Efficacy of Antileukotriene Therapy in Exercise-Induced Bronchospasm in Skiers and Biathlonists

Though the evidence base on application of antileukotrienesin asthmatic patients with exercise-induced bronchoconstriction is plentiful, their efficacy in preventing of exercise-induced bronchospasm (EIB) in winter sports athletes without asthma remains insufficiently studied.

The aim of the investigation was to assess the efficacy of montelukast to prevent exercise-induced bronchoconstriction in skiers and biathlonists.

Materials and Methods. 92 sportsmen were examined in the preparatory period, and 78 — in the competitive period of an annual training cycle (average age 17.5±2.3 years). A control group comprised 64 healthy volunteers of the similar age, not involved in professional sports. EIB screening was performed using afield-test with training at subfreezing temperature with a dynamic spirometry assessment (ERF, MasterScreenPneumo, Jaeger, Germany). Fractional exhaled NO (FeNO) level (CLD 88 with Denox 88, Switzeland) as well as NO₂^–/NO₃^– (R&D Systems, USA) and 3-nitrothyrosine (Hycultbiotech, Netherlands) in the exhaled breeze condensate (EBC) were measured before and after the exercise. Urinary excretion of cysteinyl leukotriene E₄ (LTE₄) (AssayDesign, USA) was also studied using ELISA with the correction according to the creatinine level. Sportsmen with EIB were treated with montelukast 10 mg once daily during 10 days with the following control examination in the described manner.

Results. A total prevalence of EIB among the sportsmen in both training periods amounted to 6.5%, and was comparable with the rate in the control group. At the end of the montelukast therapy all the sportsmen demonstrated no signs of EIB. Before treatment post-exercise increase of FeNO was noted. In contrast, after the montelukast course post-exercise decrease in FeNO level (∆FeNO=–22.9%) was registered. Significant changes in EBC NO₂^–/NO₃^–, 3-nitrothyrosine, as well as in urine LTE₄ excretion were not found. However, a total concentration of NO₂^–/NO₃^– tended to decrease mainly owing to NO₂^– fraction. Sportsmen with EIB were characterized by the highest LTE₄/FeNO ratio.

Conclusion. EIB prevalence among the winter sports athletes does not exceed that of the control group. Montelukast may be used for EIB prevention in skiers and biathlonists, and its application is accompanied by a marked clinical dynamics without any changes in EBC level of NO metabolites and urinary excretion of LTE₄ at the end of a 10-day treatment period.

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Nikitina L.Y., Soodaeva S.K., Kotlyarova V.N., Petrovskaya Y.А., Shashkova Т.V., Gasymova S.Sh., Petrovsky F.I. Efficacy of Antileukotriene Therapy in Exercise-Induced Bronchospasm in Skiers and Biathlonists. Sovremennye tehnologii v medicine 2014; 6(4): 134