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Antonisamy B, Shailesh H, Hani Y, Ahmed LHM, Noor S, Ahmed SY, Alfaki M, Muhayimana A, Jacob SS, Balayya SK, Soloviov O, Liu L, Mathew LS, Wang K, Tomei S, Al Massih A, Mathew R, Karim MY, Ramanjaneya M, Worgall S, Janahi IA. Sphingolipids in Childhood Asthma and Obesity (SOAP Study): A Protocol of a Cross-Sectional Study. Metabolites 2023; 13:1146. [PMID: 37999242 PMCID: PMC10673587 DOI: 10.3390/metabo13111146] [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: 10/08/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Asthma and obesity are two of the most common chronic conditions in children and adolescents. There is increasing evidence that sphingolipid metabolism is altered in childhood asthma and is linked to airway hyperreactivity. Dysregulated sphingolipid metabolism is also reported in obesity. However, the functional link between sphingolipid metabolism, asthma, and obesity is not completely understood. This paper describes the protocol of an ongoing study on sphingolipids that aims to examine the pathophysiology of sphingolipids in childhood asthma and obesity. In addition, this study aims to explore the novel biomarkers through a comprehensive multi-omics approach including genomics, genome-wide DNA methylation, RNA-Seq, microRNA (miRNA) profiling, lipidomics, metabolomics, and cytokine profiling. This is a cross-sectional study aiming to recruit 440 children from different groups: children with asthma and normal weight (n = 100), asthma with overweight or obesity (n = 100), overweight or obesity (n = 100), normal weight (n = 70), and siblings of asthmatic children with normal weight, overweight, or obesity (n = 70). These participants will be recruited from the pediatric pulmonology, pediatric endocrinology, and general pediatric outpatient clinics at Sidra Medicine, Doha, Qatar. Information will be obtained from self-reported questionnaires on asthma, quality of life, food frequency (FFQ), and a 3-day food diary that are completed by the children and their parents. Clinical measurements will include anthropometry, blood pressure, biochemistry, bioelectrical impedance, and pulmonary function tests. Blood samples will be obtained for sphingolipid analysis, serine palmitoyltransferase (SPT) assay, whole-genome sequencing (WGS), genome-wide DNA methylation study, RNA-Seq, miRNA profiling, metabolomics, lipidomics, and cytokine analysis. Group comparisons of continuous outcome variables will be carried out by a one-way analysis of variance or the Kruskal-Wallis test using an appropriate pairwise multiple comparison test. The chi-squared test or a Fisher's exact test will be used to test the associations between categorical variables. Finally, multivariate analysis will be carried out to integrate the clinical data with multi-omics data. This study will help us to understand the role of dysregulated sphingolipid metabolism in obesity and asthma. In addition, the multi-omics data from the study will help to identify novel genetic and epigenetic signatures, inflammatory markers, and mechanistic pathways that link asthma and obesity in children. Furthermore, the integration of clinical and multi-omics data will help us to uncover the potential interactions between these diseases and to offer a new paradigm for the treatment of pediatric obesity-associated asthma.
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Affiliation(s)
- Belavendra Antonisamy
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Harshita Shailesh
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Yahya Hani
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Lina Hayati M. Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Safa Noor
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Salma Yahya Ahmed
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Mohamed Alfaki
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Abidan Muhayimana
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
| | - Shana Sunny Jacob
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Saroja Kotegar Balayya
- Analytical Chemistry Core, Advanced Diagnostic Core Facilities, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.S.J.); (S.K.B.)
| | - Oleksandr Soloviov
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Li Liu
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Lisa Sara Mathew
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Kun Wang
- Clinical Genomics Laboratory, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (O.S.); (L.L.); (L.S.M.); (K.W.)
| | - Sara Tomei
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Alia Al Massih
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Rebecca Mathew
- Omics Core, Integrated Genomics Services, Sidra Medicine, Doha P.O. Box 26999, Qatar; (S.T.); (A.A.M.); (R.M.)
| | - Mohammed Yousuf Karim
- Department of Pathology, Sidra Medicine, Doha P.O. Box 26999, Qatar;
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar;
- Translational Research Institute, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Stefan Worgall
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10021, USA;
| | - Ibrahim A. Janahi
- Department of Pediatric Medicine, Sidra Medicine, Doha P.O. Box 26999, Qatar; (B.A.); (H.S.); (Y.H.); (L.H.M.A.); (S.N.); (S.Y.A.); (M.A.); (A.M.)
- Department of Pediatrics, Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar
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Argentato PP, Guerra JVDS, Luzia LA, Ramos ES, Maschietto M, Rondó PHDC. Excessive Gestational Weight Gain Alters DNA Methylation and Influences Foetal and Neonatal Body Composition. EPIGENOMES 2023; 7:18. [PMID: 37606455 PMCID: PMC10443290 DOI: 10.3390/epigenomes7030018] [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: 06/24/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Changes in body weight are associated with the regulation of DNA methylation (DNAm). In this study, we investigated the associations between maternal gestational weight gain-related DNAm and foetal and neonatal body composition. METHODS Brazilian pregnant women from the Araraquara Cohort Study were followed up during pregnancy, delivery, and after hospital discharge. Women with normal pre-pregnancy BMI were allocated into two groups: adequate gestational weight gain (AGWG, n = 45) and excessive gestational weight gain (EGWG, n = 30). Foetal and neonatal body composition was evaluated via ultrasound and plethysmography, respectively. DNAm was assessed in maternal blood using Illumina Infinium MethylationEPIC BeadChip arrays. Linear regression models were used to explore the associations between DNAm and foetal and neonatal body composition. RESULTS Maternal weight, GWG, neonatal weight, and fat mass were higher in the EGWG group. Analysis of DNAm identified 46 differentially methylated positions and 11 differentially methylated regions (DMRs) between the EGWG and AGWG groups. Nine human phenotypes were enriched for these 11 DMRs located in 13 genes (EMILIN1, HOXA5, CPT1B, CLDN9, ZFP57, BRCA1, POU5F1, ANKRD33, HLA-B, RANBP17, ZMYND11, DIP2C, TMEM232), highlighting the terms insulin resistance, and hyperglycaemia. Maternal DNAm was associated with foetal total thigh and arm tissues and subcutaneous thigh and arm fat, as well as with neonatal fat mass percentage and fat mass. CONCLUSION The methylation pattern in the EGWG group indicated a risk for developing chronic diseases and involvement of maternal DNAm in foetal lean and fat mass and in neonatal fat mass.
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Affiliation(s)
- Perla Pizzi Argentato
- Nutrition Department, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, São Paulo 01246-904, SP, Brazil; (P.P.A.); (L.A.L.)
| | - João Victor da Silva Guerra
- Brazilian Biosciences National Laboratory (LNBio), Brazilian Centre for Research in Energy and Materials (CNPEM) and Graduate Program in Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, University of Campinas, Rua Giuseppe Máximo Scolfaro 10.000, Cidade Universitária, Campinas 13083-970, SP, Brazil;
| | - Liania Alves Luzia
- Nutrition Department, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, São Paulo 01246-904, SP, Brazil; (P.P.A.); (L.A.L.)
| | - Ester Silveira Ramos
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto 14049-900, SP, Brazil;
| | - Mariana Maschietto
- Boldrini Children’s Hospital, University of Campinas, Rua Márcia Mendes 619, Cidade Universitária, Campinas 13083-884, SP, Brazil;
| | - Patrícia Helen de Carvalho Rondó
- Nutrition Department, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, São Paulo 01246-904, SP, Brazil; (P.P.A.); (L.A.L.)
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Guerrero SC, Panettieri RA, Rastogi D. Mechanistic Links Between Obesity and Airway Pathobiology Inform Therapies for Obesity-Related Asthma. Paediatr Drugs 2023; 25:283-299. [PMID: 36656428 PMCID: PMC11071627 DOI: 10.1007/s40272-022-00554-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 01/20/2023]
Abstract
Obesity-related asthma is associated with a high disease burden and a poor response to existent asthma therapies, suggesting that it is a distinct asthma phenotype. The proposed mechanisms that contribute to obesity-related asthma include the effects of the mechanical load of obesity, adipokine perturbations, and immune dysregulation. Each of these influences airway smooth muscle function. Mechanical fat load alters airway smooth muscle stretch affecting airway wall geometry, airway smooth muscle contractility, and agonist delivery; weight loss strategies, including medically induced weight loss, counter these effects. Among the metabolic disturbances, insulin resistance and free fatty acid receptor activation influence distinct signaling pathways in the airway smooth muscle downstream of both the M2 muscarinic receptor and the β2 adrenergic receptor, such as phospholipase C and the extracellular signal-regulated kinase signaling cascade. Medications that decrease insulin resistance and dyslipidemia are associated with a lower asthma disease burden. Leptin resistance is best understood to modulate muscarinic receptors via the neural pathways but there are no specific therapies for leptin resistance. From the immune perspective, monocytes and T helper cells are involved in systemic pro-inflammatory profiles driven by obesity, notably associated with elevated levels of interleukin-6. Clinical trials on tocilizumab, an anti-interleukin antibody, are ongoing for obesity-related asthma. This armamentarium of therapies is distinct from standard asthma medications, and once investigated for its efficacy and safety among children, will serve as a novel therapeutic intervention for pediatric obesity-related asthma. Irrespective of the directionality of the association between asthma and obesity, airway-specific mechanistic studies are needed to identify additional novel therapeutic targets for obesity-related asthma.
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Affiliation(s)
- Silvia Cabrera Guerrero
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Reynold A Panettieri
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Deepa Rastogi
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA.
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Li N, He F, Shang Y. Growth differentiation factor 15 protects the airway by inhibiting cell pyroptosis in obese asthmatic mice through the phosphoinositide 3-kinase/AKT pathway. Int Immunopharmacol 2023; 119:110149. [PMID: 37058747 DOI: 10.1016/j.intimp.2023.110149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/11/2023] [Accepted: 03/31/2023] [Indexed: 04/16/2023]
Abstract
Obese asthma is a form of refractory asthma with inflammation as the underlying mechanism. The specific mechanism of action of anti-inflammatory growth differentiation factor 15 (GDF15) in obese asthma is unclear. The purpose of this study was to explore the effect of GDF15 on cell pyroptosis in obese asthma and to determine its mechanism of airway protection. Male C57BL6/J mice were fed with a high-fat diet, sensitized, and challenged with ovalbumin. Recombinant human (rh)GDF15 was administered 1 h before the challenge. GDF15 treatment significantly reduced airway inflammatory cell infiltration, mucus hypersecretion and airway resistant, and decreased cell counts and inflammatory factors in bronchoalveolar lavage fluid. Serum inflammatory factors decreased, and the increased levels of NLR family pyrin domain containing 3 (NLRP3), caspase-1, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), and gasdermin-D (GSDMD-N) in obese asthmatic mice were inhibited. Furthermore, the suppressed phosphoinositide 3-kinase (PI3K)/AKT signal pathway was activated after rhGDF15 treatment. The same result was obtained by overexpression of GDF15 in human bronchial epithelial cells induced by lipopolysaccharide (LPS) in vitro, and the effect of GDF15 was reversed after the application of a PI3K pathway inhibitor. Thus, GDF15 could protect the airway by inhibiting cell pyroptosis in obese asthmatic mice through the PI3K/AKT signaling pathway.
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Affiliation(s)
- Na Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China; Department of Pediatrics, The Second Hospital of Dalian Medical University, No. 467, Zhongshan Road, Shahekou District, Dalian 116021, Liaoning Province, China
| | - Fanghan He
- Department of Pediatrics, Xi'an Children's Hospital, No. 69, Xi Ju Yuan Xiang, Lianhu District, Xi'an 710002, Shanxi Province, China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China.
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Dixon AE, Que LG. Interplay between Immune and Airway Smooth Muscle Cells in Obese Asthma. Am J Respir Crit Care Med 2023; 207:388-389. [PMID: 36219828 PMCID: PMC9940139 DOI: 10.1164/rccm.202210-1870ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Anne E Dixon
- Department of Medicine University of Vermont Burlington, Vermont
| | - Loretta G Que
- Department of Medicine Duke University Health System Durham, North Carolina
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Yon C, Thompson DA, Jude JA, Panettieri RA, Rastogi D. Crosstalk between CD4 + T Cells and Airway Smooth Muscle in Pediatric Obesity-related Asthma. Am J Respir Crit Care Med 2023; 207:461-474. [PMID: 36194662 DOI: 10.1164/rccm.202205-0985oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Pediatric obesity-related asthma is a nonatopic asthma phenotype with high disease burden and few effective therapies. RhoGTPase upregulation in peripheral blood T helper (Th) cells is associated with the phenotype, but the mechanisms that underlie this association are not known. Objectives: To investigate the mechanisms by which upregulation of CDC42 (Cell Division Cycle 42), a RhoGTPase, in Th cells is associated with airway smooth muscle (ASM) biology. Methods: Chemotaxis of obese asthma and healthy-weight asthma Th cells, and their adhesion to obese and healthy-weight nonasthmatic ASM, was investigated. Transcriptomics and proteomics were used to determine the differential effect of obese and healthy-weight asthma Th cell adhesion to obese or healthy-weight ASM biology. Measurements and Main Results: Chemotaxis of obese asthma Th cells with CDC42 upregulation was resistant to CDC42 inhibition. Obese asthma Th cells were more adherent to obese ASM compared with healthy-weight asthma Th cells to healthy-weight ASM. Compared with coculture with healthy-weight ASM, obese asthma Th cell coculture with obese ASM was positively enriched for genes and proteins involved in actin cytoskeleton organization, transmembrane receptor protein kinase signaling, and cell mitosis, and negatively enriched for extracellular matrix organization. Targeted gene evaluation revealed upregulation of IFNG, TNF (tumor necrosis factor), and Cluster of Differentiation 247 (CD247) among Th cell genes, and of Ak strain transforming (AKT), Ras homolog family member A (RHOA), and CD38, with downregulation of PRKCA (Protein kinase C-alpha), among smooth muscle genes. Conclusions: Obese asthma Th cells have uninhibited chemotaxis and are more adherent to obese ASM, which is associated with upregulation of genes and proteins associated with smooth muscle proliferation and reciprocal nonatopic Th cell activation.
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Affiliation(s)
- Changsuek Yon
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC; and
| | - David A Thompson
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC; and
| | - Joseph A Jude
- Rutgers Institute for Translational Medicine and Science, Child Health Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Reynold A Panettieri
- Rutgers Institute for Translational Medicine and Science, Child Health Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Deepa Rastogi
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC; and
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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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Thompson D, Wood LG, Williams EJ, McLoughlin RF, Rastogi D. Endotyping pediatric obesity-related asthma: Contribution of anthropometrics, metabolism, nutrients, and CD4 + lymphocytes to pulmonary function. J Allergy Clin Immunol 2022; 150:861-871. [PMID: 35654239 PMCID: PMC9547831 DOI: 10.1016/j.jaci.2022.04.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/12/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obesity-related complications including visceral fat, metabolic abnormalities, nutrient deficiencies, and immune perturbations are interdependent but have been individually associated with childhood asthma. OBJECTIVE We sought to endotype childhood obesity-related asthma by quantifying contributions of obesity-related complications to symptoms and pulmonary function. METHODS Multiomics analysis using Similarity Network Fusion followed by mediation analysis were performed to quantify prediction of obese asthma phenotype by different combinations of anthropometric, metabolic, nutrient, and TH-cell transcriptome and DNA methylome data sets. RESULTS Two clusters (n = 28 and 26) distinct in their anthropometric (neck and midarm circumference, waist to hip ratio [WHR], and body mass index [BMI] z score), metabolic, nutrient, and TH-cell transcriptome and DNA methylome footprint predicted 5 or more pulmonary function indices across 7 different data set combinations. Metabolic measures attenuated the association of neck, WHR, and BMI z score with FEV1/forced vital capacity (FVC) ratio and expiratory reserve volume (ERV), of neck, midarm, and BMI z score with functional residual capacity, but only of WHR with inspiratory capacity. Nutrient levels attenuated the association of neck, midarm circumference, and BMI z score with functional residual capacity, and of WHR with FEV1/FVC ratio, ERV, and inspiratory capacity. TH-cell transcriptome attenuated the association of all 4 anthropometric measures with FEV1/FVC ratio, but only of WHR with ERV and inspiratory capacity. The DNA methylome attenuated the association of all 4 anthropometric measures with FEV1/FVC ratio and ERV, but only of WHR with inspiratory capacity. CONCLUSIONS Anthropometric, metabolic, nutrient, and immune perturbations have individual but interdependent contributions to obese asthma phenotype, with the most consistent effect of WHR, highlighting the role of truncal adiposity in endotyping childhood obesity-related asthma.
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Affiliation(s)
- David Thompson
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, University of Newcastle, New Lambton Heights, Australia
| | - Evan J Williams
- Priority Research Centre for Healthy Lungs, University of Newcastle, New Lambton Heights, Australia
| | - Rebecca F McLoughlin
- Priority Research Centre for Healthy Lungs, University of Newcastle, New Lambton Heights, Australia
| | - Deepa Rastogi
- Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC.
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Reyes-Angel J, Kaviany P, Rastogi D, Forno E. Obesity-related asthma in children and adolescents. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:713-724. [PMID: 35988550 DOI: 10.1016/s2352-4642(22)00185-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 05/23/2023]
Abstract
There is substantial epidemiological and experimental evidence of an obesity-related asthma phenotype. Compared to children of healthy weight, children with obesity are at higher risk of asthma. Children with obesity who have asthma have greater severity and poorer control of their asthma symptoms, more frequent asthma exacerbations, and overall lower asthma-related quality of life than children with asthma who have a healthy weight. In this Review, we examine some of the latest evidence on the characteristics of this phenotype and its main underlying mechanisms, including genetics and genomics, changes in airway mechanics and lung function, sex hormone differences, alterations in immune responses, systemic and airway inflammation, metabolic dysregulation, and modifications in the microbiome. We also review current recommendations for the treatment of these children, including in the management of their asthma, and current evidence for weight loss interventions. We then discuss initial evidence for potential novel therapeutic approaches, such as dietary modifications and supplements, antidiabetic medications, and statins. Finally, we identify knowledge gaps and future directions to improve our understanding of asthma in children with obesity, and to improve outcomes in these susceptible children. We highlight important needs, such as designing paediatric-specific studies, implementing large multicentric trials with standardised interventions and outcomes, and including racial and ethnic groups along with other under-represented populations that are particularly affected by obesity and asthma.
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Affiliation(s)
- Jessica Reyes-Angel
- Division of Pulmonary Medicine and Pediatric Asthma Center, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Parisa Kaviany
- Division of Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Deepa Rastogi
- Division of Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Erick Forno
- Division of Pulmonary Medicine and Pediatric Asthma Center, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Xu Z, Forno E, Acosta-Pérez E, Han YY, Rosser F, Manni ML, Canino G, Chen W, Celedón JC. Differential gene expression in nasal airway epithelium from overweight or obese youth with asthma. Pediatr Allergy Immunol 2022; 33:e13776. [PMID: 35470932 PMCID: PMC9047012 DOI: 10.1111/pai.13776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND The mechanisms underlying the known link between overweight/obesity and childhood asthma are unclear. We aimed to identify differentially expressed genes and pathways associated with obesity-related asthma through a transcriptomic analysis of nasal airway epithelium. METHODS We compared the whole transcriptome in nasal airway epithelium of youth with overweight or obesity and asthma with that of youth of normal weight and asthma, using RNA sequencing data from a cohort of 235 Puerto Ricans aged 9-20 years (EVA-PR) and an independent cohort of 66 children aged 6-16 years in Pittsburgh (VDKA). Differential expression analysis adjusting for age, sex, sequencing plate number, and sample sorting protocol, and the first five principal components were performed independently in each cohort. Results from the two cohorts were combined in a transcriptome-wide meta-analysis. Gene enrichment and network analyses were performed on top genes. RESULTS In the meta-analysis, 29 genes were associated with obesity-related asthma at an FDR-adjusted p <.05, including pro-inflammatory genes known to be differentially expressed in adipose tissue of obese subjects (e.g., CXCL11, CXCL10, and CXCL9) and several novel genes. Functional enrichment analyses showed that pathways for interferon signaling, and innate and adaptive immune responses were down-regulated in overweight/obese youth with asthma, while pathways related to ciliary structure or function were up-regulated. Upstream regulatory analysis predicted significant inhibition of the IRF7 pathway. Network analyses identified "hub" genes like GBP5 and SOCS1. CONCLUSION Our transcriptome-wide analysis of nasal airway epithelium identified biologically plausible genes and pathways for obesity-related asthma in youth.
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Affiliation(s)
- Zhongli Xu
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, PR, USA
| | - Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Franziska Rosser
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michelle L. Manni
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, PR, USA
| | - Wei Chen
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Juan C. Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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11
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Zhang Q, Jin D, Mou X, Ye H. PBMC CDC42 reveals the disease activity and treatment efficacy of TNF inhibitor in patients with ankylosing spondylitis. J Clin Lab Anal 2022; 36:e24267. [PMID: 35104386 PMCID: PMC8906019 DOI: 10.1002/jcla.24267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Cell division cycle 42 (CDC42) regulates the polarization of M2 macrophage and maintains the T cell homeostasis, to participate in multiple autoimmune diseases, while its clinical involvement in ankylosing spondylitis (AS) remains unclear. Hence, the current study aimed to investigate the correlation of CDC42 with clinical characteristics and treatment outcome in AS patients receiving tumor necrosis factor (TNF) inhibitor therapy. METHODS Peripheral blood mononuclear cell (PBMC) CDC42 expression was detected at baseline, week (W) 4, W8, and W12 after TNF inhibitor treatment in 91 AS patients and in 50 HCs after enrollment. Furthermore, serum TNF-α, interferon-γ (IFN-γ), interleukin-10 (IL-10), and interleukin-17A (IL-17A) from AS patients were detected at baseline. RESULTS Blood CDC42 was lower in AS patients compared with HCs (p < 0.001). Additionally, blood CDC42 was negatively linked with CRP (r = -0.349, p = 0.001), BASDAI score (r = -0.243, p = 0.020), and ASDASCRP score (r = -0.238, p = 0.023) in AS patients; however, blood CDC42 was not correlated with other clinical characteristics. Besides, CDC42 was negatively correlated with TNF-α (r = -0.237, p = 0.024) and IL-17A (r = -0.339, p = 0.001) but not with IFN-γ (p = 0.083) or IL-10 (p = 0.280). Moreover, blood CDC42 was elevated after TNF inhibitor treatment (p < 0.001). Meanwhile, blood CDC42 was not varied at baseline and W4 between response patients and non-response patients, while it was higher at W8 (p = 0.019) and W12 (p = 0.002) in response patients than in non-response patients after treatment. CONCLUSION Blood CDC42 deficiency links with elevated pro-inflammatory cytokines, disease activity and unsatisfying response to TNF inhibitor in AS patients.
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Affiliation(s)
- Qian Zhang
- Department of RheumatologyTaizhou First People’s HospitalTaizhouChina
| | - Du Jin
- Department of RheumatologyTaizhou First People’s HospitalTaizhouChina
| | - Xiaoyue Mou
- Department of RheumatologyTaizhou First People’s HospitalTaizhouChina
| | - Hengli Ye
- Department of OrthopedicsHuangyan Hospital Of Traditional Chinese MedicineTaizhouChina
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12
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Alfano R, Robinson O, Handakas E, Nawrot TS, Vineis P, Plusquin M. Perspectives and challenges of epigenetic determinants of childhood obesity: A systematic review. Obes Rev 2022; 23 Suppl 1:e13389. [PMID: 34816569 DOI: 10.1111/obr.13389] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
The tremendous increase in childhood obesity prevalence over the last few decades cannot merely be explained by genetics and evolutionary changes in the genome, implying that gene-environment interactions, such as epigenetic modifications, likely play a major role. This systematic review aims to summarize the evidence of the association between epigenetics and childhood obesity. A literature search was performed via PubMed and Scopus engines using a combination of terms related to epigenetics and pediatric obesity. Articles studying the association between epigenetic mechanisms (including DNA methylation and hydroxymethylation, non-coding RNAs, and chromatin and histones modification) and obesity and/or overweight (or any related anthropometric parameters) in children (0-18 years) were included. The risk of bias was assessed with a modified Newcastle-Ottawa scale for non-randomized studies. One hundred twenty-one studies explored epigenetic changes related to childhood obesity. DNA methylation was the most widely investigated mechanism (N = 101 studies), followed by non-coding RNAs (N = 19 studies) with evidence suggestive of an association with childhood obesity for DNA methylation of specific genes and microRNAs (miRNAs). One study, focusing on histones modification, was identified. Heterogeneity of findings may have hindered more insights into the epigenetic changes related to childhood obesity. Gaps and challenges that future research should face are herein described.
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Affiliation(s)
- Rossella Alfano
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Evangelos Handakas
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Unit of Molecular and Genetic Epidemiology, Human Genetic Foundation (HuGeF), Turin, Italy
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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13
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Forno E, Abman SH, Singh J, Robbins ME, Selvadurai H, Schumacker PT, Robinson PD. Update in Pediatrics 2020. Am J Respir Crit Care Med 2021; 204:274-284. [PMID: 34126039 DOI: 10.1164/rccm.202103-0605up] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Erick Forno
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven H Abman
- Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado.,University of Colorado Anschutz School of Medicine, Denver, Colorado
| | - Jagdev Singh
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mary E Robbins
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; and.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Hiran Selvadurai
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Paul T Schumacker
- Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois; and.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paul D Robinson
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Pediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
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14
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Abstract
PURPOSE OF REVIEW Pediatric obese asthma is a complex disease that remains poorly understood. The increasing worldwide incidence of both asthma and obesity over the last few decades, their current high prevalence and the challenges in treating obese asthmatic patients all highlight the importance of a better understanding of the pathophysiological mechanisms in obese asthma. While it is well established that patients with obesity are at an increased risk of developing asthma, the mechanisms by which obesity drives the onset of asthma, and modifies existing asthma, remain unclear. Here, we will focus on mechanisms by which obesity alters immune function in asthma. RECENT FINDINGS Lung parenchyma has an altered structure in some pediatric obese asthmatics, known as dysanapsis. Central adiposity is linked to reduced pulmonary function and a better predictor of asthma risk in children than BMI. Obesity in young children is associated with an increased risk of developing asthma, as well as early puberty, and hormonal alterations are implicated in obese asthma. Obesity and asthma each yield immunometabolic dysregulation separately and we are learning more about alterations in these pathways in pediatric obese asthma and the potential impact of bariatric surgery on those processes. SUMMARY The recent progress in clarifying the connections between childhood obesity and asthma and their combined impacts on immune function moves us closer to the goals of improved understanding of the pathophysiological mechanisms underpinning obese asthma and improved therapeutic target selection. However, this common inflammatory disease remains understudied, especially in children, and much remains to be learned.
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Affiliation(s)
- Ceire Hay
- Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Allergy Immunology, Philadelphia, PA
| | - Sarah E. Henrickson
- Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Allergy Immunology, Philadelphia, PA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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15
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Abstract
PURPOSE OF REVIEW Asthma is a common disease worldwide, however, its pathogenesis has not been fully elucidated. Emerging evidence suggests that epigenetic modifications may play a role in the development and natural history of asthma. The aim of this review is to highlight recent progress in research on epigenetic mechanisms in asthma. RECENT FINDINGS Over the past years, epigenetic studies, in particular DNA methylation studies, have added to the growing body of evidence supporting a link between epigenetic regulation of gene expression and asthma. Recent studies demonstrate that epigenetic mechanisms also play a role in asthma remission. Although most existing studies in this field have been conducted on blood cells, recent evidence suggests that epigenetic signatures are also crucial for the regulation of airway epithelial cells. Studies conducted on nasal epithelium revealed highly replicable epigenetic patterns that could be used for diagnostic purposes. SUMMARY Further research is needed to explore the diagnostic and therapeutic potential of epigenetic modifications in asthma. Multiomics studies on asthma will become increasingly important for a better understanding of etiology, heterogeneity, and severity of asthma, as well as establishing molecular biomarkers that could be combined with clinical information to improve the management of asthma patients.
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16
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Affiliation(s)
- Sunita Sharma
- Pulmonary Sciences and Critical Care MedicineUniversity of Colorado DenverDenver, Colorado
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