Title:Obesity-associated Airway Hyperresponsiveness: Mechanisms Underlying
Inflammatory Markers and Possible Pharmacological Interventions
Volume: 24
Issue: 9
Author(s): Manash Pratim Pathak*, Pompy Patowary, Pronobesh Chattopadhyay, Pervej Alom Barbhuiyan, Johirul Islam, Jyotchna Gogoi and Wankupar Wankhar
Affiliation:
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati, India
Keywords:
Obesity, co-morbidities, airway hyperresponsiveness, adiponectin, macrophage polarization, NLRP3, UCP1.
Abstract: Obesity is rapidly becoming a global health problem affecting about 13% of the
world’s population affecting women and children the most. Recent studies have stated that
obese asthmatic subjects suffer from an increased risk of asthma, encounter severe symptoms,
respond poorly to anti-asthmatic drugs, and ultimately their quality-of-life decreases. Although,
the association between airway hyperresponsiveness (AHR) and obesity is a growing concern
among the public due to lifestyle and environmental etiologies, however, the precise mechanism
underlying this association is yet to establish. Apart from aiming at the conventional antiasthmatic
targets, treatment should be directed towards ameliorating obesity pathogenesis too.
Understanding the pathogenesis underlying the association between obesity and AHR is limited,
however, a plethora of obesity pathologies have been reported viz., increased pro-inflammatory
and decreased anti-inflammatory adipokines, depletion of ROS controller Nrf2/HO-1 axis,
NLRP3 associated macrophage polarization, hypertrophy of WAT, and down-regulation of
UCP1 in BAT following down-regulated AMPKα and melanocortin pathway that may be correlated
with AHR. Increased waist circumference (WC) or central obesity was thought to be related
to severe AHR, however, some recent reports suggest body mass index (BMI), not WC tends
to exaggerate airway closure in AHR due to some unknown mechanisms. This review aims to
co-relate the above-mentioned mechanisms that may explain the copious relation underlying
obesity and AHR with the help of published reports. A proper understanding of these mechanisms
discussed in this review will ensure an appropriate treatment plan for patients through
advanced pharmacological interventions.