Relationships Between Airway Inflammation And Response To Methacoline Or Eucapnic Voluntary Hyperventilation In Athletes Training In Cold Air

Abstract

Background : In asthma, airway hyperresponsiveness may be associated with an eosinophilic airway inflammatory process. High-level exercise may induce a systemic and/or airway neutrophilic response. In athletes, the prevalence of exercise-induced bronchoconstriction is higher than that of symptomatic asthma. Purpose : To examine the relationships between responses to EVH (% fall in FEV1), methacholine (PC20) and eosinophilic airway inflammation in athletes training in cold air. Methods : Thirty-one athletes (cross-country skiing, biathlon and speed skating-long track) had a medical examination, a questionnaire on respiratory symptoms, a spirometry, a methacholine provocation test, skin prick tests for common respiratory allergens, EVH test and induced sputum analysis. Results : IS analysis revealed a low eosinophilic count (mean % cells ± SEM: 0.82 ± 1.9 %) and a mild neutrophilia (46.8 ± 21.3 %). PC20 was positively correlated with the fall in FEV1 after EVH (r = 0.41, p = 0.02) and with the % of eosinophils (r = 0.58, p = 0.01) in sputum. The fall in FEV1 after EVH was also positively correlated with eosinophil count (r = 0.72, p = 0.001). There was no relationships between these parameters and IS neutrophil count. Conclusion :Response to methacholine and EVH in athletes correlates with the degree of eosinophilic airway inflammation, although this last is small.