Respiratory health of elite athletes – preventing airway injury: a critical review
Identifieur interne : 001D84 ( Pmc/Checkpoint ); précédent : 001D83; suivant : 001D85Respiratory health of elite athletes – preventing airway injury: a critical review
Auteurs : Pascale Kippelen [Royaume-Uni] ; Kenneth D. Fitch [Australie] ; Sandra Doreen Anderson [Australie] ; Valerie Bougault [France] ; Louis-Philippe Boulet [Canada] ; Kenneth William Rundell [États-Unis] ; Malcolm Sue-Chu [Norvège] ; Donald C. Mckenzie [Canada]Source :
- British Journal of Sports Medicine [ 0306-3674 ] ; 2012.
Abstract
Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.
Url:
DOI: 10.1136/bjsports-2012-091056
PubMed: 22522585
PubMed Central: 3371227
Affiliations:
- Australie, Canada, France, Norvège, Royaume-Uni, États-Unis
- Hauts-de-France, Nord-Pas-de-Calais, Pennsylvanie, Trøndelag
- Lille, Trondheim
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Mckenzie</name><affiliation wicri:level="1"><nlm:aff id="A9">Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author></analytic><series><title level="j">British Journal of Sports Medicine</title><idno type="ISSN">0306-3674</idno><idno type="eISSN">1473-0480</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Fitch, Kd" uniqKey="Fitch K">KD Fitch</name></author><author><name sortKey="Anderson, Sd" uniqKey="Anderson S">SD Anderson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mckenzie, Dc" uniqKey="Mckenzie D">DC McKenzie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kippelen, P" uniqKey="Kippelen P">P Kippelen</name></author><author><name sortKey="Anderson, Sd" uniqKey="Anderson S">SD Anderson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anderson, Sd" uniqKey="Anderson S">SD Anderson</name></author><author><name sortKey="Kippelen, P" uniqKey="Kippelen P">P Kippelen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bougault, V" uniqKey="Bougault V">V Bougault</name></author><author><name sortKey="Boulet, Lp" uniqKey="Boulet L">LP Boulet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sue Chu, M" uniqKey="Sue Chu M">M Sue-Chu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rundell, Kw" uniqKey="Rundell K">KW Rundell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fitch, Kd" uniqKey="Fitch K">KD Fitch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boulet, Lp" uniqKey="Boulet L">LP Boulet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bougault, V" uniqKey="Bougault V">V Bougault</name></author><author><name sortKey="Turmel, J" uniqKey="Turmel J">J Turmel</name></author><author><name sortKey="Boulet, Lp" uniqKey="Boulet L">LP Boulet</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Sports Med</journal-id><journal-id journal-id-type="iso-abbrev">Br J Sports Med</journal-id><journal-id journal-id-type="hwp">bjsports</journal-id><journal-id journal-id-type="publisher-id">bjsm</journal-id><journal-title-group><journal-title>British Journal of Sports Medicine</journal-title></journal-title-group><issn pub-type="ppub">0306-3674</issn><issn pub-type="epub">1473-0480</issn><publisher><publisher-name>BMJ Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22522585</article-id><article-id pub-id-type="pmc">3371227</article-id><article-id pub-id-type="publisher-id">bjsports-2012-091056</article-id><article-id pub-id-type="doi">10.1136/bjsports-2012-091056</article-id><article-categories><subj-group subj-group-type="heading"><subject>Highlight Papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject></subj-group></article-categories><title-group><article-title>Respiratory health of elite athletes – preventing airway injury: a critical review</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kippelen</surname><given-names>Pascale</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Fitch</surname><given-names>Kenneth D</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Anderson</surname><given-names>Sandra Doreen</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Bougault</surname><given-names>Valerie</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Boulet</surname><given-names>Louis-Philippe</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Rundell</surname><given-names>Kenneth William</given-names></name><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Sue-Chu</surname><given-names>Malcolm</given-names></name><xref ref-type="aff" rid="A7">7</xref><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>McKenzie</surname><given-names>Donald C</given-names></name><xref ref-type="aff" rid="A9">9</xref></contrib></contrib-group><aff id="A1"><label>1</label>Centre for Sports Medicine & Human Performance, Brunel University, Uxbridge, UK</aff><aff id="A2"><label>2</label>School of Sports Science, Exercise and Health, Faculty of Life Sciences, University of Western Australia, Crawley, Western Australia, Australia</aff><aff id="A3"><label>3</label>Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia</aff><aff id="A4"><label>4</label>Faculté des Sciences du Sport, Université Droit et Santé de Lille 2, Lille, France</aff><aff id="A5"><label>5</label>Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada</aff><aff id="A6"><label>6</label>Medical Affairs, Pharmaxis, Exton, Pennsylvania, USA</aff><aff id="A7"><label>7</label>Department of Thoracic Medicine, St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway</aff><aff id="A8"><label>8</label>Department of Circulation and Imaging, Norwegian University of Science and Technology, Trondheim, Norway</aff><aff id="A9"><label>9</label>Division of Sports Medicine, School of Human Kinetics, University of British Columbia, Vancouver, Canada</aff><author-notes><corresp><bold>Correspondence to</bold> Pascale Kippelen, Brunel University, Centre for Sports Medicine & Human Performance, Uxbridge UB8 3PH, UK; <email>pascale.kippelen@brunel.ac.uk</email></corresp></author-notes><pub-date pub-type="collection"><day>1</day><month>6</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>29</day><month>4</month><year>2012</year></pub-date><volume>46</volume><issue>7</issue><fpage>471</fpage><lpage>476</lpage><history><date date-type="received"><day>9</day><month>2</month><year>2011</year></date><date date-type="accepted"><day>6</day><month>3</month><year>2012</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bjsm-46-7-0471.pdf"></self-uri><abstract><p>Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.</p></abstract><custom-meta-group><custom-meta><meta-name>special-feature</meta-name><meta-value>unlocked</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Australie</li><li>Canada</li><li>France</li><li>Norvège</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Hauts-de-France</li><li>Nord-Pas-de-Calais</li><li>Pennsylvanie</li><li>Trøndelag</li></region><settlement><li>Lille</li><li>Trondheim</li></settlement></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Kippelen, Pascale" sort="Kippelen, Pascale" uniqKey="Kippelen P" first="Pascale" last="Kippelen">Pascale Kippelen</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Fitch, Kenneth D" sort="Fitch, Kenneth D" uniqKey="Fitch K" first="Kenneth D" last="Fitch">Kenneth D. Fitch</name></noRegion><name sortKey="Anderson, Sandra Doreen" sort="Anderson, Sandra Doreen" uniqKey="Anderson S" first="Sandra Doreen" last="Anderson">Sandra Doreen Anderson</name></country><country name="France"><region name="Hauts-de-France"><name sortKey="Bougault, Valerie" sort="Bougault, Valerie" uniqKey="Bougault V" first="Valerie" last="Bougault">Valerie Bougault</name></region></country><country name="Canada"><noRegion><name sortKey="Boulet, Louis Philippe" sort="Boulet, Louis Philippe" uniqKey="Boulet L" first="Louis-Philippe" last="Boulet">Louis-Philippe Boulet</name></noRegion><name sortKey="Mckenzie, Donald C" sort="Mckenzie, Donald C" uniqKey="Mckenzie D" first="Donald C" last="Mckenzie">Donald C. Mckenzie</name></country><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Rundell, Kenneth William" sort="Rundell, Kenneth William" uniqKey="Rundell K" first="Kenneth William" last="Rundell">Kenneth William Rundell</name></region></country><country name="Norvège"><region name="Trøndelag"><name sortKey="Sue Chu, Malcolm" sort="Sue Chu, Malcolm" uniqKey="Sue Chu M" first="Malcolm" last="Sue-Chu">Malcolm Sue-Chu</name></region><name sortKey="Sue Chu, Malcolm" sort="Sue Chu, Malcolm" uniqKey="Sue Chu M" first="Malcolm" last="Sue-Chu">Malcolm Sue-Chu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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