engleski

Effect of exercise on FENO levels in climate specific environment, in children with mild to moderate persistent asthma

Background: Because of the fear from triggering exercise-induced bronchoconstriction (EIB), many asthmatic patients in pediatric population avoid participating in sport activities, which affects their quality of life. Although exercise can provoke EIB, it has been suggested that specially designed and controlled training programmes could have a positive effect on exercise capacity, lung function and problems with breathlessness, resulting in better control of the disease. Fraction of exhaled nitric oxide (FeNO) is considered to be a non- invasive marker of airway inflammation in asthmatic patients, which is why we wanted to compare its values before and after controlled physical activity and to see whether there could be an improvement in children with asthma. Method: 110 children with mild to moderate persistent asthma were recruited in paediatric pulmonology, allergology and immunology clinic of Srebrnjak Children's Hospital. All of the children participated in pulmonary rehabilitation program (PRP) for two weeks, in climate specific environment at Island Lošinj, in the Adriatic Sea. Physical program consisted of at least two hours of active exercise per day, including aerobic and anaerobic training, in combination with breathing exercises. In order to determine airway inflammation level, FeNO was measured on site using a portable FeNO device, at baseline and at the end of two week program. Results: There was a significant decrease in FeNO levels in participants two weeks after PRP, going from 27 ppb to 19 ppb (p<0.001), highlighting improvement in airway inflammation. Also, there was an improvement of running distance going from 903±272 m at baseline to 968±289 m two weeks after PRP (p<0.001), implying improved exercise capacity even in a short amount of time. Conlusion: Our results show that daily exercise could have a positive effect in children with asthma, by reducing the airway inflammation. This suggests that even a short-term program of specifically organised physical activity, under controlled conditions and in an allergen safe environment, could have a beneficial clinical effect and possibly be an important factor in patients with poor response to prescribed medication. All of this highlights the need for better understanding of exercise effect on asthma control and its potential clinical relevance.

Asthma, Exercise, Pulmonary function, Bronchoconstriction

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