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Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes

Simpson, A. J. ; Tufvesson, Ellen LU ; Anderson, S. D. ; Romer, L. M. ; Bjermer, Leif LU and Kippelen, P. (2013) In Journal of Applied Physiology 115(10). p.1450-1456
Abstract
Repeated injury of the airway epithelium caused by hyperpnoea of poorly conditioned air has been proposed as a key factor in the pathogenesis of exercise-induced bronchoconstriction (EIB) in athletes. In animals, the short-acting beta(2)-agonist terbutaline has been shown to reduce dry airflow-induced bronchoconstriction and the associated shedding of airway epithelial cells. Our aim was to test the efficacy of inhaled terbutaline in attenuating hyperpnoea-induced bronchoconstriction and airway epithelial injury in athletes. Twenty-seven athletes with EIB participated in a randomized, double-blind, placebo-controlled, crossover study. Athletes completed an 8-min eucapnic voluntary hyperpnoea (EVH) test with dry air on two separate days 15... (More)
Repeated injury of the airway epithelium caused by hyperpnoea of poorly conditioned air has been proposed as a key factor in the pathogenesis of exercise-induced bronchoconstriction (EIB) in athletes. In animals, the short-acting beta(2)-agonist terbutaline has been shown to reduce dry airflow-induced bronchoconstriction and the associated shedding of airway epithelial cells. Our aim was to test the efficacy of inhaled terbutaline in attenuating hyperpnoea-induced bronchoconstriction and airway epithelial injury in athletes. Twenty-seven athletes with EIB participated in a randomized, double-blind, placebo-controlled, crossover study. Athletes completed an 8-min eucapnic voluntary hyperpnoea (EVH) test with dry air on two separate days 15 min after inhaling 0.5 mg terbutaline or a matching placebo. Forced expiratory volume in 1 s (FEV1) and urinary concentration of the club cell (Clara cell) protein 16 (CC16, a marker of airway epithelial perturbation) were measured before and up to 60 min after EVH. The maximum fall in FEV1 of 17 +/- 8% (SD) on placebo was reduced to 8 +/- 5% following terbutaline (P < 0.001). Terbutaline gave bronchoprotection (i.e., post-EVH FEV1 fall <10%) to 22 (81%) athletes. EVH caused an increase in urinary excretion of CC16 in both conditions (P < 0.001), and terbutaline significantly reduced this rise (pre- to postchallenge CC16 increase 416 +/- 495 pg/mu mol creatinine after placebo vs. 315 +/- 523 pg/mu mol creatinine after terbutaline, P = 0.016). These results suggest that the inhalation of a single therapeutic dose of terbutaline offers significant protection against hyperpnoea-induced bronchoconstriction and attenuates acute airway epithelial perturbation in athletes. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
exercise-induced bronchoconstriction, epithelial injury, inhaled, beta(2)-agonist, Clara cell
in
Journal of Applied Physiology
volume
115
issue
10
pages
1450 - 1456
publisher
American Physiological Society
external identifiers
  • wos:000327398600005
  • scopus:84888391102
  • pmid:24030662
ISSN
1522-1601
DOI
10.1152/japplphysiol.00716.2013
language
English
LU publication?
yes
id
2087defd-5884-4519-8a04-c8c55fae24ee (old id 4274268)
date added to LUP
2016-04-01 10:52:17
date last changed
2020-03-03 01:48:22
@article{2087defd-5884-4519-8a04-c8c55fae24ee,
  abstract     = {Repeated injury of the airway epithelium caused by hyperpnoea of poorly conditioned air has been proposed as a key factor in the pathogenesis of exercise-induced bronchoconstriction (EIB) in athletes. In animals, the short-acting beta(2)-agonist terbutaline has been shown to reduce dry airflow-induced bronchoconstriction and the associated shedding of airway epithelial cells. Our aim was to test the efficacy of inhaled terbutaline in attenuating hyperpnoea-induced bronchoconstriction and airway epithelial injury in athletes. Twenty-seven athletes with EIB participated in a randomized, double-blind, placebo-controlled, crossover study. Athletes completed an 8-min eucapnic voluntary hyperpnoea (EVH) test with dry air on two separate days 15 min after inhaling 0.5 mg terbutaline or a matching placebo. Forced expiratory volume in 1 s (FEV1) and urinary concentration of the club cell (Clara cell) protein 16 (CC16, a marker of airway epithelial perturbation) were measured before and up to 60 min after EVH. The maximum fall in FEV1 of 17 +/- 8% (SD) on placebo was reduced to 8 +/- 5% following terbutaline (P &lt; 0.001). Terbutaline gave bronchoprotection (i.e., post-EVH FEV1 fall &lt;10%) to 22 (81%) athletes. EVH caused an increase in urinary excretion of CC16 in both conditions (P &lt; 0.001), and terbutaline significantly reduced this rise (pre- to postchallenge CC16 increase 416 +/- 495 pg/mu mol creatinine after placebo vs. 315 +/- 523 pg/mu mol creatinine after terbutaline, P = 0.016). These results suggest that the inhalation of a single therapeutic dose of terbutaline offers significant protection against hyperpnoea-induced bronchoconstriction and attenuates acute airway epithelial perturbation in athletes.},
  author       = {Simpson, A. J. and Tufvesson, Ellen and Anderson, S. D. and Romer, L. M. and Bjermer, Leif and Kippelen, P.},
  issn         = {1522-1601},
  language     = {eng},
  number       = {10},
  pages        = {1450--1456},
  publisher    = {American Physiological Society},
  series       = {Journal of Applied Physiology},
  title        = {Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes},
  url          = {http://dx.doi.org/10.1152/japplphysiol.00716.2013},
  doi          = {10.1152/japplphysiol.00716.2013},
  volume       = {115},
  year         = {2013},
}