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Mechanisms of asthma in Olympic athletes--practical implications
T Haahtela1, P Malmberg, A Moreira
1Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
Allergy
|May 1, 2008
Summary
Athlete asthma presents distinct phenotypes, often linked to atopy and intense exercise. Differentiating these requires objective testing to avoid misdiagnosis in athletes.
Area of Science:
- Sports Medicine
- Pulmonology
- Allergy and Immunology
Background:
- Athletes experience respiratory symptoms, sometimes only under extreme exercise conditions.
- Atopy (IgE-mediated allergy) combined with endurance sports increases asthma risk.
- Athlete's asthma is complex, with varied causes and presentations across disciplines.
Purpose of the Study:
- To investigate the distinct clinical phenotypes of asthma in athletes.
- To explore the underlying mechanisms and risk factors for respiratory symptoms in athletes.
- To highlight challenges in diagnosing asthma in athletic populations.
Main Methods:
- Analysis of clinical phenotypes in Finnish Olympic athletes.
- Assessment of atopy, methacholine responsiveness, and exhaled nitric oxide levels.
- Evaluation of bronchial responsiveness to eucapnic hyperventilation tests.
Main Results:
- Identified two primary phenotypes: 'classical asthma' (early onset, atopy, eosinophilic inflammation) and a late-onset type (exercise-induced responsiveness).
- Observed mixed eosinophilic and neutrophilic inflammation in swimmers and skiers, suggesting multifactorial causes.
- Noted significant issues with both under- and overdiagnosis of asthma in athletes.
Conclusions:
- Athlete's asthma is not a single entity; distinct phenotypes exist with different etiological factors.
- Objective testing is crucial for accurate diagnosis and management of asthma in athletes.
- Further longitudinal studies are needed to understand the interplay of genetics, environment, and training intensity.
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