The Journal of Allergy and Clinical Immunology: In Practice
Review and Feature ArticleImproving Screening and Diagnosis of Exercise-Induced Bronchoconstriction: A Call to Action
Section snippets
Prevalence and Burden of EIB
EIB is an acute bronchoconstriction triggered by exercise, which may occur in the presence of established asthma or in the absence of other features of chronic asthma.1, 2 Common symptoms of EIB include shortness of breath, wheezing, cough, and chest tightness during or immediately after exercise.1, 2 More subtle symptoms that may be suggestive of EIB include fatigue, feeling out of shape, feeling unable to keep up with peers, symptoms that occur repeatedly in specific environments (such as
Underdiagnosis
Research findings indicate that EIB is frequently underdiagnosed, possibly due to insufficient awareness of EIB and its burden and the lack of a questionnaire to screen effectively for this condition. Many individuals who report symptoms suggestive of EIB or who objectively test positive for EIB have never been formally diagnosed with EIB. In a general population survey, 26% of respondents reported experiencing respiratory symptoms with exercise, but only 5% had been diagnosed with EIB by a
Conclusion
EIB is a common condition that, when undiagnosed and untreated, may lead many individuals to forego regular exercise, which carries significant negative consequences. Detection of EIB early in life through screening may allow for early treatment, resulting in increased physical activity levels throughout life, improved cardiovascular conditioning, reduced rates of obesity, and better physical and emotional quality of life. Renewed efforts are needed to develop an EIB screening questionnaire by
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Exercise-induced bronchoconstriction in elite or endurance athletes:: Pathogenesis and diagnostic considerations
2020, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :Currently, there is a lack of an effective, validated screening questionnaire for EIB. This likely contributes to frequent underdiagnosis.70 However, overdiagnosis may occur when clinicians base their assessment on history alone without objective testing for accompanying BHR.2,3,70
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2020, Apunts Sports MedicineCitation Excerpt :It is characterized by breathlessness, wheezing, coughing, and chest tightness occurring during or after exercise. Asthmatic individuals react by avoiding exercise and physical activity due to a fear of experiencing EIB symptoms may be the best explanation for the lack of aerobic fitness.84 As a result, skeletal muscle deconditioning caused by hypoactivity may play a key in decreasing physical fitness levels.82
Exercise-induced bronchoconstriction update—2016
2016, Journal of Allergy and Clinical ImmunologyManagement of Intermittent and Persistent Asthma in Adolescent and High School Athletes
2020, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :They may discount exercise-induced symptoms as due to bad conditioning or a poor training day. Furthermore, EIB/EIBa is frequently underdiagnosed because of lack of awareness among athletes and athletic trainers.71,72 This lack of awareness and subsequent misperception of symptoms may lead to unnecessary morbidity and potential mortality in college athletes.
Teva Pharmaceuticals sponsored the expert panel meeting, which led to this article, but had no role in the development of this article.
Conflicts of interest: T. S. Hallstrand has received consultancy fees from Teva and Amgen; has received research support from the National Institutes of Health and Amgen; and has received lecture fees from Merck Schering Plough. J. P. Parsons has received consulting fees and travel support from Teva. C. Randolph has received consulting fees, travel support, payment for development of educational presentations from Teva; is on the American College of Allergy, Asthma & Immunology Board; has received lecture fees from AstraZeneca, Teva, Merck, GlaxoSmithKline, and Genentech; is a speaker for Med and Mylan; and is on the Teva Advisory Board. W. S. Silvers has received travel support and lecture fees from Teva. W. W. Storms has received consultancy and speaker's fees from Alcon, AstraZeneca, Bausch and Lomb, Merck; has received research support and consultancy fees from Amgen; has received research support and speaker's fees from Genentech/Novartis; has received research support from GlaxoSmithKline and Meda; has received research support, consultancy fees, and speaker's fees from Ista, Sunovion, and Teva; and has received consultancy fees from Strategic Pharmaceutical Advisors, and TREAT Foundation. J. M. Weiler has received consultancy fees and travel support from Teva and is employed by and owns stock/stock options in CompleWare Corporation. A. Bronstone is employed by BioMedEcon, LLC, which has received consultancy fees from Teva.