Exercise-induced bronchoconstriction: celebrating 50 years.

This article examines in detail the history of more than half a century of investigations into elucidating the causation of exercise-induced bronchoconstriction. Despite earnest attempts by many researchers from many countries, answers to some pivotal questions await the next generation of investigators into exercise-induced bronchoconstriction.

Exercise-induced asthma: an overview.

Asthmatic attack in exercise-induced asthma is brought about by hyperventilation (not necessarily to exercise), cold air, and low humidity of the air breathed. The effects are an increase in airway resistance, damage to bronchial mucosa, and an increase in bronchovascular permeability. The mechanism of these changes is the release of mediators such as histamine, leukotrienes, nitric oxide, sensory neuropeptides, the inhibition of neuronal activity, and bronchovascular permeability. The cause of asthma and exercise-induced asthma is unknown. It is probably an abnormality of vascular control in the peribronchium and/or an alteration in local adrenergic function. The importance of exercise-induced asthma definition and the use of stimulants in sport and antidoping in sport are discussed.

Broncoespasmo induzido por exercício (BIE) / Bronchospasm caused by exercise

Objetivo: O autor apresenta uma revisão a respeito do broncoespasmo induzido por exercício com ênfase na sua prevalência e sintomas respiratórios. Métodos: Foram selecionados os artigos mais significativos e de maior destaque acerca da doença desde a sua descrição em 1946. Resultados: O broncoespasmo, induzido por exercício, representa um exemplo de responsividade brônquica anormal a estímulo não imunológico. A hiper-responsividade brônquica é uma condição básica para que haja o desenvolvimento do broncoespasmo induzido por exercício. É importante ressaltar que esta condição é reversível, principalmente se o tratamento é estabelecido no início da doença. Conclusão: O broncoespasmo, induzido por exercício, é uma patologia ainda pouco conhecida no que se refere ao seu tratamento, diagnóstico e prognóstico. A maioria necessita de um tratamento completo da asma, pois os sinais e sintomas relacionados ao exercício, na verdade são manifestações de um processo inflamatório mais acentuado e hiper-responsividade brônquica subjacente.

Objective: The author presents a review about exercise induced bronchospasm, with particular emphasis on prevalence and respiratory symptoms. Methods: The most relevant articles concerning the disorder were selected, from the inicial description of the disease, in 1946. Results: Exercise induce bronchospasm represents an abnormal bronchial responsiveness to a non immunological stimulus. Bronchial responsiveness in necessary to have exercise induce bronchospasm. It is important to emphasise that this condition is reversible particularly if the treatment is started in the beginning of the disease. Conclusions: Exercise induce bronchospasm is still a condition scarcely known among paediatricians, particularly regarding treatment, diagnosis and prognosis. The majority needs a complete treatment of asthma particularly because the respiratory symptoms related to exercise represents a great inflammatory process.

History of exercise-induced asthma.

Strenuous exercise prolonged for several minutes can cause airway obstruction in asthmatic subjects. Initial obstruction becomes most extreme 5-10 min after the completion of exercise and usually remits within a few minutes but may recur 3-6 h later. The response to exercise depends upon the type of exercise. Swimming is less likely to cause exercise-induced asthma than running. Recent exercise or pretreatment with a bronchodilator or cromolyn can inhibit exercise-induced asthma. Nasal breathing or inhalation of warm, fully humidified air during exercise can minimize exercise-induced asthma. Local changes in osmolarity or cooling of mast cells probably causes release of mediators that cause airway obstruction.