Exhaled NO as a predictor of exercise-induced asthma in cold air

For sensitive individuals, exercise-induced asthma is triggered by cold and dry air and is often accompanied by a productive cough. In this study, we determined whether cold solutions and/or solutions of increased tonicity directly caused an increase in glycoconjugate (GC) secretion. To test this, we used isolated swine tracheal submucosal gland cells (TSGCs) and measured the rate of GC secretion at 37 and 32 degrees C in isotonic solutions and in solutions made hypertonic by 30 mosM. TSGCs were isolated under conditions that minimized the rate of GC secretion and were perfused with medium 199 equilibrated with 5% CO2 to a pH of 7.4. A lectin-based assay was used to specifically detect GC present in each 2-min fraction of the perfusate. Basal secretion was 3.1-fold greater at 32 degrees C (n = 3) than at 37 degrees C (n = 4; P < 0.05). At 37 degrees C, increasing perfusate osmolarity by 30 mosM increased the average rate of secretion by 41 +/- 11% (n = 4; P < 0.05); return to isotonic perfusate caused a 4.5 +/- 1.8-fold transient increase in secretion (n = 4; P < 0.05) that was complete within 10 min. At 32 degrees C, changing tonicity of the perfusate had no significant effect but returning to isotonic perfusate caused a 2.3 +/- 0.7-fold transient increase in secretion (n = 3; P < 0.05). Thus key stimuli that trigger obstruction of airflow (cold and increased osmolarity) can also directly stimulate GC secretion in the airway. Such increased secretions may contribute to the productive cough observed in some individuals in response to cold air.

Download Full-text

Reduced hyperpnea-induced bronchospasm following repeated cold air challenge

Journal of Applied Physiology ◽

10.1152/jappl.1986.61.1.210 ◽

1986 ◽

Vol 61 (1) ◽

pp. 210-214 ◽

Cited By ~ 7

Author(s):

F. Haas ◽

N. Levin ◽

S. Pasierski ◽

M. Bishop ◽

K. Axen

Keyword(s):

Base Line ◽

Maximum Heart Rate ◽

Cold Air ◽

Asthma Symptoms ◽

Rest Periods ◽

Before And After ◽

Exercise Induced ◽

Inflammatory Changes ◽

Training Protocol

This study assessed reduction in expiratory function in 12 asthmatic subjects both after 5 min of cold air provocation (CAP) with dry air conditioned to approximately 0 degrees C and after exercise (to 85% of predicted maximum heart rate) while breathing ambient room air (approximately 21 degrees C and 40% relative humidity). These assessments were done both before and after the following training protocol. Three 5-min periods of isocapnic cold air hyperpnea separated by 5-min rest periods were performed breathing 0 degrees to -10 degrees C air, for 36 sessions over 12 wk. As expected, pretraining expiratory function was significantly reduced (P less than 0.001) after both CAP and exercise. The posttraining reduction in expiratory function after CAP and exercise, however, was significantly less pronounced (largest P less than 0.05). These data support our hypothesis that repeated bouts of cold air challenge result in airway acclimatization to cold air and consequent decrease in exercise-induced bronchospasm. Acclimatization may result directly either by habituation of the airways or by vasodilation leading to increased bronchial blood flow and consequent reduced airway cooling. An unanticipated finding, though, is that repeated cold air challenge may also cause long-term inflammatory changes in the airways. A significant percentage of subjects experienced reduced base-line pulmonary function and overall exacerbation of asthma symptoms during the training period.

Download Full-text

Effects of atropine on potentiation of exercise-induced bronchospasm by cold air

Journal of Applied Physiology ◽

10.1152/jappl.1978.45.2.238 ◽

1978 ◽

Vol 45 (2) ◽

pp. 238-243 ◽

Cited By ~ 34

Author(s):

E. C. Deal ◽

E. R. McFadden ◽

R. H. Ingram ◽

J. J. Jaeger

Keyword(s):

Ambient Air ◽

Small Airways ◽

Flow Limitation ◽

Ambient Conditions ◽

Cold Air ◽

Relative Contribution ◽

Maximal Expiratory Flow ◽

Before And After ◽

Expiratory Flow ◽

Exercise Induced

The role of vagal efferent activity in the cold air potentiation of exercise-induced asthma was assessed by exercising nine subjects who breathed air at ambient and subfreezing temperatures before and after cholinergic blockade. Lung volumes and maximal expiratory flow volume curves with air and with 80% helium-20% oxygen were obtained before and 5--10 min after each challenge. Isovolume comparisons of maximal expiratory flow rates with the two gases were used to assess relative contributions of large and small airways to flow limitation. Exercise under ambient conditions resulted in the expected airway obstruction and cold air exaggerated the response. Atropine pretreatment had no effect on the cold air potentiation. After atropine with ambient air exercise, there was an increase in the relative contribution of large airways to flow limitation, whereas exercise with cold air resulted in an increase in the contribution of small airways. We concluded that the potentiating effects of cold air are local and suggest that the immediate stimulus is related to cooling of intrathoracic airways.

Download Full-text

The protective effect of a nasal corticosteroid (Avamys®) on exercise induced airway obstruction in cold air in children

http://isrctn.org/> ◽

10.1186/isrctn90761040 ◽

2012 ◽

Author(s):

Janneke van Leeuwen

Keyword(s):

Protective Effect ◽

Airway Obstruction ◽

Cold Air ◽

Exercise Induced

Download Full-text

A Microcomputer-Based Respiratory Heat Exchange Facility for Use in the Diagnosis of Thermally Induced Asthma

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/pime_proc_1989_203_006_01 ◽

1989 ◽

Vol 203 (1) ◽

pp. 43-48 ◽

Cited By ~ 1

Author(s):

R D Farley ◽

K R Patel

Keyword(s):

Heat Exchange ◽

Heat Loss ◽

Ambient Air ◽

Pilot Studies ◽

Cold Air ◽

Thermally Induced ◽

Air Supply ◽

Lung Dysfunction ◽

Exercise Induced ◽

Respiratory Heat Exchange

Exercise-induced asthma is prevalent in many asthmatics and during the winter months can be exacerbated by cold air inhalation. A laboratory facility was required to permit early diagnosis of cold air sensitivity in these patients. This paper describes the development of a modular air conditioning system to produce a range of inhalative thermal burdens and the microcomputer interfacing to measure the rate of airway heat loss imposed. A single-stage refrigerator was built capable of cooling 150 1/min air to —25°C. This was also used to generate dry ambient temperature air by rewarming the chilled air supply. An air humidifier was developed based upon natural convection and evaporation. It was capable of raising 150 1/min ambient air to 37°C, 100 per cent relative humidity. In two pilot studies of 18 asthmatics it was found that the rate of respiratory heat exchange could be correlated with the magnitude of post exertional bronchoconstriction (lung dysfunction) and that exercise-induced asthma could be minimized by attenuating the rate of airway heat loss.

Download Full-text

Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma. A double-blind placebo-controlled trial.

10.21203/rs.2.20334/v2 ◽

2020 ◽

Author(s):

Melanie Dreßler ◽

Daniela Fussbroich ◽

Lisa Böhler ◽

Eva Herrmann ◽

Nicole Benker ◽

...

Keyword(s):

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Protective Effect ◽

Outcome Measure ◽

Double Blind ◽

Cold Air ◽

Double Blind Placebo ◽

Exercise Challenge ◽

Exercise Induced ◽

Long Chain

Abstract Background Many patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV 1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA. Methods In this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model. Primary outcome measure: Decrease in FEV 1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo. Results 99 patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. 73 patients fulfilled the inclusion criteria of a FEV 1 decrease >15% and were treated double-blind placebo-controlled for four weeks either with sc-LCPUFA or placebo. 32 patients in each group completed the study. Mean FEV 1 decrease after cold air exercise challenge and eNO were unchanged after four weeks sc-LCPUFA supplementation. Conclusion Supplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective ant anti-inflammatory effects on EIA.

Download Full-text