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Erschienen in: Sports Medicine 7/2005

01.07.2005 | Review Article

Asthma, Airway Inflammation and Treatment in Elite Athletes

verfasst von: Dr Ilkka Helenius, Aki Lumme, Tari Haahtela

Erschienen in: Sports Medicine | Ausgabe 7/2005

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Abstract

Highly trained athletes are repeatedly and strongly exposed to cold air during winter training and to many inhalant irritants and allergens all year round. Asthma occurs most commonly in athletes engaging in endurance events such as cross-country skiing, swimming, or long-distance running. As well as the type of training, a major risk factor is atopic disposition. A mixed type of eosinophilic and neutrophilic airway inflammation has been shown to affect elite swimmers, icehockey players, and cross-country skiers. The inflammation may represent a form of repeated thermal, mechanical, or osmotic airway trauma resulting in a healing or remodelling process. Elite athletes commonly use antiasthma drugs to treat exercise-induced bronchial symptoms. Only a few controlled studies have been conducted on the effects of antiasthma drugs on asthma symptoms, bronchial hyperresponsiveness and airway inflammation in elite athletes. Inhaled β2-adrenoceptor agonists are effective against exercise-induced bronchospasm. In contrast, airway inflammation, bronchial hyperresponsiveness and symptoms have responded poorly to inhaled corticosteroids and leukotriene antagonists. As discontinuing high-level exercise has proved effective in reducing eosinophilic airway inflammation, exercise or training should be restricted in athletes having troublesome symptoms and sputum eosinophilia. Switching training to less irritating environments should be considered whenever possible. It appears to be difficult to change the ‘natural course’ of asthma in athletes by anti-inflammatory treatment.
Literatur
1.
Zurück zum Zitat Helenius I, Haahtela T. Allergy and asthma in elite summer sports athletes. J Allergy Clin Immunol 2000; 106: 444–52PubMedCrossRef Helenius I, Haahtela T. Allergy and asthma in elite summer sports athletes. J Allergy Clin Immunol 2000; 106: 444–52PubMedCrossRef
2.
Zurück zum Zitat Anderson SD, Holzer K. Exercise-induced asthma: is it the right diagnosis in elite athletes? J Allergy Clin Immunol 2000; 106: 419–28PubMedCrossRef Anderson SD, Holzer K. Exercise-induced asthma: is it the right diagnosis in elite athletes? J Allergy Clin Immunol 2000; 106: 419–28PubMedCrossRef
3.
Zurück zum Zitat Bonini S, Brusasco V, Carlsen K-H, et al. Diagnosis of asthma and permitted use of inhaled β2-agonists in athletes. Allergy 2004; 59: 33–6PubMedCrossRef Bonini S, Brusasco V, Carlsen K-H, et al. Diagnosis of asthma and permitted use of inhaled β2-agonists in athletes. Allergy 2004; 59: 33–6PubMedCrossRef
4.
Zurück zum Zitat Rundell KW, Wilber RL, Szmedra DM, et al. Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 2000; 32: 309–16PubMedCrossRef Rundell KW, Wilber RL, Szmedra DM, et al. Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 2000; 32: 309–16PubMedCrossRef
5.
Zurück zum Zitat Rundell KW, Im J, Mayers LB, et al. Self-reported symptoms and exercise-induced asthma in elite athletes. Med Sci Sports Exerc 2001; 33: 208–13PubMed Rundell KW, Im J, Mayers LB, et al. Self-reported symptoms and exercise-induced asthma in elite athletes. Med Sci Sports Exerc 2001; 33: 208–13PubMed
6.
Zurück zum Zitat Rundell KW, Jenkinson DM. Exercise-induced bronchospasm in the elite athlete. Sports Med 2002; 32: 583–600PubMedCrossRef Rundell KW, Jenkinson DM. Exercise-induced bronchospasm in the elite athlete. Sports Med 2002; 32: 583–600PubMedCrossRef
7.
Zurück zum Zitat Rundell KW, Spiering BA, Judelson DA, et al. Bronchoconstriction during cross-country skiing: is there really a refractory period. Med Sci Sports Exerc 2003; 35: 18–26PubMedCrossRef Rundell KW, Spiering BA, Judelson DA, et al. Bronchoconstriction during cross-country skiing: is there really a refractory period. Med Sci Sports Exerc 2003; 35: 18–26PubMedCrossRef
8.
Zurück zum Zitat Rundell KW, Spiering BA, Evans TM, et al. Baseline lung function, exercise-induced bronchoconstriction, and asthma-like symptoms in elite women ice hockey players. Med Sci Sports Exerc 2004; 36: 405–10PubMedCrossRef Rundell KW, Spiering BA, Evans TM, et al. Baseline lung function, exercise-induced bronchoconstriction, and asthma-like symptoms in elite women ice hockey players. Med Sci Sports Exerc 2004; 36: 405–10PubMedCrossRef
10.
Zurück zum Zitat Dosman JA, Hodgson WC, Cockcroft DW. Effect of cold air on the bronchial response to inhaled histamine in patients with asthma. Am Rev Respir Dis 1991; 144: 45–50PubMedCrossRef Dosman JA, Hodgson WC, Cockcroft DW. Effect of cold air on the bronchial response to inhaled histamine in patients with asthma. Am Rev Respir Dis 1991; 144: 45–50PubMedCrossRef
11.
Zurück zum Zitat Larsson K, Tornling G, Gavhed D, et al. Inhalation of cold air increases the number of inflammatory cells in the lungs in healthy subjects. Eur Resp J 1998; 12: 825–30CrossRef Larsson K, Tornling G, Gavhed D, et al. Inhalation of cold air increases the number of inflammatory cells in the lungs in healthy subjects. Eur Resp J 1998; 12: 825–30CrossRef
12.
Zurück zum Zitat Suzuki S, Chonan T, Sasaki H, et al. Bronchial hyperresponsiveness to methacholine after exercise in asthmatics. Ann Allergy 1985; 54: 136–41PubMed Suzuki S, Chonan T, Sasaki H, et al. Bronchial hyperresponsiveness to methacholine after exercise in asthmatics. Ann Allergy 1985; 54: 136–41PubMed
13.
Zurück zum Zitat Strauss RH, McFadden Jr ER, Ingram Jr RH, et al. Enhancement of exercise-induced asthma by cold air. N Engl J Med 1977; 297: 743–7PubMedCrossRef Strauss RH, McFadden Jr ER, Ingram Jr RH, et al. Enhancement of exercise-induced asthma by cold air. N Engl J Med 1977; 297: 743–7PubMedCrossRef
14.
Zurück zum Zitat Helenius IJ. Allergy and asthma in elite athletes [dissertation]. Helsinki: Yliopistopaino, 1998 Helenius IJ. Allergy and asthma in elite athletes [dissertation]. Helsinki: Yliopistopaino, 1998
15.
Zurück zum Zitat Helenius I, Rytilä P, Sarna S, et al. Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a prospective follow-up study of 42 elite swimmers. J Allergy Clin Immunol 2002; 109: 962–8PubMed Helenius I, Rytilä P, Sarna S, et al. Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a prospective follow-up study of 42 elite swimmers. J Allergy Clin Immunol 2002; 109: 962–8PubMed
16.
Zurück zum Zitat Potts J. Factors associated with respiratory problems in swimmers. Sports Med 1996; 21: 256–61PubMedCrossRef Potts J. Factors associated with respiratory problems in swimmers. Sports Med 1996; 21: 256–61PubMedCrossRef
17.
Zurück zum Zitat Drobnik F, Freixa A, Casan P, et al. Assessment of chlorine exposure in swimmers during training. Med Sci Sports Exerc 1996; 28: 271–4CrossRef Drobnik F, Freixa A, Casan P, et al. Assessment of chlorine exposure in swimmers during training. Med Sci Sports Exerc 1996; 28: 271–4CrossRef
18.
Zurück zum Zitat Helenius IJ, Tikkanen HO, Sarna S, et al. Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors. J Allergy Clin Immunol 1998; 101: 646–52PubMedCrossRef Helenius IJ, Tikkanen HO, Sarna S, et al. Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors. J Allergy Clin Immunol 1998; 101: 646–52PubMedCrossRef
19.
Zurück zum Zitat Chan-Yeung M, Lam S, Kennedy SM, et al. Persistent asthma after repeated exposure to high concentrations of gases in pulpmills. Am J Respir Crit Care Med 1994; 149: 1676–80 Chan-Yeung M, Lam S, Kennedy SM, et al. Persistent asthma after repeated exposure to high concentrations of gases in pulpmills. Am J Respir Crit Care Med 1994; 149: 1676–80
20.
Zurück zum Zitat Kosunen TU, Höök-Nikanne J, Salomaa A, et al. Increase of allergen-specific immunoglobulin E antibodies from 1973 to 1994 in a Finnish population and a possible relationship to Helicobacter pylori infections. Clin Exp Allergy 2002; 32: 373–8PubMedCrossRef Kosunen TU, Höök-Nikanne J, Salomaa A, et al. Increase of allergen-specific immunoglobulin E antibodies from 1973 to 1994 in a Finnish population and a possible relationship to Helicobacter pylori infections. Clin Exp Allergy 2002; 32: 373–8PubMedCrossRef
21.
Zurück zum Zitat Krause T, Koch A, Friborg J, et al. Frequency of atopy in the Arctic in 1987 and 1998. Lancet 2002; 360: 691–2PubMedCrossRef Krause T, Koch A, Friborg J, et al. Frequency of atopy in the Arctic in 1987 and 1998. Lancet 2002; 360: 691–2PubMedCrossRef
22.
Zurück zum Zitat Lumme A, Haahtela T, Öunap J, et al. Airway inflammation, bronchial hyperresponsiveness, and asthma in elite ice hockey players. Eur Resp J 2003; 22: 113–7CrossRef Lumme A, Haahtela T, Öunap J, et al. Airway inflammation, bronchial hyperresponsiveness, and asthma in elite ice hockey players. Eur Resp J 2003; 22: 113–7CrossRef
23.
Zurück zum Zitat Mussalo-Rauhamaa H, Reijula K, Malmberg M, et al. Dog allergen in indoor air and dust during dog shows. Allergy 2001; 56: 878–82PubMed Mussalo-Rauhamaa H, Reijula K, Malmberg M, et al. Dog allergen in indoor air and dust during dog shows. Allergy 2001; 56: 878–82PubMed
24.
Zurück zum Zitat Platts-Mills TA, Ward Jr GW, Sporik R, et al. Epidemiology of the relationship between exposure to indoor allergens and asthma. Int Arch Allergy Appl Immunol 1991; 94: 339–45PubMedCrossRef Platts-Mills TA, Ward Jr GW, Sporik R, et al. Epidemiology of the relationship between exposure to indoor allergens and asthma. Int Arch Allergy Appl Immunol 1991; 94: 339–45PubMedCrossRef
25.
Zurück zum Zitat Helenius IJ, Tikkanen HO, Haahtela T. Association between type of training and risk of asthma in elite athletes. Thorax 1997; 52: 157–60PubMedCrossRef Helenius IJ, Tikkanen HO, Haahtela T. Association between type of training and risk of asthma in elite athletes. Thorax 1997; 52: 157–60PubMedCrossRef
26.
Zurück zum Zitat Larsson K, Ohlsen P, Larsson L, et al. High prevalence of asthma in cross-country skiers. BMJ 1993; 307: 1326–9PubMedCrossRef Larsson K, Ohlsen P, Larsson L, et al. High prevalence of asthma in cross-country skiers. BMJ 1993; 307: 1326–9PubMedCrossRef
27.
Zurück zum Zitat Sue-Chu M, Larsson L, Bjermer L. Prevalence of asthma in young cross-country skiers in central Scandinavia: differences between Norway and Sweden. Resp Med 1996; 90: 99–105CrossRef Sue-Chu M, Larsson L, Bjermer L. Prevalence of asthma in young cross-country skiers in central Scandinavia: differences between Norway and Sweden. Resp Med 1996; 90: 99–105CrossRef
28.
Zurück zum Zitat Langdeau JB, Turcotte H, Bowie DM, et al. Airway hyperresponsiveness in elite athletes. Am J Respir Crit Care Med 2000; 161: 1479–84PubMed Langdeau JB, Turcotte H, Bowie DM, et al. Airway hyperresponsiveness in elite athletes. Am J Respir Crit Care Med 2000; 161: 1479–84PubMed
29.
Zurück zum Zitat Helenius IJ, Rytilä P, Metso T, et al. Respiratory symptoms, bronchial responsiveness and cellular characteristics of induced sputum in elite swimmers. Allergy 1998; 53: 346–52PubMedCrossRef Helenius IJ, Rytilä P, Metso T, et al. Respiratory symptoms, bronchial responsiveness and cellular characteristics of induced sputum in elite swimmers. Allergy 1998; 53: 346–52PubMedCrossRef
30.
Zurück zum Zitat Leuppi JD, Kuhn M, Comminot C, et al. High prevalence of bronchial hyperresponsivness and asthma in ice hockey players. Eur Resp J 1998; 12: 13–6CrossRef Leuppi JD, Kuhn M, Comminot C, et al. High prevalence of bronchial hyperresponsivness and asthma in ice hockey players. Eur Resp J 1998; 12: 13–6CrossRef
31.
Zurück zum Zitat Wilber RL, Rundell KW, Szmedra L, et al. Incidence of exercise-induced bronchospasm in Olympic Winter sport athletes. Med Sci Sports Exerc 2000; 32: 732–7PubMedCrossRef Wilber RL, Rundell KW, Szmedra L, et al. Incidence of exercise-induced bronchospasm in Olympic Winter sport athletes. Med Sci Sports Exerc 2000; 32: 732–7PubMedCrossRef
32.
Zurück zum Zitat Karjalainen EM, Laitinen A, Sue-Chu M, et al. Evidence of airway inflammation and remodeling in ski athletes with and without bronchial hyperresponsiveness to methacholine. Am J Respir Crit Care Med 2000; 161: 2086–91PubMed Karjalainen EM, Laitinen A, Sue-Chu M, et al. Evidence of airway inflammation and remodeling in ski athletes with and without bronchial hyperresponsiveness to methacholine. Am J Respir Crit Care Med 2000; 161: 2086–91PubMed
33.
Zurück zum Zitat Sue-Chu M, Larsson L, Moen T, et al. Bronchoscopy and bronchoalveolar lavage fluid findings in cross-country skiers with and without ski asthma. Eur Resp J 1999; 13: 626–32CrossRef Sue-Chu M, Larsson L, Moen T, et al. Bronchoscopy and bronchoalveolar lavage fluid findings in cross-country skiers with and without ski asthma. Eur Resp J 1999; 13: 626–32CrossRef
34.
Zurück zum Zitat Sue-Chu M, Karjalanen EM, Altraja A, et al. Lymphoid aggregates in endobronchial biopsies from young elite cross-country skiers. Am J Respir Crit Care Med 1998; 158: 597–601PubMed Sue-Chu M, Karjalanen EM, Altraja A, et al. Lymphoid aggregates in endobronchial biopsies from young elite cross-country skiers. Am J Respir Crit Care Med 1998; 158: 597–601PubMed
35.
Zurück zum Zitat Rytilä P, Metso T, Heikkinen K, et al. Airway inflammation in patients with symptoms suggesting asthma but with normal lung function. Eur Resp J 2000; 19: 824–30CrossRef Rytilä P, Metso T, Heikkinen K, et al. Airway inflammation in patients with symptoms suggesting asthma but with normal lung function. Eur Resp J 2000; 19: 824–30CrossRef
36.
Zurück zum Zitat Bonsignore MR, Morici G, Vignola AM, et al. Increased airway inflammatory cells in endurance athletes: what do they mean? Clin Exp Allergy 2003; 33: 14–21PubMedCrossRef Bonsignore MR, Morici G, Vignola AM, et al. Increased airway inflammatory cells in endurance athletes: what do they mean? Clin Exp Allergy 2003; 33: 14–21PubMedCrossRef
37.
Zurück zum Zitat Wetter TJ, Xiang Z, Sonetti DA, et al. Role of lung inflammatory mediators as a cause of exercise-induced arterial hypoxemia in young athletes. J Appl Physiol 2002; 93: 116–26PubMed Wetter TJ, Xiang Z, Sonetti DA, et al. Role of lung inflammatory mediators as a cause of exercise-induced arterial hypoxemia in young athletes. J Appl Physiol 2002; 93: 116–26PubMed
38.
Zurück zum Zitat Sue-Chu M, Karjalainen EM, Laitinen A, et al. Placebo-controlled study of inhaled budesonide on indices of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsies in cross-country skiers. Respiration 2000; 67: 417–25PubMedCrossRef Sue-Chu M, Karjalainen EM, Laitinen A, et al. Placebo-controlled study of inhaled budesonide on indices of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsies in cross-country skiers. Respiration 2000; 67: 417–25PubMedCrossRef
39.
Zurück zum Zitat Helenius I, Lumme A, Öunap J, et al. No effect of montelukast on asthma-like symptoms in elite ice hockey players. Allergy 2004; 59: 39–44PubMedCrossRef Helenius I, Lumme A, Öunap J, et al. No effect of montelukast on asthma-like symptoms in elite ice hockey players. Allergy 2004; 59: 39–44PubMedCrossRef
40.
Zurück zum Zitat McKenzie DC, McLuckie SL, Stirling DR. The protective effects of continuous and interval exercise in athletes with exercise-induced asthma. Med Sci Sports Exerc 1994; 26: 951–6PubMed McKenzie DC, McLuckie SL, Stirling DR. The protective effects of continuous and interval exercise in athletes with exercise-induced asthma. Med Sci Sports Exerc 1994; 26: 951–6PubMed
41.
Zurück zum Zitat Carlsen KH. Exercise-induced asthma in children and adolescents and the relationship to sports. Pediatr Allergy Immunol 1998; 9: 173–80PubMedCrossRef Carlsen KH. Exercise-induced asthma in children and adolescents and the relationship to sports. Pediatr Allergy Immunol 1998; 9: 173–80PubMedCrossRef
42.
Zurück zum Zitat Koskela H, Tukiainen H, Kononoff A, et al. Effect of whole-body exposure to cold and wind on lung function in asthmatic patients. Chest 1994; 105: 1728–31PubMedCrossRef Koskela H, Tukiainen H, Kononoff A, et al. Effect of whole-body exposure to cold and wind on lung function in asthmatic patients. Chest 1994; 105: 1728–31PubMedCrossRef
43.
Zurück zum Zitat Heir T, Aanestad G, Carlsen KH, et al. Respiratory tract infection and bronchial responsiveness in elite athletes and sedentary control subjects. Scand J Med Sci Sports 1995; 5: 94–9PubMedCrossRef Heir T, Aanestad G, Carlsen KH, et al. Respiratory tract infection and bronchial responsiveness in elite athletes and sedentary control subjects. Scand J Med Sci Sports 1995; 5: 94–9PubMedCrossRef
44.
Zurück zum Zitat Alaranta A A, Alaranta H, Palmu P, et al. Asthma medication in Finnish olympic athletes: no signs of inhaled β2-agonist overuse. Med Sci Sports Exerc 2004; 36: 919–24PubMedCrossRef Alaranta A A, Alaranta H, Palmu P, et al. Asthma medication in Finnish olympic athletes: no signs of inhaled β2-agonist overuse. Med Sci Sports Exerc 2004; 36: 919–24PubMedCrossRef
45.
Zurück zum Zitat Weiler JM. Why must Olympic athletes prove that they have asthma to be permitted to take inhaled β2-agonists? J Allergy Clin Immunol 2003; 111: 36–7PubMedCrossRef Weiler JM. Why must Olympic athletes prove that they have asthma to be permitted to take inhaled β2-agonists? J Allergy Clin Immunol 2003; 111: 36–7PubMedCrossRef
46.
Zurück zum Zitat Anderson SD, Fitch K, Perry CP, et al. Responses to bronchial challenge submitted for approval to use inhaled β2-agonists before an event at the 2002 Winter Olympics. J Allergy Clin Immunol 2003; 111: 45–50PubMedCrossRef Anderson SD, Fitch K, Perry CP, et al. Responses to bronchial challenge submitted for approval to use inhaled β2-agonists before an event at the 2002 Winter Olympics. J Allergy Clin Immunol 2003; 111: 45–50PubMedCrossRef
47.
Zurück zum Zitat Ferrari M, Balestreri F, Baratieri S, et al. Evidence of the rapid protective effect of formoterol dry-powder inhalation against exercise-induced bronchospasm in athletes with asthma. Respiration 2000; 67: 5103–513CrossRef Ferrari M, Balestreri F, Baratieri S, et al. Evidence of the rapid protective effect of formoterol dry-powder inhalation against exercise-induced bronchospasm in athletes with asthma. Respiration 2000; 67: 5103–513CrossRef
48.
Zurück zum Zitat Mickleborough TD, Murray RL, Ionescu AA, et al. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med 2003; 168: 1181–9PubMedCrossRef Mickleborough TD, Murray RL, Ionescu AA, et al. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med 2003; 168: 1181–9PubMedCrossRef
49.
Zurück zum Zitat Bjermer L, Bisgaard H, Bousquet J, et al. Montelukast and fluticasone compared with salmeterol and fluticasone in protecting against asthma exacerbation in adults: one year, double-blind, randomised, comparative trial. BMJ 2003; 327: 891–6PubMedCrossRef Bjermer L, Bisgaard H, Bousquet J, et al. Montelukast and fluticasone compared with salmeterol and fluticasone in protecting against asthma exacerbation in adults: one year, double-blind, randomised, comparative trial. BMJ 2003; 327: 891–6PubMedCrossRef
50.
Zurück zum Zitat Leff JA, Busse WW, Pearlman D, et al. Montelukast, a leukotriene antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction. N Engl J Med 1998; 339: 147–52PubMedCrossRef Leff JA, Busse WW, Pearlman D, et al. Montelukast, a leukotriene antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction. N Engl J Med 1998; 339: 147–52PubMedCrossRef
51.
Zurück zum Zitat Pizzichini E, Leff JA, Reiss TF, et al. Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial. Eur Resp J 1999; 14: 12–8CrossRef Pizzichini E, Leff JA, Reiss TF, et al. Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial. Eur Resp J 1999; 14: 12–8CrossRef
52.
Zurück zum Zitat McKenzie DC, Stewart IB. Asthma medications as ergogenic aids. In: Rundell KW, Lemanske RF, editors. Exercise-induced asthma: pathophysiology and treatment. Champaign (IL): Human Kinetics, 2002: 237–50 McKenzie DC, Stewart IB. Asthma medications as ergogenic aids. In: Rundell KW, Lemanske RF, editors. Exercise-induced asthma: pathophysiology and treatment. Champaign (IL): Human Kinetics, 2002: 237–50
53.
Zurück zum Zitat Helenius I, Tikkanen HO, Helenius M, et al. Exercise-induced changes in pulmonary function of healthy elite long-distance runners in cold air and pollen season exercise challenge tests. Int J Sports Med 2002; 23: 252–61PubMedCrossRef Helenius I, Tikkanen HO, Helenius M, et al. Exercise-induced changes in pulmonary function of healthy elite long-distance runners in cold air and pollen season exercise challenge tests. Int J Sports Med 2002; 23: 252–61PubMedCrossRef
54.
Zurück zum Zitat Mickleborough TD, Gotshall RW. Dietary components with demonstrated effectiveness in decreasing the severity of exercise-induced asthma. Sports Med 2003; 33: 671–81PubMedCrossRef Mickleborough TD, Gotshall RW. Dietary components with demonstrated effectiveness in decreasing the severity of exercise-induced asthma. Sports Med 2003; 33: 671–81PubMedCrossRef
55.
Zurück zum Zitat Sadeh J, Israel E. Airway narrowing in athletes:a different kettle of fish. Am J Resp Crit Care Med 2003; 168: 1146–7PubMedCrossRef Sadeh J, Israel E. Airway narrowing in athletes:a different kettle of fish. Am J Resp Crit Care Med 2003; 168: 1146–7PubMedCrossRef
56.
Zurück zum Zitat Arm JP, Horton CE, Mencia-Huerta JM, et al. Effect of dietary supplementation with fish oil lipids on mild asthma. Thorax 1988; 43: 84–92PubMedCrossRef Arm JP, Horton CE, Mencia-Huerta JM, et al. Effect of dietary supplementation with fish oil lipids on mild asthma. Thorax 1988; 43: 84–92PubMedCrossRef
57.
Zurück zum Zitat Katelaris CH, Carrozzi FM, Burke TV, et al. A springtime Olympics demands special consideration for allergic athletes. J Allergy Clin Immunol 2000; 106: 260–6PubMedCrossRef Katelaris CH, Carrozzi FM, Burke TV, et al. A springtime Olympics demands special consideration for allergic athletes. J Allergy Clin Immunol 2000; 106: 260–6PubMedCrossRef
58.
Zurück zum Zitat Bousquet J, van Cauwenberge P, Bachert C, et al. Requirements for medications commonly used in the treatment of allergic rhinitis. European Academy of Allergy and Clinical Immunology (EAACI), Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy 2003; 58: 192–7PubMedCrossRef Bousquet J, van Cauwenberge P, Bachert C, et al. Requirements for medications commonly used in the treatment of allergic rhinitis. European Academy of Allergy and Clinical Immunology (EAACI), Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy 2003; 58: 192–7PubMedCrossRef
59.
Zurück zum Zitat Katelaris CH, Carrozzi FM, Burke TV. Allergic rhinoconjunctivitis in elite athletes: optimal management for quality of life and performance. Sports Med 2003; 33: 401–6PubMedCrossRef Katelaris CH, Carrozzi FM, Burke TV. Allergic rhinoconjunctivitis in elite athletes: optimal management for quality of life and performance. Sports Med 2003; 33: 401–6PubMedCrossRef
60.
Zurück zum Zitat Walker SM, Pajno GB, Lima MT, et al. Grass pollen immunotherapy for seasonal rhinitis and asthma: a randomized clinical trial. J Allergy Clin Immunol 2001; 107: 87–93PubMedCrossRef Walker SM, Pajno GB, Lima MT, et al. Grass pollen immunotherapy for seasonal rhinitis and asthma: a randomized clinical trial. J Allergy Clin Immunol 2001; 107: 87–93PubMedCrossRef
61.
Zurück zum Zitat Griffin JW, Hunter G, Ferguso-Sillers MJ. Physiologic effects of external nasal dilator. Laryngoscope 1997; 107: 1235–8PubMedCrossRef Griffin JW, Hunter G, Ferguso-Sillers MJ. Physiologic effects of external nasal dilator. Laryngoscope 1997; 107: 1235–8PubMedCrossRef
62.
Zurück zum Zitat McFadden Jr ER, Zawadski DK. Vocal cord dysfunction masquerading as exercise-induced asthma. a physiologic cause for ‘choking’ during athletic activities. Am J Respir Crit Care Med 1996; 153: 942–7PubMed McFadden Jr ER, Zawadski DK. Vocal cord dysfunction masquerading as exercise-induced asthma. a physiologic cause for ‘choking’ during athletic activities. Am J Respir Crit Care Med 1996; 153: 942–7PubMed
63.
Metadaten
Titel
Asthma, Airway Inflammation and Treatment in Elite Athletes
verfasst von
Dr Ilkka Helenius
Aki Lumme
Tari Haahtela
Publikationsdatum
01.07.2005
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 7/2005
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200535070-00002

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