Nedocromil sodium and diphenhydramine HCl ameliorate exercise-induced arterial hypoxemia in highly trained athletes

Physiol Rep. 2022 Jan;10(1):e15149. doi: 10.14814/phy2.15149.

Abstract

Introduction: Exercise-induced arterial hypoxemia (EIAH) has been observed in highly trained endurance athletes during near maximal exercise, which may be influenced by a histamine-mediated inflammatory response at the pulmonary capillary-alveolar membrane. In order to test this hypothesis, we examined whether the mast cell stabilizer nedocromil sodium (NS) and H1 -receptor antagonist diphenhydramine HCL (DH) would ameliorate EIAH and mitigate the drop in arterial oxyhemoglobin saturation (Sa O2 ) during intensive exercise.

Methods: Seven highly trained male cross country runners (age, 21 ± 2 years; V̇O2max , 74.7 ± 3.5 ml·kg-1 ·min-1 ) participated in the study. All subjects completed a maximal exercise treadmill test to exhaustion, followed by three 5-min constant-load exercise bouts at 70%, 80%, and 90% V̇O2max . Prior to testing, subjects received either placebo (PL), NS, or DH.

Results: Compared to PL, there was a significant treatment effect on Sa O2 (p < 0.001) for both NS and DH during both constant-load exercise and at V̇O2max . Post hoc tests revealed Sa O2 values, compared to PL, were significantly higher at V̇O2max and during DH trials and higher with NS at constant-load intensities except at 70% (p = 0.13).

Conclusion: The findings provide further evidence that histamine contributes directly or indirectly to the development of EIAH during intense exercise in highly trained athletes.

Keywords: blood-gas barrier; gas exchange; histamine; interstitial pulmonary edema.

MeSH terms

  • Adult
  • Athletes
  • Diphenhydramine / therapeutic use
  • Exercise / physiology
  • Exercise Test
  • Humans
  • Hypoxia* / drug therapy
  • Male
  • Nedocromil* / therapeutic use
  • Oxygen
  • Oxygen Consumption / physiology
  • Young Adult

Substances

  • Nedocromil
  • Diphenhydramine
  • Oxygen