Effect of Pharmacological Treatment on Exercise-Induced Bronchoconstriction and Allergic Inflammatory Response in Endurance Athletes

# Background Endurance athletes (EA) with lung disease and allergic inflammation have worse performance. # Purpose To examine whether pharmacological treatment can reduce airway disorders such as exercise-induced bronchoconstriction (EIB) and allergic inflammatory response (AIR) in EA. # Study Des...

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Main Authors: Ronaldo Aparecido da Silva, Renata Nakata Teixeira, Gerson dos Santos Leite, Rosana C. Agondi, Renata Gorjão, Cristina Maria Kokron, Yara Nely Fiks, Celso Ricardo Fernandes Carvalho
Format: Article
Language:English
Published: North American Sports Medicine Institute 2025-08-01
Series:International Journal of Sports Physical Therapy
Online Access:https://doi.org/10.26603/001c.141859
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Summary:# Background Endurance athletes (EA) with lung disease and allergic inflammation have worse performance. # Purpose To examine whether pharmacological treatment can reduce airway disorders such as exercise-induced bronchoconstriction (EIB) and allergic inflammatory response (AIR) in EA. # Study Design Prospective, controlled clinical trial # Methods EA who were marathon runners underwent eucapnic voluntary hyperventilation (EVH) for screening assessment. EA who fulfilled the criteria for an EIB+ after an EVH were included in the treatment group (EIB+; n=13), and those who did not were included in the control group (CON; n=18). The athletes were assessed before and 30 days after the intervention. Outcomes included cardiopulmonary exercise testing, lung function, allergic symptoms (allergic questionnaire for athletes \[AQUA©]), AIR (T helper \[Th]-1, Th2, and Th17 lymphocytes in cell cultures), inflammatory mediator expression, salivary immunoglobulin (Ig)A, blood cortisol, blood IgE levels, and airway inflammation (fraction exhaled nitric oxide \[FeNO]). Both groups were advised to keep the same training routine, and only the EIB+ received pharmacological treatment with inhaled corticosteroids (400-800 mcg/day) and long-acting bronchodilators (12 mcg/day). The CON and EIB+ groups underwent the same assessments after the intervention and were compared pre- and post-intervention, and effect sizes were calculated. # Results EIB+ (males, age 28.1±7.4 years, BMI 20.3±1.0 kg/m2) CON (males, age 29.8±6.5 years, BMI 20.5±1.6 kg/m2) participated. At baseline, the O2 peak, lung function, allergic symptoms, IgE, IgA, FeNO levels, and AIR were not significancly different between groups (p>0.05). After pharmacological treatment, only the EIB+ group showed a decrease in EIB (p<0.001) and an increase in VO2peak compared to baseline (p<0.05). However, no difference was observed in the expression of inflammatory mediators (p>0.05). # Conclusion Pharmacological treatment reduces EIB and increases the aerobic perforance/fitness in endurance athletes. These benefits occur without modification of the AIR. # Level of Evidence Level II- Prospective Comparative Study
ISSN:2159-2896