Asthma, GERD and Obesity: Triangle of Inflammation

Overview

Journal Indian J Pediatr

Specialty Pediatrics

Date 2017 Nov 12

PMID 29127618

Citations 13

Authors

Samriti Gupta

Rakesh Lodha

S K Kabra

Affiliations

Soon will be listed here.

Abstract

There is increasing prevalence of both asthma and obesity in children globally in recent years. Various epidemiological studies link obesity as a risk factor for asthma and suggest a possible causal association. Obesity asthma phenotype is considered as distinct in view of greater severity and poor asthma control. Various mechanisms underlying this phenotype have been suggested including mechanical effects of obesity and systemic inflammation, but still the exact mechanism is unclear. Also, the comorbidities like gastroesophageal reflux disease (GERD) and sleep disordered breathing (SDB) lead to inflammation in airways and contribute to asthma obesity association. A better understanding of mechanisms by which obesity and GERD lead to inflammation in airways and increase the risk of asthma may provide insight towards targeted treatment approach of these patients.

Citing Articles

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References

Busse W, Holgate S, Kerwin E, Chon Y, Feng J, Lin J . Randomized, double-blind, placebo-controlled study of brodalumab, a human anti-IL-17 receptor monoclonal antibody, in moderate to severe asthma. Am J Respir Crit Care Med. 2013; 188(11):1294-302. DOI: 10.1164/rccm.201212-2318OC. View

Rogers L . Role of Sleep Apnea and Gastroesophageal Reflux in Severe Asthma. Immunol Allergy Clin North Am. 2016; 36(3):461-71. DOI: 10.1016/j.iac.2016.03.008. View

Owen C, Marks D, Banks M . The dangers of proton pump inhibitor therapy. Br J Hosp Med (Lond). 2014; 75(7):C108-12. DOI: 10.12968/hmed.2014.75.sup7.c108. View

Icitovic N, Onyebeke L, Wallenstein S, Dasaro C, Harrison D, Jiang J . The association between body mass index and gastroesophageal reflux disease in the World Trade Center Health Program General Responder Cohort. Am J Ind Med. 2016; 59(9):761-6. DOI: 10.1002/ajim.22637. View

Stein M . Possible mechanisms of influence of esophageal acid on airway hyperresponsiveness. Am J Med. 2003; 115 Suppl 3A:55S-59S. DOI: 10.1016/s0002-9343(03)00194-3. View

Pal R, Dahal S, Pal S . Prevalence of bronchial asthma in Indian children. Indian J Community Med. 2010; 34(4):310-6. PMC: 2822191. DOI: 10.4103/0970-0218.58389. View

Dixon A, Clerisme-Beaty E, Sugar E, Cohen R, Lang J, Brown E . Effects of obstructive sleep apnea and gastroesophageal reflux disease on asthma control in obesity. J Asthma. 2011; 48(7):707-13. PMC: 3171804. DOI: 10.3109/02770903.2011.601778. View

Vijayakanthi N, Greally J, Rastogi D . Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation. Pediatrics. 2016; 137(5). PMC: 4845863. DOI: 10.1542/peds.2015-0812. View

Berry M, Hargadon B, Shelley M, Parker D, Shaw D, Green R . Evidence of a role of tumor necrosis factor alpha in refractory asthma. N Engl J Med. 2006; 354(7):697-708. DOI: 10.1056/NEJMoa050580. View

10.

Naik R, Vaezi M . Extra-esophageal gastroesophageal reflux disease and asthma: understanding this interplay. Expert Rev Gastroenterol Hepatol. 2015; 9(7):969-82. DOI: 10.1586/17474124.2015.1042861. View

11.

Rastogi D, Suzuki M, Greally J . Differential epigenome-wide DNA methylation patterns in childhood obesity-associated asthma. Sci Rep. 2013; 3:2164. PMC: 3712321. DOI: 10.1038/srep02164. View

12.

Cardet J, Ash S, Kusa T, Camargo Jr C, Israel E . Insulin resistance modifies the association between obesity and current asthma in adults. Eur Respir J. 2016; 48(2):403-10. PMC: 5815169. DOI: 10.1183/13993003.00246-2016. View

13.

Leiria L, Martins M, Saad M . Obesity and asthma: beyond T(H)2 inflammation. Metabolism. 2014; 64(2):172-81. DOI: 10.1016/j.metabol.2014.10.002. View

14.

Coffey M, Torretti B, Mancuso P . Adipokines and Cysteinyl Leukotrienes in the Pathogenesis of Asthma. J Allergy (Cairo). 2016; 2015:157919. PMC: 4684870. DOI: 10.1155/2015/157919. View

15.

Endo Y, Yokote K, Nakayama T . The obesity-related pathology and Th17 cells. Cell Mol Life Sci. 2016; 74(7):1231-1245. PMC: 11107749. DOI: 10.1007/s00018-016-2399-3. View

16.

Cazzola M, Segreti A, Calzetta L, Rogliani P . Comorbidities of asthma: current knowledge and future research needs. Curr Opin Pulm Med. 2012; 19(1):36-41. DOI: 10.1097/MCP.0b013e32835b113a. View

17.

Calixto M, Lintomen L, Andre D, Leiria L, Ferreira D, Lellis-Santos C . Metformin attenuates the exacerbation of the allergic eosinophilic inflammation in high fat-diet-induced obesity in mice. PLoS One. 2013; 8(10):e76786. PMC: 3811997. DOI: 10.1371/journal.pone.0076786. View

18.

Gonzalez J, Caceres A, Esko T, Cusco I, Puig M, Esnaola M . A common 16p11.2 inversion underlies the joint susceptibility to asthma and obesity. Am J Hum Genet. 2014; 94(3):361-72. PMC: 3951940. DOI: 10.1016/j.ajhg.2014.01.015. View

19.

Davidson W, Mackenzie-Rife K, Witmans M, Montgomery M, Ball G, Egbogah S . Obesity negatively impacts lung function in children and adolescents. Pediatr Pulmonol. 2013; 49(10):1003-10. DOI: 10.1002/ppul.22915. View

20.

Dal Negro R, Guerriero M, Micheletto C . Pattern of airway inflammation and remodelling in mild persistent atopic asthma and in mild persistent asthma related to gastroesophageal reflux. Eur Ann Allergy Clin Immunol. 2013; 44(6):236-42. View