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      Dehydration affects exercise-induced asthma and anaphylaxis

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          Abstract

          Allergies are generally triggered by food, medication, physical exercise, stress, alcohol consumption, and dehydration. There are reports that indicate dehydration affects various kinds of physical allergies. However, there are few studies that have focused on the effects of dehydration on asthma and allergy anaphylaxis. Therefore, we analyzed the effects of dehydration on several kinds of allergy responses and exercise-induced asthma especially during the endurance exercise. PubMed was searched from April to July of 2019 using predefined search terms “dehydration,” “exercise,” and “allergy responses.” Based on the reference search, more than one-hundred articles were identified but eighteen papers met the inclusion criteria and were analyzed for connections among exercise and dehydration, dehydration and exercise-induced asthma, and allergy responses in the main text. Results suggest that dehydration directly impairs stroke volume, cardiac output, and skin blood flow. This results in larger increases in core temperature, heart rate, and stroke volume. Additionally, exercise-induced dehydration reduces airway surface hydration, which results in an amplified brocnchoconstriction. This response to exercise occurs in those who suffer from exercise-induced asthma. Moreover, damage to the gut and impaired gut function relates to increased intestinal permeability after endurance exercise. Endurance exercise changes the immunological profiles to activate antibody-mediated immunity. Also, numerous mast cells and eosinophils were recruited, therefore isotype switching to IgE antibodies occur, this hypersensitivity activates mast cell degranulation. After degranulation, proteases, leukotrienes, prostaglandins, and histamine lead to many kinds of allergy symptoms.

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          Most cited references18

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          The impact of physical exercise on the gastrointestinal tract.

          Physical exercise can be both beneficial and harmful for the gastrointestinal tract in a dose-effect relationship between its intensity and health. Mild-to-moderate intensity exercises play a protective role against colon cancer, diverticular disease, cholelithiasis and constipation, whereas acute strenuous exercise may provoke heartburn, nausea, vomiting, abdominal pain, diarrhea and even gastrointestinal bleeding. This review focuses on mechanisms involved in those symptoms and their associations with type of exercises in humans. One quarter to one half of elite athletes are hampered by the gastrointestinal symptoms that may deter them from participation in training and competitive events. Vigorous exercise-induced gastrointestinal symptoms are often attributed to altered motility, mechanical factor or altered neuroimmunoendocrine secretions. Training, lifestyle modifications, meal composition, adequate hydration and avoidance of excessive use of some medications are the recommendations. Strenuous exercise and dehydrated states would be the causes of gastrointestinal symptoms referred by 70% of the athletes. Gut ischemia would be the main cause of nausea, vomiting, abdominal pain and (bloody) diarrhea. The frequency is almost twice as high during running than during other endurance sports as cycling or swimming and 1.5-3.0 times higher in the elite athletes than the recreational exercisers.
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            Airway injury as a mechanism for exercise-induced bronchoconstriction in elite athletes.

            Exercise-induced bronchoconstriction (EIB) is a consequence of evaporative water loss in conditioning the inspired air. The water loss causes cooling and dehydration of the airway surface. One acute effect of dehydration is the release of mediators, such as prostaglandins, leukotrienes, and histamine, that can stimulate smooth muscle, causing contraction and a change in vascular permeability. Inspiring cold air increases dehydration of the surface area and causes changes in bronchial blood flow. This article proposes that the pathogenesis of EIB in elite athletes relates to the epithelial injury arising from breathing poorly conditioned air at high flows for long periods of time or high volumes of irritant particles or gases. The evidence to support this proposal comes from many markers of injury. The restorative process after injury involves plasma exudation and movement of cells into the airways, a process repeated many times during a season of training. This process has the potential to expose smooth muscle to a wide variety of plasma- and cell-derived substances. The exposure to these substances over time can lead to an alteration in the contractile properties of the smooth muscle, making it more sensitive to mediators of bronchoconstriction. It is proposed that cold-weather athletes have airway hyperresponsiveness (AHR) to pharmacologic agents as a result of epithelial injury. In those who are allergic, AHR can also be expressed as EIB. The role of beta(2)-receptor agonists in inhibiting and enhancing the development of AHR and EIB is discussed.
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              Effects of exercise on mesenteric blood flow in man.

              M Qamar, A READ (1987)
              Transcutaneous Doppler ultrasound was used to assess the effects of exercise on both fasting and postprandial superior mesenteric artery blood flow. After treadmill exercise (speed 5 km/h, gradient 20%, duration 15 min) in 16 subjects, superior mesenteric artery blood flow decreased by 43% immediately after the end of the exercise and by 29% at five minutes and 24% at 10 minutes postexercise. The superior mesenteric artery blood flow response to a combination of a treadmill exercise and a liquid meal in 15 volunteers was significantly smaller at five minutes from the end of the stimuli, than the response to the meal alone (15 controls) (635 +/- 51 ml/min v 846 +/- 72 ml/min) (p less than 0.025), but not different at any other time. Thus exercise reduces mesenteric blood flow in both the fasting and postprandial state in normal subjects.
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                Author and article information

                Journal
                J Exerc Rehabil
                J Exerc Rehabil
                Journal of Exercise Rehabilitation
                Korean Society of Exercise Rehabilitation
                2288-176X
                2288-1778
                October 2019
                28 October 2019
                : 15
                : 5
                : 647-650
                Affiliations
                [1 ]Youngsan Health Science Institute, Department of Marine Leisure and Tourism, Youngsan University, Busan, Korea
                [2 ]DEU Exe-Physio Lab, Department of Physical Education, Dong-Eui University, Busan, Korea
                Author notes
                [* ]Corresponding author: Yi-Sub Kwak, https://orcid.org/0000-0003-4545-7250, Department of Physical Education, College of Arts, Design and Sports Science, Dong-Eui University, 176 Eomgwang-ro, Busanjin-gu, Busan 47340, Korea, E-mail: ysk2003@ 123456deu.ac.kr
                Author information
                http://orcid.org/0000-0003-4545-7250
                Article
                jer-15-5-647
                10.12965/jer.1938470.235
                6834710
                31723551
                4f506e09-09b0-4698-ab6e-ad5a97a1d23e
                Copyright © 2019 Korean Society of Exercise Rehabilitation

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 August 2019
                : 9 September 2019
                Categories
                Review Article

                dehydration,intestinal immunity,bronchoconstriction,iso-type switching,anaphylaxis

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