Exercise-induced bronchoconstriction, allergy and sports in children

Angela Klain; Mattia Giovannini; Luca Pecoraro; Simona Barni; Francesca Mori; Lucia Liotti; Carla Mastrorilli; Francesca Saretta; Riccardo Castagnoli; Stefania Arasi; Lucia Caminiti; Mariannita Gelsomino; Cristiana Indolfi; Michele Miraglia Del Giudice; Elio Novembre

doi:10.1186/s13052-024-01594-0

Exercise-induced bronchoconstriction, allergy and sports in children

Ital J Pediatr. 2024 Mar 13;50(1):47. doi: 10.1186/s13052-024-01594-0.

Authors

Angela Klain¹, Mattia Giovannini^{2

3}, Luca Pecoraro⁴, Simona Barni², Francesca Mori², Lucia Liotti⁵, Carla Mastrorilli⁶, Francesca Saretta⁷, Riccardo Castagnoli^{8

9}, Stefania Arasi¹⁰, Lucia Caminiti¹¹, Mariannita Gelsomino¹², Cristiana Indolfi¹³, Michele Miraglia Del Giudice¹³, Elio Novembre²

Affiliations

¹ Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy. klainangela95@gmail.com.
² Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy.
³ Department of Health Sciences, University of Florence, 50139, Florence, Italy.
⁴ Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126, Verona, Italy.
⁵ Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, 60123, Ancona, Italy.
⁶ Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, 70126, Bari, Italy.
⁷ Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100, Udine, Italy.
⁸ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy.
⁹ Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy.
¹⁰ Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy.
¹¹ Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98124, Messina, Italy.
¹² Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS, Catholic University of the Sacred Heart, 00168, Rome, Italy.
¹³ Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy.

Abstract

Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.

Keywords: Allergy; Asthma; Atopy; Children; Diagnosis; Exercise-induced asthma; Exercise-induced bronchoconstriction; Sport; Treatment.

Publication types

Review

MeSH terms

Asthma, Exercise-Induced* / diagnosis
Asthma, Exercise-Induced* / drug therapy
Asthma, Exercise-Induced* / epidemiology
Bronchoconstriction
Child
Exercise
Humans
Hypersensitivity*
Hypersensitivity, Immediate*
Sports*