TY - JOUR T1 - Activation of epithelial and inflammatory pathways in adolescent elite athletes exposed to intense exercise and air pollution JF - Thorax JO - Thorax DO - 10.1136/thorax-2022-219651 SP - thorax-2022-219651 AU - Janne Goossens AU - Anne-Charlotte Jonckheere AU - Sven F Seys AU - Ellen Dilissen AU - Tatjana Decaesteker AU - Camille Goossens AU - Koen Peers AU - Vincent Vanbelle AU - Jeroen Stappers AU - Sven Aertgeerts AU - Barbara De Wilde AU - Jasmine Leus AU - Sophie Verelst AU - Marc Raes AU - Lieven Dupont AU - Dominique M Bullens Y1 - 2023/03/16 UR - http://thorax.bmj.com/content/early/2023/03/16/thorax-2022-219651.abstract N2 - Rationale Participation in high-intensity exercise in early life might act as stressor to the airway barrier.Objectives To investigate the effect of intense exercise and associated exposure to air pollution on the airway barrier in adolescent elite athletes compared with healthy controls and to study exercise-induced bronchoconstriction (EIB) in this population.Methods Early-career elite athletes attending ‘Flemish-Elite-Sports-Schools’ (12–18 years) of 4 different sport disciplines (n=90) and control subjects (n=25) were recruited. Presence of EIB was tested by the eucapnic voluntary hyperventilation (EVH) test. Markers at mRNA and protein level; RNA-sequencing; carbon load in airway macrophages were studied on induced sputum samples.Results 444 genes were differentially expressed in sputum from athletes compared with controls, which were related to inflammation and epithelial cell damage and sputum samples of athletes contained significantly more carbon loaded airway macrophages compared with controls (24%, 95% CI 20% to 36%, p<0.0004). Athletes had significantly higher substance P (13.3 pg/mL, 95% CI 2.0 to 19.2) and calprotectin (1237 ng/mL, 95% CI 531 to 2490) levels as well as IL-6, IL-8 and TNF-α mRNA levels compared with controls (p<0.05). The incidence of EIB in athletes was 9%. The maximal fall in forced expiratory volume in 1 s (%) after EVH test in athletes was significantly associated with prior PM10 and PM2.5 exposure.Conclusion Early-career elite athletes showed increased markers of air pollution exposure, epithelial damage and airway inflammation compared with controls. Acute exposure to increased air pollution PM10 levels was linked to increased airway hyper-reactivity.Trial registration number NCT03587675.Data are available in a public, open access repository. We will provide the data in open access to allow analysis over different study cohorts in for example a systematic review. ER -