Obesity, Inflammation, and Severe Asthma: an Update

Area of Science:

• Pulmonology
• Immunology
• Metabolic Diseases

Background:

• Obesity-associated difficult asthma presents a significant clinical challenge with limited understanding and treatments.
• The interplay between obesity, asthma, and inflammation is complex, impacting morbidity and mortality.
• Current asthma biomarkers may be affected by obesity, necessitating the development of specific biomarkers.

Purpose of the Study:

• To review the complex association between asthma, obesity, and inflammation.
• To explore recent advances in treatment options for obesity-associated difficult asthma.
• To highlight the need for phenotype-specific treatments and further research into immunopathological mechanisms.

Main Methods:

• Literature review of studies examining the relationship between obesity and asthma.
• Analysis of the impact of obesity on asthma pathogenesis and outcomes.
• Exploration of current and potential therapeutic strategies, including weight loss interventions.

Main Results:

• Obesity negatively impacts asthma outcomes and is causally linked to adult-onset asthma.
• Obesity promotes a pro-inflammatory state systemically and in the airways.
• Surgical weight loss improves asthma control and quality of life, but evidence for conservative options is limited.

Conclusions:

• Further research into the immunopathology of obesity-associated asthma is crucial for developing novel therapies.
• Weight loss is effective in improving asthma in this patient cohort.
• Focus on non-surgical, real-world applicable treatments for obesity-mediated airway inflammation is needed.