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Pediatric obesity and severe asthma: Targeting pathways driving inflammation. Pharmacol Res 2023; 188:106658. [PMID: 36642111 DOI: 10.1016/j.phrs.2023.106658] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA) is a particular and rare phenotype requiring treatment with high-dose inhaled corticosteroids plus a second controller and/or systemic glucocorticoid courses to achieve symptom control or remaining "uncontrolled" despite this therapy. In SA, other diagnoses have been excluded, and potential exacerbating factors have been addressed. Notably, obese asthmatics are at higher risk of developing SA. Obesity is both a major risk factor and a disease modifier of asthma in children and adults: two main "obese asthma" phenotypes have been described in childhood with high or low levels of Type 2 inflammation biomarkers, respectively, the former characterized by early onset and eosinophilic inflammation and the latter by neutrophilic inflammation and late-onset. Nevertheless, the interplay between obesity and asthma is far more complex and includes obese tissue-driven inflammatory pathways, mechanical factors, comorbidities, and poor response to corticosteroids. This review outlines the most recent findings on SA in obese children, particularly focusing on inflammatory pathways, which are becoming of pivotal importance in order to identify selective targets for specific treatments, such as biological agents.
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Tenório LHS, Vieira FC, Souza HCMD, Andrade ADFDD, Lorena VMBD, Medeiros D, Rizzo JÂ, Lira GVDAG, Correia Junior MADV, Sarinho ESC. Respiratory burden in obese and young asthmatics: a study of diaphragmatic kinetics. ACTA ACUST UNITED AC 2021; 47:e20210166. [PMID: 34586303 PMCID: PMC8642816 DOI: 10.36416/1806-3756/e20210166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Objective The aim of this study was to assess the diaphragm kinetics, respiratory function, and serum dosage of leptin and inflammatory cytokines (IL-6 and TNF-α) in three clinical groups: obese, asthmatic, and healthy. Methods This is a clinical exploratory study performed on 73 youths (12-24 years of age, 42.5% male) allocated into three groups: obesity (OG, n=33), body mass index (BMIz-score) ≥ +2, asthmatic (AG, n=26) controlled mild asthmatics, classified by GINA, and Healthy Control Group (CG, n=14). The participants were subjected to diaphragmatic ultrasound, spirometry, maximal respiratory pressure, serum leptin levels, and IL-6 and TNF-α whole blood cell culture levels. Results Diaphragm thickness was higher in OG in comparison to AG and CG (2.0±0.4 vs 1.7±0.5 and 1.6±0.2, both with p<0.05). Maximal voluntary ventilation (MVV) was significantly lower in OG and AG in relation to the CG (82.8±21.4 and 72.5±21.2 vs 102.8±27.3, both with p<0.05). OG has the highest leptin rate among the groups (with the other two groups had p<0.05). All groups had similar TNF-α and IL-6 levels. Conclusion The muscular hypertrophy found in the diaphragm of the obese individuals can be justified by the increase in respiratory work imposed by the chronic condition of the disease. Such increase in thickness did not occur in controlled mild asthmatics. The IL-6 and TNF-α markers detected no evidence of muscle inflammation, even though leptin was expected to be altered in obese individuals. Both obese and asthmatic patients had lower pulmonary resistance than the healthy ones.
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Affiliation(s)
| | - Fabiana Cavalcanti Vieira
- Programa de Pós-Graduação em Criança e Saúde do Adolescente, Universidade Federal de Pernambuco, Recife (PE), Brasil
| | | | | | | | - Décio Medeiros
- Programa de Pós-Graduação em Criança e Saúde do Adolescente, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Centro de Pesquisa em Alergia e Imunologia, Universidade Federal de Pernambuco, Recife (PE), Brasil
| | - José Ângelo Rizzo
- Programa de Pós-Graduação em Criança e Saúde do Adolescente, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Centro de Pesquisa em Alergia e Imunologia, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife (PE), Brasil
| | - Georgia Veras de Araújo Gueiros Lira
- Programa de Pós-Graduação em Criança e Saúde do Adolescente, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Centro de Pesquisa em Alergia e Imunologia, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife (PE), Brasil
| | - Marco Aurélio de Valois Correia Junior
- Centro de Pesquisa em Alergia e Imunologia, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Pós-graduação em Hebiatria e Educação Física, Universidade de Pernambuco, Recife (PE), Brasil
| | - Emanuel Sávio Cavalcanti Sarinho
- Programa de Pós-Graduação em Criança e Saúde do Adolescente, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife (PE), Brasil.,Centro de Pesquisa em Alergia e Imunologia, Universidade Federal de Pernambuco, Recife (PE), Brasil
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Bantulà M, Roca-Ferrer J, Arismendi E, Picado C. Asthma and Obesity: Two Diseases on the Rise and Bridged by Inflammation. J Clin Med 2021; 10:jcm10020169. [PMID: 33418879 PMCID: PMC7825135 DOI: 10.3390/jcm10020169] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
Asthma and obesity are two epidemics affecting the developed world. The relationship between obesity and both asthma and severe asthma appears to be weight-dependent, causal, partly genetic, and probably bidirectional. There are two distinct phenotypes: 1. Allergic asthma in children with obesity, which worsens a pre-existing asthma, and 2. An often non allergic, late-onset asthma developing as a consequence of obesity. In obesity, infiltration of adipose tissue by macrophages M1, together with an increased expression of multiple mediators that amplify and propagate inflammation, is considered as the culprit of obesity-related inflammation. Adipose tissue is an important source of adipokines, such as pro-inflammatory leptin, produced in excess in obesity, and adiponectin with anti-inflammatory effects with reduced synthesis. The inflammatory process also involves the synthesis of pro-inflammatory cytokines such as IL-1β, IL-6, TNFα, and TGFβ, which also contribute to asthma pathogenesis. In contrast, asthma pro-inflammatory cytokines such as IL-4, IL-5, IL-13, and IL-33 contribute to maintain the lean state. The resulting regulatory effects of the immunomodulatory pathways underlying both diseases have been hypothesized to be one of the mechanisms by which obesity increases asthma risk and severity. Reduction of weight by diet, exercise, or bariatric surgery reduces inflammatory activity and improves asthma and lung function.
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Affiliation(s)
- Marina Bantulà
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (J.R.-F.); (E.A.)
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
| | - Jordi Roca-Ferrer
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (J.R.-F.); (E.A.)
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 08036 Barcelona, Spain
| | - Ebymar Arismendi
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (J.R.-F.); (E.A.)
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 08036 Barcelona, Spain
- Servei de Pneumologia, Hospital Clinic, 08036 Barcelona, Spain
| | - César Picado
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (J.R.-F.); (E.A.)
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 08036 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-227-5400
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Mustafa WW, Moahammed SS, Al-Jewari WM, Abdulrahman HS, Hussain SA. Association of Visceral Adiposity Index, Lipid Profile, and Serum Leptin with Glucose Intolerance Risks in Iraqi Obese Patients: A Cross-sectional Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:468-474. [PMID: 33679095 PMCID: PMC7909059 DOI: 10.4103/jpbs.jpbs_324_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 11/06/2022] Open
Abstract
Aims: The aim of this study was to evaluate the possibility of using visceral adiposity index (VAI), serum leptin, and lipid profile as indicators of impaired glucose tolerance in Iraqi obese patients. Subjects and Methods: A cross-sectional study was performed in Iraqi obese patients of both sexes. Body mass index (BMI), waist circumference, hip circumference, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), VAI, waist-to-hip ratio (WHR), serum leptin, and 2-h glucose tolerance test (2-h GT) were determined and compared with those of healthy non-obese control group. A correlation analysis was performed to determine the strength of association between the studied markers. Data were adjusted to determine gender differences in this regard. Statistical Analysis: Kolmogorov–Smirnov, Shapiro–Wilk analyses, Mann–Whitney U test, and unpaired t test were used for the two-group comparisons once applicable. Pearson’s and Spearman’s correlation analyses were used to measure the relationship levels between the studied variables. Results: A total of 144 obese patients were included; the mean age was 37.11 ± 8.2 years and 92 (63.9%) were females. Compared with non-obese subjects, the participants had significantly higher levels of BMI, WC, WHR, VAI, TG, leptin, and 2-h GTObese male subjects had significantly higher values of body weight, WC, HC, VAI, and TG compared with obese females. Elevated 2-h GT was significantly associated with VAI (r = 0.291, P = 0.0004), TG (r = 0.319, P = 0.0001), and LDL-C/HDL-C ratio (r = 0.435, P < 0.0001) in the obese patients only. Conclusions: The results provide evidence that VAI, TG, and LDL-C/HDL-C ratio can be suggested as potential markers for the risk assessment of impaired glucose tolerance in Iraqi obese patients.
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Affiliation(s)
- Wael Waleed Mustafa
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | - Samer Shukur Moahammed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | - Wathiq Mohammed Al-Jewari
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | | | - Saad Abdulrahman Hussain
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
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Haidari F, Abiri B, Haghighizadeh MH, Kayedani GA, Birgani NK. Association of Hematological Parameters with Obesity- Induced Inflammation Among Young Females in Ahvaz, South-West of Iran. Int J Prev Med 2020; 11:55. [PMID: 32577185 PMCID: PMC7297432 DOI: 10.4103/ijpvm.ijpvm_35_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Iron deficiency is prevalent in overweight and obese individuals and may be induced by adiposity-related inflammation that affect iron metabolism. Objective: The objective of this study was to investigate the relationship between hematological parameters and obesity-induced inflammation among young females. Methods: A total of 170 young women (aged between 18-35 years) participated in this cross-sectional study. Obesity was assessed by BMI (body mass index), WHR (waist to hip ratio), and body fat percentage. Inflammatory and hematological parameters including hs-CRP (high-sensitivity C-reactive protein), serum Fe, hemoglobin, ferritin, transferrin, TIBC (total iron binding capacity) were measured. Dietary intakes of some nutrients (total iron, proteins, calcium, and vitamin C) were assessed according to BMI, WHR and fat mass categories. Results: Serum iron were negatively correlated with BMI (P = 0.045, r = −0.154) and hs-CRP (P = 0.032, r = −0.165). Hemoglobin were also negatively correlated with BMI (P = 0.043, r = −0.155). A significant correlation was also shown between WHR with transferrin (P = 0.034, r = 0.163) and TIBC levels (P = 0.035, r = 0.162), hs-CRP was positively correlated with BMI (P = 0.014, r = 0.183), WHR (P = 0.009, r = 0.202) and body fat percentage (P = 0.037, r = 0.353). Dietary intakes did not differ significantly among BMI, WHR and fat mass categories (P > 0.05). Conclusions: Obesity-induced inflammation, regardless of dietary intake of iron, can lead to iron deficiency. Therefore, weight control, especially in obese subjects is necessary to prevent iron deficiency and anemia.
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Affiliation(s)
- Fatemeh Haidari
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Hossein Haghighizadeh
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholam A Kayedani
- Department of Laboratory Sciences, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Negar K Birgani
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Berky AJ, Ryde IT, Feingold B, Ortiz EJ, Wyatt LH, Weinhouse C, Hsu-Kim H, Meyer JN, Pan WK. Predictors of mitochondrial DNA copy number and damage in a mercury-exposed rural Peruvian population near artisanal and small-scale gold mining: An exploratory study. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2019; 60:197-210. [PMID: 30289587 PMCID: PMC6452630 DOI: 10.1002/em.22244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/22/2018] [Accepted: 07/31/2018] [Indexed: 05/22/2023]
Abstract
Mitochondrial DNA (mtDNA) copy number (CN) and damage in circulating white blood cells have been proposed as effect biomarkers for pollutant exposures. Studies have shown that mercury accumulates in mitochondria and affects mitochondrial function and integrity; however, these data are derived largely from experiments in model systems, rather than human population studies that evaluate the potential utility of mitochondrial exposure biomarkers. We measured mtDNA CN and damage in white blood cells (WBCs) from 83 residents of nine communities in the Madre de Dios region of the Peruvian Amazon that vary in proximity to artisanal and small-scale gold mining. Prior research from this region reported high levels of mercury in fish and a significant association between food consumption and human total hair mercury level of residents. We observed that mtDNA CN and damage were both associated with consumption of fruit and vegetables, higher diversity of fruit consumed, residential location, and health characteristics, suggesting common environmental drivers. Surprisingly, we observed negative associations of mtDNA damage with both obesity and age. We did not observe any association between total hair mercury or, in contrast to previous results, age, with either mtDNA damage or CN. The results of this exploratory study highlight the importance of combining epidemiological and laboratory research in studying the effects of stressors on mitochondria, suggesting that future work should incorporate nutritional and social characteristics, and caution should be taken when applying conclusions from epidemiological studies conducted in the developed world to other regions, as results may not be easily translated. Environ. Mol. Mutagen. 60: 197-210, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Axel J. Berky
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Ian T. Ryde
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Beth Feingold
- University of Albany, School of Public Health, Rensselaer, NY 12144, USA
| | - Ernesto J. Ortiz
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Lauren H. Wyatt
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
| | - Caren Weinhouse
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Heileen Hsu-Kim
- Department of Civil and Engineering, Box 90287, Duke University, Durham, NC 27708, USA
| | - Joel N. Meyer
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
- Corresponding authors: William Pan, Duke Global Health Institute, 310 Trent Drive, Campus Box 90519, Durham, NC 27708, fax 681-7748, , Joel N. Meyer, Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA,
| | - William K. Pan
- Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
- Corresponding authors: William Pan, Duke Global Health Institute, 310 Trent Drive, Campus Box 90519, Durham, NC 27708, fax 681-7748, , Joel N. Meyer, Nicholas School of the Environment, Box 90328, Duke University, Durham, NC 27708, USA,
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Hijjawi NS, Al-Radaideh AM, Al-Fayomi KI, Nimer NA, Alabadi HA, Al-Zu'bi RM, Agraib LM, Allehdan SS, Tayyem RF. Relationship of serum leptin with some biochemical, anthropometric parameters and abdominal fat volumes as measured by magnetic resonance imaging. Diabetes Metab Syndr 2018; 12:207-213. [PMID: 28967613 DOI: 10.1016/j.dsx.2017.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/20/2017] [Indexed: 12/15/2022]
Abstract
AIMS To measure the level of leptin in volunteers and correlate it with several anthropometric, biochemical variables and abdominal fat volumes. METHODS The level of leptin was investigated in 167 disease-free volunteers. Serum levels of IL-6, adiponectin, and resistin, blood lipid profile (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were determined. Waist circumference (WC) was measured using tape and magnetic resonance imaging (MRI) images. RESULTS All measured anthropometric (BMI, WC measured by tape and MRI) and biochemical variables (adiponectin, resistin, cholesterol, HDL, LDL and TG); and abdominal fats showed a significant (p<0.05) difference between participants with abnormal serum leptin levels and those with normal leptin levels. A higher percentage of participants with abnormal serum leptin were obese males while participants with normal leptin levels were either overweight or normal weight females. A significant (p <0.05) positive correlation was detected between serum leptin concentration and WC, BMI, subcutaneous fat, visceral fat, total abdominal fat, and resistin. A moderate association was found between serum leptin concentration and the inflammatory cytokine IL-6. CONCLUSION Abnormal serum leptin, was detected in obese male individuals which may be considered as an important indicator for the development of cardiovascular diseases and type 2 diabetes.
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Affiliation(s)
- Nawal S Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Ali M Al-Radaideh
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Kholoud I Al-Fayomi
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Nisreen A Nimer
- Department of Chemistry, College of Sciences and Health Professions, Cleveland State University, Cleveland, OH, USA
| | - Hadeel A Alabadi
- Department of Radiology, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Rana M Al-Zu'bi
- Department of Nutrition, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Lana M Agraib
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Sabika S Allehdan
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Reema F Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan.
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