Study of Airway Inflammation in Relation to Exercise in Elite Athletes

High school elite training programs are today more and more under development in several 'elite sport schools' in Belgium, in order to select and train future elite athletes already at young age. Little is known about the effects of sustained training on the potential development of asthma in adolescents during lung growth. It would be of great importance to be able to select the individuals at risk to develop exercise-induced asthma, already at the start of their enrollment in the 'elite sport school. This would allow physicians to follow their lung function parameters very closely and regularly; and, if necessary, start treatment early after the first signs of exercise-induced asthma.

Study Overview

• Status: Completed
• Conditions: Exercise Induced Asthma

Detailed Description

Competitive swimmers, competitive indoor athletes and control individuals performing sports at a recreational level will be recruited for the study.

They will perform a sport-specific training (swimmers and controls: swimming for 90 minutes, indoor athletes: basketball or volleyball for 90 minutes)

Baseline measurements:

• Airway inflammation upper and lower airways will be assessed by collection of nasal fluid (nasal sponge will be inserted in nostril for 5 minutes), Fraction of exhaled Nitric Oxide measurement and sputum induction.
• Upper and lower airway symptoms will be assessed by questionnaires (SinoNasal Outcome Measure-22, Visual Analogue Score, Asthma Symptom Score and Juniper Score)
• Allergy will be assessed by skin prick test (on skin) and immunocap test (in blood, 1 tube of 10 ml).
• Lung function and nasal patency will be measured by spirometry and Peak Nasal Inspiratory Flow measurement.
• Exercise induced bronchoconstriction will be assessed by eucapnic voluntary hyperventilation test.

Measurements immediately after training:

• Collection of nasal fluid
• Assessment of upper airway symptoms (Visual Analogue Score)
• Spirometry and Fraction of Exhaled Nitric Oxide measurement
• Peak Nasal Inspiratory Flow measurement

Measurements 24 hours after training:

• Collection of nasal fluid
• Assessment of upper airway symptoms (Visual Analogue Score)
• Spirometry and Fraction of Exhaled Nitric Oxide measurement
• Peak Nasal Inspiratory Flow measurement
• Sputum induction
• Venous puncture (1 tube of 10 ml)

• Study Type: Observational
• Enrollment (Actual): 66

Contacts and Locations

Study Locations

• Belgium
  • Vlaams-Brabant
    • Leuven, Vlaams-Brabant, Belgium, 3000
      • UZ Leuven

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 25 years (ADULT, CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Competitive swimmers, competitive indoor athletes and healthy individuals

Description

Inclusion Criteria:

• Performing sports at national or international level (swimmers and indoor athletes)

Exclusion Criteria:

• Performing sport at recreational level (not more than 4 hours/week for healthy individuals)

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Competitive swimmers; Swimmers performing at national or international level
Competitive indoor athletes; Indoor athletes performing at national or international level
Healthy control individuals; Individuals performing sports at a recreational level

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Measurement of airway inflammation	Airway inflammation upper and lower airways will be assessed by collection of nasal fluid (nasal sponge will be inserted in nostril for 5 minutes), Fraction of exhaled Nitric Oxide measurement and sputum induction.	Baseline, immediately after and 24 hours after sport-specific training

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Measurement of exercise induced bronchoconstriction	Exercise induced bronchoconstriction will be assessed by eucapnic voluntary hyperventilation test.	baseline

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Detection of allergy	-Allergy will be assessed by skin prick test (on skin) and immunocap test (in blood, 1 tube of 10 ml).	baseline
Assessment of upper and lower airway symptoms	-Upper and lower airway symptoms will be assessed by questionnaires (SinoNasal Outcome Measure-22, Visual Analogue Score, Asthma Symptom Score and Juniper Score)	Baseline, immediately after and 24 hours after sport-specific training
Measurement of lung function and nasal patency	-Lung function and nasal patency will be measured by spirometry and Peak Nasal Inspiratory Flow measurement.	at baseline, immediately after and 24 hours sport-specific training

Collaborators and Investigators

• Sponsor: Universitaire Ziekenhuizen KU Leuven
• Investigators: Study Director: Sven F Seys, MSc, lab of clinical immunology, CDG 8th floor, Herestraat 49, 3000 Leuven; Study Director: Valerie Hox, MD, lab of clinical immunology, CDG 8th floor, Herestraat 49, 3000 Leuven

Publications and helpful links

General Publications

• Seys SF, Hox V, Van Gerven L, Dilissen E, Marijsse G, Peeters E, Dekimpe E, Kasran A, Aertgeerts S, Troosters T, Vanbelle V, Peers K, Ceuppens JL, Hellings PW, Dupont LJ, Bullens DM. Damage-associated molecular pattern and innate cytokine release in the airways of competitive swimmers. Allergy. 2015 Feb;70(2):187-94. doi: 10.1111/all.12540.
• Steelant B, Hox V, Van Gerven L, Dilissen E, Dekimpe E, Kasran A, Aertgeerts S, Van Belle V, Peers K, Dupont LJ, Hellings PW, Bullens DM, Seys SF. Nasal symptoms, epithelial injury and neurogenic inflammation in elite swimmers. Rhinology. 2018 Sep 1;56(3):279-287. doi: 10.4193/Rhin17.167.

Study record dates

Study Major Dates

• Study Start: December 1, 2011
• Primary Completion (Actual): August 1, 2013
• Study Completion (Actual): August 1, 2013

Study Registration Dates

• First Submitted: August 26, 2013
• First Submitted That Met QC Criteria: September 9, 2013
• First Posted (Estimate): September 13, 2013

Study Record Updates

• Last Update Posted (Actual): July 16, 2018
• Last Update Submitted That Met QC Criteria: July 12, 2018
• Last Verified: July 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Immune System Diseases; Hypersensitivity, Immediate; Bronchial Diseases; Respiratory Hypersensitivity; Hypersensitivity; Asthma; Inflammation; Asthma, Exercise-Induced
• Other Study ID Numbers: ML7650

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Overall results are presented in a closed session for participants and parents. Confidential individual data are afterwards discussed with the respective parents and participants.