Obesity-Related Asthma: Structure and Inflammation

PURPOSE OF REVIEW: Asthma and obesity are affecting children and teenagers at higher rates than previous generations. Epidemiological data link obesity during childhood with the subsequent development of asthma. In this review we describe developmental and inflammatory factors that contribute to asthma severity in children with obesity. RECENT FINDINGS: Asthma driven by obesity is likely due to both structural and inflammatory changes. Excess weight places mechanical stress on the airway thereby reducing lung volumes. In addition, obesity is linked to chronic inflammation. Adipose tissue releases pro-inflammatory cytokines (IL-6 and TNF-α) which drives the airway towards hyperresponsiveness. This "obesity-related asthma" phenotype does not respond well to corticosteroids making these patients difficult to treat. In children and teenagers, treatment options are limited to currently approved asthma medications; however, improvement in asthma control has been observed in adults utilizing metformin and GLP-1 agonists. Children with obesity are more likely to develop asthma. Their asthma symptoms tend to be more frequent and harder to control. With the rate of obesity on the rise, it is paramount to identify the mechanisms underlying systemic inflammation in those with elevated BMIs. This will allow us to find better treatment options for "obesity-related asthma."