Allergy Asthma Immunol Res.  2012 Jul;4(4):192-198. 10.4168/aair.2012.4.4.192.

Seasonal Factors Influencing Exercise-Induced Asthma

• Choi IS
• Ki WJ
• Kim TO
• Han ER
• Seo IK

• KMID: 1970707
• DOI: http://doi.org/10.4168/aair.2012.4.4.192

Abstract

PURPOSE
Exercise-induced bronchoconstriction (EIB) in patients with asthma occurs more frequently in winter than in summer. The concentration of house dust mite (HDM) allergens in beds also shows seasonal variation. This study examined the relationship between seasonal differences in the prevalence of EIB and sensitization to HDMs in patients with asthma.
METHODS
The medical records of 74 young adult male patients with asthma-like symptoms who underwent bronchial challenge with methacholine, 4.5% saline and exercise, and allergen skin prick tests, were reviewed. The subjects were divided into summer (n=27), spring/fall (n=26) and winter (n=21) groups according to the season during which they underwent testing.
RESULTS
The positive responses to exercise differed according to season (48.1% in summer, 73.1% in spring/fall, and 90.5% in winter; P<0.01). In addition, the prevalence of positive responses to HDM (70.4%, 88.5%, and 95.2%, respectively; P<0.05) and pollen skin tests (37.0%, 19.2%, and 0%, respectively; P<0.01) also showed significant seasonal differences. Severe responses to 4.5% saline showed a similar trend, although it was not statistically significant (44.4%, 50.0%, and 71.4%, respectively; P=0.07). Skin test reactivity to HDMs was significantly related to maximal fall in forced expiratory volume in one second (FEV1) following exercise (r=0.302, P<0.01) and the index of airway hyperresponsiveness (AHR) to 4.5% saline (r=-0.232, P<0.05), but not methacholine (r=-0.125, P>0.05).
CONCLUSIONS
Positive skin test reactions to HDMs and EIB occurred in winter, spring/fall, and summer in decreasing order of frequency. Seasonal variation in the prevalence of EIB may be related to seasonal variation in sensitization to HDMs, accompanied by differences in indirect, but not direct, AHR.

Keyword

Asthma; bronchoconstriction; exercise; house dust mite; season

MeSH Terms

Allergens
Asthma
Asthma, Exercise-Induced
Bronchoconstriction
Forced Expiratory Volume
Humans
Male
Medical Records
Methacholine Chloride
Pollen
Prevalence
Pyroglyphidae
Seasons
Skin
Skin Tests
Young Adult
Allergens
Methacholine Chloride

Figure

• 

  Figure Comparisons of the distribution of subjects with varying degrees of airway responsiveness to methacholine and 4.5% hypertonic saline aerosols, and exercise challenges across different seasons. Mild/moderate/severe: methacholine PC20, 2-16/0.2-2/<0.2 mg/mL; 4.5% saline-PD15, 6-20/2-6/<2 mL; % fall in FEV1 after exercise, 15-25/25-50/>50%.

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