Small airways and exercise-induced bronchoconstriction (EIB) in elite athletes

Background EIB is particularly frequent in elite athletes and represents a distinct phenotype of clinical asthma (Parsons JP et al. 2013) . Baseline spirometry and clinical symptoms have been shown to be poorly predictive of EIB (Bonini M et al. 2007) . Small airways (SA) represent a relevant topic in Respiratory Medicine and their involvement in chronic inflammatory pulmonary diseases has been extensively studied. However, the role of SA in EIB still needs to be clarified. Aim To assess if SA function and inflammation may be considered reliable predictive markers of EIB in elite athletes. Methods Study procedures of this ongoing study are summarized in Fig.1. Results Out of the 40 athletes representing the powered study population, 10 Caucasian males (mean age: 31.9±9 yrs) were studied. Baseline spirometry was normal in all subjects (FEV1 107.4±12.1%; FVC 110.3±15.2%; FEV1/FVC 81.6±5.9%). Seven athletes were atopic and 3 referred respiratory symptoms. Two athletes showed a positive response (FEV1 fall >10%) to the EVH challenge. Exhaled nitric oxide alveolar concentration was significantly higher in the two athletes with EIB. No differences were detected in spirometric values, clinical symptoms, airways resistance and reactance between subjects with- or without EIB. Conclusions Preliminary data seem to suggest a role of SA inflammation in predicting EIB. This research hypothesis should be supported by the completion of the study.