Table 1.

Primary respiratory challenges in treating and managing athletes with exercise-induced bronchoconstriction (EIB) and possible solutions or suggestions.

Topic	Problem	Clinical Relevance
Pathogenesis	EIBA and EIBwA may exhibit distinct inflammatory patterns	Variations in disease response and management strategies
Hyper-responsiveness	Athletes demonstrate heightened airway sensitivity	Greater susceptibility to EIB during extended exercise or specific environmental conditions
Diagnosis	Aspecific symptoms or symptoms misattributed to other causes	Risk of delayed EIB diagnosis leading to sport changes for undiagnosed asthma
	Normal pulmonary function tests or situational variability	Potential for EIB to remain undetected in some athletes, requiring multiple tests for conclusive diagnosis
	Complex diagnosis of asthma or concurrent conditions	The risk of under- or over-treatment
Therapy	Overreliance on short-acting β2 agonists	Risk of tachyphylaxis and treatment unresponsiveness, potentially culminating in fatal asthma
	Treatment ambiguity for EIBwA	Lack of clarity on whether short-acting β2 agonists or a combination therapy with inhaled corticosteroids is more effective