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Asthma and exercise-induced respiratory symptoms in the athlete: new insights

Boulet, Louis-Philippe; Turmel, Julie; Côté, Andréanne

Current Opinion in Pulmonary Medicine: January 2017 - Volume 23 - Issue 1 - p 71–77
doi: 10.1097/MCP.0000000000000339
ASTHMA: Edited by Nicola A. Hanania and Zuzana Diamant

Purpose of review Asthma and exercise-induced bronchoconstriction (EIB) are common in the athlete and can interfere with sport performances. In this review, we report recent findings on the prevalence, diagnosis and evaluation of these conditions, in addition to specific issues regarding their treatment and antidoping regulations.

Recent findings Recent studies confirmed the high prevalence of exercise-induced respiratory symptoms, asthma and EIB, in athletes and showed that these conditions are still underdiagnosed and undertreated. Recent studies highlight the suboptimal use of asthma medication in asthmatic and allergic athletes. Regarding the diagnosis and treatment, questions about the role and criteria for positivity of eucapnic voluntary hyperpnea test were raised. It was confirmed that there is a subgroup of athletes with poor response to asthma medication. Finally, regarding antidoping regulations, new methods and changes in criteria for urinary bronchodilator thresholds were suggested.

Summary Recent publications confirm that exercise-induced respiratory symptoms, asthma and EIB are common in athletes but often unrecognized and not optimally or successfully treated. It was suggested that current criteria for diagnostic bronchoprovocation test responses could be reassessed, as well as antidoping criteria for β2-agonists urinary levels. There is a need for more research on prevention of airways dysfunction in athletes, identification of different asthma phenotypes and the benefits of standard asthma medication in this population.

aQuebec Heart and Lung Institute, Laval University, Quebec City, Quebec

bCritical Care Department, University of Calgary, Calgary, Alberta, Canada

Correspondence to Louis-Philippe Boulet, MD, FRCPC, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec, Québec G1 V 4G5, Canada. Tel: +418 656 4747; fax: +418 656 4762; e-mail:

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