Bianco Andrea, Nigro Ersilia, Monaco Maria Ludovica, Matera Maria Gabriella, Scudiero Olga, Mazzarella Gennaro, Daniele Aurora
Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Seconda Università degli Studi di Napoli, via L. Bianchi, 80131, Napoli, Italy.
Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, Seconda Università degli Studi di Napoli, via G. Vivaldi 42, 81100 Caserta, Italy; CEINGE-Biotecnologie Avanzate Scarl, via G. Salvatore 486, 80145 Napoli, Italy.
Pulm Pharmacol Ther. 2017 Apr;43:20-25. doi: 10.1016/j.pupt.2017.01.004. Epub 2017 Jan 20.
The influence of obesity on development, severity and prognosis of both asthma and COPD is attracting growing interest. The impact of obesity on the respiratory system ranges from structural modifications (decline of total lung capacity) to humoral alterations. Adipose tissue strongly contributes to the establishment of an inflammatory state being an important source of adipokines. Amongst adipokines, adiponectin is an important component of organ cross talk with adipose tissue exerting protective effects on a variety of pathophysiological processes. Adiponectin is secreted in serum where it abundantly circulates as complexes of different molecular weight. Adiponectin properties are mediated by specific receptors that are widely expressed with AdipoR1, AdipoR2, and T-cadherin being present on epithelial and endothelial pulmonary cells indicating a functional role on lung physiology. In COPD, mild to moderate obesity has been shown to have protective effects on patient's survival, while a higher mortality rate has been observed in patients with low BMI. A specific cluster of obese patients has been identified; in this group, asthma features are particularly severe and difficult to treat. Better understanding of the molecular mechanisms at the base of cross talk among different tissues and organs will lead to identification of new targets for both diagnosis and treatment of asthma and COPD.
肥胖对哮喘和慢性阻塞性肺疾病（COPD）的发生发展、严重程度及预后的影响正日益受到关注。肥胖对呼吸系统的影响范围从结构改变（肺总量下降）到体液改变。脂肪组织对炎症状态的形成有重要作用，是脂肪因子的重要来源。在脂肪因子中，脂联素是器官与脂肪组织相互作用的重要组成部分，对多种病理生理过程具有保护作用。脂联素分泌到血清中，以不同分子量的复合物形式大量循环。脂联素的特性由特定受体介导，这些受体广泛表达，肺上皮细胞和内皮细胞上存在脂联素受体1（AdipoR1）、脂联素受体2（AdipoR2）和T-钙黏蛋白，表明其在肺生理中具有功能性作用。在COPD中，轻度至中度肥胖已被证明对患者生存具有保护作用，而体重指数（BMI）较低的患者死亡率较高。已确定了一组特定的肥胖患者群体；在该群体中，哮喘特征尤为严重且难以治疗。更好地理解不同组织和器官间相互作用的分子机制将有助于确定哮喘和COPD诊断及治疗的新靶点。
