![]() ![]() Minimal Amount of Exercise to Prolong Life. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. The authors declare no conflict of interest. This leads to the development of airway remodeling and to chronic asthma. This is a possible explanation for why we see a thickening of the basement membrane with increased deposition of extracellular matrix proteins like collagen and tenascin. This creates an imbalance between the proteases that degrades the extracellular matrix and the anti-proteases that inhibit proteases. The IFN gamma inhibits anti-elastase (SLP1), which implies the persistence of proteases such as metalloprotease produced by neutrophils. The elastase produced by neutrophils contributes to inhibiting anti-protease (TIMP). In addition to the production of TGF-beta, metalloprotease (MMP9), and elastase, neutrophils have a role in airway remodeling by degrading the extracellular matrix and the epithelial barrier. They have an important role in the defense of the organism with their antimicrobial activity through the generation of reactive oxygen species (ROS), the activation of protease, and the establishment of neutrophil extracellular traps (NET). Neutrophils release chemotactic factors to attract monocytes and macrophages. The Il-21 also induces the production of IL-8 while IL-6 and IL-17 increase mucus production. These two factors favor proliferation and induce the recruitment of neutrophils. The IL-17 and IL-22 are associated with the stimulation of the production of granulopoietic factors such as IL-8 and G-CSF, notably by bronchial epithelial cells. It cannot be concluded that there is a significant doping effect of beta-2 adrenergic agonists. An improvement in lung function in athletes with or without asthma, particularly in forced expiratory volume (FEV1), is found with inhaled SABA or long-acting beta-2 agonists (LABA). In the large majority of studies, there was no improvement in the performance of a healthy athlete with beta-adrenergic agonist inhalation. However, in another study, there was an increase in sprinting ability over 30 m with LABA inhalation (200 micrograms of salmeterol or 24 micrograms of formoterol) compared to a placebo. One showed no effect after inhalation of 1600 micrograms of salbutamol on sprinting performance in footballers (30 m). on the effects of acute and two-week administration of salbutamol on exercise performance, sprint of 30 s repeatability, and muscle strength in athletes without asthma and exercise-induced bronchoconstriction (EIB) showed only an improvement in sprinting ability. ![]() This could be due to a final-kick effect, or a possible beneficial effect on the sprinting abilities (maximum effort of 10–30 s) of salbutamol. Time trials seem to show beneficial effects of inhaling beta-adrenergic agonists, whereas “time to exhausting” efforts show no effect. The results of these studies vary depending on the protocol used. A significant proportion of these high-level athletes suffer from non-allergic asthma, involving the th1-th17 pathway. Inhaled corticosteroids (ICS) have a low efficacy in the treatment of asthma and EIB in elite athletes, leading to a much greater use of SABAs. Some sports lead to a higher risk of asthma than others due to the hyperventilation required over long periods of time and/or the high environmental exposure while performing the sport (for example swimming and the associated chlorine exposure). It appears that many years of intensive endurance training can provoke airway injury, EIB, and asthma in athletes without any past history of respiratory diseases. ![]() Asthma and EIB have a high prevalence in elite athletes, especially within endurance sports. This overuse of SABA by high-level athletes, therefore, raises some questions, and many explanatory hypotheses are proposed. Recently, studies based on the results of the Olympic Games revealed that athletes with confirmed asthma/airway hyperresponsiveness (AHR) or exercise-induced bronchoconstriction (EIB) outperformed their non-asthmatic rivals. These drugs are used in respiratory diseases (such as asthma) that might reduce athletes’ performances. The World Anti-Doping Code places some restrictions on prescribing inhaled β2-agonists. ![]() The use of short-acting beta-2 agonists (SABAs) is more common in elite athletes than in the general population, especially in endurance sports. ![]()
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