Listyoko Aditya Sri, Okazaki Ryota, Harada Tomoya, Inui Genki, Yamasaki Akira
Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.
Pulmonology and Respiratory Medicine Department, Faculty of Medicine, Brawijaya University-Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Front Allergy. 2024 Mar 18;5:1365801. doi: 10.3389/falgy.2024.1365801. eCollection 2024.
The prevalence of obesity among asthma patients has surged in recent years, posing a significant risk factor for uncontrolled asthma. Beyond its impact on asthma severity and patients' quality of life, obesity is associated with reduced lung function, increased asthma exacerbations, hospitalizations, heightened airway hyperresponsiveness, and elevated asthma-related mortality. Obesity may lead to metabolic dysfunction and immune dysregulation, fostering chronic inflammation characterized by increased pro-inflammatory mediators and adipocytokines, elevated reactive oxygen species, and reduced antioxidant activity. This chronic inflammation holds the potential to induce airway remodeling in individuals with asthma and obesity. Airway remodeling encompasses structural and pathological changes, involving alterations in the airway's epithelial and subepithelial layers, hyperplasia and hypertrophy of airway smooth muscle, and changes in airway vascularity. In individuals with asthma and obesity, airway remodeling may underlie heightened airway hyperresponsiveness and increased asthma severity, ultimately contributing to the development of persistent airflow limitation, declining lung function, and a potential increase in asthma-related mortality. Despite efforts to address the impact of obesity on asthma outcomes, the intricate mechanisms linking obesity to asthma pathophysiology, particularly concerning airway remodeling, remain incompletely understood. This comprehensive review discusses current research investigating the influence of obesity on airway remodeling, to enhance our understanding of obesity's role in the context of asthma airway remodeling.
近年来，哮喘患者中肥胖的患病率急剧上升，成为哮喘控制不佳的一个重要风险因素。除了对哮喘严重程度和患者生活质量产生影响外，肥胖还与肺功能下降、哮喘发作增加、住院率上升、气道高反应性增强以及哮喘相关死亡率升高有关。肥胖可能导致代谢功能障碍和免疫失调，促进以促炎介质和脂肪细胞因子增加、活性氧升高以及抗氧化活性降低为特征的慢性炎症。这种慢性炎症有可能在哮喘和肥胖患者中诱发气道重塑。气道重塑包括结构和病理变化，涉及气道上皮和上皮下层面的改变、气道平滑肌的增生和肥大以及气道血管的变化。在哮喘和肥胖患者中，气道重塑可能是气道高反应性增强和哮喘严重程度增加的基础，最终导致持续性气流受限的发展、肺功能下降以及哮喘相关死亡率可能上升。尽管人们努力应对肥胖对哮喘结局的影响，但肥胖与哮喘病理生理学之间的复杂机制，尤其是与气道重塑相关的机制，仍未完全了解。这篇综述讨论了目前研究肥胖对气道重塑影响的研究，以加深我们对肥胖在哮喘气道重塑背景下作用的理解。
