Our study identifies the CDC42 pathway as a novel target that is upregulated in T cells of obese asthmatic children, suggesting its role in nonatopic T1-polarized systemic inflammation and pulmonary function deficits found in patients with pediatric obesity-related asthma.

Background Paediatric obesity‐related asthma causes high disease burden, is associated with metabolic abnormalities, has few therapeutic options, and disproportionately affects urban minority children. Although poor diet quality is linked to asthma, the association of nutritional status with disease burden among children with obesity‐related asthma is not well understood. Objective To quantify nutritional status, defined as concentrations of serum carotenoids and n‐3 fatty acids, and its association with pulmonary function and metabolic markers among obese asthmatic children. Methods We quantified serum carotenoids and fatty acids in a study cohort of 158 urban minority adolescents including 39 obese asthmatics, 39 healthy weight asthmatics, 38 obese controls and 42 healthy weight controls and compared between the groups. We correlated carotenoid and fatty acid levels with pulmonary function indices and with insulin resistance and dyslipidemia. Results Mean total carotenoids were lowest in obese asthmatic children (0.41 μg/mL), lower than healthy weight asthmatics (0.52 μg/mL, P < 0.05) and healthy weight controls (0.60 μg/mL, P < 0.001). n‐6/n‐3 polyunsaturated fatty acid (PUFA) ratio also differed between the groups (P < 0.05). Total carotenoids positively correlated with per cent‐predicted FEV1 and inversely correlated with insulin resistance among obese asthmatics only. n‐6/n‐3 PUFA ratio inversely correlated with per cent‐predicted FEV1 in obese asthmatics. Conclusions & Clinical Relevance Our findings suggest that carotenoids, which are lowest in obese asthmatic children, may have protective effects on metabolic health and pulmonary function among obese asthmatic children. Similarly, n‐3 PUFA appear to be protective for pulmonary function.