Individuals with severe refractory asthma may benefit from high-altitude treatment, irrespective of their sensitivity to airborne allergens, suggest findings from a study conducted in the Swiss Alps.
When 137 adults with severe refractory asthma underwent 12 weeks of daily exercise at an altitude of 1600 m, a significant overall improvement was seen in clinical and functional parameters of asthma.
These postintervention improvements were accompanied by a reduction in the oral corticosteroid dose required by patients on a daily basis.
Both allergic (n=92) and nonallergic (n=45) asthma patients exhibited clinical and physiologic improvement, including asthma symptoms, quality of life, exercise performance, and lung function, after the treatment program.
"These findings suggest that high-altitude treatment is a valuable treatment option not only for patients with house dust mite allergic asthma, but also for patients with severe, refractory, nonallergic or 'intrinsic' asthma," say the authors.
The high-altitude treatment was preceded by questionnaire-based assessment of asthma control and asthma-related quality of life. Patients also underwent clinical tests to determine sino-nasal symptoms, medication requirement, postbronchodilator forced expiratory volume in 1 second, 6-minute walking distance, total immunoglobulin (Ig)E, blood eosinophil levels, and exhaled nitric oxide fraction levels.
All tests were repeated at the end of the 12-week treatment program.
At this time, only patients with allergic asthma showed improvement in the atopy parameters, namely, IgE, exhaled nitric oxide, and blood eosinophil levels.
Lucia Rijssenbeek-Nouwens (Dutch Asthma Centre Davos, Switzerland) and co-authors hypothesize that the beneficial effect of high-altitude treatment on asthma may relate to the very low levels of allergens and pollution in the Alps.
The authors also suggest that high-altitude environments may improve asthma symptoms because at such heights, air viscosity and oxygen pressure are lower than at sea level. This, in turn, facilitates full lung expansion and makes it easier to breathe.
Rijssenbeek-Nouwens et al conclude: "Because of its beneficial effects on asthma control, exercise capacity and corticosteroid requirement, it [high altitude treatment] should be offered to all patients with severe refractory asthma, including middle-aged and older adults with intrinsic disease."
The study is published in the European Respiratory Journal.
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