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Obesity-associated asthma in children: a distinct entity

Deepa Rastogi1, Stephen M Canfield2, Andrea Andrade1

  • 1Department of Pediatrics, Albert Einstein College of Medicine, Bronx.

Chest
|October 8, 2011
PubMed

Insights

Pediatric asthma in obese children shows a T helper 1 (Th1) immune response, unlike typical atopic asthma. This Th1 polarization is linked to poorer lung function in obese children with asthma.

Area of Science:

  • Immunology
  • Pediatrics
  • Respiratory Medicine

Background:

  • Obesity-associated asthma is a distinct clinical entity in children.
  • Mechanisms involve obesity-mediated inflammation and adiposity, poorly defined in pediatric populations.
  • Hypothesized a T helper 1 (Th1) immune response, contrasting with Th2 in atopic asthma.

Purpose of the Study:

  • To investigate immune differences in pediatric obesity-associated asthma.
  • To explore the relationship between Th1/Th2 biomarkers, anthropometry, and pulmonary function in obese asthmatic children.

Main Methods:

  • Recruited 120 children across four groups: obese asthmatic, nonobese asthmatic, obese nonasthmatic, and nonobese nonasthmatic.
  • Conducted pulmonary function testing (PFTs) and measured serum cytokines.
  • Analyzed T-cell responses for intracellular interferon-γ (IFN-γ) (Th1) and IL-4 (Th2) via flow cytometry.

Main Results:

  • Obese asthmatic children exhibited significantly higher Th1 responses and lower Th2 responses compared to nonobese asthmatic children.
  • Th-cell patterns were similar between obese asthmatic and obese nonasthmatic children.
  • Obese asthmatic children showed reduced FEV1/FVC and RV/TLC ratios, correlating with serum IFN-γ levels.

Conclusions:

  • Pediatric obesity-associated asthma is characterized by Th1 immune polarization, differentiating it from atopic asthma.
  • The altered immune environment in obese asthmatic children inversely correlates with pulmonary function.
Abstract

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