Abstract
There is an increase in the prevalence of asthma and obesity, constituting a public health problem at national and global levels. The association between the two pathologies has not been clearly determined; however, a certain synergy has been proposed, which leads to more severe bronchospasms, longer recovery time, and more prolonged use of medications in obese asthmatic patients. The discovery of leptin, an adipokine that is directly related to the amount of total body fat and the production of proinflammatory cytokines, has generated greater interest in white adipose tissue. Our objective was to describe the possible mechanisms involved and the association between obesity and asthma. A bibliographic search was conducted in the scientific literature using the National Biotechnology Information Center (NCBI) database of the USA as a search tool; keywords used were: asthma, leptin, obesity and inflammation. There are numerous clinical and experimental studies that explore the role of obesity as an inflammatory entity in asthma, some of which have evaluated the role of “shared” genetic polymorphisms in both pathologies. Apparently, the interaction between asthma and obesity is complex, there are mechanisms that link both pathologies, these can influence the improvement or exacerbation of symptoms.
References
Global Initiative for Asthma. [Sitio web]. Global Strategy for Asthma Management and Prevention (update 2016). USA: GINA; 2016. Disponible en: http://ginasthma.org/
Braman SS. The global burden of asthma. Chest. 2006;130(1 Suppl):4S-12S. DOI: http://dx.doi.org/10.1378/chest.130.1_suppl.4S.
Subbarao P, Mandhane PJ, Sears MR. Asthma: Epidemiology, etiology and risk factors. CMAJ. 2009;181(9):E181-E190. DOI: http://dx.doi.org/10.1503/cmaj.080612.
Carroll CL, Bhandari A, Zucker AR, Schramm CM. Childhood obesity increases duration of therapy during severe asthma exacerbations. Pediatr Crit Care Med. 2006;7(6):527-531. DOI: http://dx.doi.org/10.1097/01.PCC.0000243749.14555.E8.
Castro-Rodríguez JA, Holberg CJ, Morgan WJ, Wright AL, Martínez FD. Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med. 2001;163(6):1344-1349. DOI: http://dx.doi.org/10.1164/ajrccm.163.6.2006140.
Gutiérrez-Delgado RI, Barraza-Villarreal A, Escamilla-Núñez MC, Solano-González M, Moreno-Macías H, Romieu I. [Food consumption and asthma in school children in Cuernavaca, Morelos, Mexico]. Salud Publica Mex. 2009;51(3):202-211.
Peroni D, Paiola G, Tenero L, de-Luca G. Exercise-induced bronchospasm or dyspnoea in obese children? Allergol Immunopathol (Madr). 2009;37(4):173-174. DOI: http://dx.doi.org/10.1016/j.aller.2009.04.001.
Lopes WA, Radominski RB, Rosário Filho NA, Leite N. Exercise-induced bronchospasm in obese adolescents. Allergol Immunopathol (Madr). 2009;37(4):175-179. DOI: http://dx.doi.org/10.1016/j.aller.2009.03.001.
Stenius-Aarniala B, Poussa T, Kvarnström J, Grönlund EL, Ylikahri M, Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: Randomised controlled study. BMJ. 2000;320(7238):827-832. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27319/
Dhabuwala A, Cannan RJ, Stubbs RS. Improvement in co-morbidities following weight loss from gastric bypass surgery. Obes Surg. 2000;10(5):428-435. DOI: http://dx.doi.org/10.1381/096089200321594291.
Geffner ME. Aromatase inhibitors to augment height: continued caution and study required. J Clin Res Pediatr Endocrinol. 2009;1(6):256-261. DOI: http://dx.doi.org/10.4274/jcrpe.v1i6.256.
Camargo CA, Weiss ST, Zhang S, Willett WC, Speizer FE. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med. 1999;159(21):2582-2588.
Kim S-H, Kim D-J, Seo IA, Min YK, Lee MS, Kim KW, Lee MK. Significance of beta2-adrenergic receptor gene polymorphism in obesity and type 2 diabetes mellitus in Korean subjects. Metabolism. 2002;51(7):833-837.
Ellsworth DL, Coady SA, Chen W, Srinivasan SR, Boerwinkle E, Berenson GS. Interactive effects between polymorphisms in the beta-adrenergic receptors and longitudinal changes in obesity. Obes Res. 2005;13(3):519-526. DOI: http://dx.doi.org/10.1038/oby.2005.55.
Martin AC, Zhang G, Rueter K, Khoo SK, Bizzintino J, Hayden CM, et al. Beta2-adrenoceptor polymorphisms predict response to beta2-agonists in children with acute asthma. J Asthma. 2008;45(5):383-388. DOI: http://dx.doi.org/10.1080/02770900801971792.
Cellini E, Castellini G, Ricca V, Bagnoli S, Tedde A, Rotella CM, et al. Glucocorticoid receptor gene polymorphisms in Italian patients with eating disorders and obesity. Psychiatr Genet. 2010;20(6):282-288. DOI: http://dx.doi.org/10.1097/YPG.0b013e32833a2142.
Jiménez-Morales S, Velázquez-Cruz R, Ramírez-Bello J, Bonilla-González E, Romero-Hidalgo S, Escamilla-Guerrero G, et al. Tumor necrosis factor-alpha is a common genetic risk factor for asthma, juvenile rheumatoid arthritis, and systemic lupus erythematosus in a Mexican pediatric population. Hum Immunol. 2009;70(4):251-256. DOI: http://dx.doi.org/10.1016/j.humimm.2009.01.027.
Castro-Giner F, Kogevinas M, Imboden M, de-Cid R, Jarvis D, Mächler M, et al. Joint effect of obesity and TNFA variability on asthma: two international cohort studies. Eur Respir J. 2009;33(5):1003-1009. DOI: http://dx.doi.org/10.1183/09031936.00140608.
Hsu Y-H, Niu T, Song Y, Tinker L, Kuller LH, Liu S. Genetic variants in the UCP2-UCP3 gene cluster and risk of diabetes in the Women’s Health Initiative Observational Study. Diabetes. 2008;57(4):1101-1107. DOI: http://dx.doi.org/10.2337/db07-1269.
Shao C, Suzuki Y, Kamada F, Kanno K, Tamari M, Hasegawa K, et al. Linkage and association of childhood asthma with the chromosome 12 genes. J Hum Genet. 2004;49(3):115-122. DOI: http://dx.doi.org/10.1007/s10038-003-0118-z.
Sin DD, Man SFP. Impaired lung function and serum leptin in men and women with normal body weight: A population based study. Thorax. 2003;58(8):695-698. DOI: http://dx.doi.org/10.1136/thorax.58.8.695
Kato H, Ueki S, Kamada R, Kihara J, Yamauchi Y, Suzuki T, et al. Leptin has a priming effect on eotaxin-induced human eosinophil chemotaxis. Int Arch Allergy Immunol. 2011;155(4):335-344. DOI: http://dx.doi.org/10.1159/000321195.
Soferman R, Glatstein M, Sivan Y, Weisman Y. HsCRP levels: Measurement of airway inflammation in asthmatic children. Pediatr Int. 2008;50(1):12-16. DOI: http://dx.doi.org/10.1111/j.1442-200X.2007.02517.x
Michelson PH, Williams LW, Benjamin DK, Barnato AE. Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001-2004. Ann Allergy Asthma Immunol. 2009;103(5):381-385. DOI: http://dx.doi.org/10.1016/S1081-1206(10)60356-0.
Huber J, Kiefer FW, Zeyda M, Ludvik B, Silberhumer GR, Prager G, et al. CC chemokine and CC chemokine receptor profiles in visceral and subcutaneous adipose tissue are altered in human obesity. J Clin Endocrinol Metab. 2008;93(8):3215-3221. DOI: http://dx.doi.org/10.1210/jc.2007-2630.
Zhang F, Basinski MB, Beals JM, Briggs SL, Churgay LM, Clawson DK, et al. Crystal structure of the obese protein leptin-E100. Nature. 1997;387(6629):206-209. DOI: http://dx.doi.org/10.1038/387206a0.
Kshatriya S, Liu K, Salah A, Szombathy T, Freeman RH, Reams GP, et al. Obesity hypertension: the regulatory role of leptin. Int J Hypertens. 2011;2011:270624. DOI: http://dx.doi.org/10.4061/2011/270624.+28.
Bergen HT, Cherlet TC, Manuel P, Scott JE. Identification of leptin receptors in lung and isolated fetal type II cells. Am J Respir Cell Mol Biol. 2002;27(1):71-77. DOI: http://dx.doi.org/10.1165/ajrcmb.27.1.4540.
Isse N, Ogawa Y, Tamura N, Masuzaki H, Mori K, Okazaki T, et al. Structural organization and chromosomal assignment of the human obese gene. J Biol Chem. 1995;270(46):27728-27733. Disponible en: http://www.jbc.org/content/270/46/27728.long
Gómez R, Conde J, Gómez Reino JJ, Lago F, Gualillo O. Las adipocinas: mediadores emergentes de la respuesta inmune y de la inflamación. Reumatol Clin. 2009;5:6-12. DOI: http://dx.doi.org/10.1016/j.reuma.2008.12.003
Mai X-M, Böttcher MF, Leijon I. Leptin and asthma in overweight children at 12 years of age. Pediatr Allergy Immunol. 2004;15(6):523-530. DOI: http://dx.doi.org/10.1111/j.1399-3038.2004.00195.x.
Mai X-M, Chen Y, Krewski D. Does leptin play a role in obesity-asthma relationship? Pediatr Allergy Immunol. 2009;20(3):207-212.
Malavia NK, Raub CB, Mahon SB, Brenner M, Panettieri RA, George SC. Airway epithelium stimulates smooth muscle proliferation. Am J Respir Cell Mol Biol. 2009;41(3):297-304. DOI: http://dx.doi.org/10.1165/rcmb.2008-0358OC.
Story RE. Asthma and obesity in children. Curr Opin Pediatr. 2007;19(6):680-684. DOI: http://dx.doi.org/10.1097/MOP.0b013e3282f1ddfa

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2017 Revista Alergia México