By: Dianna Rogan
INTRODUCTION
The rising obesity crisis has caused increased health problems worldwide. From diabetes to depression, obesity has been correlated with a number of additional health issues. Asthma is one such health condition that may be worsened due to complications caused by obesity. This, in turn, may introduce additional challenges in the treatment of asthma in obese individuals. Obesity has also been shown to increase the severity of asthma over time.
While the exact mechanisms are not yet perfectly understood, there is emerging evidence that certain pathways in the body might be suppressed or manipulated in order to successfully navigate the complications of treating asthma in patients with obesity.
HOW OBESITY AFFECTS ASTHMA
Inflammation happens when the immune system responds to stimuli in the body. The blood rushes an area of the body affection by a foreign allergen or pathogen in the body. In individuals with asthma, this leads to a chronic constriction of the airways typified by the disease.
It has been shown that obesity is a risk factor for chronic inflammation. Since a prolonged state of inflammation has been shown to result in a variety of diseases, obesity resultant inflammation may eventually cause the onset of these conditions, including asthma. (4)
According to the Center for Disease control, obesity is associated with the onset of asthma, the exacerbation of existing asthma symptoms and as well as increased difficulty in the treatment of asthma. This may be due to the fact that obesity has be linked to heightened levels of inflammation in the body, thereby initiating or increasing the inflammation. associated with asthma.
TREATMENTS
Certain standard treatments for asthma, such as inhaled corticosteroids, have been shown to be less effective in patients with obesity. This is why there is a need to develop medicines that will improve outcomes in these patients, giving them an opportunity to make more effective and long lasting lifestyle changes. This will increase their response to asthma treatments in the future.
A 2023 study conducted on obese mice, showed there may be certain biological products that are produced in higher amounts as a result of the inflammation caused by increased fat cells in the body. These products may also increase the inflammation that results in asthma attacks in these mice. The study showed that developing a treatment that interrupts this pathway, may result in a more effective treatment for asthma patients with obesity.
Another study done 2022, show the reduced expression of various inflammatory agents in patients that had lost weight through bariatric surgery, compared to when they were obese. Reducing inflammatory responses in the body by reducing fat cells, may lead to improved outcomes when treating asthma in these patients.
CONCLUSION
While loosing weight would likely improve outcomes for patients that fall into this cross section, solutions are needed in the interim phase in order to treat the asthma symptoms until more permanent changes can be made. Additional studies are needed better understand the mechanisms involved in order to develop more effective treatments.
For patients affected by these ailments, being informed about how these interactions function within the body, and the far reaching effects of conditions such as obesity, can help increase the urgency of making lasting changes. In addition, being aware of the complications that obesity may cause in the treatment of asthma will help patients to better advocate for themselves and request alternate therapies when needed.
SOURCES
Centers for Disease Control and Prevention. (2024). Asthma and Obesity. Retrieved from [https://www.cdc.gov/asthma/asthma_stats/asthma_obesity.htm#:~:text=Obesity%20is%20a%20risk%20factor,increase%20medication%20use%20and%20hospitalizations.]
Panganiban, R.A.M., Yang, Z., Sun, M. et al. Antagonizing cholecystokinin A receptor in the lung attenuates obesity-induced airway hyperresponsiveness. Nat Commun 14, 47 (2023). https://doi.org/10.1038/s41467-022-35739-8
Hiroki Tashiro, Yuki Kurihara, Yuki Kuwahara, Koichiro Takahashi. Impact of obesity in asthma: Possible future therapies,Allergology International, Volume 73, Issue 1, 2024,
Pages 48-57, ISSN 1323-8930, https://doi.org/10.1016/j.alit.2023.08.007.
M. Bantula, V. Tubita, J. Roca-Ferrer, J. Mullol, A. Valero, I. Bobolea, et al. Differences in Inflammatory Cytokine Profile in Obesity-Associated Asthma: Effects of Weight Loss. J. Clin. Med. 2022; 11(13), 3782; https://doi.org/10.3390/jcm11133782 Assessed and Endorsed by the MedReport Medical Review Board