Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 141, Issue 4, Pages 1169-1179Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2018.02.004
Keywords
Asthma; obesity; obese asthma; metabolic syndrome; microbiome
Categories
Funding
- US National Institutes of Health (NIH) [HL125666, HL119952]
- Children's Hospital of Pittsburgh of UPMC
- Klosterfrau Foundation
- NIH [HL133920, HL130847]
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Obesity is a vast public health problem and both a major risk factor and disease modifier for asthma in children and adults. Obese subjects have increased asthma risk, and obese asthmatic patients have more symptoms, more frequent and severe exacerbations, reduced response to several asthma medications, and decreased quality of life. Obese asthma is a complex syndrome, including different phenotypes of disease that are just beginning to be understood. We examine the epidemiology and characteristics of this syndrome in children and adults, as well as the changes in lung function seen in each age group. We then discuss the better recognized factors and mechanisms involved in disease pathogenesis, focusing particularly on diet and nutrients, the microbiome, inflammatory and metabolic dysregulation, and the genetics/genomics of obese asthma. Finally, we describe current evidence on the effect of weight loss and mention some important future directions for research in the field.
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