Airway responsiveness and inflammation in adolescent elite swimmers.
BACKGROUND
Whereas increased airway hyperresponsiveness (AHR) and airway inflammation are well documented in adult elite athletes, it remains uncertain whether the same airway changes are present in adolescents involved in elite sport.


OBJECTIVE
To investigate airway responsiveness and airway inflammation in adolescent elite swimmers.


METHODS
We performed a cross-sectional study on adolescent elite swimmers (n = 33) and 2 control groups: unselected adolescents (n = 35) and adolescents with asthma (n = 32). The following tests were performed: questionnaire, exhaled nitric oxide (FeNO), spirometry, induced sputum, methacholine challenge, eucapnic voluntary hyperpnea (EVH) test, and exhaled breath condensate pH.


RESULTS
There were no differences in FeNO, exhaled breath condensate pH, cellular composition in sputum, or prevalence of AHR to either EVH or methacholine among the 3 groups. When looking at airway responsiveness as a continuous variable, the swimmers were more responsive to EVH than unselected subjects, but less responsive to methacholine compared with subjects with asthma. We found no differences in the prevalence of respiratory symptoms between the swimmers and the unselected adolescents. There was no difference in FeNO, cellular composition of sputum, airway reactivity, or prevalence of having AHR to methacholine and/or EVH between swimmers with and without respiratory symptoms.


CONCLUSIONS
Adolescent elite swimmers do not have significant signs of airway damage after only a few years of intense training and competition. This leads us to believe that elite swimmers do not have particularly susceptible airways when they take up competitive swimming when young, but that they develop respiratory symptoms, airway inflammation, and AHR during their swimming careers.
Respiratory and Allergy Research Unit, Department of Respiratory Medicine L, Bispebjerg Hospital, Copenhagen, Denmark. lars.pedersen@dadlnet.dk
Lars
L
Pedersen
Thomas K
TK
Lund
Peter J
PJ
Barnes
Sergei A
SA
Kharitonov
Vibeke
V
Backer
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D016535:Bronchial Hyperreactivity / Q000453:epidemiology*; D001985:Bronchial Provocation Tests; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology; D008168:Lung / Q000502:physiology*; D008297:Male; D016210:Methacholine Chloride; D009569:Nitric Oxide / Q000032:analysis; D012129:Respiratory Function Tests; D013147:Spirometry; D013550:Swimming
D016210:Methacholine Chloride; D009569:Nitric Oxide