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Role of Obesity in Asthma: Mechanisms and Management Strategies

  • Allergies and the Environment (M Hernandez, Section Editor)
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Abstract

Purpose of Review

Obesity is a commonly reported comorbidity in asthma, particularly in severe asthma. Obese asthmatics are highly symptomatic with a poor quality of life, despite using high-dose inhaled corticosteroids. While the clinical manifestations have been documented, the aetiologies of obese-asthma remain unclear.

Recent Findings

Several potential mechanisms have been proposed, including poor diet quality, physical inactivity and consequent accrual of excess adipose tissue. Each of these factors independently activates inflammatory pathways, potentially exerting effects in the airways. Because the origins of obesity are multifactorial, it is now believed there are multiple obese-asthma phenotypes, with varied aetiologies and clinical consequences.

Summary

In this review, we will describe the clinical implications of obesity in people with asthma, our current understanding of the mechanisms driving this association and describe recently proposed obese-asthma phenotypes. We will then discuss how asthma management is complicated by obesity, and provide graded recommendations for the management of obesity in this population.

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Authors and Affiliations

  1. Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW, 2305, Australia

    Hayley A Scott, Lisa G Wood & Peter G Gibson

  2. School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, 2308, Australia

    Hayley A Scott & Lisa G Wood

  3. School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia

    Hayley A Scott & Peter G Gibson

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  1. Hayley A Scott
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Correspondence to Peter G Gibson.

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Dr. Wood reports personal fees from Boehringer Ingelheim and grants from NSA LLC, and DSM Nutraceuticals. Drs. Scott and Gibson declare no conflicts of interest relevant to this manuscript.

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Scott, H.A., Wood, L.G. & Gibson, P.G. Role of Obesity in Asthma: Mechanisms and Management Strategies. Curr Allergy Asthma Rep 17, 53 (2017). https://doi.org/10.1007/s11882-017-0719-9

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