title: Airway Hyperresponsiveness to Mannitol in Obesity Before and After Bariatric Surgery.
abstract: BACKGROUND
  The relationship between airway hyperresponsiveness (AHR) and obesity, a low-grade systemic inflammatory condition, remains largely unknown. It is established that AHR to indirect stimuli is associated with active airway inflammation. The objectives were to investigate the rate of AHR to mannitol in obese subjects and its changes 1 year after bariatric surgery (BS).
  
  
  METHODS
  We enrolled 58 candidates to BS severely obese (33 nonsmokers and 25 smokers) without history of asthma and 20 healthy, nonobese participants and related AHR to functional findings and serum and exhaled biomarkers.
  
  
  RESULTS
  Before surgery, AHR was observed in 16 (28 %) obese with the provocation doses of mannitol to induce a 15 % fall in FEV1 (PD15) of (geometric mean [95 % CI]) 83 (24-145) mg. Compared to control participants, obese participants had lower spirometric values and higher serum and exhaled biomarkers (p < 0.05 each). After surgery, AHR was abolished (p < 0.01) in all but four obese subjects.
  
  
  CONCLUSIONS
  Weight loss induced by BS was the key independent factor associated to AHR improvement. AHR to mannitol is highly prevalent in obesity, and it is largely abolished by BS.
authors.affiliation: Servei de Pneumologia (Institut del Tòrax), and Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain.
authors.forename: Ebymar
authors.initials: E
authors.lastname: Arismendi
authors.forename: Eva
authors.initials: E
authors.lastname: Rivas
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
authors.forename: Esther
authors.initials: E
authors.lastname: Barreiro
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torralba
authors.forename: Felip
authors.initials: F
authors.lastname: Burgos
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez-Roisin
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D016535:Bronchial Hyperreactivity / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology; D016085:Bronchoconstrictor Agents / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects*; D008297:Male; D008353:Mannitol / Q000494:pharmacology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013147:Spirometry
chemical_list: D016085:Bronchoconstrictor Agents; D008353:Mannitol