Problems of interpreting exercise-induced asthma

doi:10.1016/0091-6749(73)90058-4

Journal of Allergy and Clinical Immunology

Volume 52, Issue 4, October 1973, Pages 199-209

https://doi.org/10.1016/0091-6749(73)90058-4 Get rights and content

Abstract

Factors affecting exercise-induced asthma are reviewed based on studies in large numbers of children and young adults. Evidence is presented to show that running is a more potent and reproducible stimulus than cycling and that walking and swimming have a small and variable effect. The greatest amount of exercise-induced asthma is found after 6 to 8 minutes of steady-state running at a work rate equivalent to about two thirds of the working capacity of the subject. Exercise may be repeated every 2 hours throughout the day without any diminution of its effect in causing postexercise bronchoconstriction. The use of exercise in assessing drugs used to treat asthma is discussed, and the importance of the type of exercise test and the use of placebo preparations is emphasized. Serial exercise tests may be used to study the duration of protection from exercise-induced asthma afforded by drugs such as cromolyn sodium.

References (34)

RS. Jones et al.
The effect of exercise on ventilatory function in the child with asthma
Br. J. Dis. Chest
(1962)
R.M. Sly et al.
Exercise induced bronchospasm: Effect of adrenergic and cholinergic blockade
J. Allergy
(1967)
P.A. Eggleston et al.
A double blind trial of the effect of cromolyn sodium on exercise-induced bronchospasm
J. Allergy Clin. Immunol
(1972)
J.G. Scadding
Patterns of respiratory insufficiency
Lancet
(1966)
W.E. Pierson et al.
Cycloergometer-induced bronchospasm
J. Allergy
(1969)
R.M. Katz et al.
Exercise-induced bronchospasm, ventilation, and blood gases in asthmatic children
J. Allergy
(1971)
A.S. Rebuck et al.
Exercise-induced asthma
Lancet
(1968)
H. Herxheimer
Hyperventilation asthma
Lancet
(1946)
H. Herxheimer
Exercise asthma
Lancet
(1972)
T. Willis
Pharmaceutice rationales, Part 2
(1679)

Sir John A. Floyer

Treatise of the asthma

(1717)

S.D. Anderson et al.

Changes in lung volumes and airways resistance after exercise in asthmatic subjects

Am. Rev. Resp. Dis

(1972)

M. Silverman et al.

Metabolic changes preceding exercise induced bronchoconstriction

Br. Med. J

(1972)

N.M. Connolly et al.

Assessment of the child with asthma

J. Asthma Res

(1970)

M.I. Blackhall et al.

Effect of Intal on postexercise bronchoconstriction in asthma

B.G. Simmonsson et al.

Exercise induced airways constriction

Thorax

(1972)

S.D. Anderson et al.

Comparison of bronchoconstriction induced by cycling and running

Thorax

(1971)

Cited by (108)

Update of the 2021 Recommendations for the management of and follow-up of adolescent asthmatic patients (over 12 years) under the guidance of the French Society of Pulmonology and the Paediatric Society of Pulmonology and Allergology. Long version
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Time-effect of montelukast on protection against exercise-induced bronchoconstriction
2011, Respiratory Medicine
Citation Excerpt :
FEV1 values were plotted against time for each treatment. Percentage of protection was calculated as [(Ps − Pt)/Ps] · 100 where Ps is the percentage fall in FEV1 at the screening visit, and Pt is the fall after each treatment.24 Clinical protection was considered achieved if the percentage fall (ΔFEV1) after receiving MNT was one-half or less of the percentage fall after receiving the placebo.
Montelukast has been proven to assure a protective effect against exercise-induced bronchoconstriction.
To verify exactly when montelukast begins protection in asthmatic children by evaluating different time intervals between dosing and challenge.
In a double blind, placebo-controlled, three day doses, crossover study, patients were randomized to receive in sequence treatment with either a placebo or montelukast and assigned to one of seven groups that were tested 1, 2, 3, 4, 5, 6 and 8 h after drug administration, respectively. For each group, the exercise challenge was always performed at the same hour on the first and third days of treatment.
Sixty-nine asthmatic children took part in the study. On day 3, the mean FEV₁ % fall from baseline was 25.54 (95% CI = 21.63/29.46) and 14.89 (95% CI = 11.85/17.92) for the placebo and active drug (p < 0.05), respectively. On day 1, the mean fall of FEV₁ was 28.20 (95% CI = 24.46/31.94) and 19.01 (95% CI = 15.71/22.31) for the placebo and montelukast (p < 0.05), respectively. Clinical protection was achieved in 21 (30%) and 33 (48%) subjects by montelukast on the first and third days, respectively.
Montelukast assured protection against exercise-induced bronchoconstriction from the first through the eighth hour from thefirst day of treatment. However, individual susceptibility to protection was evident since some individuals were not protected at any time. We conclude that in clinical use individual responses to the drug should be carefully evaluated in the follow-up management.
Asthma and the Athlete
2010, Pediatric Allergy: Principles and Practice Expert Consult: Second Edition
Thermoregulatory and respiratory responses in asthmatic and nonasthmatic subjects breathing cold and warm air during exercise in the cold
2007, Journal of Thermal Biology
- 1.
  The effects of whole-body exposure to ambient temperature of −15 °C on thermoregulatory and respiratory responses in asthmatic and nonasthmatic subjects were investigated. The subjects were exposed to inhalation of cold dry and warm humid air during 30 min submaximal exercise.
- 2.
  Exercise-induced bronchoconstriction in the asthmatic group was significantly reduced, but not eliminated by inspiration of warm, humid air. The reduction was significantly larger in the asthmatic than in the nonasthmatic group.
- 3.
  Higher oxygen uptake was measured when cold, rather than warm humid air was breathed during exercise in both groups.
- 4.
  Mean skin temperature and maximal finger temperature were higher when breathing warm compared with cold air.
The prevalence of allergic asthma and rhinitis in children of Polichni, Thessaloniki
2004, Allergologia et Immunopathologia
To define the prevalence of asthma and rhinitis in primary school children in the Polichni Municipality of the city of Thessaloniki
The parents of 2005 students living in the area of Polichni completed a questionnaire for the detection of pulmonary disease in childhood. Of 493 children who gave positive answers to the questions about allergies, asthma and rhinitis, 203 were excluded after an interview with the parents, because they suffered from either atopic dermatitis or drug allergy or had normal lgE levels.Of the remaining children, 290 were further examined: methacholine test was positive in 109, exercise test was positive in 67, nasal provocation test with histamine was positive in 244, and rhinodilation test with tramazoline was positive in 206. Skin prick tests were positive in 142 children (90 to grass-cereal pollen, 66 to acarea and 59 to Parietaria officinalis)
We found that 168 children suffered from rhinitis, 84 from both asthma and rhinitis concurrently and 38 from asthma alone. Only 37 % of the parents knew that their children suffered from asthma, while even fewer (32 %) knew that their children had rhinitis. The prevalence of asthma was 6.1 % and that of rhinitis was 12.6 % among children aged 9-12 years in the area of Polichni, Thessaloniki. Childhood rhinitis and asthma seem to be frequently underdiagnosed and undertreated
El objetivo del estudio era definir la prevalencia de asma y rinitis en estudiantes de educación primaria en colegios del municipio de Polichni en la ciudad de Tesalónica
Los padres de 2.005 estudiantes, que vivían en el área de Polichni, rellenaron un cuestionario para la detección de enfermedades pulmonares durante la infancia. De los 493 niños que respondieron de manera positiva a las preguntas referentes a alergias, asma y rinitis, se excluyó a 203 después de una entrevista con los padres porque padecían dermatitis atópica o alergia a fármacos, o presentaban valores normales de IgE. Por lo que respecta a los otros niños, se examinó con más detenimiento a 290; 109 respondieron positivamente a la prueba de la metacolina, 67 realizaron una prueba de esfuerzo positiva, 244 una prueba de provocación nasal positiva con histamina y 206 una prueba positiva de rinodilatación con tramazolina, mientras que las pruebas de punción cutánea fueron positivas en 142 niños (90 a polen de gramíneas-cereales, 66 a ácaros y 59 a Parietaria officinalis)
Se comprobó que 168 niños presentaban rinitis, 84 asma y rinitis al mismo tiempo y 38 sólo asma. Únicamente el 37 % de los padres sabían que sus hijos padecían asma, mientras que un porcentaje aún menor (32 %) sabía que sus hijos tenían rinitis. Se observó que la prevalencia de asma es del 6,1 %, mientras que la de la rinitis es del 12,6% en los niños de 9-12 años del área de Polichni en Tesalónica. Parece que la rinitis y el asma durante la infancia suelen ser enfermedades diagnosticadas y tratadas insuficientemente
Activity-induced asthma
2003, Pediatric Clinics of North America

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View full text

Problems of interpreting exercise-induced asthma

Abstract

Br. J. Dis. Chest

J. Allergy

J. Allergy Clin. Immunol

Lancet

J. Allergy

J. Allergy

Lancet

Lancet

Lancet

Pharmaceutice rationales, Part 2

Treatise of the asthma

Changes in lung volumes and airways resistance after exercise in asthmatic subjects

Am. Rev. Resp. Dis

Metabolic changes preceding exercise induced bronchoconstriction

Br. Med. J

Assessment of the child with asthma

J. Asthma Res

Effect of Intal on postexercise bronchoconstriction in asthma

Exercise induced airways constriction

Thorax

Comparison of bronchoconstriction induced by cycling and running

Thorax