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肥胖与激素对哮喘的影响:作用机制、管理挑战及新兴治疗策略

Obesity and hormonal influences on asthma: Mechanisms, management challenges, and emerging therapeutic strategies.

作者信息

Weare-Regales Natalia, Carr Tara, Holguin Fernando, Tibbitt Christopher Andrew, Lockey Richard F

机构信息

Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, and the Division of Endocrinology, Department of Internal Medicine, James A. Haley Veterans Administration, Tampa.

Asthma and Airway Disease Research Center, University of Arizona, and the Section of Allergy and Immunology, Department of Medicine, University of Arizona College of Medicine, Tucson.

出版信息

J Allergy Clin Immunol. 2024 Dec;154(6):1355-1368. doi: 10.1016/j.jaci.2024.09.018. Epub 2024 Oct 1.

Abstract

Obesity and hormone dysregulation, common comorbidities of asthma, not only influence asthma risk and onset but can also complicate its management. The pathobiologic characteristics of obesity, such as insulin resistance and metabolism alterations, can impact lung function and airway inflammation while highlighting potential opportunities for therapeutic intervention. Likewise, obesity alters immune cell phenotypes and corticosteroid pharmacokinetics. Hormones such as sex hormones, incretins, and thyroid hormones can also affect asthma. This review highlights the mechanisms underlying obesity-related asthma and hormonal pathologies while exploring potential therapeutic strategies and the need for more research and innovative approaches in managing these comorbid conditions.

摘要

肥胖和激素失调是哮喘常见的合并症,不仅影响哮喘风险和发病,还会使其治疗复杂化。肥胖的病理生物学特征,如胰岛素抵抗和代谢改变,可影响肺功能和气道炎症,同时凸显了治疗干预的潜在机会。同样,肥胖会改变免疫细胞表型和皮质类固醇药代动力学。性激素、肠促胰岛素和甲状腺激素等激素也会影响哮喘。本综述重点介绍了肥胖相关哮喘和激素病理的潜在机制,同时探讨了潜在的治疗策略,以及在管理这些合并症方面开展更多研究和创新方法的必要性。

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