Airway inflammation in the elite athlete and type of sport

Background: The prevalence of asthma and bronchial hyperresponsiveness is greater in elite athletes than in the general population and its association with mild airway inflammation has recently been reported. Objective: To study the relation between the type of sport practiced at the highest levels of competition (on land or in water) and sputum induction cell counts in a group of healthy and asthmatic individuals. Material and methods: Fifty athletes were enrolled. We analyzed medical history, results of methacholine challenge tests and sputum induced by hypertonic saline. Results: Full results were available for 43 athletes, who were classified by asthma diagnosis and type of sport (land or water sports). Nineteen were healthy (10 land and 9 water athletes) and 24 were asthmatic (13 land and 11 water athletes). Although the eosinophil counts of healthy and asthmatic individuals were significantly different (mean difference 3.1%, confidence interval [CI] 0.4 to 6.2, P=0.008), ANOVA showed no effect on eosinophil count for either diagnosis of asthma or type of sport. However, an effect was observed for neutrophil counts (analysis of variance: F=2.87, P=0.04). We also detected a significant correlation between neutrophil counts and both duration of training and bronchial hyperresponsiveness among athletes exposed to water (Spearman’s rank correlations, 0.36 and 0.47, P=0.04 and 0.04, respectively). Conclusions: Elite athletes who practice water sports have mild neutrophilic inflammation, whether or not asthma is present, related to the degree of bronchial hyperreactivity and the duration of training in pool water. group.bmj.com on June 21, 2017 Published by http://bjsm.bmj.com/ Downloaded from