Abstract
BackgroundExercise-induced cough is common among athletes. Athletes training in cold air often report an increasingly troublesome cough during the winter season. Chronic airway irritation or inflammation may increase the sensory response of cough receptors. The aim of this study was to evaluate the seasonal variability of cough reflex sensitivity to capsaicin in elite athletes.MethodsFifty-three elite winter athletes and 33 sedentary subjects completed a respiratory questionnaire and a capsaicin provocation test during the summer, fall, and winter. Allergy skin prick tests, spirometry, eucapnic voluntary hyperpnea test (EVH), methacholine inhalation test (MIT), and induced sputum analysis were also performed.ResultsIn athletes, the prevalence of cough immediately after exercise was high, particularly during winter. Athletes often showed a late occurrence of cough between 2-8 h after exercise. The cough reflex sensitivity to capsaicin was unchanged through the seasons in both athletes and non-athlete subjects. No significant correlations were found in groups between cough reflex sensitivity to capsaicin and the number of years in sport training, the number of hours of training per week, EVH response (% fall in FEV1), airway responsiveness to methacholine (PC20), airway inflammation or atopy.ConclusionThe prevalence of cough immediately and a few hours after exercise is high in athletes and more frequently reported during winter. However, cough does not seem to be associated with cough reflex hypersensitivity to capsaicin, bronchoconstriction, or airway inflammation in the majority of athletes.
Highlights
IntroductionAthletes training in cold air often report an increasingly troublesome cough during the winter season
The prevalence of cough within the first hour after exercise was higher in athletes compared to non-athlete subjects (54% vs 3%, p = 0.02)
The difference in cough reflex sensitivity to capsaicin is not statistically significant, athletes’ C5 values are lower than what is reported in the literature in healthy subjects (C5: 125-186 μM), while our non-athlete subjects were in the same range
Summary
Athletes training in cold air often report an increasingly troublesome cough during the winter season. Chronic airway irritation or inflammation may increase the sensory response of cough receptors. The inspired air is warmed up to body temperature through heat exchange in the upper airways, before entering into the lungs. This mechanism is compromised during exercise in cold. An increase in cough reflex sensitivity could be due to an irritation and/or inflammation of the airways. Such hypersensitivity can lead to an abnormal response to inhaled stimuli such as cold air or pollutants [8]. Airway sensory hyperreactivity (SHR) is defined in those individuals who reported aggravation or triggering of cough in the presence of one or more of the following; change in air temperature, odours and/or during talking, laughing, or singing
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