Review. Occurrence of exercise-induced bronchospasm in high-level athletes: prevalence, pathogenesis, diagnosis and treatment
DOI:
https://doi.org/10.32782/2415-8127.2026.73.12Keywords:
cardiopulmonary exercise test, airway dehydration, airway hydration, elite athletes, exercise-induced bronchospasmAbstract
Exercise induced bronchospasm (EIB) is a common respiratory condition observed in elite athletes and represents an important clinical and sports medicine challenge. Intense physical activity is associated with a significant increase in pulmonary ventilation, which may lead to airway cooling, dehydration of the bronchial mucosa, development of a hyperosmotic environment, and activation of inflammatory pathways. According to recent studies, the prevalence of EIB in the general population ranges from 7% to 10%, while among elite athletes it may reach 20–50%, particularly in sports requiring prolonged aerobic effort.
Objective: To analyze To summarize current scientific evidence regarding the prevalence, pathophysiological mechanisms, clinical manifestations, diagnostic approaches, and strategies for prevention and treatment of exercise induced bronchospasm in elite athletes.
A structured review of scientific publications indexed in international databases including Medline, PubMed, Google Scholar, and Scopus was performed. Literature searches were conducted using the following keywords: exercise induced bronchospasm, elite athletes, sports asthma, spirometry, bronchial provocation tests, and cardiopulmonary exercise testing. Clinical studies, narrative reviews, and guideline based publications related to respiratory disorders in athletes were analyzed.
The analysis demonstrated that the development of EIB is associated with several key mechanisms, including hyperventilation, osmotic changes in airway surfaces, bronchial cooling, and repeated microtrauma of the airway epithelium caused by high ventilation rates during intense training. These processes activate inflammatory cells and mediators, particularly leukotrienes, resulting in increased bronchial hyperresponsiveness and potential airway remodeling. Clinical manifestations may include dyspnea, cough, chest tightness, wheezing, and reduced exercise performance; however, the condition may remain asymptomatic in some athletes. Diagnosis relies on objective assessment of lung function using spirometry, bronchodilator reversibility testing, bronchial provocation tests, and exercise challenge tests, including eucapnic voluntary hyperventilation.
Exercise induced bronchospasm is a prevalent and clinically significant condition in elite athletes that may adversely affect athletic performance and respiratory health. Due to the nonspecific nature of symptoms, accurate diagnosis requires the use of standardized functional tests. Early detection, environmental control, and the application of modern pharmacological and non pharmacological interventions may significantly reduce symptoms and improve both respiratory health and athletic performance.
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