title: Exercise-induced bronchoconstriction.
abstract: OBJECTIVE
  To review the literature regarding the pathophysiology of exercise-induced bronchoconstriction (EIB).
  
  
  METHODS
  The databases of PubMed, Ovid MEDLINE, and Scopus were searched for articles using the subject headings and/or keywords asthma, exercise-induced/etiology, exercise, mechanism, pathogenesis, and bronchoconstriction.
  
  
  METHODS
  Articles were selected based on their relevance to the focus of this review, with emphasis on the specific pathophysiologic mechanisms of EIB.
  
  
  RESULTS
  EIB occurs in response to the loss of water from the lower airways that results from heating and humidifying large volumes of air in a short period. The resulting hyperosmolar environment activates various cellular mechanisms to release mediators from mast cells, eosinophils, epithelial cells, and sensory nerves. These mediators, in turn, lead to airway smooth muscle contraction and bronchoconstriction. Airway hyperresponsiveness in elite athletes may develop from a process of airway injury and changes in the contractile properties of airway smooth muscle.
  
  
  CONCLUSIONS
  EIB commonly affects individuals with and without clinically recognized asthma, especially those who participate in competitive athletics. Through years of research, the pathophysiology of EIB is now better understood and involves a complex interaction between several different cell types and mediators. Continued research to improve the knowledge regarding the mechanisms of EIB should aid the identification, diagnosis, and treatment of this common condition.
authors.affiliation: Mayo Clinic, Division of Allergy and Pulmonary Medicine, Jacksonville, FL 32224, USA. pongdee.thanai@mayo.edu
authors.forename: Thanai
authors.initials: T
authors.lastname: Pongdee
authors.forename: James T
authors.initials: JT
authors.lastname: Li
mesh_terms: D056352:Athletes; D016084:Bronchoconstriction / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D055370:Lung Injury / Q000503:physiopathology