Farzan Sherry, Coyle Tyrone, Coscia Gina, Rebaza Andre, Santiago Maria
Division of Allergy & Immunology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Great Neck, NY, USA.
Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Queens, NY, USA.
J Asthma Allergy. 2022 May 18;15:673-689. doi: 10.2147/JAA.S285738. eCollection 2022.
The rates of asthma and obesity are increasing concurrently in the United States. Epidemiologic studies demonstrate that the incidence of asthma increases with obesity. Furthermore, obese individuals have asthma that is more severe, harder to control, and resistant to standard medications. In fact, specific asthma-obesity phenotypes have been identified. Various pathophysiologic mechanisms, including mechanical, inflammatory, metabolic and microbiome-associated, are at play in promulgating the obese-asthma phenotypes. While standard asthma medications, such as inhaled corticosteroids and biologics, are currently used to treat obese asthmatics, they may have limited effectiveness. Targeting the underlying aberrant processes, such as addressing steroid resistance, microbiome, metabolic and weight loss approaches, may be helpful.
在美国，哮喘和肥胖的发生率正在同时上升。流行病学研究表明，哮喘的发病率随肥胖程度的增加而上升。此外，肥胖个体患的哮喘更严重，更难控制，且对标准药物有抗药性。事实上，已经确定了特定的哮喘-肥胖表型。包括机械性、炎症性、代谢性和微生物群相关的各种病理生理机制，在促成肥胖-哮喘表型方面发挥着作用。虽然目前使用标准的哮喘药物，如吸入性皮质类固醇和生物制剂，来治疗肥胖型哮喘患者，但它们的效果可能有限。针对潜在的异常过程，如解决类固醇抵抗、微生物群、代谢和减肥方法等问题，可能会有所帮助。
