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Exercise induced asthma: A clinical perspective

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Abstract

Exercise is a very common precipitant of asthma. Inflammation and edema are felt to be important components of the asthmatic response. Heat and water loss from the airway mucosa are most likely important in its pathogenesis, although the exact etiology remains unknown. A good history combined with proper diagnostic testing can usually determine the diagnosis, and prevention is the key to effective management. Although modified training techniques are often helpful, medications are usually needed for both prevention and treatment. While antiinflammatory agents are gaining therapeutic importance, inhaled beta-agonists remain the treatment of choice. With appropriate diagnosis and management, exercise-induced asthma should not limit participation nor performance in athletics for the great majority of the population.

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References

  1. AAP issues statement on exercise-induced asthma in children (1989) Am Fam Physician 40:314–316

    Google Scholar 

  2. Afrasiabi R, Spector SL (1991) Exercise-induced asthma: it needn't sideline your patients. Phys Sportsmed 19:49–62

    Google Scholar 

  3. Anderson SD (1984) Is there a unifying hypothesis for exercise-induced asthma? J Allergy Clin Immunol 73:660–665

    Google Scholar 

  4. Anderson SD (1985) Issues in exercise-induced asthma. J Allergy Clin Immunol 76:763–772

    Google Scholar 

  5. Anderson SD (1985) Exercise-induced asthma: the state of the art. Chest 87 (Suppl 5):191S-195S

    Google Scholar 

  6. Barnes PJ (1989) A new approach to the treatment of asthma. N Engl J Med 321:1517–1527

    Google Scholar 

  7. Barnes PJ, Brown MJ (1981) Venous plasma histamine in exercise- and hyperventilation-induced asthma in man. Clin Sci 61:159–162

    Google Scholar 

  8. Bierman CW, Spiro SG, Petheram I (1984) Characterization of the late response in exercise-induced asthma. J Allergy Clin Immunol 74:701–706

    Google Scholar 

  9. Boner AL, Sette L, Piacentini G, Peroni D, Warner JO (1990) Exercise-induced biphasic responses and methacoline reactivity in asthma. Ann Allergy 65:284–628

    Google Scholar 

  10. Casale TB, Keahey TM, Kalinger M (1986) Exercise-induced anaphylactic syndromes: insights into diagnostic and pathophysiologic features. JAMA 255:2049–2053

    Google Scholar 

  11. Christopher KL, Wood RP II, Eckert RC, Blager FB, Raney RA, Souhrada JF (1983) Vocalcord dysfunction presenting as asthma. N Engl J Med 308:1566–1570

    Google Scholar 

  12. Cropp GJA (1983) Exercise-induced asthma. In: Middleton EM Jr, Reed CE, Ellis EF (eds) Allergy: Principles and Practice. C.V. Mosby Company, St. Louis, pp 1003–1014

    Google Scholar 

  13. Dahl R, Henriksen JM (1980) Development of late asthmatic reactions after allergen or exercise challenge tests. Eur J Respir Dis 61:320–324

    Google Scholar 

  14. Deal EC Jr, McFadden ER Jr, Ingram RH Jr, Jaeger JJ (1979) Hyperpnea and heat flux: initial reaction sequence in exercise-induced asthma. J Appl Physiol 46:476–483

    Google Scholar 

  15. Downing ET, Braman SS, Fox MJ, Corrao WM (1982) Fictitious asthma: physiological approach to diagnosis. JAMA 248:2878–2881

    Google Scholar 

  16. Edmunds AT, Tooley M, Godfrey S (1978) The refractory period after exercise induced asthma: its duration and relation to severity of exercise. Am Rev Respir Dis 117:247–254

    Google Scholar 

  17. Eggleston PA (1986) Pathophysiology of exercise-induced asthma. Med Sci Sports Exerc 18:318–321

    Google Scholar 

  18. Fetter RA, Kokkinos PF (1991) Diagnosing and treating exercise-induced anaphylaxis. Your Patient Fitness 5:11–17

    Google Scholar 

  19. Fitch KD, Morton AR (1971) Specificity of exercise in exercise-induced asthma. Br Med J 4:577–581

    Google Scholar 

  20. Gilbert IA, Fouke JM, McFadden ER Jr (1987) Heat and water flux in the intrathoracic airways and exercise-induced asthma. J Appl Physiol 63:1681–1691

    Google Scholar 

  21. Henriksen JM (1985) Effect of inhalation of corticosteroids on exercise induced asthma: randomize double blind crossover study of budesonide in asthmatic children. Br Med J 291:248–249

    Google Scholar 

  22. Katz RM (1986) Prevention with and without the use of medications for exercise-induced asthma. Med Sci Sports Exerc 18:331–333

    Google Scholar 

  23. Katz RM (1987) Coping with exercise-induced asthma in sports. Phys Sportsmed 15:100–108

    Google Scholar 

  24. Lee TH, Nagakura T, Papageorgiou N, Cromwell O, Iikura Y, Kay AB (1984) Mediators in exercise-induced asthma. J Allergy Clin Immunol 73:634–639

    Google Scholar 

  25. Manning PJ, Watson RM, Margolskee DJ, Williams VC, Schwartz JI, O'Byrne PM (1990) Inhibition of exercise-induced bronchoconstriction by MK-571, a potent leukotriene D4-receptor antagonist. N Engl J Med 323:1736–1739

    Google Scholar 

  26. McCarthy P (1989) Wheezing or breezing through exercise-induced asthma. Phys Sportsmed 17:125–130

    Google Scholar 

  27. McFadden ER Jr (1981) Calcium-channel blocking agents and asthma, editorial. Ann Intern Med 95:232–233

    Google Scholar 

  28. McFadden ER Jr (1987) Exercise-induced asthma: assessment of current etiologic concepts. Chest 91 (Suppl 6):151S-157S

    Google Scholar 

  29. McFadden ER Jr (1987) Exercise and asthma, editorial. N Engl J Med 317:502–504

    Google Scholar 

  30. McFadden ER Jr (1990) Hypothesis: exercise-induced asthma as a vascular phenomenon. Lancet 335:880–883

    Google Scholar 

  31. McFadden ER Jr (1991) Fatal and near-fatal asthma, editorial. N Engl J Med 324:409–411

    Google Scholar 

  32. McFadden ER Jr, Ingram RH Jr (1979) Exercise induced asthma: observations on the initiating stimulus. N Engl J Med 301:763–769

    Google Scholar 

  33. McNally JF Jr, Enright P, Hirsch JE, Souhrada JF (1979) The attenuation of exercise-induced bronchoconstriction by oropharyngeal anesthesia. Am Rev Respir Dis 119:247–252

    Google Scholar 

  34. McNeil D, Strauss RH (1988) Exercise-induced anaphylaxis related to food intake. Ann Allergy 61:440–442

    Google Scholar 

  35. Roberts JA (1988) Exercise-induced asthma in athletes. Sports Med 6:193–196

    Google Scholar 

  36. Rubinstein I, Levinson H, Slutsky AS, Hak H, Wells J, Zamel N, Rebuck AS (1987) Immediate and delayed bronchoconstriction after exercise in patients with asthma. N Engl J Med 317:482–485

    Google Scholar 

  37. Sheffer AL, Soter NA, McFadden ER Jr, Austen KF (1983) Exercise-induced anaphylaxis: a distinct form of physical allergy. J Allergy Clin Immunol 71:311–316

    Google Scholar 

  38. Sly RM (1986) History of exercise-induced asthma. Med Sci Sports Exerc 18:314–317

    Google Scholar 

  39. Anderson SD, Daviskas E, Godfrey S (1990) Exercise-induced asthma as a vascular phenomenon, letters. Lancet 335:1410–1412

    Google Scholar 

  40. Stamford B (1991) Exercise-induced asthma: taking the wheeze out of your workout. Phys Sportsmed 19:139–140

    Google Scholar 

  41. Voy RO (1986) The US Olympic Committee experience with exercise-induced bronchospasm, 1984. Med Sci Sports Exerc 18:328–330

    Google Scholar 

  42. Zawadski DK, Lenner KA, McFadden ER Jr (1988) Comparison of intraairway temperatures in normal and asthmatic subjects after hyperpnea with hot, cold, and ambient air. Am Rev Respir Dis 138:1553–1558

    Google Scholar 

  43. Zawadski DK, Lenner KA, McFadden ER Jr (1988) Effect of exercise on nonspecific airway reactivity in asthmatics. J Appl Physiol 64:812–816

    Google Scholar 

  44. Zawadski DK, Lenner KA, McFadden ER Jr (1988) Re-examination of the late asthmatic response to exercise. Am Rev Respir Dis 137:837–841

    Google Scholar 

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Hendrickson, C.D., Lynch, J.M. & Gleeson, K. Exercise induced asthma: A clinical perspective. Lung 172, 1–14 (1994). https://doi.org/10.1007/BF00186165

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