Long-term effect of weight loss induced by bariatric surgery on asthma control and health related quality of life in asthmatic patients with severe obesity: A pilot study

Maniscalco, Mauro; Zamparelli, Alessandro Sanduzzi; Vitale, Dino Franco; Faraone, Stanislao; Molino, Antonio; Zedda, Anna; Motta, Andréa

doi:10.1016/j.rmed.2017.06.010

Cited by 28 publications

(12 citation statements)

References 37 publications

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“…Improvement was seen in all five components of the score, whereas the ACT score was unchanged in the control group who had no change in their weight. Similar improvements in ACT and Mini Asthma Quality of Life Questionnaire (mini-AQLQ) were reported in another study and persisted after 5 years [22]. O'BRIEN et al [25] used the Asthma Severity Score to assess 33 asthmatic patients before and after laparoscopic placement of an adjustable gastric band and found that the score decreased from 44.5 before operation to 14.3 at follow-up (p<0.001).…”

Section: Bariatric Surgery and Asthma Controlsupporting

confidence: 55%

“…Few studies have evaluated the effects of bariatric surgery on spirometry parameters in asthma [18][19][20][21][22]. BOULET et al [18] reported improvement in FEV1, FVC, expiratory reserve volume, functional residual capacity (FRC) and FRC/total lung capacity (TLC) in 12 asthmatic patients 1 year after surgery; none of these patients had obstruction at baseline (defined as FEV1/FVC <70%) and only two patients had FEV1 <80% of predicted value at baseline.…”

Section: Bariatric Surgery and Lung Functionmentioning

confidence: 99%

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Bariatric surgery: a potential cure for asthma?

Chaaban

2019

Eur Respir Rev

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Asthma incidence and severity are increased in obese populations. Systematic reviews have shown benefit from weight-loss interventions on asthma outcomes, but the role of bariatric surgery is still unclear. In this review, cohorts of obese asthmatic patients undergoing bariatric surgery were examined regarding different asthma outcomes. The available data on patients who were followed up showed improvements in asthma control, exacerbation risk, asthma-related hospitalisation, medication use and airway hyperresponsiveness, with some patients not requiring further treatment for asthma. Follow-up duration was variable, being mostly of 1 year, with some studies reporting long-term outcomes after 5 years. The studies reviewed had many limitations, including small numbers of patients, lack of control arm in some studies and lack of standardisation of asthma diagnosis, classification and outcome measures, in addition to possible reporting bias. Data on small numbers of patients also show the possibility of benefit exclusively in nonallergic asthma. Larger, more stringent clinical trials are needed before recommending bariatric surgery for treatment of asthma.

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Section: Bariatric Surgery and Asthma Controlsupporting

confidence: 55%

Section: Bariatric Surgery and Lung Functionmentioning

confidence: 99%

Bariatric surgery: a potential cure for asthma?

Chaaban

2019

Eur Respir Rev

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“…However, in another study, the improved effect on AHR was only found in the group of obese asthmatics with high serum (IgE) levels [187]. The effect on asthma control, therapeutic reduction, and lung function seems to persist after five years of bariatric surgery [190].…”

Section: Effects Of Weight Loss On Asthma and Inflammationmentioning

confidence: 93%

Asthma and Obesity: Two Diseases on the Rise and Bridged by Inflammation

Bantulà

Roca‐Ferrer

Arismendi

et al. 2021

JCM

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Asthma and obesity are two epidemics affecting the developed world. The relationship between obesity and both asthma and severe asthma appears to be weight-dependent, causal, partly genetic, and probably bidirectional. There are two distinct phenotypes: 1. Allergic asthma in children with obesity, which worsens a pre-existing asthma, and 2. An often non allergic, late-onset asthma developing as a consequence of obesity. In obesity, infiltration of adipose tissue by macrophages M1, together with an increased expression of multiple mediators that amplify and propagate inflammation, is considered as the culprit of obesity-related inflammation. Adipose tissue is an important source of adipokines, such as pro-inflammatory leptin, produced in excess in obesity, and adiponectin with anti-inflammatory effects with reduced synthesis. The inflammatory process also involves the synthesis of pro-inflammatory cytokines such as IL-1β, IL-6, TNFα, and TGFβ, which also contribute to asthma pathogenesis. In contrast, asthma pro-inflammatory cytokines such as IL-4, IL-5, IL-13, and IL-33 contribute to maintain the lean state. The resulting regulatory effects of the immunomodulatory pathways underlying both diseases have been hypothesized to be one of the mechanisms by which obesity increases asthma risk and severity. Reduction of weight by diet, exercise, or bariatric surgery reduces inflammatory activity and improves asthma and lung function.

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“…There is a clear need for more studies that consider the effect of a restrictive diet before surgery if one was employed. Finally, despite growing evidence that bariatric surgery could be beneficial for patients with asthma (7,9,92,93), to the best of our knowledge, no study has explored whether the airway/lung microbiome changes after bariatric surgery.…”

Section: Microbiomes and Bariatric Surgerymentioning

confidence: 99%

The Gut/Lung Microbiome Axis in Obesity, Asthma, and Bariatric Surgery: A Literature Review

Kim

Womble

Gunsch

et al. 2021

Obesity

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Mounting evidence suggests that obesity, parameters of metabolic syndrome, and asthma are significantly associated. Interestingly, these conditions are also associated with microbiome dysbiosis, notably in the airway microbiome for patients with asthma and in the gut microbiome for patients with obesity and/or metabolic syndrome. Considering that improvements in asthma control, lung function, and airway hyperresponsiveness are often reported after bariatric surgery, this review investigated the potential role of bacterial gut and airway microbiome changes after bariatric surgery in ameliorating asthma symptoms. Rapid and persistent gut microbiota alterations were reported following surgery, some of which can be sustained for years. The gut microbiome is thought to modulate airway cellular responses via short-chain fatty acids and inflammatory mediators, such that increased propionate and butyrate levels following surgery may aid in reducing asthma symptoms. In addition, increased prevalence of Akkermansia muciniphila after Roux-en-Y gastric bypass and sleeve gastrectomy may confer protection against airway hyperreactivity and inflammation. Metabolic syndrome parameters also improved following bariatric surgery, and whether weight-loss-independent metabolic changes affect airway processes and asthma pathobiology merits further research. Fulfilling knowledge gaps outlined in this review could facilitate the development of new therapeutic options for patients with obesity and asthma.

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Long-term effect of weight loss induced by bariatric surgery on asthma control and health related quality of life in asthmatic patients with severe obesity: A pilot study

Abstract: In severe obese asthmatic patients, the significant improvement of asthma control test and HRQoL, observed one year after LAGB, persists five years after surgery.

Cited by 28 publications

References 37 publications

Bariatric surgery: a potential cure for asthma?

Bariatric surgery: a potential cure for asthma?

Asthma and Obesity: Two Diseases on the Rise and Bridged by Inflammation

The Gut/Lung Microbiome Axis in Obesity, Asthma, and Bariatric Surgery: A Literature Review

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