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Khare M, Piparia S, Tantisira KG. Pharmacogenetics of childhood uncontrolled asthma. Expert Rev Clin Immunol 2023:1-14. [PMID: 37190963 PMCID: PMC10657335 DOI: 10.1080/1744666x.2023.2214363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Asthma is a heterogeneous, multifactorial disease with multiple genetic and environmental risk factors playing a role in pathogenesis and therapeutic response. Understanding of pharmacogenetics can help with matching individualized treatments to specific genotypes of asthma to improve therapeutic outcomes especially in uncontrolled or severe asthma. AREAS COVERED In this review, we outline novel information about biology, pathways, and mechanisms related to interindividual variability in drug response (corticosteroids, bronchodilators, leukotriene modifiers, and biologics) for childhood asthma. We discuss candidate gene, genome-wide association studies and newer omics studies including epigenomics, transcriptomics, proteomics, and metabolomics as well as integrative genomics and systems biology methods related to childhood asthma. The articles were obtained after a series of searches, last updated November 2022, using database PubMed/CINAHL DB. EXPERT OPINION Implementation of pharmacogenetic algorithms can improve therapeutic targeting in children with asthma, particularly with severe or uncontrolled asthma who typically have challenges in clinical management and carry considerable financial burden. Future studies focusing on potential biomarkers both clinical and pharmacogenetic can help formulate a prognostic test for asthma treatment response that would represent true bench to bedside clinical implementation.
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Affiliation(s)
- Manaswitha Khare
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Rady Children's Hospital of San Diego, San Diego, CA, USA
| | - Shraddha Piparia
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Kelan G Tantisira
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, Rady Children's Hospital of San Diego, San Diego, CA, USA
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Sørensen KG, Øymar K, Jonsson G, Dalen I, Halvorsen T, Mikalsen IB. Are BMI and adipokines associated with asthma, atopy and lung function in young adults previously hospitalized for bronchiolitis? Respir Med 2023; 209:107149. [PMID: 36754217 DOI: 10.1016/j.rmed.2023.107149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Children hospitalized for bronchiolitis have increased risk of asthma and low lung function persisting into adulthood, but the underlying mechanisms are poorly understood. Body mass index (BMI) and adipokines are associated with respiratory morbidity. We aimed to investigate if associations between BMI and adipokines and the outcomes asthma, atopy, and lung function differed between young adults previously hospitalized for bronchiolitis and control subjects. METHODS This sub study of a historical cohort enrolled 185 young adults previously hospitalized for bronchiolitis and 146 matched control subjects. Exposures (BMI and the adipokines: adiponectin, leptin, resistin, and ghrelin) and outcomes (asthma, atopy, and lung function) were measured cross-sectionally at 17-20 years of age. Associations were tested in regression models, and differences between the post-bronchiolitis- and control group were tested by including interaction terms. RESULTS BMI was associated with asthma and lung function, but we did not find that the associations differed between the post-bronchiolitis- and control group. We also found some associations between adipokines and outcomes, but only associations between adiponectin and forced vital capacity (FVC) and between resistin and current asthma differed between the groups (p-value interaction term 0.027 and 0.040 respectively). Adiponectin tended to be positively associated with FVC in the post-bronchiolitis group, with an opposite tendency in the control group. Resistin was positively associated with current asthma only in the control group. CONCLUSION The increased prevalence of asthma and impaired lung function observed in young adults previously hospitalized for bronchiolitis do not seem to be related to growth and fat metabolism.
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Affiliation(s)
- Karen Galta Sørensen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Knut Øymar
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Grete Jonsson
- Department of Medical Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Pediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ingvild Bruun Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
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Predictive and prognostic value of leptin status in asthma. NPJ Prim Care Respir Med 2023; 33:10. [PMID: 36914629 PMCID: PMC10011586 DOI: 10.1038/s41533-023-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/13/2023] [Indexed: 03/16/2023] Open
Abstract
Asthma is closely associated with inflammation. We evaluated the predictive and prognostic value of leptin status in asthma. We searched the electronic databases for articles that determined the leptin level in asthma cases through May 2020. We compared the differences of leptin level between asthma and non-asthma controls, as well as between severe and mild asthma cases. We also investigated the impact of age and gender on these differences by using meta-regression analysis. 59 studies were included in our pooled analysis. Asthma cases demonstrated significantly higher leptin level than that in non-asthma controls among overall populations (SMD:1.061, 95% CI: 0.784-1.338, p < 10-4), Caucasians (SMD:0.287, 95% CI: 0.125-0.448, p = 0.001), Asians (SMD:1.500, 95% CI: 1.064-1.936, p < 10-4) and Africans (SMD: 8.386, 95% CI: 6.519-10.253, p < 10-4). Severe asthma cases showed markedly higher leptin level than that in mild asthma cases among overall populations (SMD:1.638, 95% CI: 0.952-2.323, p < 10-4) and Asians (SMD:2.600, 95% CI: 1.854-3.345, p < 10-4). No significant difference of leptin level between severe and mild asthma was observed in Caucasians (SMD:-0.819, 95% CI: -1.998-0.360, p = 0.173). Cumulative analyses yielded similar results regarding the difference of leptin status between asthma and non-asthma controls, as well as between severe and mild asthma cases among overall populations. Age and male/ female ratio were not associated with the difference of leptin status between asthma and non-asthma controls (coefficient:-0.031, 95% CI: -0.123-0.061, p = 0.495; coefficient:0.172, 95% CI: -2.445-2.789, p = 0.895), as well as between severe and mild asthma cases among overall populations (coefficient:-0.072, 95% CI: -0.208-0.063, p = 0.279; coefficient: 2.373, 95% CI: -0.414-5.161, p = 0.090). Asthma demonstrated significantly higher level of leptin than that in non-asthma controls among overall populations, Caucasians, Asians and Africans. Severe asthma cases showed markedly higher leptin level than that in mild cases among overall populations and Asians. Leptin may be a risk predictor and prognostic marker of asthma. Early monitoring and intervention of leptin may be needed for asthma.
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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: 8] [Impact Index Per Article: 8.0] [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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Sánchez-Ortega H, Jiménez-Cortegana C, Novalbos-Ruiz JP, Gómez-Bastero A, Soto-Campos JG, Sánchez-Margalet V. Role of Leptin as a Link between Asthma and Obesity: A Systematic Review and Meta-Analysis. Int J Mol Sci 2022; 24:ijms24010546. [PMID: 36613991 PMCID: PMC9820321 DOI: 10.3390/ijms24010546] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
Asthma and obesity are considered as highly prevalent diseases with a great impact on public health. Obesity has been demonstrated to be an aggravating factor in the pathogenesis of asthma. Adipose tissue secretes proinflammatory cytokines and mediators, including leptin, which may promote the development and severity of asthma in obese patients. This study is a systematic review and a meta-analysis based on the relationship between leptin and asthma during obesity. MEDLINE, Cochrane, EMBASE and CINAHL databases were used. Data heterogeneity was analyzed using Cochran’s Q and treatment effect with the DerSimonian and Laird method. Random effect analyses were carried out to test data sensitivity. Asymmetry was estimated using Begg’s and Egger’s tests. All studies showed significant differences in leptin levels. The effect of the measures (p < 0.001), data sensitivity (p < 0.05) and data asymmetry were statistically significant, as well as tBegg’s test (p = 0.010) and Egge’s test (p < 0.001). Despite the existing limiting factors, the results of this study support the relevant role of leptin in the pathophysiology of asthma in obese subjects. Nevertheless, further studies are needed to obtain better insight in the relationship between leptin and asthma in obesity.
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Affiliation(s)
- Helena Sánchez-Ortega
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
| | - Carlos Jiménez-Cortegana
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
| | - José P. Novalbos-Ruiz
- Department of Biomedicine, Biotechnology and Public Health, Medical School, University of Cadiz, 11003 Cádiz, Spain
| | - Ana Gómez-Bastero
- Pneumology Service, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - José G. Soto-Campos
- Pneumology Service, Jerez University Hospital, University of Cadiz, 11003 Cádiz, Spain
| | - Víctor Sánchez-Margalet
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
- Correspondence:
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Wang Y, Hu C. Leptin and Asthma: What Are the Interactive Correlations? Biomolecules 2022; 12:biom12121780. [PMID: 36551211 PMCID: PMC9775505 DOI: 10.3390/biom12121780] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Leptin is an adipokine directly correlated with the proinflammatory obese-associated phenotype. Leptin has been demonstrated to inhibit adipogenesis, promote fat demarcation, promote a chronic inflammatory state, increase insulin sensitivity, and promote angiogenesis. Leptin, a regulator of the immune response, is implicated in the pathology of asthma. Studies involved in the key cell reaction and animal models of asthma have provided vital insights into the proinflammatory role of leptin in asthma. Many studies described the immune cell and related cellular pathways activated by leptin, which are beneficial in asthma development and increasing exacerbations. Subsequent studies relating to animal models support the role of leptin in increasing inflammatory cell infiltration, airway hyperresponsiveness, and inflammatory responses. However, the conclusive effects of leptin in asthma are not well elaborated. In the present study, we explored the general functions and the clinical cohort study supporting the association between leptin and asthma. The main objective of our review is to address the knowns and unknowns of leptin on asthma. In this perspective, the arguments about the different faces of leptin in asthma are provided to picture the potential directions, thus yielding a better understanding of asthma development.
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Affiliation(s)
- Yang Wang
- Department of Respiratory Medicine (Department of Respiratory and Critical Care Medicine), Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Chengping Hu
- Department of Respiratory Medicine (Department of Respiratory and Critical Care Medicine), Xiangya Hospital, Central South University, Changsha 410008, China
- Correspondence:
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Regulatory Peptides in Asthma. Int J Mol Sci 2021; 22:ijms222413656. [PMID: 34948451 PMCID: PMC8707337 DOI: 10.3390/ijms222413656] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023] Open
Abstract
Numerous regulatory peptides play a critical role in the pathogenesis of airway inflammation, airflow obstruction and hyperresponsiveness, which are hallmarks of asthma. Some of them exacerbate asthma symptoms, such as neuropeptide Y and tachykinins, while others have ameliorating properties, such as nociception, neurotensin or β-defensin 2. Interacting with peptide receptors located in the lungs or on immune cells opens up new therapeutic possibilities for the treatment of asthma, especially when it is resistant to available therapies. This article provides a concise review of the most important and current findings regarding the involvement of regulatory peptides in asthma pathology.
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Womble JT, McQuade VL, Ihrie MD, Ingram JL. Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity. J Asthma Allergy 2021; 14:967-980. [PMID: 34408442 PMCID: PMC8364356 DOI: 10.2147/jaa.s318017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022] Open
Abstract
Asthma is a common, chronic airway inflammatory disease marked by airway hyperresponsiveness, inflammation, and remodeling. Asthma incidence has increased rapidly in the past few decades and recent multicenter analyses have revealed several unique asthma endotypes. Of these, type-2 high asthma with comorbid obesity presents a unique clinical challenge marked by increased resistance to standard therapies and exacerbated disease development. The extrinsic coagulation pathway plays a significant role in both type-2 high asthma and obesity. The type-2 high asthma airway is marked by increased procoagulant potential, which is readily activated following damage to airway tissue. In this review, we summarize the current understanding of the role the extrinsic coagulation pathway plays in the airway of type-2 high asthma with comorbid obesity. We propose that asthma control is worsened in obesity as a result of a systemic and local airway shift towards a procoagulant and anti-fibrinolytic environment. Lastly, we hypothesize bariatric surgery as a treatment for improved asthma management in type-2 high asthma with comorbid obesity, facilitated by normalization of systemic procoagulant and pro-inflammatory mediators. A better understanding of attenuated coagulation parameters in the airway following bariatric surgery will advance our knowledge of biomolecular pathways driving asthma pathobiology in patients with obesity.
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Affiliation(s)
- Jack T Womble
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, 27710, USA
| | - Victoria L McQuade
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, 27710, USA
| | - Mark D Ihrie
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, 27710, USA
| | - Jennifer L Ingram
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, 27710, USA
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9
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Kytikova OY, Antonyuk MV, Gvozdenko TA, Novgorodtseva TP. The pathophysiological role of adipokines in the development of bronchial asthma combined with obesity. TERAPEVT ARKH 2021; 93:327-332. [DOI: 10.26442/00403660.2021.03.200659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 11/22/2022]
Abstract
The combined course of bronchial asthma (BA) and obesity is one of the urgent medical and social problems that requires a comprehensive and careful study in connection with a decrease in the quality of life of such patients, an increase in the frequency, duration of hospitalization and a high economic burden for the state as a whole. The relationship between BA and obesity is now confirmed by numerous studies, at the same time, despite the variability of the proposed mechanisms of pathogenetic effects of obesity on asthma, metabolic aspects of the relationship of these diseases need further study. Adipose tissue hormones are responsible for the energy homeostasis of the body therefore, excessive accumulation of adipose tissue is accompanied by the development of an imbalance in metabolic processes in various organs and tissues. Due to the emergence of new scientific data on the role and function of adipokines in the body, metabolic effects of adipokines are considered in the focus of their pathophysiological association with obesity and asthma. This literary review highlights the current understanding of the role of metabolic effects of the most studied adipokines (resistin, retinol-binding protein, leptin and adiponectin) in the development of obesity and BA. Gender and age-dependent features of adipokine levels in BA and obesity are described. Data on the confirmed role of adiponectin and leptin in the progression of BA combined with obesity are presented. It has been shown that the role of resistin and retinol-binding protein in the development of BA combined with obesity has not been studied. It is demonstrated that further study of metabolic activity of adipokines in BA is an actual and perspective direction of researches which will allow to develop new diagnostic and therapeutic strategies in patients with BA with obesity.
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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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Wang H, Bai C, Yi M, Jia Y, Li Y, Jiang D, Chen O. Metabolic Syndrome and Incident Asthma in Chinese Adults: An Open Cohort Study. Diabetes Metab Syndr Obes 2020; 13:3411-3420. [PMID: 33061502 PMCID: PMC7532911 DOI: 10.2147/dmso.s274159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/12/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Although metabolic syndrome is awell-known risk factor for many non-communicable diseases, its contribution to asthma remains controversial. OBJECTIVE The aim of this study was to explore the associations of metabolic syndrome and its components with incident asthma in Chinese adults. METHODS We conducted an open cohort study of participants who were asthma-free at baseline (n=42,304) in the Shandong multi-center health check-up longitudinal study from 2004 to 2015. Participants aged ≥20 years and had regular physical examination (once ayear) more than three times during follow-up. RESULTS Ninety subjects (38 women and 52 men) developed incident asthma over 12 years of follow-up. Our study suggested that metabolic syndrome itself was not significantly associated with incident asthma in either women or men (P>0.050). Interestingly, we found that overweight and/or obesity was arisk factor for incident asthma among women but not men in the Cox proportional hazards model after adjusting covariates (adjusted incidence rate ratio (IRR)= 2.940, 95% confidence interval (CI): 1.467-5.894, P=0.002). The result was consistent with the Poisson regression model (hazard ratio (HR)= 2.241, 95% CI: 1.135-4.988, P=0.026). After stratifying according to overweight and/or obesity, we found that female subjects with overweight and obesity were associated with the occurrence of incident asthma (P<0.050). However, we did not find this result among men. CONCLUSION Metabolic syndrome was not significantly associated with incident asthma in both women and men; however, overweight and/or obesity was shown to be asignificant risk factor for incident asthma but only in women, not in men.
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Affiliation(s)
- Haixia Wang
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Chenxiao Bai
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Mo Yi
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Yuanmin Jia
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Yizhang Li
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Di Jiang
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
| | - Ou Chen
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
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Esteves de Oliveira E, de Castro E Silva FM, Caçador Ayupe M, Gomes Evangelista Ambrósio M, Passos de Souza V, Costa Macedo G, Ferreira AP. Obesity affects peripheral lymphoid organs immune response in murine asthma model. Immunology 2019; 157:268-279. [PMID: 31112301 DOI: 10.1111/imm.13081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 01/12/2023] Open
Abstract
Asthma and obesity present rising incidence, and their concomitance is a reason for concern, as obese individuals are usually resistant to conventional asthma treatments and have more exacerbation episodes. Obesity affects several features in the lungs during asthma onset, shifting the T helper type 2 (Th2)/eosinophilic response towards a Th17/neutrophilic profile. Moreover, those individuals can present reduced atopy and delayed cytokine production. However, the impact of obesity on follicular helper T (Tfh) cells and B cells that could potentially result in antibody production disturbances are still unclear. Therefore, we aimed to assess the peripheral response to ovalbumin (OVA) in a concomitant model of obesity and asthma. Pulmonary allergy was induced, in both lean and obese female BALB/c mice, through OVA sensitizations and challenges. Mediastinal lymph nodes (MLNs) and spleen were processed for immunophenotyping. Lung was used for standard allergy analysis. Obese-allergic mice produced less anti-OVA IgE and more IgG2a than lean-allergic mice. Dendritic cells (CD11c+ MHCIIhigh ) expressed less CD86 and more PDL1 in obese-allergic mice compared with lean-allergic mice, in the MLNs. Meanwhile, B cells (CD19+ CD40+ ) were more frequent and the amount of PDL1/PD1+ cells was diminished by obesity, with the opposite effects in the spleen. Tfh cells (CD3+ CD4+ CXCR5+ PD1+ ) expressing FoxP3 were more frequent in obese mice, associated with the predominance of Th (CD3+ CD4+ ) cells expressing interleukin-4/GATA3 in the MLNs and interleukin-17A/RORγT in the spleen. Those modifications to the main components of the germinal centers could be resulting in the increased IgG2a production, which - associated with the Th17/neutrophilic profile - contributes to asthma worsening and represents an important target for future treatment strategies.
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Affiliation(s)
- Erick Esteves de Oliveira
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Flávia Márcia de Castro E Silva
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Marina Caçador Ayupe
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Marcilene Gomes Evangelista Ambrósio
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Viviane Passos de Souza
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Gilson Costa Macedo
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Ana Paula Ferreira
- Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
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13
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Kong Y, Zhang S, Wu R, Su X, Peng D, Zhao M, Su Y. New insights into different adipokines in linking the pathophysiology of obesity and psoriasis. Lipids Health Dis 2019; 18:171. [PMID: 31521168 PMCID: PMC6745073 DOI: 10.1186/s12944-019-1115-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022] Open
Abstract
Psoriasis is a chronic, systemic, hyper-proliferative immune-mediated inflammatory skin disease. The results of epidemiological investigations have shown that psoriasis affects around 2% of the general population worldwide, and the total number of psoriasis patients is more than 6 million in China. Apart from the skin manifestations, psoriasis has been verified to associate with several metabolic comorbidities, such as insulin resistance, diabetes and obesity. However, the underlying mechanism is still not elucidated. Adipocytes, considered as the active endocrine cells, are dysfunctional in obesity which displays increased synthesis and secretion of adipokines with other modified metabolic properties. Currently, growing evidence has pointed to the central role of adipokines in adipose tissue and the immune system, providing new insights into the effect of adipokines in linking the pathophysiology of obesity and psoriasis. In this review, we summarize the current understanding of the pathological role of adipokines and the potential mechanisms whereby different adipokines link obesity and psoriasis. Furthermore, we also provide evidence which identifies a potential therapeutic target aiming at adipokines for the management of these two diseases.
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Affiliation(s)
- Yi Kong
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Suhan Zhang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ruifang Wu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Xin Su
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Daoquan Peng
- Department of Cardiovascular Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ming Zhao
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
| | - Yuwen Su
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
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14
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Rosa M, Paris C, Sottejeau Y, Corseaux D, Robin E, Tagzirt M, Juthier F, Jashari R, Rauch A, Vincentelli A, Staels B, Van Belle E, Susen S, Dupont A. Leptin induces osteoblast differentiation of human valvular interstitial cells via the Akt and ERK pathways. Acta Diabetol 2017; 54:551-560. [PMID: 28314924 DOI: 10.1007/s00592-017-0980-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
Abstract
AIMS Calcific aortic valve disease (CAVD) affects 2-6% of the population over 65 years, and age, gender, smoking, overweight, dyslipidemia, diabetes contribute to the development of this disease. CAVD results, in part, from the osteoblast differentiation of human valvular interstitial cells (VICs). This study aims to elucidate the effects of leptin on osteoblast phenotype of VICs and the signalling pathways involved. METHODS Patients who underwent aortic valve replacement for CAVD (n = 43) were included in this study. Patients with coronary artery disease (CAD) without CAVD (n = 129) were used as controls. RESULTS Patients with CAVD had higher serum leptin concentrations than CAD patients (p = 0.002). Leptin was found in calcific aortic valves, with higher concentrations in calcified versus non-calcified zones (p = 0.01). Chronic leptin stimulation of human VICs enhanced alkaline phosphatase (ALP) activity and ALP, BMP-2 and RUNX2 expression and decreased osteopontin expression. Moreover, inhibiting Akt or ERK during leptin stimulation lowered the expression of osteoblast markers in VIC. CONCLUSIONS Taken together, these findings indicate that leptin plays a critical role in CAVD development by promoting osteoblast differentiation of human aortic VICs in an Akt- and ERK-dependent manner. This study highlights the role of leptin in CAVD development, and further studies are needed to determine whether reducing circulating leptin levels or blocking leptin actions on VICs is efficient to slow CAVD progression.
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Affiliation(s)
- Mickael Rosa
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Camille Paris
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Yoann Sottejeau
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Delphine Corseaux
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Emmanuel Robin
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Madjid Tagzirt
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Francis Juthier
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Ramadan Jashari
- European Homograft Bank, c/o Clinique Saint Jean, Brussels, Belgium
| | - Antoine Rauch
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - André Vincentelli
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Bart Staels
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
| | - Eric Van Belle
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
| | - Sophie Susen
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France.
- Institut Pasteur de Lille, 59000, Lille, France.
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France.
- INSERM U 1011, Amphi J&K, Boulevard du Professeur Jules Leclercq, 59008, Lille Cedex, France.
| | - Annabelle Dupont
- European Genomic Institute for Diabetes (E.G.I.D.), FR 3508, UNIV LILLE, Inserm UMR 1011, 59000, Lille, France
- Institut Pasteur de Lille, 59000, Lille, France
- Cardiovascular and Pulmonary and Haematology Department, CHRU de Lille, Lille, France
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15
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Association between obesity and asthma - epidemiology, pathophysiology and clinical profile. Nutr Res Rev 2016; 29:194-201. [PMID: 27514726 DOI: 10.1017/s0954422416000111] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obesity is a risk factor for asthma, and obese asthmatics have lower disease control and increased symptom severity. Several putative links have been proposed, including genetics, mechanical restriction of the chest and the intake of corticosteroids. The most consistent evidence, however, comes from studies of cytokines produced by the adipose tissue called adipokines. Adipokine imbalance is associated with both proinflammatory status and asthma. Although reverse causation has been proposed, it is now acknowledged that obesity precedes asthma symptoms. Nevertheless, prenatal origins of both conditions complicate the search for causality. There is a confirmed role of neuro-immune cross-talk mediating obesity-induced asthma, with leptin playing a key role in these processes. Obesity-induced asthma is now considered a distinct asthma phenotype. In fact, it is one of the most important determinants of asthma phenotypes. Two main subphenotypes have been distinguished. The first phenotype, which affects adult women, is characterised by later onset and is more likely to be non-atopic. The childhood obesity-induced asthma phenotype is characterised by primary and predominantly atopic asthma. In obesity-induced asthma, the immune responses are shifted towards T helper (Th) 1 polarisation rather than the typical atopic Th2 immunological profile. Moreover, obese asthmatics might respond differently to environmental triggers. The high cost of treatment of obesity-related asthma, and the burden it causes for the patients and their families call for urgent intervention. Phenotype-specific approaches seem to be crucial for the success of prevention and treatment.
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16
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Mokina NA, Iashkov AV, Gudkova MA, Samoĭlova EN, Goriainov IA. [Investigations into the relationship between respiratory disorders and excessive body weight in the adolescents presenting with bronchial asthma treated based at a specialized health resort facility]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2015; 92:27-34. [PMID: 26285331 DOI: 10.17116/kurort2015327-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A total of 71 patients with bronchial asthma (BA) were examined and treated based at a specialized health facility of whom 43 ones presented with mild asthma and 26 patients with moderately severe asthma in remission. The median age of the patients was 12,04 ± 2,08 years. Spirometry parameters: MOS50, MOS75, and PSV, proved to be of high informative value combined with high enough sensitivity and specificity. The significant difference between the groups as a whole (p < 0.05) were documented based on the serum leptin levels that were higher in the overweight patients and especially in the girls (p < 0.05). The leptin level was a similarly sensitive/specific (AUROC > 0.5) and informative (SCDFC > 0.5) parameter which confirms its diagnostic value given it is employed in combination with overweight for the evaluation of the status of the patients suffering from asthma. Negative linear and non-parametric correlation between the functional parameters and the serum leptin levels in the overweight patients with bronchial asthma suggests that the enhanced leptin concentration may serve as a marker of strong obstruction and severe inflammation at all levels of the respiratory tract in the patients presenting with a combination of the two conditions.
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Affiliation(s)
- N A Mokina
- GBOU VPO "Samarskiĭ gosudarstvennyĭ meditsinskiĭ universitet" Minzdrava Rossii; GBUZ "Samarskiĭ oblastnoĭ detskiĭ sanatoriĭ "Iunost'"
| | - A V Iashkov
- GBOU VPO "Samarskiĭ gosudarstvennyĭ meditsinskiĭ universitet" Minzdrava Rossii
| | - M A Gudkova
- GBUZ "Samarskiĭ oblastnoĭ detskiĭ sanatoriĭ "Iunost'"
| | - E N Samoĭlova
- GBUZ "Samarskiĭ oblastnoĭ detskiĭ sanatoriĭ "Iunost'"
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