The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma

Overview

Journal Front Allergy

Specialty Allergy & Immunology

Date 2022 Apr 7

PMID 35387051

Authors

Rebecca F McLoughlin

Vanessa M McDonald

Affiliations

Soon will be listed here.

Abstract

Asthma is a complex and heterogenous disease characterized by variability in disease expression and severity. Multiple extrapulmonary comorbidities and treatable traits are common in people with asthma, and there is an increasing appreciation of how these may complicate asthma management. This review will discuss the prevalence and impact of extrapulmonary comorbidities/risk factors or "traits," which have been found to co-exist in asthma (obesity, symptoms of depression and/or anxiety and physical inactivity), the impact these traits have on future outcomes (including exacerbation risk and quality of life) and asthma management, and how we should target treatment in asthma when these extrapulmonary traits are present.

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References

Holloway E, West R . Integrated breathing and relaxation training (the Papworth method) for adults with asthma in primary care: a randomised controlled trial. Thorax. 2007; 62(12):1039-42. PMC: 2094294. DOI: 10.1136/thx.2006.076430. View

Kullowatz A, Kanniess F, Dahme B, Magnussen H, Ritz T . Association of depression and anxiety with health care use and quality of life in asthma patients. Respir Med. 2006; 101(3):638-44. DOI: 10.1016/j.rmed.2006.06.002. View

Labor S, Labor M, Juric I, Vuksic Z . The prevalence and pulmonary consequences of anxiety and depressive disorders in patients with asthma. Coll Antropol. 2012; 36(2):473-81. View

Gibson P, McDonald V, Marks G . Asthma in older adults. Lancet. 2010; 376(9743):803-13. DOI: 10.1016/S0140-6736(10)61087-2. View

Cordova-Rivera L, Gibson P, Gardiner P, Powell H, McDonald V . Physical Activity and Exercise Capacity in Severe Asthma: Key Clinical Associations. J Allergy Clin Immunol Pract. 2017; 6(3):814-822. DOI: 10.1016/j.jaip.2017.09.022. View

Parsons J, Craig T, Stoloff S, Hayden M, Ostrom N, Eid N . Impact of exercise-related respiratory symptoms in adults with asthma: Exercise-Induced Bronchospasm Landmark National Survey. Allergy Asthma Proc. 2012; 32(6):431-7. DOI: 10.2500/aap.2011.32.3501. View

Peters-Golden M, Swern A, Bird S, Hustad C, Grant E, Edelman J . Influence of body mass index on the response to asthma controller agents. Eur Respir J. 2006; 27(3):495-503. DOI: 10.1183/09031936.06.00077205. View

Bonala S, Pina D, Silverman B, Amara S, Bassett C, Schneider A . Asthma severity, psychiatric morbidity, and quality of life: correlation with inhaled corticosteroid dose. J Asthma. 2003; 40(6):691-9. DOI: 10.1081/jas-120023491. View

Turner S, Eastwood P, Cook A, Jenkins S . Improvements in symptoms and quality of life following exercise training in older adults with moderate/severe persistent asthma. Respiration. 2010; 81(4):302-10. DOI: 10.1159/000315142. View

10.

Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F . Body mass index and asthma severity in the National Asthma Survey. Thorax. 2007; 63(1):14-20. DOI: 10.1136/thx.2007.082784. View

11.

Teramoto M, Moonie S . Physical activity participation among adult Nevadans with self-reported asthma. J Asthma. 2011; 48(5):517-22. DOI: 10.3109/02770903.2011.567426. View

12.

Epstein G, Halper J, Barrett E, Birdsall C, McGee M, Baron K . A pilot study of mind-body changes in adults with asthma who practice mental imagery. Altern Ther Health Med. 2004; 10(4):66-71. View

13.

Freitas P, Ferreira P, Silva A, Stelmach R, Carvalho-Pinto R, Fernandes F . The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2016; 195(1):32-42. DOI: 10.1164/rccm.201603-0446OC. View

14.

Mancuso C, Choi T, Westermann H, Wenderoth S, Hollenberg J, Wells M . Increasing physical activity in patients with asthma through positive affect and self-affirmation: a randomized trial. Arch Intern Med. 2012; 172(4):337-43. PMC: 3640830. DOI: 10.1001/archinternmed.2011.1316. View

15.

Stoodley I, Williams L, Thompson C, Scott H, Wood L . Evidence for lifestyle interventions in asthma. Breathe (Sheff). 2019; 15(2):e50-e61. PMC: 6876140. DOI: 10.1183/20734735.0019-2019. View

16.

Bender B . Risk taking, depression, adherence, and symptom control in adolescents and young adults with asthma. Am J Respir Crit Care Med. 2006; 173(9):953-7. DOI: 10.1164/rccm.200511-1706PP. View

17.

Thomas M, McKinley R, Mellor S, Watkin G, Holloway E, Scullion J . Breathing exercises for asthma: a randomised controlled trial. Thorax. 2008; 64(1):55-61. DOI: 10.1136/thx.2008.100867. View

18.

Deshmukh V, Toelle B, Usherwood T, OGrady B, Jenkins C . Anxiety, panic and adult asthma: a cognitive-behavioral perspective. Respir Med. 2006; 101(2):194-202. DOI: 10.1016/j.rmed.2006.05.005. View

19.

Feldman J, Steinberg D, Kutner H, Eisenberg N, Hottinger K, Sidora-Arcoleo K . Perception of pulmonary function and asthma control: the differential role of child versus caregiver anxiety and depression. J Pediatr Psychol. 2013; 38(10):1091-100. PMC: 3809726. DOI: 10.1093/jpepsy/jst052. View

20.

Baltieri L, Cazzo E, de Souza A, Monte Alegre S, Vieira R, Antunes E . Influence of weight loss on pulmonary function and levels of adipokines among asthmatic individuals with obesity: One-year follow-up. Respir Med. 2018; 145:48-56. DOI: 10.1016/j.rmed.2018.10.017. View