxygenase pathway in healthy individuals.

    Conclusions:

    • Airway dehydration leads to mediator release, likely originating from mast cells.
    • Epithelial injury is a feature of EIB, and its repair process may enhance airway hyperresponsiveness in healthy individuals.
    • Evaluating airway response to exercise or surrogate stimuli is recommended for patients with asthma symptoms.