title: Obesity and asthma: beyond T(H)2 inflammation.
abstract: Obesity is a major risk factor for asthma. Likewise, obesity is known to increase disease severity in asthmatic subjects and also to impair the efficacy of first-line treatment medications for asthma, worsening asthma control in obese patients. This concept is in agreement with the current understanding that some asthma phenotypes are not accompanied by detectable inflammation, and may not be ameliorated by classical anti-inflammatory therapy. There are growing evidences suggesting that the obesity-related asthma phenotype does not necessarily involve the classical T(H)2-dependent inflammatory process. Hormones involved in glucose homeostasis and in the pathogeneses of obesity likely directly or indirectly link obesity and asthma through inflammatory and non-inflammatory pathways. Furthermore, the endocrine regulation of the airway-related pre-ganglionic nerves likely contributes to airway hyperreactivity (AHR) in obese states. In this review, we focused our efforts on understanding the mechanism underlying obesity-related asthma by exploring the T(H)2-independent mechanisms leading to this disease.
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
authors.forename: Luiz O S
authors.initials: LO
authors.lastname: Leiria
authors.affiliation: Department of Medicine, School of Medicine, University de São Paulo, São Paulo, SP, Brazil.
authors.forename: Milton A
authors.initials: MA
authors.lastname: Martins
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil. Electronic address: msaad@fcm.unicamp.br.
authors.forename: Mário J A
authors.initials: MJ
authors.lastname: Saad
mesh_terms: D052242:Adiponectin / Q000097:blood / Q000378:metabolism; D000273:Adipose Tissue / Q000276:immunology* / Q000378:metabolism; D050154:Adiposity; D000403:Airway Resistance; D000818:Animals; D001249:Asthma / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D020738:Leptin / Q000097:blood / Q000378:metabolism; D008954:Models, Biological; D009765:Obesity / Q000097:blood / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D018418:Th2 Cells / Q000276:immunology* / Q000378:metabolism
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D020738:Leptin
keywords: Adiponectin; Airway hyperreactivity; Insulin; Leptin