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Exercise-induced asthma

Parsons, Jonathan P; Mastronarde, John G

Current Opinion in Pulmonary Medicine: January 2009 - Volume 15 - Issue 1 - p 25–28
doi: 10.1097/MCP.0b013e32831da8ab
Asthma: Edited by Nicola A Hanania

Purpose of review Exercise has been recognized as a trigger of bronchospasm for centuries. However, there remains much debate regarding the mechanism of this response, nomenclature to describe it, optimal tests for diagnosis, and treatment options. There is a need to review recent findings in this area both for clinicians and to highlight areas in need of additional research.

Recent findings Recent data have confirmed the high prevalence of exercise-induced bronchospasm among athletes and raise concern that many of these athletes may be unaware of this diagnosis. Variability in nomenclature, classification, and diagnostic testing methods continue to make comparisons among reported trials difficult. Both in-vitro and animal studies reveal a heterogeneous inflammatory response correlated with exercise-induced bronchospasm. This variability may underlie the variable response to pharmacotherapy.

Summary Clinicians need to be alert to the nonspecific nature of exercise-induced symptoms and increase utilization of objective testing for accurate diagnosis. Future research is needed to better define the optimal diagnostic test or algorithm. Clinical outcome and translational studies should focus on more precise phenotyping of participants and include more global measures of inflammation.

Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA

Correspondence to John G. Mastronarde, MD, MSc, 201 Davis Heart/Lung Research Institute, 473 W.12th Avenue, Columbus, OH 43210, USA Tel: +1 614 247 7707; fax: +1 614 293 4799; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.