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Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes.
J Appl Physiol (1985). 2013 Nov; 115(10):1450-6.JA

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 β2-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/μmol creatinine after placebo vs. 315 ± 523 pg/μmol 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.

Authors+Show Affiliations

Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, United Kingdom;No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24030662

Citation

Simpson, A J., et al. "Effect of Terbutaline On Hyperpnoea-induced Bronchoconstriction and Urinary Club Cell Protein 16 in Athletes." Journal of Applied Physiology (Bethesda, Md. : 1985), vol. 115, no. 10, 2013, pp. 1450-6.
Simpson AJ, Tufvesson E, Anderson SD, et al. Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes. J Appl Physiol. 2013;115(10):1450-6.
Simpson, A. J., Tufvesson, E., Anderson, S. D., Romer, L. M., Bjermer, L., & Kippelen, P. (2013). Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes. Journal of Applied Physiology (Bethesda, Md. : 1985), 115(10), 1450-6. https://doi.org/10.1152/japplphysiol.00716.2013
Simpson AJ, et al. Effect of Terbutaline On Hyperpnoea-induced Bronchoconstriction and Urinary Club Cell Protein 16 in Athletes. J Appl Physiol. 2013;115(10):1450-6. PubMed PMID: 24030662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of terbutaline on hyperpnoea-induced bronchoconstriction and urinary club cell protein 16 in athletes. AU - Simpson,A J, AU - Tufvesson,E, AU - Anderson,S D, AU - Romer,L M, AU - Bjermer,L, AU - Kippelen,P, Y1 - 2013/09/12/ PY - 2013/9/14/entrez PY - 2013/9/14/pubmed PY - 2014/7/17/medline KW - Clara cell KW - epithelial injury KW - exercise-induced bronchoconstriction KW - inhaled β2-agonist SP - 1450 EP - 6 JF - Journal of applied physiology (Bethesda, Md. : 1985) JO - J. Appl. Physiol. VL - 115 IS - 10 N2 - 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 β2-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/μmol creatinine after placebo vs. 315 ± 523 pg/μmol 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. SN - 1522-1601 UR - https://www.unboundmedicine.com/medline/citation/24030662/Effect_of_terbutaline_on_hyperpnoea_induced_bronchoconstriction_and_urinary_club_cell_protein_16_in_athletes_ L2 - http://www.physiology.org/doi/full/10.1152/japplphysiol.00716.2013?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -