Obesity and Asthma: Implementing a Treatable Trait Care Model

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • André Miguel Afonso De Sousa Moreira

    Autor

Participantes de fora da FMUP

  • Mendes, Francisca Castro
  • Garcia-Larsen, Vanessa

Unidades de investigação

Abstract

Recognition of obesity as a treatable trait of asthma, impacting its development, clinical presentation and management, is gaining widespread acceptance. Obesity is a significant risk factor and disease modifier for asthma, complicating treatment. Epidemiological evidence highlights that obese asthma correlates with poorer disease control, increased severity and persistence, compromised lung function and reduced quality of life. Various mechanisms contribute to the physiological and clinical complexities observed in individuals with obesity and asthma. These encompass different immune responses, including Type IVb, where T helper 2 cells are pivotal and driven by cytokines like interleukins 4, 5, 9 and 13, and Type IVc, characterised by T helper 17 cells and Type 3 innate lymphoid cells producing interleukin 17, which recruits neutrophils. Additionally, Type V involves immune response dysregulation with significant activation of T helper 1, 2 and 17 responses. Finally, Type VI is recognised as metabolic-induced immune dysregulation associated with obesity. Body mass index (BMI) stands out as a biomarker of a treatable trait in asthma, readily identifiable and targetable, with significant implications for disease management. There exists a notable gap in treatment options for individuals with obese asthma, where asthma management guidelines lack specificity. For example, there is currently no evidence supporting the use of incretin mimetics to improve asthma outcomes in asthmatic individuals without Type 2 diabetes mellitus (T2DM). In this review, we advocate for integrating BMI into asthma care models by establishing clear target BMI goals, promoting sustainable weight loss via healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary. Integrating BMI into asthma care models involves establishing clear target BMI goals, promoting sustainable weight loss interventions through healthy dietary choices and physical activity and implementing regular reassessment and referral as necessary.image

Dados da publicação

ISSN/ISSNe:
0954-7894, 1365-2222

Clinical and Experimental Allergy  Wiley-Blackwell Publishing Ltd

Tipo:
Review
Páginas:
881-894
Link para outro recurso:
www.scopus.com

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Keywords

  • asthma; body mass index; obesity; treatable trait; weight loss interventions

Proyectos asociados

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Airborne food and aeroallergens levels in healthcare settings. An unaccounted but potentially relevant source of exposure?

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Estudo Clínico Académico (Aeroallergens) . 2020

Eosinophil cationic protein (ECP) correlates with eosinophil cell counts in the induced sputum of elite swimmers

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Estudo Clínico Académico (ECP) . 2021

Dietary neuroimmune modulation of asthma and respiratory health in children

Investigador Principal: André Miguel Afonso de Sousa Moreira

Estudo Clínico Académico . 2023

How exercise, physical activity and diet modulate immune and stress responses

Investigador Principal: André Miguel Afonso de Sousa Moreira

Estudo Clínico Académico . 2020

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