Obesity: changing asthma in the 21st century

Mechanistic Basis for Obesity-related Increases in Ozone-induced Airway Hyperresponsiveness in Mice

Obesity is a risk factor for asthma, especially nonallergic asthma. Ozone, a common air pollutant, is a nonallergic asthma trigger. Importantly, ozone-induced decrements in lung function are greater in obese and overweight human subjects than in lean individuals. Obese mice also exhibit exaggerated pulmonary responses to ozone. Ozone causes greater increases in pulmonary resistance, in bronchoalveolar lavage neutrophils, and in airway hyperresponsiveness in obese than in lean mice. Our data indicate that IL-33 plays a role in mediating these events. Ozone causes greater release of IL-33 into bronchoalveolar lavage fluid in obese than in lean mice. Furthermore, an antibody blocking the IL-33 receptor, ST2, attenuates ozone-induced airway hyperresponsiveness in obese but not in lean mice. Our data also indicate a complex role for tumor necrosis factor (TNF)-α in obesity-related effects on the response to ozone. In obese mice, genetic deficiency in either TNF-α or TNF-α receptor 2 augments ozone-induced airway hyperresponsiveness, whereas TNF-α receptor 2 deficiency virtually abolishes ozone-induced airway hyperresponsiveness in lean mice. Finally, obesity is known to alter the gut microbiome. In female mice, antibiotics attenuate obesity-related increases in the effect of ozone on airway hyperresponsiveness, possibly by altering microbial production of short-chain fatty acids. Asthma control is often difficult to achieve in obese patients with asthma. Our data suggest that therapeutics directed against IL-33 may ultimately prove effective in these patients. The data also suggest that dietary manipulations and other strategies (prebiotics, probiotics) that alter the microbiome and/or its metabolic products may represent a new frontier for treating asthma in obese individuals.

The number and function of T regulatory cells in obese atopic female asthmatics

BACKGROUND

Mechanisms underlying the association between asthma and obesity remain poorly understood. Obesity appears to be a risk factor for asthma, and obese asthmatics fare poorly compared to lean asthmatics.

OBJECTIVES

To explore the possibility that reduced regulatory T cell (Treg) number and function contribute to the obesity-asthma association. We concentrated on obese females with childhood-onset asthma, since Treg may be involved in this phenotype.

METHODS

We recruited 64 women (ages 18-50) into four groups: lean (BMI 18-25 kg/m²) controls (n = 17) and asthmatics (n = 13), and obese (BMI ≥ 35 kg/m²) controls (n = 17) and asthmatics (n = 17). Asthmatics had atopy and childhood-diagnosed asthma. We assessed lung function, asthma control and quality of life. Peripheral blood CD4+/CD25+/FoxP3+ Treg cells were identified and counted by flow cytometry and expressed as % total CD4+ T cells. We assessed Treg cell function by the ability of CD4+/CD25+ Treg cells to suppress autologous CD4+/CD25- responder T cell (Tresp) proliferation and measured as % suppression of Tresp cell proliferation.

RESULTS

Obese asthmatics had worse lung function, asthma control, and quality of life compared to lean asthmatics. Compared to lean or obese control groups, the number of Treg cells in the obese asthmatics was approximately 1.58- or 1.73-fold higher. The ability of Treg cells from obese-asthmatics to suppress Tresp cell proliferation was reduced.

CONCLUSIONS

Obese, atopic women with childhood diagnosed asthma demonstrate increased Treg cell number and mildly decreased Treg cell function. Our data do not support the view that reduced Treg cell number contributes to this obese-asthma phenotype.

Almond Skin Polyphenol Extract Inhibits Inflammation and Promotes Lipolysis in Differentiated 3T3-L1 Adipocytes

Studies have shown that polyphenols reduce the risk of inflammation-related diseases and upregulates energy expenditure in adipose tissue. Here, we investigated the mechanism of the anti-inflammatory and antiobesity effects of almond skin polyphenol extract (ASP) in differentiated 3T3-L1 adipocytes. The antioxidant effects of ASP were measured based on DPPH radical scavenging activity, Trolox equivalent antioxidant capacity, and total phenolic content. Differentiated 3T3-L1 cells were treated with ASP. Subsequently, lipolysis proteins and transcription factors of adipogenesis were measured. The proinflammatory mediators monocyte chemotactic protein-1 (MCP-1) and chemokine ligand 5 (CCL-5) were determined by enzyme-linked immunosorbent assay. We found that ASP significantly promoted phosphorylation of AMP-activated protein kinase (AMPK), increased activity of adipose triglyceride lipase and hormone-sensitive lipase, and inhibited adipogenesis-related transcription factors. In addition, ASP inhibited the tumor necrosis factor-α (TNF-α)-induced cell inflammatory response via downregulation of MCP-1 and CCL-5 secretion. This study suggests that ASP regulates lipolysis through activation of AMPK, reduced adipogenesis, and suppresses proinflammatory cytokines in adipocytes.

Asthma and obesity

The problem of modern medicine is to optimize the treatment of patients with comorbidity, whose number has been growing steadily in recent years. The concurrence of asthma and obesity determines the severity of disease, low-level control, and resistance to basic therapy in conjunction with more frequent use of β-agonists for relief of symptoms, and frequent hospitalizations for a disease exacerbation. Currently, there are only a few known pathogenetic components that are responsible for the negative impact of visceral obesity on the course of asthma.

Obesity enhances Th2 inflammatory response via natural killer T cells in a murine model of allergic asthma

BACKGROUND

Obesity increases the incidence of asthma, but mechanism between asthma and obesity isn't utterly understood. NKT cells are intermediary activist between the innate and adaptive immune. It may play an equally important role in both obesity and asthma. We studied an obese mouse model of allergic asthma to test whether NKT cells act as a linkage in the development of obesity with asthma.

METHODS

Balb/c mice were divided into control group (A), asthma model group (B), the obesity group (C) and obesity with asthma group (D), asthma model made by OVA. Obesity was induced. AHR were measured; HE staining of lung was made; NKT cells were detected and IL-4 and IFN-γ concentration were determined.

RESULTS

Lung histology showed airway inflammatory in obesity with asthma are significant than in asthma. IL-4 levels were increased compared with the control group. IFN-γ levels were decreased compared with the control group. More CD69+NKT cells of asthma group and obese asthma group correlated to the enhancement of airway inflammation and AHR. IFN-γ+NKT cells vary in different states not paralleling with CD69+NKT cells.

CONCLUSION

The activity level of NKT cells in obesity with asthma mice enhances Th2 Inflammatory response by regulating IL-4 and IFN-γ secretion. The activation of NKT enhanced asthma TH2 inflammatory responce. NKT cells play an important role in the development of asthma in obesity.

Obesity and extent of emphysema depicted at CT

AIM

To investigate the underlying relationship between obesity and the extent of emphysema depicted at CT.

METHODS AND MATERIALS

A dataset of 477 CT examinations was retrospectively collected from a study of chronic obstructive pulmonary disease (COPD). The low attenuation areas (LAAs; ≤950 HU) of the lungs were identified. The extent of emphysema (denoted as %LAA) was defined as the percentage of LAA divided by the lung volume. The association between log-transformed %LAA and body mass index (BMI) adjusted for age, sex, the forced expiratory volume in one second as percent predicted value (FEV1% predicted), and smoking history (pack years) was assessed using multiple linear regression analysis.

RESULTS

After adjusting for age, gender, smoking history, and FEV1% predicted, BMI was negatively associated with severe emphysema in patients with COPD. Specifically, one unit increase in BMI is associated with a 0.93-fold change (95% CI: 0.91-0.96, p<0.001) in %LAA; the estimated %LAA for males was 1.75 (95% CI: 1.36-2.26, p<0.001) times that of females; per 10% increase in FEV1% predicated is associated with a 0.72-fold change (95% CI: 0.69-0.76, p<0.001) in %LAA.

CONCLUSION

Increasing obesity is negatively associated with severity of emphysema independent of gender, age, and smoking history.

Data-driven asthma endotypes defined from blood biomarker and gene expression data

The diagnosis and treatment of childhood asthma is complicated by its mechanistically distinct subtypes (endotypes) driven by genetic susceptibility and modulating environmental factors. Clinical biomarkers and blood gene expression were collected from a stratified, cross-sectional study of asthmatic and non-asthmatic children from Detroit, MI. This study describes four distinct asthma endotypes identified via a purely data-driven method. Our method was specifically designed to integrate blood gene expression and clinical biomarkers in a way that provides new mechanistic insights regarding the different asthma endotypes. For example, we describe metabolic syndrome-induced systemic inflammation as an associated factor in three of the four asthma endotypes. Context provided by the clinical biomarker data was essential in interpreting gene expression patterns and identifying putative endotypes, which emphasizes the importance of integrated approaches when studying complex disease etiologies. These synthesized patterns of gene expression and clinical markers from our research may lead to development of novel serum-based biomarker panels.

Relationship between obesity and sex, and prevalence of asthma-like disease and current wheeze in Han children in Nanjing, China

OBJECTIVE

To investigate the relationships between body mass index (BMI) and sex, and asthma-like disease and current wheeze in Han children in Nanjing, China.

METHODS

Han children aged 3-14 years were recruited. Height and weight were measured; individuals were classified into obesity, thinness and normal-weight groups on the basis of the calculated BMI. Questionnaires were used to measure prevalence of asthma-like disease and current wheeze. Results were evaluated using the χ(2)-test, odds ratios with 95% confidence intervals and multivariate logistic regression analyses.

RESULTS

In total 12 092 children (6,331 boys and 5,761 girls) were included. Rates of normal weight, obesity and thinness were 8915/12 092 (73.73%), 1479/12 092 (12.23%) and 1698/12 092 (14.04%), respectively. Asthma-like disease and current wheeze were reported in 2051/12 092 (16.96%) and 400/12 092 (3.31%), respectively. An increased BMI was associated with a greater risk of asthma-like disease; this relationship was strongest in girls. Current wheeze was associated positively with obesity and negatively with thinness, but only among boys. Boys had a greater risk of asthma-like disease and current wheeze than girls.

CONCLUSIONS

BMI and sex were associated independently with the prevalence of asthma-like disease and current wheeze in Han Chinese children.

Inflammasome Activity in Non-Microbial Lung Inflammation

The understanding of interleukin-1 (IL-1) family cytokines in inflammatory disease has rapidly developed, due in part to the discovery and characterization of inflammasomes, which are multi-subunit intracellular protein scaffolds principally enabling recognition of a myriad of cellular stimuli, leading to the activation of caspase-1 and the processing of IL-1β and IL-18. Studies continue to elucidate the role of inflammasomes in immune responses induced by both microbes and environmental factors. This review focuses on the current understanding of inflammasome activity in the lung, with particular focus on the non-microbial instigators of inflammasome activation, including inhaled antigens, oxidants, cigarette smoke, diesel exhaust particles, mineral fibers, and engineered nanomaterials, as well as exposure to trauma and pre-existing inflammatory conditions such as metabolic syndrome. Inflammasome activity in these sterile inflammatory states contribute to diseases including asthma, chronic obstructive disease, acute lung injury, ventilator-induced lung injury, pulmonary fibrosis, and lung cancer.

Phloretin and phlorizin promote lipolysis and inhibit inflammation in mouse 3T3-L1 cells and in macrophage-adipocyte co-cultures

SCOPE

Previous studies found that phloretin (PT) and phlorizin (PZ) could inhibit glucose transport, with PT being a better inhibitor of lipid peroxidation. This study aimed to evaluate the antiobesity effects of PT and PZ in 3T3-L1 cells and if they can modulate the relationship between adipocytes and macrophages.

METHODS AND RESULTS

Differentiated 3T3-L1 cells were treated with PT or PZ. Subsequently, transcription factors of adipogenesis and lipolysis proteins were measured. In addition, RAW 264.7 macrophages treated with PT or PZ were cultured in differentiated media from 3T3-L1 cells to analyze inflammatory mediators and signaling pathways. PT significantly enhanced glycerol release and inhibited the adipogenesis-related transcription factors. PT also promoted phosphorylation of AMP-activated protein kinase and increased activity of adipose triglyceride lipase and hormone-sensitive lipase. PT suppressed the nuclear transcription factor kappa-B and mitogen-activated protein kinase pathways when RAW 264.7 cells were cultured in differentiated media from 3T3-L1 cells. PZ improved lipolysis and inhibited the macrophage inflammatory response less effectively than PT.

CONCLUSION

This study suggests that PT is more effective than PZ at increasing lipolysis in adipocytes. In addition, PT also suppresses inflammatory response in macrophage that is stimulated by differentiated media from 3T3-L1 cells.

Mitochondrial dysfunction in metabolic syndrome and asthma

Though severe or refractory asthma merely affects less than 10% of asthma population, it consumes significant health resources and contributes significant morbidity and mortality. Severe asthma does not fell in the routine definition of asthma and requires alternative treatment strategies. It has been observed that asthma severity increases with higher body mass index. The obese-asthmatics, in general, have the features of metabolic syndrome and are progressively causing a significant burden for both developed and developing countries thanks to the westernization of the world. As most of the features of metabolic syndrome seem to be originated from central obesity, the underlying mechanisms for metabolic syndrome could help us to understand the pathobiology of obese-asthma condition. While mitochondrial dysfunction is the common factor for most of the risk factors of metabolic syndrome, such as central obesity, dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, the involvement of mitochondria in obese-asthma pathogenesis seems to be important as mitochondrial dysfunction has recently been shown to be involved in airway epithelial injury and asthma pathogenesis. This review discusses current understanding of the overlapping features between metabolic syndrome and asthma in relation to mitochondrial structural and functional alterations with an aim to uncover mechanisms for obese-asthma.