RELATIONS BETWEEN ASTHMA AND OBESITY: AN ANALYSIS OF MULTIPLE FACTORS

Bibliometric Insights into Research Hotspots and Trends in Obesity and Asthma from 2013 to 2023

INTRODUCTION

Obesity and asthma are closely linked, but the current state of research on this topic and future research directions have yet to be comprehensively explored. This study aims to provide an up-to-date overview of the research landscape in the field of obesity and asthma.

METHODS

A bibliometric analysis was conducted using the Web of Science Core Collection database to identify papers published on obesity and asthma between 2013 and 2023. VOSviewer software was utilized for statistical analysis and visualization of collaborative networks, research trends, literature sources, citation analysis, co-citation analysis, and keyword analysis.

RESULTS

A total of 3,406 records from 1,010 journals authored by 17,347 researchers affiliated with 4,573 institutes across 117 countries and regions were retrieved. The number of publications and citations increased annually. The USA and China contributed the majority of records. Major nodes in the collaboration network map included Harvard Medical School, Johns Hopkins University, University of Newcastle, Karolinska Institution, University of Toronto, and Seoul National University. Prolific authors included Anne E. Dixon, Erick Forno, Lisa G. Wood, Deepa Rastogi, and Fernando Holguin. Research trends and hotspots focused on metabolism studies, Mendelian randomization, gut microbiome, inflammation response, gene, biomarker research, and comorbidities were identified as potential future research frontiers.

CONCLUSION

This study provides a comprehensive overview of the current research status and trends in the field of obesity and asthma. Our findings highlight the importance of understanding collaboration patterns, research hotspots, and emerging frontiers to guide future research in this area.

Gastroesophageal reflux disease, obesity, bronchial asthma: simple combination or complex interaction

Gastroesophageal reflux disease (GERD) continues to be one of the most common diseases in primary health care. In recent years, the presence of several diseases in the same patient at the same time has been widely discussed. An increase in persons suffering from several chronic diseases is associated with a deterioration in the quality of life, a high risk of hospitalization and mortality, and taking into account the presence of co/poly/multimorbidity is necessary for decision-making when developing a patient management strategy in primary health care. Studies on GERD, obesity and bronchial asthma have shown that there are common and bidirectional mechanisms in the development of these diseases. And, there are many gaps in understanding these relationships, it is important to identify concomitant diseases, since they can be the cause of resistance to therapy, to form an unfavorable prognosis of their course.

SNPs, adipokynes and adiposity in children with asthma

OBJECTIVES

Asthma and obesity are complex disorders influenced by environmental and genetic factors. We performed an integrative review of genetic polymorphisms and adipokines effects in children and adolescents with asthma and obesity.

DATA SOURCES

Articles focused on these issues were collected from SciELO, PubMed, LILACS, Embase and ScienceDirect electronic databases, in 2009-2020 period.

STUDY SELECTIONS

22 articles were selected, including clinical trials, analyses approaches, case-control studies, meta-analysis and Mendelian randomization studies.

RESULTS

Leptin concentrations were higher in obesity and asthma. The high value of BMI and Leptin indicated severe asthma. Adiponectin may be reduced in obese children. The high value of BMI and low level of Adiponectin may indicate severe asthma. Some linkage of PRKCA gene, asthma and BMI was observed. FTO T allele rs62048379 was positively associated with overweight/obesity, related to protein and PUFA:SFA ratio intake and influences the choice of more energy-dense foods. FTO rs9939609 effects are more pronounced among children with insufficient vitamin D levels.

CONCLUSION

Leptin may be a potential predictor for asthma control in children. BMI and Adiponectin could have certain predictive value for asthma. FTO gene was related to a higher mean BMI Z-score and accelerated developmental age per allele. Strong genetic heterogeneity influencing on asthma and obesity susceptibilities is evident and related to distinct genetic features. GWAS with childhood obesity in asthma contributed to greater insights, mainly on later childhood. Standardized definitions for asthma and overweight/obesity in studies approaching adipokines and SNPs would provide stronger evidence in deciding the best management.

Comparison of Pulmonary Function and Inflammation in Children/Adolescents with New-Onset Asthma with Different Adiposity Statuses

(1) Background: The relationship between obesity and asthma is still uncertain. This study aimed to investigate the effect of overweight/obesity on the pulmonary function of patients with new-onset pediatric asthma and explore the possible causative factors related to concomitant obesity and asthma. (2) Methods: Patients aged 5 to 17 years old with newly diagnosed mild to moderate asthma were recruited from June 2018 to May 2019, from a respiratory clinic in Shanghai, China. Participants were categorized into three groups: normal weight, overweight, and obese asthma. A family history of atopy and patients’ personal allergic diseases were recorded. Pulmonary function, fractional exhaled nitric oxide (FeNO), eosinophils, serum-specific immunoglobulins E (sIgE), serum total IgE (tIgE), and serum inflammatory biomarkers (adiponectin, leptin, Type 1 helper T, and Type 2 helper T cytokines) were tested in all participants. (3) Results: A total of 407 asthma patients (197 normal weight, 92 overweight, and 118 obese) were enrolled. There was a reduction in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC), FEV1/FVC%, and FEF25–75% in the overweight/obese groups. No difference was found between the study groups in the main allergy characteristics. Leptin levels were higher while adiponectin was lower in asthmatics with obesity. Higher levels of IL-16 were found in overweight/obese asthmatic individuals than in normal-weight individuals. (4) Conclusions: Obesity may have an effect on impaired pulmonary function. While atopic inflammation plays an important role in the onset of asthma, nonatopic inflammation (including leptin and adiponectin) increases the severity of asthma in overweight/obese patients. The significance of different levels of IL-16 between groups needs to be further studied.

COVID-19 and Pediatric Asthma: Clinical and Management Challenges

Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents than on adults. Fever, cough and shortness of breath are the most common symptoms and signs in children; wheezing has not been frequently reported. Published studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This hypothesis raises two issues: is asthma (and/or atopy) an independent protective factor for COVID-19? If yes, why? Explanations for this could include the lower IFN-α production, protective role of eosinophils in the airway, and antiviral and immunomodulatory proprieties of inhaled steroids. Additionally, recent evidence supports that allergic sensitization is inversely related to ACE2 expression. Obesity is a known risk factor for COVID-19 in adults. However, in the childhood asthma–obesity phenotype, the classic atopic Th2 pattern seems to predominate, which could hypothetically be a protective factor for severe SARS-CoV-2 infection in children with both conditions. Finally, the return to school activities raises concerns, as asymptomatic children could act as vectors for the spread of the disease. Although this is still a controversial topic, the identification and management of asymptomatic children is an important approach during the SARS-CoV-2 epidemic. Focus on asthma control, risk stratification, and medication adherence will be essential to allow children with asthma to return safely to school.