Airway hyperresponsiveness to methacholine, adenosine 5-monophosphate, mannitol, eucapnic voluntary hyperpnoea and field exercise challenge in elite cross-country skiers.
BACKGROUND
Methacholine hyperresponsiveness is prevalent in elite athletes. Comparative studies have hitherto been limited to methacholine, eucapnic voluntary hyperpnoea and exercise. This study investigated airway responsiveness to these stimuli as well as to adenosine 5'-monophosphate (AMP) and mannitol, in 58 cross-country ski athletes.


METHODS
Exhaled nitric oxide concentration (F(E)NO), spirometry and bronchial challenge in random order with methacholine, AMP and mannitol were consecutively performed on three study days in the autumn. Specific IgE to eight aeroallergens and a self-completed questionnaire about respiratory symptoms, allergy and asthmatic medication were also performed on day 1. Eucapnic voluntary hyperventilation (EVH) and field exercise tests were randomly performed in 33 of the skiers on two study days in the following winter.


RESULTS
Of 25 (43%) skiers with airway hyperresponsiveness (AHR), 23, five and three skiers were hyperresponsive to methacholine, AMP and mannitol, respectively. Methacholine hyperresponsiveness was more prevalent in subjects without asthma-like symptoms. The F(E)NO was not significantly different in skiers with and without methacholine hyperresponsiveness. Four of 14 skiers with and four of 19 skiers without methacholine hyperresponsiveness were hyperresponsive to EVH or exercise challenge. AHR to any stimulus was present in 16 asymptomatic and nine symptomatic skiers. Asthma-like symptoms were not correlated with AHR to any stimulus.


CONCLUSIONS
Methacholine hyperresponsiveness is more common in asymptomatic skiers and is a poor predictor of hyperresponsiveness to mannitol and hyperpnoea. The low prevalence of hyperresponsiveness to indirect stimuli may suggest differences in the pathogenesis of methacholine hyperresponsiveness in elite skiers and non-athletes.
Sue-Chu
Malcolm
M
Department of Lung Medicine, St Olavs Hospital, University Hospital of Trondheim, N-7006 Trondheim, Norway. msuechu@online.no
Brannan
John D
JD
Anderson
Sandra D
SD
Chew
Nora
N
Bjermer
Leif
L
D000249:Adenosine Monophosphate / Q000494:pharmacology; D000293:Adolescent; D001980:Bronchi / Q000187:drug effects*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis; D001985:Bronchial Provocation Tests / Q000379:methods; D016085:Bronchoconstrictor Agents / Q000494:pharmacology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D016210:Methacholine Chloride / Q000494:pharmacology; D009569:Nitric Oxide / Q000032:analysis; D012865:Skiing / Q000502:physiology*
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D009569:Nitric Oxide; D008353:Mannitol; D000249:Adenosine Monophosphate
Chest. 2004 Mar;125(3):909-15
15006949
Eur Respir J. 1999 Feb;13(2):301-6
10065672
Eur J Appl Physiol. 2000 Nov;83(4 -5):370-5
11138577
Med Sci Sports Exerc. 2007 Oct;39(10):1681-6
17909392
J Allergy Clin Immunol. 2002 Sep;110(3):374-80
12209082
J Allergy Clin Immunol. 2000 Aug;106(2):260-6
10932068
Br J Sports Med. 2006 Feb;40(2):179-82; discussion 179-82
16432008
Am J Respir Crit Care Med. 2007 Mar 1;175(5):442-9
17185648
Can Respir J. 2004 Sep;11(6):399-401
15510246
Respir Med. 1999 Oct;93(10):719-25
10581661
Eur Respir J. 1998 Jul;12(1):13-6
9701407
Am J Respir Crit Care Med. 1997 Sep;156(3 Pt 1):758-65
9309990
J Allergy Clin Immunol. 2008 Aug;122(2):225-35; quiz 236-7
18554705
Ann Allergy. 1985 Dec;55(6):790-3
4073598
Respir Med. 1996 Feb;90(2):99-105
8730329
J Allergy Clin Immunol. 2004 Jul;114(1):34-9
15241341
Med Sci Sports Exerc. 2010 Feb;42(2):273-80
19927031
Scand J Med Sci Sports. 1995 Jun;5(3):152-9
7552758
Eur Respir J. 2003 Sep;22(3):491-6
14516140
Schweiz Med Wochenschr. 1993 Feb 6;123(5):174-82
8438140
Ann Allergy. 1993 Apr;70(4):339-42
8466100
BMJ. 1993 Nov 20;307(6915):1326-9
8257888
Br J Sports Med. 2009 Dec;43(14):1131-5
19201767
Am J Respir Crit Care Med. 2003 Feb 15;167(4):534-7
12456381
Am Rev Respir Dis. 1981 Jun;123(6):659-64
7271065
Med Sci Sports Exerc. 2008 Sep;40(9):1567-72
18685536
Chest. 1986 Jul;90(1):23-8
3522119
Med Sci Sports Exerc. 1986 Jun;18(3):328-30
3088378
J Allergy Clin Immunol. 1996 Aug;98(2):421-32
8757220
Allergy. 2007 Mar;62(3):301-9
17298348