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Παχυσαρκία και Βρογχικό Άσθμα

Boulet LP.

Asthma and obesity.

Clin Exp Allergy. 2013 Jan;43(1):8-21.


The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.

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Sismanopoulos N, Delivanis DA, Mavrommati D, Hatziagelaki E, Conti P, Theoharides TC.

Do mast cells link obesity and asthma?

Allergy. 2013 Jan;68(1):8-15.


Asthma is a chronic inflammatory disease of the lungs. Both the number of cases and severity of asthma have been increasing without a clear explanation. Recent evidence suggests that obesity, which has also been increasing alarmingly, may worsen or precipitate asthma, but there is little evidence of how obesity may contribute to lung inflammation. We propose that mast cells are involved in both asthma and obesity by being the target and source of adipocytokines, ‘alarmins’ such as interleukin-9 (IL-9) and interleukin-33 (IL-33), and stress molecules including corticotropin-releasing hormone (CRH) and neurotensin (NT), secreted in response to the metabolic burden. In particular, CRH and NT have synergistic effects on mast cell secretion of vascular endothelial growth factor (VEGF). IL-33 augments VEGF release induced by substance P (SP) and tumor necrosis factor (TNF) release induced by NT. Both IL-9 and IL-33 also promote lung mast cell infiltration and augment allergic inflammation. These molecules are also expressed in human mast cells leading to autocrine effects. Obese patients are also less sensitive to glucocorticoids and bronchodilators. Development of effective mast cell inhibitors may be a novel approach for the management of both asthma and obesity. Certain flavonoid combinations may be a promising new treatment approach.

Η πρόσβαση είναι ελεύθερη από το website του εκδότη :

Juel CT, Ulrik CS.

Obesity and Asthma: Impact on severity, asthma control and response to therapy.

Respir Care. 2012 Dec 18. [Προδημοσίευση].


Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard to symptoms, level of FEV(1), fraction of exhaled nitric oxide, and airway responsiveness. Some studies suggest that asthma in the obese patient might be more responsive to leukotriene modifiers, orchestrated by leptin and/or adiponectin derived from adipose tissue, than to inhaled corticosteroids, possibly reflecting differences in the underlying airway inflammation in obese vs. non-obese asthmatics.In conclusion, overweight and obesity is associated with poorer asthma control and, very importantly, overall poorer response to asthma therapy compared with normal weight individuals.

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Η σχέση μεταξύ παχυσαρκίας και του μεταβολικού συνδρόμου είναι γνωστή, όπως επίσης γνωστή είναι και η σχέση μεταξύ παχυσαρκίας και των επιμέρους άμεσων ή έμμεσων επιπλοκών του μεταβολικού συνδρόμου : υπέρτασης, σακχαρώδους διαβήτη, καρδιαγγειακών συμβαμάτων , εγκεφαλικών επεισοδίων.

Εκείνο που δεν είναι ευρέως γνωστό είναι πως η παχυσαρκία συσχετίζεται με το σοβαρό, ανθεκτικό στην θεραπεία βρογχικό άσθμα.

Μπορείτε να συμβουλευθείτε την παραπάνω, πρόσφατη βιβλιογραφία η οποία προσπαθεί να διαλευκάνει την σχέση μεταξύ παχυσαρκίας και του σοβαρού-ανθεκτικού στην θεραπεία βρογχικού άσθματος.

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