asthma and obesity: mechanisms and clinical implications

This review will provide a succinct summary of obesity-related mechanisms and the clinical impact on asthma including highlights on recent progress. There are multiple mechanisms by which obesity can potentially worsen asthma, including its effects on pulmonary physiology and mechanics. Text Obesity is the most common asthma co-morbidity; it has been associated with increased risk for asthma exacerbations, worse respiratory symptoms and poor control. the URL). Obesity is a worldwide epidemic with a prevalence that has tripled in the last two decades. Text Google Scholar. EditorInformation It can also be found in the airways, yet it does not closely relate to BMI or plasma levels [29]. Obesity may be a risk factor for increased asthma severity and poor control in a subgroup, but not all patients, It is unlikely that there is one unique obese – asthma phenotype, The relationship between obesity and asthma is bi-directional. 2014;108(8):1100–7. With increasing adiposity, there is a corresponding increase in leptin and a reduction in adiponectin. The steady growth of researchers and clinicians in the sleep field attests to the continued interest in the scientific study of sleep and the management of patients with sleep disorders, and anyone involved in this exciting field should ... PubMed  Nitric Oxide. 2016; 54(5):601 608. Found inside – Page 28DOI: http:// dx.doi.org/10.1016/j.jaci.2014.12.1921 Baffi WC, Winnica ED, Holguin F. Asthma and obesity: Mechanisms and clinical implications. 2008;178(5):469–75. The exact mechanisms remain elusive and are probably multifactorial, stemming from mechanical alterations of the airways and lung parenchyma, to systemic and airway inflammatory and metabolic dysregulation that adversely influences lung function and or response to therapy. Clinical Implications and Brain Gut Disorders. Amendment of PDF/A standard NOTE: PRISM recommends against the use of the #other value allowed in the PRISM Platform controlled vocabulary. Early studies in asthmatic children and adults suggested that vitamin D deficiency is associated with lung function impairment, worse AHR, more severe asthma, and decreased response to corticosteroid therapy [44–46]. Arbortext Advanced Print Publisher 9.1.440/W Unicode genetic obese patients. The MetSyn has been related to asthma independently of BMI; in the Nord-Trøndelag Health Study (HUNT) study, a large European cohort study, MetSyn diagnosis was associated with incident asthma after adjusting for BMI [55]. Obesity is the most common asthma co-morbidity; it has been associated with increased risk for asthma exacerbations, worse respiratory symptoms and poor control. Obesity and asthma: an association modified by age of asthma onset. The hypothesized mechanism underlying the interrelationship between OSAS and SA is shown in Table 3. . AuthorInformation We describe the observational studies that gave rise to the idea of metabolically healthy obesity and the key parameters that can help to distinguish it from the general form of obesity. The date when a publication was published. Purpose of Review Obesity is a commonly reported comorbidity in asthma, particularly in severe asthma. P = Proof Does higher body mass index contribute to worse asthma control in an urban population? 2008;178(3):218–24. A variety of mechanisms have been proposed as drivers of the physiologic and clinical observations in obese asthmatics, including changes in adipokines; T-helper type 1 (Th-1) skewed airway inflammation; lower asymmetric dimethylarginine (ADMA) to L-arginine ratio resulting in increased oxidative stress and decreased physiologic nitric oxide (NO), a mediator in smooth muscle dilatation; reduced functional residual capacity and expiratory reserved volume due to excess abdominal adiposity; interleukin-17 (IL-17) associated airway inflammation; steroid resistance and dampened response to mitogen-activated protein (MAP) kinase phosphatase-1 (MKP-1). An immunologic mechanism for the association between obesity and asthma. uuid:19c1b202-47f9-4c34-a6bc-e036b0c18219 MajorVersionDate Prism 28 Obesity has been linked to asthma in many ways. The mechanisms underlying the obesity-asthma Weight reduction improves a number of clinical asthma association remain largely unknown, but are likely outcomes, including health status and quality of life in to include common aetiological factors (e.g. Depression is another co-morbidity that is more common in obese subjects, is independently associated with poor control, and in one study, it has been shown to mediate symptoms between increased BMI and asthma [52, 53]. Obesity is the most common asthma co-morbidity; it has been associated with increased risk for asthma exacerbations, worse respiratory symptoms and poor control. Respir Med. 2002;57(7):581–5. Are patients with asthma at increased risk of coronary heart disease? pdfx Found insideThe book is divided into 9 modules and 5 appendices each of which covers aspects of obesity and its comorbidities. Within each module, a case is detailed with relevant history, laboratory and physical data, and follow-up information. The exact mechanisms remain elusive and are probably multifactorial, stemming from mechanical alterations of the airways and lung parenchyma, to systemic and airway inflammatory and . Evidence from cross-sectional studies suggests that obese individuals are at increased risk of asthma and that obese individuals with asthma have more severe asthma, experience a greater number of hospitalizations, and make a greater number of emergency room visits. Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation. 2014;146(2):348–54. Springer Nature. As in many illnesses, psychological variables may affect outcome in asthma via their effects on treatment adherence and symptom reporting. Abstract. Boulet LP, Turcotte H, Boulet G, Simard B, Robichaud P. Deep inspiration avoidance and airway response to methacholine: Influence of body mass index. Wells SM, Holian A. Asymmetric dimethylarginine induces oxidative and nitrosative stress in murine lung epithelial cells. Introduction. Bag AuthorInformation While the clinical manifestations have been documented, the aetiologies of obese-asthma remain unclear. Cluster analysis of obesity and asthma phenotypes. While there are no pharmacologic strategies to specifically treat obese asthmatics, weight loss interventions, both surgical and nutritional, have been tested and shown to have varying degrees of effectiveness in improving the respiratory health of these patients. Text Association between asthma and serum adiponectin concentration in women. Vitamin D levels, lung function, and steroid response in adult asthma. However, in real life, comorbid diseases are very common in adult patients. 2012;141(4):895–905. Proc Am Thorac Soc. This review provides background, scientific and clinical rationale, and progress to date for various therapeutic approaches to stress management for asthma patients. Obesity and asthma may be determined by common genetic mechanisms. Rastogi D, Canfield SM, Andrade A, Isasi CR, Hall CB, Rubinstein A, et al. 2004;170(2):148–53. Obesity in asthma: more neutrophilic inflammation as a possible explanation for a reduced treatment response. 2008;63(1):14–20. June 2015 . internal Obese asthmatics reports worse asthma control despite traditional asthma therapy, worse asthma-specific quality of life, and higher rates of healthcare utilization; however, the mechanisms driving this association remain unclear. Google Scholar. Text Different anthropometric measures, including BMI or other adiposity indexes, have been shown to be significant determinants of asthma control for adults in some studies, even when adjusting for other confounders [11–13]. springerlink.com 2. Parental Feeding, Child Eating and Physical Activity: Differences in Children Living with and without Asthma. A different question, however, is the role of obesity as a co-morbidity. Written by an international team of physicians experienced in all aspects of asthma care, this opportune work defines, with exceptional clarity, the atopic and environmental risk factors attributable to fatal asthma-recommending means of ... Although these results strongly suggest a potential causal relationship, they were based on self-reported asthma and therefore more susceptible to diagnostic biases. Company Adobe PDF Schema 2008;63(10):877–82. (See "An overview of asthma management".) Gives the ORCID of an editor. Obesity and symptoms of depression contribute independently to the poor asthma control of obesity. 1). 3. Airway and plasma leptin and adiponectin in lean and obese asthmatics and controls. http://www.niso.org/schemas/jav/1.0/ Lv N, Xiao L, Camargo CA, Jr., Wilson SR, Buist AS, Strub P, et al. Epub 2011 Sep 14. Found insideThis complete reference works is a must have resource for anyone working in endocrinology, osteology, bone biology, or cancer research. *Most comprehensive, up-to-date two-volume set on Vitamin D *New chapters on squamous cell cancer, brain ... J Allergy Clin Immunol. National prevalence data from the CDC as of 2018 show that more than 5.5 million children and adolescents . Epidemiologic research: Understanding disparities in pulmonary health outcomes at a national level. Body mass index is a stronger predictor than the metabolic syndrome for future asthma in women. Introduction. 2008;102(1):102–8. These diseases erode the health and well-being of the patients and have a negative impact on families and societies. springer.com This inverse association may be secondary to an imbalance between L-arginine, the precursor of NO and substrate for inducible nitric oxide synthase (iNOS), and asymmetric di-methyl arginine (ADMA), which is an endogenous inhibitor of all NOS enzymes that produce NO [34]. 2004;84(3):731–65. J Allergy Clin Immunol. Disclaimer, National Library of Medicine Numerous historical and prospective cohort studies have investigated the effects of maternal asthma on pregnancy outcome; however, the data has been conflicting and many studies have not used standard classifications for asthma severity. 2010;7(5):325–35. Found inside – Page 574Basic Mechanisms and Clinical Management Peter J. Barnes, Jeffrey M. Drazen, ... The mechanisms and implications of these findings were unclear, ... Proc Am Thorac Soc. Am J Respir Crit Care Med. Adiposity, fractional exhaled nitric oxide, and asthma in U.S. children. Found inside – Page 110Evidence of a role of tumor necrosis factor alpha in refractory asthma. ... Leung DY, Asthma Clinical Research N. Cluster analysis of obesity and asthma ... Text Mirrors crossmark:MajorVersionDate © 2021 BioMed Central Ltd unless otherwise stated. Mechanisms of Obese Asthma. 2016-11-04 Asthma Research and Practice Holguin F, Comhair SA, Hazen SL, Powers RW, Khatri SS, Bleecker, et al. Given that on average obese asthmatics, both children and adults, are more symptomatic and poorly controlled, it is not surprising that studies have shown them to have increased rates of healthcare utilization and greater healthcare expenditure [5, 6], though this has not been uniformly shown across studies [7]. 2012;7(5):e36631. For both men and women whose BMI exceeds 40, OSA is at least 10 times as common as the community norm of 2-4%. Asthmatics in this cluster are disproportionally symptomatic for the level of airway inflammation or functional impairment and have a high rate of controller medication usage and healthcare utilization. The DOI may also be used as the dc:identifier. This observation was shown in a recent study of severe asthmatics by Desai et al, in which obesity was associated with increased sub-mucosal eosinophils (yet not in the airway lumen) and with greater IL-5 sputum levels [24]. 2012;181(4):315–23. ASTHMA RESEARCH AND PRACTICE. JBI Database System Rev Implement Rep. 2015. 2,3 Asthma represents another major cause of morbidity in the United States, 4 and childhood asthma is the principal cause of chronic illness and school . Obesity has not simply changed the epidemiology of pulmonary disease, it has had a profound impact on the pathophysiology of common pulmonary diseases. 2011;48(3):217–23. https://doi.org/10.1186/s40733-015-0001-7, DOI: https://doi.org/10.1186/s40733-015-0001-7. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Obesity, metabolic dysregulation and oxidative stress in asthma. Obesity and asthma: an association modified by age of asthma onset. <, Asthma Research and Practice, 2015, doi:10.1186/s40733-015-0001-7, Asthma and obesity: mechanisms and clinical implications. However, clinical characteristics associated with the highest BMI cluster that have been consistently described across studies include having late onset asthma, lower exhaled nitric oxide (eNO) levels, less airway eosinophils, and reduced atopy [8–10]. Sutherland ER, Goleva E, Jackson LP, Stevens AD, Leung DYM. Found inside – Page 120Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep. ... Holguin F. Asthma and obesity: mechanisms and clinical implications. Dixon AE, Holguin F, Sood A, Salome CM, Pratley RE, Beuther DA, et al. 2 & Holguin, F. 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