TY - JOUR

T1 - Beyond bronchodilation

T2 - Illuminating the performance benefits of inhaled beta2-agonists in sports

AU - Hostrup, Morten

AU - Jessen, Søren

N1 - Publisher Copyright: © 2024 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.

PY - 2024

Y1 - 2024

N2 - Given the prevalent use of inhaled beta2-agonists in sports, there is an ongoing debate as to whether they enhance athletic performance. Over the last decades, inhaled beta2-agonists have been claimed not to enhance performance with little consideration of dose or exercise modality. In contrast, orally administered beta2-agonists are perceived as being performance enhancing, predominantly on muscle strength and sprint ability, but can also induce muscle hypertrophy and slow-to-fast fiber phenotypic switching. But because inhaled beta2-agonists are more efficient to achieve high systemic concentrations than oral delivery relative to dose, it follows that the inhaled route has the potential to enhance performance too. The question is at which inhaled doses such effects occur. While supratherapeutic doses of inhaled beta2-agonists enhance muscle strength and short intense exercise performance, effects at low therapeutic doses are less apparent. However, even high therapeutic inhaled doses of commonly used beta2-agonists have been shown to induce muscle hypertrophy and to enhance sprint performance. This is concerning from an anti-doping perspective. In this paper, we raise awareness of the circumstances under which inhaled beta2-agonists can constitute a performance-enhancing benefit.

AB - Given the prevalent use of inhaled beta2-agonists in sports, there is an ongoing debate as to whether they enhance athletic performance. Over the last decades, inhaled beta2-agonists have been claimed not to enhance performance with little consideration of dose or exercise modality. In contrast, orally administered beta2-agonists are perceived as being performance enhancing, predominantly on muscle strength and sprint ability, but can also induce muscle hypertrophy and slow-to-fast fiber phenotypic switching. But because inhaled beta2-agonists are more efficient to achieve high systemic concentrations than oral delivery relative to dose, it follows that the inhaled route has the potential to enhance performance too. The question is at which inhaled doses such effects occur. While supratherapeutic doses of inhaled beta2-agonists enhance muscle strength and short intense exercise performance, effects at low therapeutic doses are less apparent. However, even high therapeutic inhaled doses of commonly used beta2-agonists have been shown to induce muscle hypertrophy and to enhance sprint performance. This is concerning from an anti-doping perspective. In this paper, we raise awareness of the circumstances under which inhaled beta2-agonists can constitute a performance-enhancing benefit.

KW - asthma

KW - athletes

KW - doping

KW - exercise

KW - performance

KW - sports

U2 - 10.1111/sms.14567

DO - 10.1111/sms.14567

M3 - Journal article

C2 - 38268072

AN - SCOPUS:85182652535

VL - 34

JO - Scandinavian Journal of Medicine & Science in Sports

JF - Scandinavian Journal of Medicine & Science in Sports

SN - 0905-7188

IS - 1

M1 - e14567

ER -