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Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma.

Publication ,  Journal Article
McCravy, M; Ingram, JL; Que, LG
Published in: J Asthma Allergy
2021

Asthma is an obstructive airway disease that is characterized by reversible airway obstruction and is classically associated with atopic, TH2 driven inflammation. Landmark studies in the second half of the twentieth century identified eosinophils as a key mediator of inflammation and steroids, both inhaled and systemic, as a cornerstone of therapy. However, more recently other phenotypes of asthma have emerged that do not respond as well to traditional therapies. In particular, obese patients who develop asthma as adults are less likely to have eosinophilic airway inflammation and do not respond to traditional therapies. Obese patients often have metabolic comorbidities such as impaired glucose tolerance and dyslipidemias, also known as metabolic syndrome (MetS). The unified pathophysiology of metabolic syndrome is not known, however, several signaling pathways, such as the neuropeptide glucagon-like peptide-1 (GLP-1) and nitric oxide (NO) signaling have been shown to be dysregulated in MetS. These pathways are targeted by commercially available medications. This review discusses the potential roles that dysregulation of the GLP-1 and NO signaling pathways, along with arginine metabolism, play in the development of asthma in obese patients. GLP-1 receptors are found in high density in the lung and are also detectable in bronchoalveolar lavage fluid. NO has long been associated with asthma. We hypothesize that these derangements in metabolic signaling pathways underpin the asthmatic phenotype seen in obese patients with non-eosinophilic airway inflammation and poor response to established therapies. While still an active area of research, novel interventions are needed for this subset of patient who respond poorly to available asthma therapies.

Duke Scholars

Published In

J Asthma Allergy

DOI

ISSN

1178-6965

Publication Date

2021

Volume

14

Start / End Page

179 / 186

Location

New Zealand

Related Subject Headings

  • 3204 Immunology
  • 1107 Immunology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
McCravy, M., Ingram, J. L., & Que, L. G. (2021). Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma. J Asthma Allergy, 14, 179–186. https://doi.org/10.2147/JAA.S282284
McCravy, Matthew, Jennifer L. Ingram, and Loretta G. Que. “Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma.J Asthma Allergy 14 (2021): 179–86. https://doi.org/10.2147/JAA.S282284.
McCravy M, Ingram JL, Que LG. Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma. J Asthma Allergy. 2021;14:179–86.
McCravy, Matthew, et al. “Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma.J Asthma Allergy, vol. 14, 2021, pp. 179–86. Pubmed, doi:10.2147/JAA.S282284.
McCravy M, Ingram JL, Que LG. Dysregulated Metabolism in the Pathophysiology of Non-Allergic Obese Asthma. J Asthma Allergy. 2021;14:179–186.

Published In

J Asthma Allergy

DOI

ISSN

1178-6965

Publication Date

2021

Volume

14

Start / End Page

179 / 186

Location

New Zealand

Related Subject Headings

  • 3204 Immunology
  • 1107 Immunology