Obesity and childhood asthma - mechanisms and manifestations
Megan E Jensen1, Lisa G Wood, Peter G Gibson
1Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, NSW 2310, Australia.
Insights
Obesity in childhood asthma reduces inhaled corticosteroid effectiveness but minimally impacts lung function. Further research is needed to understand this subgroup
Area of Science:
- Pediatric Pulmonology
- Metabolic Disorders
- Chronic Disease Management
Background:
- Obesity is a global chronic condition, disproportionately affecting children with asthma.
- Obese children often remain obese into adulthood, necessitating early intervention.
- Understanding the interplay between obesity and childhood asthma is crucial for current and future management.
Purpose of the Study:
- To review recent findings (past 18 months) on the presentation and mechanisms of obesity in childhood asthma.
- To highlight the clinical implications for managing this specific patient subgroup.
- To identify knowledge gaps in characterizing obese asthmatic children.
Main Methods:
- Literature review focusing on studies published within the last 18 months.
- Analysis of recent findings on clinical presentation, airway inflammation, and lung function.
- Examination of the link between metabolic abnormalities and childhood asthma.
Main Results:
- Inhaled corticosteroid efficacy is reduced in obese asthmatic children.
- Ventilatory function and bronchoreactivity show marginal effects in this subgroup.
- Metabolic abnormalities associated with obesity may contribute to the asthma-obesity link.
Conclusions:
- There is a need for more descriptive studies on airway inflammation and lung volumes in obese asthmatic children.
- Longitudinal studies are essential to characterize the obese asthma phenotype from childhood to adulthood.
- Understanding these manifestations will guide clinical management and therapeutic strategies.
Purpose Of Review:
Obesity is a chronic condition affecting children worldwide. However, the prevalence is higher in asthmatic children. Obese children most likely become obese adults. Understanding the clinical presentation of this subgroup is essential to their clinical management, now and in the future. This review highlights the most recent findings over the past 18 months in understanding the presentation and potential mechanisms of obesity in childhood asthma.
Recent Findings:
Recent research suggests that inhaled corticosteroid efficacy is reduced in obese asthmatic children whereas ventilatory function and bronchoreactivity appear to be marginally affected. A paucity of studies describing airway inflammation and lung volume measurements in this subgroup limits their clinical characterization. Recent studies indicate metabolic abnormalities that typically manifest with excess adiposity may be associated with asthma, providing an interesting factor in the asthma-obesity link. The inception, persistence and composition of obesity prove important considerations for future studies.
Summary:
Highlighted is the need for more descriptive airway inflammation studies, lung volume assessments and longitudinal studies to better characterize the obese asthma phenotype in children and understand the pathogenesis from childhood to adulthood. Understanding the manifestations and mechanisms of obese asthma in childhood will help direct clinical management and targeted therapeutic interventions.
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