Acute Exercise Challenge and Airway Dynamics in Youth With Sickle Cell Anemia: A Multicenter Study

Area of Science:

• Pediatric Pulmonology
• Hematology
• Exercise Physiology

Background:

• Sickle cell anemia (SCA) is associated with reduced physical functioning and cardiopulmonary fitness.
• Airway hyperresponsiveness is noted in SCA, but exercise-induced bronchospasm (EIB) prevalence is understudied.
• EIB may impact exercise capacity and quality of life in children with SCA.

Purpose of the Study:

• To investigate the prevalence of EIB in children with SCA compared to healthy controls.
• To determine if SCA status is associated with an increased risk of EIB following exercise.
• To inform exercise guidelines for individuals with SCA.

Main Methods:

• A comparative study involving non-asthmatic children aged 10-21 with SCA and race-matched controls.
• Participants underwent maximal cardiopulmonary exercise testing (CPET) and a controlled intensity interval test (CIIT).
• Spirometry was performed pre- and post-exercise to assess for EIB.

Main Results:

• Subjects with SCA had lower hemoglobin and reduced baseline spirometry compared to controls.
• The prevalence of EIB did not differ significantly between SCA participants and controls after CPET (21% vs. 26%) or CIIT (32% vs. 17%).
• SCA status was not independently associated with EIB in adjusted logistic regression models.

Conclusions:

• EIB is not more common in children with SCA than in healthy controls.
• Maximal and submaximal exercise challenges did not reveal a higher incidence of EIB in the SCA group.
• Further research is warranted to understand exercise effects on airway dynamics in SCA and to develop appropriate exercise recommendations.