Abstract
Exercise-induced asthma (EIA) occurs after exercise and subsides spontaneously within 2 hours in most individuals with asthma. However, a subpopulation of patients has a late asthmatic reaction 4 to 12 hours later. An increasing number of papers have documented this late reaction. This study further characterizes the late pulmonary reaction to exercise.
Nine young adult subjects who developed asthma after a standard treadmill exercise test were studied. Pulmonary function tests were performed before and after exercise and serially for at least 6 hours aferwards. The subjects performed pulmonary function tests while breathing room air and after 3 inhalations of an oxygen-helium mixture with each test. Although pulmonary function returned to normal within 3 hours after exercising in all subjects, 8 of the 9 had a late asthmatic reaction 3 to 5 hours afterwards. In general, the late response was less severe than the initial. Two subjects, however, noticed clinical asthma. In the immediate response, 8 of 9 were helium "responders" suggesting that the immediate response involved both large and small airways. In the late response, all were helium "nonresponders" suggesting that it occurred primarily in small airways.
One could speculate that the immediate reaction to exercise is due both to airway cooling which would affect primarily large central airways and mediator release which would affect smaller peripheral airways while the late response is due solely to mediator release and affects primarily small airways.
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Bierman, C., Spiro, S. CHARACTERISTICS OF THE LATE RESPONSE IN EXERCISE INDUCED ASTHMA. Pediatr Res 18 (Suppl 4), 386 (1984). https://doi.org/10.1203/00006450-198404001-01760
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DOI: https://doi.org/10.1203/00006450-198404001-01760
