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Increasing proportions of young athletes are atopic, i.e. they show signs of IgE\u2010mediated allergy which is, along with the sport event (endurance sport), a major risk factor for asthma and respiratory symptoms. Mechanisms in the etiology and clinical phenotypes vary between disciplines and individuals, and it may be an oversimplification to discuss athlete\u2019s asthma as a distinct and unambiguous disease. Nevertheless, the experience on Finnish Olympic athletes suggests at least two different clinical phenotypes, which may reflect different underlying mechanisms. The pattern of \u2018classical asthma\u2019 is characterized by early onset childhood asthma, methacholine responsiveness, atopy and signs of eosinophilic airway inflammation, reflected by increased exhaled nitric oxide levels. Another distinct phenotype includes late onset symptoms (during sports career), bronchial responsiveness to eucapnic hyperventilation test, but not necessarily to inhaled methacholine, and a variable association with atopic markers and nitric oxide. A mixed type of eosinophilic and neutrophilic airway inflammation seems to affect especially swimmers, ice\u2010hockey players, and cross\u2010country skiers. The inflammation may represent a multifactorial trauma, in which both allergic and irritant mechanisms play a role. There is a significant problem of both under\u2010 and overdiagnosing asthma in athletes and the need for objective testing is emphasized. Follow\u2010up studies are needed to assess the temporal relationship between asthma and competitive sporting, taking better into account individual disposition, environmental factors (exposure), intensity of training and potential confounders.<\/jats:p>","DOI":"10.1111\/j.1398-9995.2008.01686.x","type":"journal-article","created":{"date-parts":[[2008,4,25]],"date-time":"2008-04-25T13:45:45Z","timestamp":1209131145000},"page":"685-694","source":"Crossref","is-referenced-by-count":63,"title":["Mechanisms of asthma in Olympic athletes \u2013 practical implications"],"prefix":"10.1111","volume":"63","author":[{"given":"T.","family":"Haahtela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Malmberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,4,25]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"472","article-title":"Respiratory heat and water loss during exercise in patients with asthma. 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