哮喘联盟

   摘要 
   背景和目的：流行病学数据显示肥胖是偶发性哮喘的危险因素之一。但是，肥胖与哮喘关联的机制尚未完全明了。本文总结目前对肥胖和哮喘可能关系的认识。
   方法：系统文献综述。
   结果：肥胖与哮喘有一些共同的致病因子，如共同的基因诱发因子、子宫内作用，同时具有共同的预测因子，如身体锻炼和饮食。肥胖会引起呼吸系统的重要改变，这可以解释哮喘的发生。但是，似乎存在肥胖导致或加重哮喘的生物机制。这种机制包括胃食管反流、睡眠呼吸障碍、低肺流量呼吸、慢性系统性炎症在内的合并症，还有内分泌因子，如脂肪因子和生殖激素。肥胖相关哮喘通常不与嗜酸性气道炎症总体相关，脂肪因子在肥胖哮喘患者炎性致病机制中似乎有重要地位。
   结论：肥胖与哮喘的关系并不明确，需要进一步的研究。理解潜在机制可能为哮喘高危人群带来新的治疗方案。

 

(林江涛 审校)
Respir Med. 2013 May 1. pii: S0954-6111(13)00129-7. doi: 10.1016/j.rmed.2013.03.019. [Epub ahead of print]

 

Obesity and asthma: A coincidence or a causal relationship? A systematic review.

Ali Z, Ulrik CS.

Abstract
BACKGROUND AND AIM: Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed association between obesity and asthma.
METHODS:Systematic literature review.
RESULTS:Obesity and asthma share some etiological factors, such as a common genetic predisposition and effects of in utero conditions, and may also have common predisposing factors such as physical activity and diet.Obesity results in important changes in the mechanical properties of the respiratory system which could explain the occurrence of asthma. However, there are also plausible biological mechanisms whereby obesity could be expected to either cause or worsen asthma. These include co-morbidities such as gastro-oesophageal reflux, complications from sleep-disordered breathing, breathing at low lung volumes, chronic systemic inflammation, and endocrine factors, including adipokines and reproductive hormones. Obesity related asthma is in general not associated with eosinophilic airway inflammation, and adipokines are likely to play important roles in the inflammatory pathogenesis of asthma in obese individuals.
CONCLUSION: The association between obesity and asthma is not straightforward, and further knowledge is clearly needed, as understanding the underlying mechanisms may lead to new therapeutic options for this high-risk part of the asthma population.
 

Respir Med. 2013 May 1. pii: S0954-6111(13)00129-7. doi: 10.1016/j.rmed.2013.03.019. [Epub ahead of print]