title: Effect of inhaled corticosteroids on bronchial asthma in Japanese athletes.
abstract: BACKGROUND
  Asthma has a higher prevalence in athlete populations such as Olympic athletes than in the general population. Correct diagnosis and management of asthma in athletes is important for symptom control and avoidance of doping accusations. However, few reports are available on asthma treatment in the athlete population in clinical practice. In this study, we focused on the clinical efficacy of inhaled corticosteroid (ICS) for asthma in a Japanese athlete population.
  
  
  METHODS
  The study subjects included athletes who visited the Niigata Institute for Health and Sports Medicine, Niigata, Japan for athletic tests and who were diagnosed with asthma on the basis of respiratory symptoms and positive results in a bronchodilator or bronchial provocation test such as exercise, hypertonic saline, or methacholine provocation. The athletes received ICS alone for at least 3 months, and the clinical background, sports type, and treatment efficacy were analyzed.
  
  
  RESULTS
  The study population comprised 80 athletes (59 men and 21 women) with a median age of 16.0 years. Regarding sports type, 28 athletes engaged in winter sports (35%), 22 in endurance sports (27.5%), and 25 in indoor sports (31.3%). Although ICS is the primary treatment in athlete asthma, 16.3% of the athletes showed an unsatisfactory response to treatment according to the Global Evaluation of Treatment Effectiveness (GETE). These subjects were characterized by a decreased response to methacholine and lower values for FEV1/FVC and type 2 helper T cell (Th2)-associated biomarkers relative to responsive athletes. In multivariate analysis, FEV1/FVC and the logarithm to the base 10 of the IgE level were independently associated with the ICS response.
  
  
  CONCLUSIONS
  These data suggest that ICS is effective for asthma in most athletes. However, certain asthmatic athletes are less responsive to ICS than expected. The pathogenesis in these subjects may differ from that of conventional asthma characterized by chronic allergic airway inflammation.
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Hoshino
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. Electronic address: tkoya@med.niigata-u.ac.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Koya
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kagamu
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tsukioka
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Toyama
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Sakagami
authors.affiliation: Department of General Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Division of Respiratory Medicine, Department of Homeostatic Regulation and Development, Course in Biological Functions and Medical Control, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Niigata Institute for Health and Sports Medicine, Niigata, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Arakawa
authors.affiliation: Department of General Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suzuki
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D044466:Asian People; D001249:Asthma / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D056352:Athletes; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004804:Eosinophils / Q000166:cytology / Q000276:immunology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D011852:Radioallergosorbent Test; D013177:Sports; D013183:Sputum / Q000166:cytology; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D007073:Immunoglobulin E
keywords: Bronchial provocation test; Fraction of exhaled NO; IgE; Inhaled corticosteroid; Pulmonary function testing