Reviews and feature articleObesity and asthma
Section snippets
Obesity and asthma: Adults
Data noted in the literature regarding obesity and asthma are inconsistent. It is generally accepted that obesity is a risk factor for adult asthma. Ten years ago a workshop report of the American Thoracic Society officially documented obesity as a risk factor for asthma in all demographic groups.1 Asthma in the obese may represent a unique phenotype of asthma, with a more severe disease outcome that does not respond as well to conventional therapy. Factors that could contribute to the
Experimental models
The development of allergic and other noncommunicable systemic diseases is a multifactorial process in which, besides genetic predisposition, the environment (allergen exposure, nutrients) and immunologic mechanisms play a decisive role. In particular, the highly complex interactions of different cell types of the immune system and tissues cannot be imitated in vitro. Therefore, mouse models offer the opportunity to study the complex interactions between the fatty tissue and the inflammatory
Detailed metabolic assessment: Immune-metabolic interventions
Association of asthma and obesity has been demonstrated in numerous epidemiological studies; however, the exact underlying mechanisms and detailed pathogenic link for this association are not well understood. A large number of factors are postulated including inflammation and immunometabolic dysregulation,50, 51, 52, 53, 54 microbial dysbiosis,55 mitochondrial dysfunction,56 free fatty acid receptors,57 glucagon-like peptide pathway,58 and innate lymphoid cells (Fig 1).28
It has been shown that
Is asthma a risk factor for obesity?
Several studies have shown the correlation between childhood obesity and the resulting increased risk for developing asthma.102 So far little is known about the reversed order of asthmatic children having a higher risk for obesity incidence. A longitudinal study in the United States of early-life history of asthma demonstrated a higher risk of becoming obese in later childhood and adolescence.19 A European study demonstrated that not only asthma but also childhood wheezing and allergic rhinitis
Conclusions
Recent clinical, epidemiological, and experimental data strengthen the cause-effect relationship between obesity and asthma. Obesity is the result of metabolic dysregulation on the level of sugar and lipid metabolites. The adipose tissue is functionally highly active, which is reflected by the presence of local and systemic subclinical inflammation. This inflammatory response seems to contribute to airway inflammation, lung function, and asthma exacerbation. However, many open questions remain,
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H.R. is supported by the German Lung Centre (DZL).
Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.
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