TY - JOUR T1 - Let research leave you breathless, not physical exercise! JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00010-2018 VL - 4 IS - 1 SP - 00010-2018 AU - Matteo Bonini AU - Omar S. Usmani Y1 - 2018/01/01 UR - http://openres.ersjournals.com/content/4/1/00010-2018.abstract N2 - Regular physical activity is strongly recommended by healthcare systems worldwide and evidence-based guidelines and is one of the most effective approaches for preventing chronic inflammatory diseases and maintaining health status [1]. Indeed, extensive evidence exists on the beneficial effect of physical training and rehabilitation programmes in asthma [2]. Physical activity has been shown to improve quality of life, exercise capacity, pulmonary function and symptoms, as well as reduce airway inflammation and bronchial responsiveness in patients with asthma [3–5]. However, intense physical exercise may trigger airway narrowing by imposing a high demand on the respiratory system, requiring subjects to ventilate primarily through the mouth and by-pass the nasal filter, with a subsequent increased pulmonary exposure to inhalant allergens, pollutants, irritants and adverse (i.e. cold, dry) environmental conditions [6]. Such airway narrowing, which transiently occurs as a result of exercise, is defined as exercise-induced bronchoconstriction (EIB) [7]. Interestingly, in a 5-year prospective study, subjects who stopped training experienced an attenuation, or in some circumstances disappearance, of EIB, whereas bronchial responsiveness, exercise-induced respiratory symptoms and eosinophilic airway inflammation increased amongst those who continued strenuous physical exercise, regardless of the pharmacological treatment strategies [8]. Put into context, ongoing intense training appears to be a causative, and not just a concomitant, factor of airway inflammation and narrowing.Proper endotyping of EIB and precision medicine strategies would allow subjects to fully profit from the very beneficial effects of exercise, without incurring health risks or affecting performances http://ow.ly/spjT30irzjX ER -