title: Facial cooling enhances exercise-induced bronchoconstriction in asthmatic children.
abstract: OBJECTIVE
  Exercising in cold air enhances bronchial responsiveness (BR) as compared with exercising in warm air. This may be due to intrathoracic cooling or to increased vagal activity caused by facial cooling. The purpose of this study was to compare the effects on BR of cold air inhalation and of facial exposure to cold air, as well as the combined effect of both.
  
  
  METHODS
  Fourteen children with asthma (eight girls) performed four exercise challenge tests in a climatic chamber, under one of the following conditions: 1) inhaling warm air while the face was exposed to warm air (WW, 21 degrees C, 25% relative humidity (RH)); 2) inhaling warm air while the face was exposed to cold air (WC, 0 degrees C, 80% RH); 3) inhaling cold air while the face was exposed to cold air (CC); and 4) inhaling cold air while the face was exposed to warm air (CW). The study was analyzed, using a one- and two-way ANOVA.
  
  
  RESULTS
  Postexercise forced expiratory volume in the first second (FEV1) and maximal mid-expiratory flow (MMEF) values as percent predicted (% pred) showed significant reductions over time (P < 0.001), significant differences among the four experimental conditions (P < 0.001) and a significant condition x time interaction (FEV1:P < 0.001, MMEF:P < 0.01). FEV1 was significantly lower for CC and WC, as compared with WW and CW at 5 and 10 min postexercise. The lowest postexercise values for FEV1 occurred in the CC and WC sessions (76% predicted in both). A similar pattern was obtained for MMEF.
  
  
  CONCLUSIONS
  Facial cooling combined with either cold or warm air inhalation causes the greatest EIB, as compared with the isolated challenge with cold air inhalation. We suggest that vagal mechanisms play a major role in exercise and cold-induced bronchoconstriction.
authors.affiliation: Children's Exercise and Nutrition Centre, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mona
authors.initials: M
authors.lastname: Zeitoun
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Wilk
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuzaka
authors.forename: Bruno H
authors.initials: BH
authors.lastname: KnOpfli
authors.forename: Brian A
authors.initials: BA
authors.lastname: Wilson
authors.forename: Oded
authors.initials: O
authors.lastname: Bar-Or
mesh_terms: D000704:Analysis of Variance; D001250:Asthma, Exercise-Induced / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction / Q000502:physiology*; D002648:Child; D003080:Cold Temperature / Q000009:adverse effects*; D005145:Face / Q000294:innervation*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D014630:Vagus Nerve / Q000502:physiology*