药物治疗对耐力运动员运动诱发支气管收缩和变应性炎症反应的影响。
Effect of Pharmacological Treatment on Exercise-Induced Bronchoconstriction and Allergic Inflammatory Response in Endurance Athletes.
作者信息
da Silva Ronaldo Aparecido, Teixeira Renata Nakata, Leite Gerson Dos Santos, Agondi Rosana C, Gorjão Renata, Kokron Cristina Maria, Fiks Yara Nely, Carvalho Celso Ricardo Fernandes
机构信息
Strictly Academic Postgraduate Program Institute of Medical Assistance for State Public Servants of São Paulo.
Physical Therapy Universidade de São Paulo.
出版信息
Int J Sports Phys Ther. 2025 Aug 1;20(8):1222-1231. doi: 10.26603/001c.141859. eCollection 2025.
BACKGROUND
Endurance athletes (EA) with lung disease and allergic inflammation have worse performance.
PURPOSE
To examine whether pharmacological treatment can reduce airway disorders such as exercise-induced bronchoconstriction (EIB) and allergic inflammatory response (AIR) in EA.
STUDY DESIGN
Prospective, controlled clinical trial.
METHODS
EA who were marathon runners underwent eucapnic voluntary hyperventilation (EVH) for screening assessment. EA who fulfilled the criteria for an EIB+ after an EVH were included in the treatment group (EIB+; n=13), and those who did not were included in the control group (CON; n=18). The athletes were assessed before and 30 days after the intervention. Outcomes included cardiopulmonary exercise testing, lung function, allergic symptoms (allergic questionnaire for athletes [AQUA©]), AIR (T helper [Th]-1, Th2, and Th17 lymphocytes in cell cultures), inflammatory mediator expression, salivary immunoglobulin (Ig)A, blood cortisol, blood IgE levels, and airway inflammation (fraction exhaled nitric oxide [FeNO]). Both groups were advised to keep the same training routine, and only the EIB+ received pharmacological treatment with inhaled corticosteroids (400-800 mcg/day) and long-acting bronchodilators (12 mcg/day). The CON and EIB+ groups underwent the same assessments after the intervention and were compared pre- and post-intervention, and effect sizes were calculated.
RESULTS
EIB+ (males, age 28.1±7.4 years, BMI 20.3±1.0 kg/m2) CON (males, age 29.8±6.5 years, BMI 20.5±1.6 kg/m2) participated. At baseline, the O2 peak, lung function, allergic symptoms, IgE, IgA, FeNO levels, and AIR were not significancly different between groups (p>0.05). After pharmacological treatment, only the EIB+ group showed a decrease in EIB (p<0.001) and an increase in VO2peak compared to baseline (p<0.05). However, no difference was observed in the expression of inflammatory mediators (p>0.05).
CONCLUSION
Pharmacological treatment reduces EIB and increases the aerobic perforance/fitness in endurance athletes. These benefits occur without modification of the AIR.
LEVEL OF EVIDENCE
Level II- Prospective Comparative Study.
背景
患有肺部疾病和过敏性炎症的耐力运动员（EA）表现较差。
目的
研究药物治疗是否能减轻EA的气道疾病，如运动诱发的支气管收缩（EIB）和过敏性炎症反应（AIR）。
研究设计
前瞻性对照临床试验。
方法
马拉松运动员EA接受等碳酸氧自主过度通气（EVH）进行筛查评估。EVH后符合EIB+标准的EA被纳入治疗组（EIB+；n = 13），不符合标准的被纳入对照组（CON；n = 18）。在干预前后对运动员进行评估。结果包括心肺运动测试、肺功能、过敏症状（运动员过敏问卷[AQUA©]）、AIR（细胞培养中的辅助性T细胞[Th]-1、Th2和Th17淋巴细胞）、炎症介质表达、唾液免疫球蛋白（Ig）A、血皮质醇、血IgE水平和气道炎症（呼出一氧化氮分数[FeNO]）。两组均被建议保持相同的训练常规，只有EIB+组接受吸入性糖皮质激素（400 - 800 mcg/天）和长效支气管扩张剂（12 mcg/天）的药物治疗。干预后CON组和EIB+组进行相同评估，并对干预前后进行比较，计算效应量。
结果
EIB+组（男性，年龄28.1±7.4岁，BMI 20.3±1.0 kg/m²）和CON组（男性，年龄29.8±6.5岁，BMI 20.5±1.6 kg/m²）参与研究。基线时，两组间的氧峰值、肺功能、过敏症状、IgE、IgA、FeNO水平和AIR无显著差异（p>0.05）。药物治疗后，与基线相比，只有EIB+组的EIB有所下降（p<0.001），VO2峰值有所增加（p<0.05）。然而，炎症介质表达无差异（p>0.05）。
结论
药物治疗可减轻EIB并提高耐力运动员的有氧表现/体能。这些益处的出现并未改变AIR。
证据水平
II级——前瞻性比较研究。
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