title: Association between obesity and asthma - epidemiology, pathophysiology and clinical profile.
abstract: Obesity is a risk factor for asthma, and obese asthmatics have lower disease control and increased symptom severity. Several putative links have been proposed, including genetics, mechanical restriction of the chest and the intake of corticosteroids. The most consistent evidence, however, comes from studies of cytokines produced by the adipose tissue called adipokines. Adipokine imbalance is associated with both proinflammatory status and asthma. Although reverse causation has been proposed, it is now acknowledged that obesity precedes asthma symptoms. Nevertheless, prenatal origins of both conditions complicate the search for causality. There is a confirmed role of neuro-immune cross-talk mediating obesity-induced asthma, with leptin playing a key role in these processes. Obesity-induced asthma is now considered a distinct asthma phenotype. In fact, it is one of the most important determinants of asthma phenotypes. Two main subphenotypes have been distinguished. The first phenotype, which affects adult women, is characterised by later onset and is more likely to be non-atopic. The childhood obesity-induced asthma phenotype is characterised by primary and predominantly atopic asthma. In obesity-induced asthma, the immune responses are shifted towards T helper (Th) 1 polarisation rather than the typical atopic Th2 immunological profile. Moreover, obese asthmatics might respond differently to environmental triggers. The high cost of treatment of obesity-related asthma, and the burden it causes for the patients and their families call for urgent intervention. Phenotype-specific approaches seem to be crucial for the success of prevention and treatment.
authors: 1CIAS - Research Centre for Anthropology and Health,Department of Life Sciences,University of Coimbra,Calçada Martim de Freitas,3000-456,Coimbra,Portugal.
authors: Magdalena
authors: M
authors: Muc
authors: 3General Pathology Laboratory, Faculty of Medicine,University of Coimbra,Rua Larga,3004-504,Coimbra,Portugal.
authors: Anabela
authors: http://orcid.org/0000-0002-0820-9568
authors: A
authors: Mota-Pinto
authors: 1CIAS - Research Centre for Anthropology and Health,Department of Life Sciences,University of Coimbra,Calçada Martim de Freitas,3000-456,Coimbra,Portugal.
authors: Cristina
authors: http://orcid.org/0000-0002-1967-3497
authors: C
authors: Padez
mesh_terms: D054392:Adipokines; D000328:Adult; D001249:Asthma / Q000150:complications*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate; D020738:Leptin; D008297:Male; D009765:Obesity / Q000150:complications*; D063766:Pediatric Obesity
chemical_list: D054392:Adipokines; D020738:Leptin
keywords:  Th T helper; Asthma; Obesity; Obesity-induced asthma; Overweight; Phenotypes