141 Abnormal Immune Response Against Respiratory Pathogens in Olympic Athletes

BACKGROUND: Viruses and bacteria are important contributors to asthma exacerbations. Exercise at competitive level is believed to increase susceptibility to respiratory infections. The study aimed at investigation of the anti-infectious immune response in athletes in the context of exercise intensity, atopy and allergic diseases. METHODS: Questionnaire data were obtained from 219 Polish athletes (median age 26 years) preparing for Beijing Olympic Games during the multicenter study within the GA(2)LEN project (WP 2.8.2). Allergy Questionnaire for Athletes (AQUA) (Bonini et al 2009) was used to obtain data about symptoms and exercise pattern. Athletes were evaluated by allergist. Control group consisted of 77 healthy never-smokers (median age 29 years) not performing sport at competitive level. Serum IgG against parainfluenza virus 1,2 and 3 (PIV), respiratory syncytial virus (RSV), adenovirus and Mycoplasma pneumoniae were determined by ELISA. RESULTS: Percentage of athletes with positive serological testing was lower than percentage of HC in case of PIV (P < 0.0003), RSV (P = 0.01) and M. pneumoniae (P = 0.01). Analysis of IgG only in subjects with positive testing showed lower anti-PIV IgG levels in non-atopic athletes compared to HC (P < 0.001) and atopic athletes (P < 0.01) (median 66.0 vs 104.8 and 88.1 U/mL). In contrast, higher adenovirus IgG titres were found in atopic and non-atopic athletes as compared to HC (52.3 and 48.5 vs 36.6 EIU, P < 0.001). Positive anti-PIV serology test was most frequent in athletes with allergic rhinitis compared to asthmatic and healthy athletes (78.3 vs 50.0 and 46.8%; P = 0.002). For PIV and M. pneumoniae the difference was also seen when atopic and non-atopic athletes were compared separately with HC. Positive RSV serology was more frequent in atopic versus non-atopic athletes (76.3 vs 60.8%, P = 0.03) and in HC versus non-atopic athletes (84.4 vs 60.8%, P = 0.001) but no significant difference between atopic athletes and HC was seen. Positive RSV serology was associated with atopy (OR 2.89; 95% CI, 1.34-6.23; P = 0.007). No differences were observed with regard to exercise pattern (endurance vs non-endurance). CONCLUSIONS: Competitive sport at Olympic level may be associated with altered immune response against respiratory pathogens. For some agents this response may be affected by the atopic status.