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Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation

Background Asthma in obese subjects is poorly understood, and these patients are often refractory to standard therapy. Objectives We sought to gain insights into the pathogenesis and treatment of asthma in obese subjects by determining how obesity and bariatric surgery affect asthma control, airway... Full description

Journal Title: Journal of allergy and clinical immunology 2011, Vol.128 (3), p.508-515.e2
Main Author: Dixon, Anne E., MA, BM BCh
Other Authors: Pratley, Richard E., MD , Forgione, Patrick M., MD , Kaminsky, David A., MD , Whittaker-Leclair, Laurie A., MD , Griffes, Laurianne A., BA , Garudathri, Jayanthi, MS , Raymond, Danielle, BS , Poynter, Mathew E., PhD , Bunn, Janice Y., PhD , Irvin, Charles G., PhD
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Mosby, Inc
ID: ISSN: 0091-6749
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3164923
title: Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation
format: Article
creator:
  • Dixon, Anne E., MA, BM BCh
  • Pratley, Richard E., MD
  • Forgione, Patrick M., MD
  • Kaminsky, David A., MD
  • Whittaker-Leclair, Laurie A., MD
  • Griffes, Laurianne A., BA
  • Garudathri, Jayanthi, MS
  • Raymond, Danielle, BS
  • Poynter, Mathew E., PhD
  • Bunn, Janice Y., PhD
  • Irvin, Charles G., PhD
subjects:
  • Abridged Index Medicus
  • Adult
  • airway hyperreactivity
  • Allergy and Immunology
  • Article
  • Asthma
  • Asthma - complications
  • Asthma - immunology
  • Asthma - physiopathology
  • Asthma - prevention & control
  • bariatric surgery
  • Bariatric Surgery - methods
  • Biological and medical sciences
  • Bronchial Hyperreactivity
  • Bronchoalveolar Lavage Fluid
  • CD4 T cell
  • CD4-Positive T-Lymphocytes - immunology
  • Chronic obstructive pulmonary disease, asthma
  • Cross-Sectional Studies
  • Cytokines
  • Family medical history
  • Female
  • Fundamental and applied biological sciences. Psychology
  • Fundamental immunology
  • Gastrointestinal surgery
  • Humans
  • Immunopathology
  • Inflammation
  • Lymphocytes
  • Male
  • Medical colleges
  • Medical sciences
  • Methacholine Chloride - pharmacology
  • Middle Aged
  • Obesity
  • Obesity - complications
  • Obesity - surgery
  • Pathogenesis
  • Pneumology
  • Prospective Studies
  • Questionnaires
  • Respiratory Function Tests
  • Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
  • Sleep apnea
  • Surgery
  • Treatment Outcome
  • Weight control
  • Weight Loss
ispartof: Journal of allergy and clinical immunology, 2011, Vol.128 (3), p.508-515.e2
description: Background Asthma in obese subjects is poorly understood, and these patients are often refractory to standard therapy. Objectives We sought to gain insights into the pathogenesis and treatment of asthma in obese subjects by determining how obesity and bariatric surgery affect asthma control, airway hyperresponsiveness (AHR), and markers of asthmatic inflammation. Methods We performed a prospective study of (1) asthmatic and nonasthmatic patients undergoing bariatric surgery compared at baseline and (2) asthmatic patients followed for 12 months after bariatric surgery. Results We studied 23 asthmatic and 21 nonasthmatic patients undergoing bariatric surgery. At baseline, asthmatic patients had lower FEV1 and forced vital capacity and lower numbers of lymphocytes in bronchoalveolar lavage fluid. After surgery, asthmatic participants experienced significant improvements in asthma control (asthma control score, 1.55 to 0.74; P  < .0001) and asthma quality of life (4.87 to 5.87, P  < .0001). Airways responsiveness to methacholine improved significantly (methacholine PC20 , 3.9 to 7.28, P  = .03). There was a statistically significant interaction between IgE status and change in airways responsiveness ( P for interaction = .01). The proportion of lymphocytes in bronchoalveolar lavage fluid and the production of cytokines from activated peripheral blood CD4+ T cells increased significantly. Conclusions Bariatric surgery improves AHR in obese asthmatic patients with normal serum IgE levels. Weight loss has dichotomous effects on airway physiology and T-cell function typically involved in the pathogenesis of asthma, suggesting that obesity produces a unique phenotype of asthma that will require a distinct therapeutic approach.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0091-6749
fulltext: fulltext
issn:
  • 0091-6749
  • 1097-6825
url: Link


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titleEffects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation
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creatorDixon, Anne E., MA, BM BCh ; Pratley, Richard E., MD ; Forgione, Patrick M., MD ; Kaminsky, David A., MD ; Whittaker-Leclair, Laurie A., MD ; Griffes, Laurianne A., BA ; Garudathri, Jayanthi, MS ; Raymond, Danielle, BS ; Poynter, Mathew E., PhD ; Bunn, Janice Y., PhD ; Irvin, Charles G., PhD
creatorcontribDixon, Anne E., MA, BM BCh ; Pratley, Richard E., MD ; Forgione, Patrick M., MD ; Kaminsky, David A., MD ; Whittaker-Leclair, Laurie A., MD ; Griffes, Laurianne A., BA ; Garudathri, Jayanthi, MS ; Raymond, Danielle, BS ; Poynter, Mathew E., PhD ; Bunn, Janice Y., PhD ; Irvin, Charles G., PhD
descriptionBackground Asthma in obese subjects is poorly understood, and these patients are often refractory to standard therapy. Objectives We sought to gain insights into the pathogenesis and treatment of asthma in obese subjects by determining how obesity and bariatric surgery affect asthma control, airway hyperresponsiveness (AHR), and markers of asthmatic inflammation. Methods We performed a prospective study of (1) asthmatic and nonasthmatic patients undergoing bariatric surgery compared at baseline and (2) asthmatic patients followed for 12 months after bariatric surgery. Results We studied 23 asthmatic and 21 nonasthmatic patients undergoing bariatric surgery. At baseline, asthmatic patients had lower FEV1 and forced vital capacity and lower numbers of lymphocytes in bronchoalveolar lavage fluid. After surgery, asthmatic participants experienced significant improvements in asthma control (asthma control score, 1.55 to 0.74; P  < .0001) and asthma quality of life (4.87 to 5.87, P  < .0001). Airways responsiveness to methacholine improved significantly (methacholine PC20 , 3.9 to 7.28, P  = .03). There was a statistically significant interaction between IgE status and change in airways responsiveness ( P for interaction = .01). The proportion of lymphocytes in bronchoalveolar lavage fluid and the production of cytokines from activated peripheral blood CD4+ T cells increased significantly. Conclusions Bariatric surgery improves AHR in obese asthmatic patients with normal serum IgE levels. Weight loss has dichotomous effects on airway physiology and T-cell function typically involved in the pathogenesis of asthma, suggesting that obesity produces a unique phenotype of asthma that will require a distinct therapeutic approach.
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publisherNew York, NY: Mosby, Inc
subjectAbridged Index Medicus ; Adult ; airway hyperreactivity ; Allergy and Immunology ; Article ; Asthma ; Asthma - complications ; Asthma - immunology ; Asthma - physiopathology ; Asthma - prevention & control ; bariatric surgery ; Bariatric Surgery - methods ; Biological and medical sciences ; Bronchial Hyperreactivity ; Bronchoalveolar Lavage Fluid ; CD4 T cell ; CD4-Positive T-Lymphocytes - immunology ; Chronic obstructive pulmonary disease, asthma ; Cross-Sectional Studies ; Cytokines ; Family medical history ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Gastrointestinal surgery ; Humans ; Immunopathology ; Inflammation ; Lymphocytes ; Male ; Medical colleges ; Medical sciences ; Methacholine Chloride - pharmacology ; Middle Aged ; Obesity ; Obesity - complications ; Obesity - surgery ; Pathogenesis ; Pneumology ; Prospective Studies ; Questionnaires ; Respiratory Function Tests ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Sleep apnea ; Surgery ; Treatment Outcome ; Weight control ; Weight Loss
ispartofJournal of allergy and clinical immunology, 2011, Vol.128 (3), p.508-515.e2
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12011 American Academy of Allergy, Asthma & Immunology
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6Garudathri, Jayanthi, MS
7Raymond, Danielle, BS
8Poynter, Mathew E., PhD
9Bunn, Janice Y., PhD
10Irvin, Charles G., PhD
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0Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation
1Journal of allergy and clinical immunology
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descriptionBackground Asthma in obese subjects is poorly understood, and these patients are often refractory to standard therapy. Objectives We sought to gain insights into the pathogenesis and treatment of asthma in obese subjects by determining how obesity and bariatric surgery affect asthma control, airway hyperresponsiveness (AHR), and markers of asthmatic inflammation. Methods We performed a prospective study of (1) asthmatic and nonasthmatic patients undergoing bariatric surgery compared at baseline and (2) asthmatic patients followed for 12 months after bariatric surgery. Results We studied 23 asthmatic and 21 nonasthmatic patients undergoing bariatric surgery. At baseline, asthmatic patients had lower FEV1 and forced vital capacity and lower numbers of lymphocytes in bronchoalveolar lavage fluid. After surgery, asthmatic participants experienced significant improvements in asthma control (asthma control score, 1.55 to 0.74; P  < .0001) and asthma quality of life (4.87 to 5.87, P  < .0001). Airways responsiveness to methacholine improved significantly (methacholine PC20 , 3.9 to 7.28, P  = .03). There was a statistically significant interaction between IgE status and change in airways responsiveness ( P for interaction = .01). The proportion of lymphocytes in bronchoalveolar lavage fluid and the production of cytokines from activated peripheral blood CD4+ T cells increased significantly. Conclusions Bariatric surgery improves AHR in obese asthmatic patients with normal serum IgE levels. Weight loss has dichotomous effects on airway physiology and T-cell function typically involved in the pathogenesis of asthma, suggesting that obesity produces a unique phenotype of asthma that will require a distinct therapeutic approach.
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41Respiratory Function Tests
42Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
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45Treatment Outcome
46Weight control
47Weight Loss
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titleEffects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation
authorDixon, Anne E., MA, BM BCh ; Pratley, Richard E., MD ; Forgione, Patrick M., MD ; Kaminsky, David A., MD ; Whittaker-Leclair, Laurie A., MD ; Griffes, Laurianne A., BA ; Garudathri, Jayanthi, MS ; Raymond, Danielle, BS ; Poynter, Mathew E., PhD ; Bunn, Janice Y., PhD ; Irvin, Charles G., PhD
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7Asthma - immunology
8Asthma - physiopathology
9Asthma - prevention & control
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15CD4 T cell
16CD4-Positive T-Lymphocytes - immunology
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39Prospective Studies
40Questionnaires
41Respiratory Function Tests
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43Sleep apnea
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45Treatment Outcome
46Weight control
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abstractBackground Asthma in obese subjects is poorly understood, and these patients are often refractory to standard therapy. Objectives We sought to gain insights into the pathogenesis and treatment of asthma in obese subjects by determining how obesity and bariatric surgery affect asthma control, airway hyperresponsiveness (AHR), and markers of asthmatic inflammation. Methods We performed a prospective study of (1) asthmatic and nonasthmatic patients undergoing bariatric surgery compared at baseline and (2) asthmatic patients followed for 12 months after bariatric surgery. Results We studied 23 asthmatic and 21 nonasthmatic patients undergoing bariatric surgery. At baseline, asthmatic patients had lower FEV1 and forced vital capacity and lower numbers of lymphocytes in bronchoalveolar lavage fluid. After surgery, asthmatic participants experienced significant improvements in asthma control (asthma control score, 1.55 to 0.74; P  < .0001) and asthma quality of life (4.87 to 5.87, P  < .0001). Airways responsiveness to methacholine improved significantly (methacholine PC20 , 3.9 to 7.28, P  = .03). There was a statistically significant interaction between IgE status and change in airways responsiveness ( P for interaction = .01). The proportion of lymphocytes in bronchoalveolar lavage fluid and the production of cytokines from activated peripheral blood CD4+ T cells increased significantly. Conclusions Bariatric surgery improves AHR in obese asthmatic patients with normal serum IgE levels. Weight loss has dichotomous effects on airway physiology and T-cell function typically involved in the pathogenesis of asthma, suggesting that obesity produces a unique phenotype of asthma that will require a distinct therapeutic approach.
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