Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.
Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.
Allergol Int. 2019 Apr;68(2):135-142. doi: 10.1016/j.alit.2018.10.004. Epub 2018 Dec 1.
Obesity is an important global health issue for both children and adults. Obesity increases the prevalence and incidence of asthma and also increases the risk for severe asthma. Here we describe the features of severe asthma phenotypes for which obesity is a defining characteristic, including steroid resistance, airway inflammation, and co-morbidities. We also review current concepts regarding the mechanistic basis for the impact of obesity in severe asthma, including possible roles for vitamin D deficiency, systemic inflammation, and the microbiome. Finally, we describe data indicating a role for diet, weight loss, and exercise in the treatment of severe asthma with obesity. Better understanding of the mechanistic basis for the role of obesity in severe asthma could lead to new therapeutic options for this population.
肥胖症是儿童和成人的一个重要全球性健康问题。肥胖症会增加哮喘的患病率和发病率，也会增加哮喘恶化的风险。在这里，我们描述了肥胖症是其特征之一的严重哮喘表型的特征，包括类固醇耐药性、气道炎症和合并症。我们还回顾了目前关于肥胖症对严重哮喘影响的机制基础的概念，包括维生素 D 缺乏、全身炎症和微生物组的可能作用。最后，我们描述了表明饮食、减肥和运动在肥胖症严重哮喘治疗中的作用的数据。更好地了解肥胖症在严重哮喘中的作用的机制基础可能会为这一人群带来新的治疗选择。
