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Medicina dello Sport 2002 March;55(1):17-22


language: Italian

Bronchial reactivity to methacholine, atopy, respiratory symptoms, peak expiratory flow variability and exercise induced bronchospasm in the asthmatic athlete

Balestreri F., Calza Contin M., Segattini C., Zanon R., Bertaiola M., Brotto E., Ferrari M.

Università degli Studi - Verona, Dipartimento di Scienze Biomediche e Chirurgiche, Servizio di Fisiopatologia Respiratoria


Background. The aim of the paper is to evaluate whether baseline airway calibre, bronchial responsiveness to methacholine, atopy, respiratory symptoms and peak expiratory flow variability (PEF) are associated and/or can predict the percentage FEV1 decrease after exercise in the athlete with bronchial asthma.
Methods. Forty-six subjects (36 male and 10 female), aged 10 to 39 years (mean 17.7 years) were selected for the study. All the subjects completed a 2 week diary card on respiratory symptoms and recorded daily morning and evening PEF. Airway calibre as the baseline FEV1, skin wheal response to 10 common allergens and airway response to methacholine were also measured. Furthermore, the subjects underwent a cycloergometry effort test, using a standardised procedure in controlled environmental conditions, with the subject breathing dehumidified air. The results of the test were expressed as the maximum percentage decrease of FEV1 in the 30 min following exercise (ΔFEV1).
Results. Atopy (positive skin prick test) and baseline airway calibre were not significantly associated with ΔFEV1. On the contrary, a weak relationship was found between ΔFEV1 and bronchial response to methacholine (expressed as PD20; r=0.41, p<0.01), PEF variability (r=0.29, p<0.05), and the degree of asthma calculated on respiratory symptoms (r=0.46, p<0.01).
Conclusions. The results from this analysis show that methacholine, PEF variability and exercise challenge reflect different components of airway dysfunction. Furthermore our data indicate that respiratory symptoms, PEF variability, airway hyperresponsiveness as detected by methacholine test and the degree of atopy cannot exactly predict the percentage decrease of FEV1 after exercise. Therefore, in order to accurately evaluate the asthmatic athlete, an exercise test is mandatory.

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