Mechanisms and Management of Exercise-Induced Bronchoconstriction

  • John D. Brannan
  • Paul M. O'Byrne
Part of the Allergy Frontiers book series (ALLERGY, volume 5)

The term “exercise-induced asthma” has been used to describe the transient narrowing of the airways and the subsequent increase in airway resistance, which can occur during, though more commonly following, vigorous exercise [1]. Exercise is a trigger for bronchoconstriction in individuals with asthma, but is not considered an independent risk factor for the development of asthma. The term “exercise-induced asthma” can be misleading and in some individuals, symptoms and airway narrowing can develop as a result of acute vigorous exercise in the absence of other clinically recognized symptoms of asthma [2]. Thus, the term exercise-induced bronchoconstriction (EIB) is now generally preferred to be a more accurate reflection of the underlying pathophysiology.


Allergy Clin Immunol Respir Crit Elite Athlete Nedocromil Sodium Airway Narrowing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Anderson SD, Daviskas E (2000) The mechanism of exercise-induced asthma is. J Allergy Clin Immunol 106:453–459CrossRefPubMedGoogle Scholar
  2. 2.
    Weiler JM, Bonini S, Coifman R, Craig T, Delgado L, Capao-Filipe M, Passali D, Randolph C, Storms W (2007) American Academy of Allergy, Asthma & Immunology Work Group Report: exercise-induced asthma. J Allergy Clin Immunol 119:1349–1358CrossRefPubMedGoogle Scholar
  3. 3.
    McFadden ER Jr, Gilbert IA (1994) Exercise-induced asthma. N Engl J Med 330:1362–1367CrossRefPubMedGoogle Scholar
  4. 4.
    Haby MM, Anderson SD, Peat JK, Mellis CM, Toelle BG, Woolcock AJ (1994) An exercise challenge protocol for epIDemiological studies of asthma in children: comparison with histamine challenge. Eur Respir J 7:43–49CrossRefPubMedGoogle Scholar
  5. 5.
    Kukafka DS, Lang DM, Porter S, Rogers J, Ciccolella D, Polansky M, D'Alonzo GE Jr (1998) Exercise-induced bronchospasm in high school athletes via a free running test: incIDence and epIDemiology. Chest 114:1613–1622CrossRefPubMedGoogle Scholar
  6. 6.
    Thole RT, Sallis RE, Rubin AL, Smith GN (2001) Exercise-induced bronchospasm prevalence in collegiate cross-country runners. Med Sci Sports Exerc 33:1641–1646CrossRefPubMedGoogle Scholar
  7. 7.
    Mannix ET, Farber MO, Palange P, Galassetti P, Manfredi F (1996) Exercise-induced asthma in figure skaters. Chest 109:312–315CrossRefPubMedGoogle Scholar
  8. 8.
    Rundell KW, Im J, Mayers LB, Wilber RL, Szmedra L, Schmitz HR (2001) Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc 33:208–213PubMedGoogle Scholar
  9. 9.
    Wilber RL, Rundell KW, Szmedra L, Jenkinson DM, Im J, Drake SD (2000) IncIDence of exercise-induced bronchospasm in Olympic winter sport athletes. Med Sci Sports Exerc 32:732–737CrossRefPubMedGoogle Scholar
  10. 10.
    Nish WA, Schwietz LA (1992) Underdiagnosis of asthma in young adults presenting for USAF basic training. Ann Allergy 69:239–242PubMedGoogle Scholar
  11. 11.
    Addo-Yobo EO, Woodcock A, Allotey A, Baffoe-Bonnie B, Strachan D, Custovic A (2007) Exercise-induced bronchospasm and atopy in Ghana: two surveys ten years apart. PLoS Med 4:e70CrossRefPubMedGoogle Scholar
  12. 12.
    Addo Yobo EO, Custovic A, Taggart SC, Asafo-Agyei AP, Woodcock A (1997) Exercise induced bronchospasm in Ghana: differences in prevalence between urban and rural schoolchildren. Thorax 52:161–165CrossRefPubMedGoogle Scholar
  13. 13.
    Brutsche M, Britschgi D, Dayer E, Tschopp JM (1995) Exercise-induced bronchospasm (EIB) in relation to seasonal and perennial specific IgE in young adults. Allergy 50:905–909CrossRefPubMedGoogle Scholar
  14. 14.
    Rouhos A, Ekroos H, Karjalainen J, Sarna S, Sovijarvi AR (2005) Exhaled nitric oxIDe and exercise-induced bronchoconstriction in young male conscripts: association only in atopics. Allergy 60:1493–1498CrossRefPubMedGoogle Scholar
  15. 15.
    Jones A (1994) Asymptomatic bronchial hyperreactivity and the development of asthma and other respiratory tract illnesses in children. Thorax 49:757–761CrossRefPubMedGoogle Scholar
  16. 16.
    Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB, Weiss ST (2004) WorldwIDe severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol 114:40–47CrossRefPubMedGoogle Scholar
  17. 17.
    Becker JM, Rogers J, Rossini G, Mirchandani H, D'Alonzo GE Jr (2004) Asthma deaths during sports: report of a 7-year experience. J Allergy Clin Immunol 113:264–267CrossRefPubMedGoogle Scholar
  18. 18.
    Anderson SD (1984) Is there a unifying hypothesis for exercise-induced asthma? J Allergy Clin Immunol 73:660–665CrossRefPubMedGoogle Scholar
  19. 19.
    Brannan JD, Koskela H, Anderson SD, Chew N (1998) Responsiveness to mannitol in asthmatic subjects with exercise- and hyperventilation-induced asthma. Am J Respir Crit Care Med 158:1120–1126PubMedGoogle Scholar
  20. 20.
    O'Sullivan S, Roquet A, Dahlen B, Larsen F, Eklund A, Kumlin M, O'Byrne PM, Dahlen SE (1998) EvIDence for mast cell activation during exercise-induced bronchoconstriction. Eur Respir J 12:345–350CrossRefPubMedGoogle Scholar
  21. 21.
    Reiss TF, Hill JB, Harman E, Zhang J, Tanaka WK, Bronsky E, Guerreiro D, Hendeles L (1997) Increased urinary excretion of LTE4 after exercise and attenuation of exercise-induced bronchospasm by montelukast, a cysteinyl leukotriene receptor antagonist. Thorax 52:1030–1035CrossRefPubMedGoogle Scholar
  22. 22.
    Jones RS, Wharton MJ, Buston MH (1963) Place of physical exercise and bronchodilator drugs in the assessment of the asthmatic child. Arch Dis Child 38:539–545CrossRefPubMedGoogle Scholar
  23. 23.
    Anderson SD, Seale JP, Rozea P, Bandler L, Theobald G, Lindsay DA (1976) Inhaled and oral salbutamol in exercise-induced asthma. Am Rev Respir Dis 114:493–500PubMedGoogle Scholar
  24. 24.
    Silverman M, Andrea T (1972) Time course of effect of disodium cromoglycate on exercise-induced asthma. Arch Dis Child 47:419–422CrossRefPubMedGoogle Scholar
  25. 25.
    Henriksen JM, Dahl R (1983) Effects of inhaled budesonIDe alone and in combination with low-dose terbutaline in children with exercise-induced asthma. Am Rev Respir Dis 128:993–997PubMedGoogle Scholar
  26. 26.
    Manning PJ, Watson RM, Margolskee DJ, Williams VC, Schwartz JI, O'Byrne PM (1990) Inhibition of exercise-induced bronchoconstriction by MK-571, a potent leukotriene D4-receptor antagonist. N Engl J Med 323:1736–1739PubMedCrossRefGoogle Scholar
  27. 27.
    Yoshikawa T, Shoji S, Fujii T, Kanazawa H, Kudoh S, Hirata K, Yoshikawa J (1998) Severity of exercise-induced bronchoconstriction is related to airway eosinophilic inflammation in patients with asthma. Eur Respir J 12:879–884CrossRefPubMedGoogle Scholar
  28. 28.
    Kivity S, Argaman A, Onn A, Shwartz Y, Man A, Greif J, Fireman E (2000) Eosinophil influx into the airways in patients with exercise-induced asthma. Respir Med 94:1200–1205CrossRefPubMedGoogle Scholar
  29. 29.
    Koh YI, Choi S (2002) Blood eosinophil counts for the prediction of the severity of exercise-induced bronchospasm in asthma. Respir Med 96:120–125CrossRefPubMedGoogle Scholar
  30. 30.
    Scollo M, Zanconato S, Ongaro R, Zaramella C, Zacchello F, Baraldi E (2000) Exhaled nitric oxIDe and exercise-induced bronchoconstriction in asthmatic children. Am J Respir Crit Care Med 161:1047–1050PubMedGoogle Scholar
  31. 31.
    Anderson SD, Bye PT, Schoeffel RE, Seale JP, Taylor KM, Ferris L (1981) Arterial plasma histamine levels at rest, and during and after exercise in patients with asthma: effects of terb-utaline aerosol. Thorax 36:259–267CrossRefPubMedGoogle Scholar
  32. 32.
    Mickleborough TD, Murray RL, Ionescu AA, Lindley MR (2003) Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med 168:1181–1189CrossRefPubMedGoogle Scholar
  33. 33.
    Mickleborough TD, Lindley MR, Ionescu AA, Fly AD (2006) Protective effect of fish oil supplementation on exercise-induced bronchoconstriction in asthma. Chest 129:39–49CrossRefPubMedGoogle Scholar
  34. 34.
    Hallstrand TS, Moody MW, Wurfel MM, Schwartz LB, Henderson WR Jr, Aitken ML (2005) Inflammatory basis of exercise-induced bronchoconstriction. Am J Respir Crit Care Med 172:679–686CrossRefPubMedGoogle Scholar
  35. 35.
    Gauvreau GM, Ronnen GM, Watson RM, O'Byrne PM (2000) Exercise-induced bronchocon-striction does not cause eosinophilic airway inflammation or airway hyperresponsiveness in subjects with asthma. Am J Respir Crit Care Med 162:1302–1307PubMedGoogle Scholar
  36. 36.
    Anderson SD, Kippelen P (2005) Exercise-induced bronchoconstriction: pathogenesis. Curr Allergy Asthma Rep 5:116–122CrossRefPubMedGoogle Scholar
  37. 37.
    Anderson SD, Kippelen P (2008) Airway injury as a mechanism for exercise-induced bron-choconstriction in elite athletes. J Allergy Clin Immunol 122:225–235; quiz 236–227CrossRefPubMedGoogle Scholar
  38. 38.
    Anderton RC, Cuff MT, Frith PA, Cockcroft DW, Morse JL, Jones NL, Hargreave FE (1979) Bronchial responsiveness to inhaled histamine and exercise. J Allergy Clin Immunol 63:315–320CrossRefPubMedGoogle Scholar
  39. 39.
    Holzer K, Anderson SD, Douglass J (2002) Exercise in elite summer athletes: challenges for diagnosis. J Allergy Clin Immunol 110:374–380CrossRefPubMedGoogle Scholar
  40. 40.
    O'Hickey SP, Arm JP, Rees PJ, Spur BW, Lee TH (1988) The relative responsiveness to inhaled leukotriene E4, methacholine and histamine in normal and asthmatic subjects. Eur Respir J 1:913–917PubMedGoogle Scholar
  41. 41.
    Mussaffi H, Springer C, Godfrey S (1986) Increased bronchial responsiveness to exercise and histamine after allergen challenge in children with asthma. J Allergy Clin Immunol 77:48–52CrossRefPubMedGoogle Scholar
  42. 42.
    Gauvreau GM, Watson RM, O'Byrne PM (1999) Kinetics of allergen-induced airway eosino-philic cytokine production and airway inflammation. Am J Respir Crit Care Med 160:640–647PubMedGoogle Scholar
  43. 43.
    Storms WW (2003) Review of exercise-induced asthma. Med Sci Sports Exerc 35:1464–1470CrossRefPubMedGoogle Scholar
  44. 44.
    Inman MD, Watson RM, Killian KJ, O'Byrne PM (1990) Methacholine airway responsiveness decreases during exercise in asthmatic subjects. Am Rev Respir Dis 141:1414–1417PubMedGoogle Scholar
  45. 45.
    Edmunds AT, Tooley M, Godfrey S (1978) The refractory period after exercise-induced asthma: its duration and relation to the severity of exercise. Am Rev Respir Dis 117:247–254PubMedGoogle Scholar
  46. 46.
    O'Byrne PM, Jones GL (1986) The effect of indomethacin on exercise-induced bronchocon-striction and refractoriness after exercise. Am Rev Respir Dis 134:69–72PubMedGoogle Scholar
  47. 47.
    Manning PJ, Watson RM, O'Byrne PM (1993) Exercise-induced refractoriness in asthmatic subjects involves leukotriene and prostaglandin interdependent mechanisms. Am Rev Respir Dis 148:950–954PubMedGoogle Scholar
  48. 48.
    Rupp NT, Brudno DS, Guill MF (1993) The value of screening for risk of exercise-induced asthma in high school athletes. Ann Allergy 70:339–342PubMedGoogle Scholar
  49. 49.
    Hallstrand TS, Curtis JR, Koepsell TD, Martin DP, Schoene RB, Sullivan SD, Yorioka GN, Aitken ML (2002) Effectiveness of screening examinations to detect unrecognized exercise-induced bronchoconstriction. J Pediatr 141:343–348CrossRefPubMedGoogle Scholar
  50. 50.
    Anderson SD, Brannan JD (2003) Methods for “indirect” challenge tests including exercise, eucapnic voluntary hyperpnea, and hypertonic aerosols. Clin Rev Allergy Immunol 24:27–54CrossRefPubMedGoogle Scholar
  51. 51.
    Rundell KW, Slee JB (2008) Exercise and other indirect challenges to demonstrate asthma or exercise-induced bronchoconstriction in athletes. J Allergy Clin Immunol 122:238–246; quiz 247–238CrossRefPubMedGoogle Scholar
  52. 52.
    Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, MacIntyre NR, McKay RT, Wanger JS, Anderson SD, Cockcroft DW, Fish JE, Sterk PJ (2000) GuIDelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 161:309–329PubMedGoogle Scholar
  53. 53.
    Anderson SD, Lambert S, Brannan JD, Wood RJ, Koskela H, Morton AR, Fitch KD (2001) Laboratory protocol for exercise asthma to evaluate salbutamol given by two devices. Med Sci Sports Exerc 33:893–900CrossRefPubMedGoogle Scholar
  54. 54.
    Rundell KW, Wilber RL, Szmedra L, Jenkinson DM, Mayers LB, Im J (2000) Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 32:309–316CrossRefPubMedGoogle Scholar
  55. 55.
    Rundell KW, Anderson SD, Spiering BA, Judelson DA (2004) Field exercise vs laboratory eucapnic voluntary hyperventilation to IDentify airway hyperresponsiveness in elite cold weather athletes. Chest 125:909–915CrossRefPubMedGoogle Scholar
  56. 56.
    Holzer K, Anderson SD, Chan HK, Douglass J (2003) Mannitol as a challenge test to IDentify exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med 167:534–537CrossRefPubMedGoogle Scholar
  57. 57.
    Anderson SD, Charlton B, Weiler JM, Nichols S, Spector SL, Pearlman DS (2009) Comparison of mannitol and methacholine to predict exercise-induced bronchoconstriction and a clinical diagnosis of asthma. Respir Res 10:4PubMedGoogle Scholar
  58. 58.
    Brannan JD, Anderson SD, Perry CP, Freed-Martens R, Lassig AR, Charlton B (2005) The safety and efficacy of inhaled dry powder mannitol as a bronchial provocation test for airway hyperre-sponsiveness: a phase 3 comparison study with hypertonic (4.5%) saline. Respir Res 6:144CrossRefPubMedGoogle Scholar
  59. 59.
    Abu-Hasan M, Tannous B, Weinberger M (2005) Exercise-induced dyspnea in children and adolescents: if not asthma then what? Ann Allergy Asthma Immunol 94:366–371PubMedCrossRefGoogle Scholar
  60. 60.
    Patessio A, Podda A, Carone M, Trombetta N, Donner CF (1991) Protective effect and duration of action of formoterol aerosol on exercise-induced asthma. Eur Respir J 4:296–300PubMedGoogle Scholar
  61. 61.
    Anderson SD, Rodwell LT, Du Toit J, Young IH (1991) Duration of protection by inhaled salmeterol in exercise-induced asthma. Chest 100:1254–1260CrossRefPubMedGoogle Scholar
  62. 62.
    Richter K, Janicki S, Jorres RA, Magnussen H (2002) Acute protection against exercise-induced bronchoconstriction by formoterol, salmeterol and terbutaline. Eur Respir J 19:865–871CrossRefPubMedGoogle Scholar
  63. 63.
    Latimer KM, O'Byrne PM, Morris MM, Roberts R, Hargreave FE (1983) Bronchoconstriction stimulated by airway cooling. Better protection with combined inhalation of terbutaline sulphate and cromolyn sodium than with either alone. Am Rev Respir Dis 128:440–443PubMedGoogle Scholar
  64. 64.
    Anderson SD, Caillaud C, Brannan JD (2006) Beta2-agonists and exercise-induced asthma. Clin Rev Allergy Immunol 31:163–180CrossRefPubMedGoogle Scholar
  65. 65.
    Newnham DM, Ingram CG, Earnshaw J, Palmer JB, Dhillon DP (1993) Salmeterol provIDes prolonged protection against exercise-induced bronchoconstriction in a majority of subjects with mild, stable asthma. Respir Med 87:439–444CrossRefPubMedGoogle Scholar
  66. 66.
    Vilsvik J, Ankerst J, Palmqvist M, Persson G, Schaanning J, Schwabe G, Johansson A (2001) Protection against cold air and exercise-induced bronchoconstriction while on regular treatment with Oxis. Respir Med 95:484–490CrossRefPubMedGoogle Scholar
  67. 67.
    Inman MD, O'Byrne PM (1996) The effect of regular inhaled albuterol on exercise-induced bronchoconstriction. Am J Respir Crit Care Med 153:65–69PubMedGoogle Scholar
  68. 68.
    Hancox RJ, Subbarao P, Kamada D, Watson RM, Hargreave FE, Inman MD (2002) Beta2-agonist tolerance and exercise-induced bronchospasm. Am J Respir Crit Care Med 165:1068–1070PubMedGoogle Scholar
  69. 69.
    Kelly KD, Spooner CH, Rowe BH (2001) Nedocromil sodium versus sodium cromoglycate in treatment of exercise-induced bronchoconstriction: a systematic review. Eur Respir J 17:39–45CrossRefPubMedGoogle Scholar
  70. 70.
    Anderson SD (2004) Single-dose agents in the prevention of exercise-induced asthma: a descriptive review. Treat Respir Med 3:365–379CrossRefPubMedGoogle Scholar
  71. 71.
    Subbarao P, Duong M, Adelroth E, Otis J, Obminski G, Inman M, Pedersen S, O'Byrne PM (2006) Effect of ciclesonIDe dose and duration of therapy on exercise-induced bronchocon-striction in patients with asthma. J Allergy Clin Immunol 117:1008–1013CrossRefPubMedGoogle Scholar
  72. 72.
    Jonasson G, Carlsen KH, Blomqvist P (1998) Clinical efficacy of low-dose inhaled budes-onIDe once or twice daily in children with mild asthma not previously treated with steroIDs. Eur Respir J 12:1099–1104CrossRefPubMedGoogle Scholar
  73. 73.
    Brannan JD, Koskela H, Anderson SD (2007) Monitoring asthma therapy using indirect bronchial provocation tests. Clin Respir J 1:3–15CrossRefPubMedGoogle Scholar
  74. 74.
    Pedersen S, Hansen OR (1995) BudesonIDe treatment of moderate and severe asthma in children: a dose-response study. J Allergy Clin Immunol 95:29–33CrossRefPubMedGoogle Scholar
  75. 75.
    Duong M, Subbarao P, Adelroth E, Obminski G, Strinich T, Inman M, Pedersen S, O'Byrne PM (2008) Sputum eosinophils and the response of exercise-induced bronchoconstriction to corticosteroID in asthma. Chest 133:404–411CrossRefPubMedGoogle Scholar
  76. 76.
    Jonasson G, Carlsen KH, Hultquist C (2000) Low-dose budesonIDe improves exercise-induced bronchospasm in schoolchildren. Pediatr Allergy Immunol 11:120–125CrossRefPubMedGoogle Scholar
  77. 77.
    Hofstra WB, Neijens HJ, Duiverman EJ, Kouwenberg JM, Mulder PG, Kuethe MC, Sterk PJ (2000) Dose-responses over time to inhaled fluticasone propionate treatment of exercise- and methacholine-induced bronchoconstriction in children with asthma. Pediatr Pulmonol 29:415–423CrossRefPubMedGoogle Scholar
  78. 78.
    Weiler JM, Nathan RA, Rupp NT, Kalberg CJ, Emmett A, Dorinsky PM (2005) Effect of fluticasone/salmeterol administered via a single device on exercise-induced bronchospasm in patients with persistent asthma. Ann Allergy Asthma Immunol 94:65–72PubMedCrossRefGoogle Scholar
  79. 79.
    Coreno A, Skowronski M, Kotaru C, McFadden ER Jr (2000) Comparative effects of long-acting beta2-agonists, leukotriene receptor antagonists, and a 5-lipoxygenase inhibitor on exercise-induced asthma. J Allergy Clin Immunol 106:500–506CrossRefPubMedGoogle Scholar
  80. 80.
    Pearlman DS, van Adelsberg J, Philip G, Tilles SA, Busse W, Hendeles L, Loeys T, Dass SB, Reiss TF (2006) Onset and duration of protection against exercise-induced bronchoconstric-tion by a single oral dose of montelukast. Ann Allergy Asthma Immunol 97:98–104PubMedCrossRefGoogle Scholar
  81. 81.
    Villaran C, O'Neill SJ, Helbling A, van Noord JA, Lee TH, Chuchalin AG, Langley SJ, Gunawardena KA, Suskovic S, Laurenzi M, Jasan J, Menten J, Leff JA (1999) Montelukast versus salmeterol in patients with asthma and exercise-induced bronchoconstriction. Montelukast/Salmeterol Exercise Study Group. J Allergy Clin Immunol 104:547–553CrossRefPubMedGoogle Scholar
  82. 82.
    Storms W, Chervinsky P, Ghannam AF, Bird S, Hustad CM, Edelman JM (2004) A comparison of the effects of oral montelukast and inhaled salmeterol on response to rescue broncho-dilation after challenge. Respir Med 98:1051–1062CrossRefPubMedGoogle Scholar
  83. 83.
    Edelman JM, Turpin JA, Bronsky EA, Grossman J, Kemp JP, Ghannam AF, DeLucca PT, Gormley GJ, Pearlman DS (2000) Oral montelukast compared with inhaled salmeterol to prevent exercise-induced bronchoconstriction. A randomized, double-blind trial. Exercise Study Group. Ann Intern Med 132:97–104PubMedGoogle Scholar
  84. 84.
    Anderson SD, Brannan JD (2002) Exercise-induced asthma: is there still a case for histamine? J Allergy Clin Immunol 109:771–773CrossRefPubMedGoogle Scholar
  85. 85.
    Patel KR (1984) Terfenadine in exercise induced asthma. Br Med J (Clin Res Ed) 288:1496–1497CrossRefGoogle Scholar
  86. 86.
    Baki A, Orhan F (2002) The effect of loratadine in exercise-induced asthma. Arch Dis Child 86:38–39CrossRefPubMedGoogle Scholar
  87. 87.
    Dahlen B, Roquet A, Inman MD, Karlsson O, Naya I, Anstren G, O'Byrne PM, Dahlen SE (2002) Influence of zafirlukast and loratadine on exercise-induced bronchoconstriction. J Allergy Clin Immunol 109:789–793CrossRefPubMedGoogle Scholar
  88. 88.
    Peroni DG, Piacentini GL, Pietrobelli A, Loiacono A, De Gasperi W, Sabbion A, Micciolo R, Boner AL (2002) The combination of single-dose montelukast and loratadine on exercise-induced bronchospasm in children. Eur Respir J 20:104–107CrossRefPubMedGoogle Scholar
  89. 89.
    Reisman J, Schachter HM, Dales RE, Tran K, Kourad K, Barnes D, Sampson M, Morrison A, Gaboury I, Blackman J (2006) Treating asthma with omega-3 fatty acIDs: where is the evIDence? A systematic review. BMC Complement Altern Med 6:26CrossRefPubMedGoogle Scholar
  90. 90.
    Mickleborough TD, Lindley MR, Ray S (2005) Dietary salt, airway inflammation, and diffusion capacity in exercise-induced asthma. Med Sci Sports Exerc 37:904–914PubMedGoogle Scholar
  91. 91.
    Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM (2007) Ascorbic acID supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med 101:1770–1778CrossRefPubMedGoogle Scholar
  92. 92.
    Poppius H, Sovijarvi AR, Tammilehto L (1986) Lack of protective effect of high-dose iprat-ropium on bronchoconstriction following exercise with cold air breathing in patients with mild asthma. Eur J Respir Dis 68:319–325PubMedGoogle Scholar
  93. 93.
    Ellis EF (1984) Inhibition of exercise-induced asthma by theophylline. J Allergy Clin Immunol 73:690–692CrossRefPubMedGoogle Scholar
  94. 94.
    Bianco S, Vaghi A, Robuschi M, Pasargiklian M (1988) Prevention of exercise-induced bron-choconstriction by inhaled frusemIDe. Lancet 2:252–255CrossRefPubMedGoogle Scholar
  95. 95.
    Melillo E, Woolley KL, Manning PJ, Watson RM, O'Byrne PM (1994) Effect of inhaled PGE2 on exercise-induced bronchoconstriction in asthmatic subjects. Am J Respir Crit Care Med 149:1138–1141PubMedGoogle Scholar
  96. 96.
    Shimizu T, Mochizuki H, Shigeta M, Morikawa A (1997) Effect of inhaled indomethacin on exercise-induced bronchoconstriction in children with asthma. Am J Respir Crit Care Med 155:170–173PubMedGoogle Scholar
  97. 97.
    Ahmed T, Gonzalez BJ, Danta I (1999) Prevention of exercise-induced bronchoconstriction by inhaled low-molecular-weight heparin. Am J Respir Crit Care Med 160:576–581PubMedGoogle Scholar
  98. 98.
    Millqvist E, Bengtsson U, Lowhagen O (2000) Combining a beta2-agonist with a face mask to prevent exercise-induced bronchoconstriction. Allergy 55:672–675CrossRefPubMedGoogle Scholar
  99. 99.
    McKenzie DC, McLuckie SL, Stirling DR (1994) The protective effects of continuous and interval exercise in athletes with exercise-induced asthma. Med Sci Sports Exerc 26:951–956PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  1. 1.Firestone Institute for Respiratory Health and the Department of Medicine, Michael G DeGroot School of MedicineMcMaster UniversityHamiltonCanada

Personalised recommendations