چکیده (انگلیسی):

Background: Asthma has a higher prevalence in athlete populations such as Olympic athletes than in the
general population. Correct diagnosis and management of asthma in athletes is important for symptom
control and avoidance of doping accusations. However, few reports are available on asthma treatment in
the athlete population in clinical practice. In this study, we focused on the clinical efficacy of inhaled
corticosteroid (ICS) for asthma in a Japanese athlete population.
Methods: The study subjects included athletes who visited the Niigata Institute for Health and Sports
Medicine, Niigata, Japan for athletic tests and who were diagnosed with asthma on the basis of respiratory
symptoms and positive results in a bronchodilator or bronchial provocation test such as exercise,
hypertonic saline, or methacholine provocation. The athletes received ICS alone for at least 3 months, and
the clinical background, sports type, and treatment efficacy were analyzed.
Results: The study population comprised 80 athletes (59 men and 21 women) with a median age of 16.0
years. Regarding sports type, 28 athletes engaged in winter sports (35%), 22 in endurance sports (27.5%),
and 25 in indoor sports (31.3%). Although ICS is the primary treatment in athlete asthma, 16.3% of the
athletes showed an unsatisfactory response to treatment according to the Global Evaluation of Treatment
Effectiveness (GETE). These subjects were characterized by a decreased response to methacholine and
lower values for FEV1/FVC and type 2 helper T cell (Th2)-associated biomarkers relative to responsive
athletes. In multivariate analysis, FEV1/FVC and the logarithm to the base 10 of the IgE level were
independently associated with the ICS response.
Conclusions: These data suggest that ICS is effective for asthma in most athletes. However, certain
asthmatic athletes are less responsive to ICS than expected. The pathogenesis in these subjects may differ
from that of conventional asthma characterized by chronic allergic airway inflammation.