Significance of physical activity on the clinical course of bronchial asthma: a literature review

This article contains a literature review of the results of experimental and clinical studies of the influence of physical exercise on the clinical course of bronchial asthma (BA) and presents the pathophysiological mechanisms of this influence. A high prevalence of sedentary lifestyle among patients with BA, its cause, and consequences are considered. Some studies have shown that patients with BA more rarely perform physical activity, and their physical exercises are less intensive and/or take shorter time. Effects of different variants of physical exercise on patients with BA are also discussed. Regular aerobic and mixed exercises of moderate intensity reliably lead to an improvement of the quality of life, reduction of exacerbations, use of inhalators «on demand», nocturnal symptoms, and sleep; to a reduction of the hyperresponsiveness of the bronchi, eosinophil count in the sputum, levels of interleukin-6, and monocyte chemotactic factor-1; and to an increase in the level of interleukin-10. SOCS-JAK-STAT plays a role in the mechanism underlying the influence of aerobic exercises on inflammation, remodeling, and hyperresponsiveness of the airways by decreasing the expression of Th2 cytokines, chemokines, adhesion molecules, growth factors, NF-kB, and P2X7 receptors by the epithelium of the airways and by an increase in interleukin-10 level. Conclusion. Data available in the literature are obtained on small cohorts of foreign patients. Clinical data devoted to the influence of aerobic exercises on control of BA and parameters of the respiratory functions are contradictory. Further investigations are required in this field.