Combining a β2-agonist with a face mask to prevent exercise-induced bronchoconstriction

Background: In this study, we aimed to test the effect of combining a beta(2)-agonist with a heat- and moisture-exchanging cellulose face mask in patients with bronchoconstriction induced by exercise in cold air. Methods: Nine allergic, asthmatic patients with a history of adverse reaction to exercise were tested on an ergometric bicycle at a temperature of approximately -10 degrees C. They were in turn given no treatment, given premedication with a beta(2)-agonist, allowed to breathe through a heat- and moisture-exchanging cellulose face mask, and given both premedication and the face mask. After each treatment regimen, they were subjected to provocation with exercise and cold air. Results: The decrease in FEV1 was greatest with no therapy (mean maximal change: 27%) and this diminished when the face mask was used (mean maximal change: 12%) or premedication with a beta(2)-agonist was given (mean maximal change: 7%); no decrease in FEV1 occurred with the combination of agonist and face mask. Conclusions: The results suggest that different mechanisms are involved in the pathophysiology of exercise-induced bronchoconstriction (EIB). This finding may be of importance for asthmatic athletes who train and compete in a cold climate and are affected by small changes in their lung function.