Symposium on Obesity and Asthma –November 2, 2006

Abstract

Asthma and obesity are frequently associated, and obesity has been considered a factor contributing to both an increase in severity of asthma and to its development. The present document summarizes the proceedings of a symposium held in Montreal, Quebec, on November 2, 2006, under the auspices of the Réseau en santé respiratoire du Fonds de la recherche en santé du Québec in collaboration with the McGill University - Strauss Severe Asthma Program, Université Laval (Quebec City) and Université de Montréal. It includes an overview of the various aspects of the relationships between asthma and obesity with regard to animal models; genetic, hormonal and physiological determinants; influence of comorbidities (eg, sleep apnea syndrome); epidemiology; clinical and psychological features; and management of asthma in the obese population.

Asthma-related comorbidities

“…First, it is associated with an upper airway inflammatory process that has the potential to influence lower airways. In this regard, significant systemic and upper airway inflammation has been reported with OSA [106,107], and Devouassoux et al reported bronchial neutrophilia and a high IL-8 concentration in patients with untreated OSA compared with controls [108].…”

“…Continuous positive airway pressure treatment of OSA, in patients with asthma, improved asthma symptoms, rescue broncho dilator use, peak expiratory flows and asthma-specific quality of life [107,116]. Lafond et al found, however, no significant changes in airway responsiveness after 6 weeks of nocturnal continuous positive airway pressure treatment, while patients' asthma-related quality of life improved [116].…”

Obesity, Nutrition, and Asthma in Children

“…114,122 Fewer studies have reported spirometric outcomes in lean and obese children with asthma. Unlike in adults, obesity does not appear to reduce vital capacity or total lung capacity substantially, 98,104,106,109 and in some reports may be associated with greater volumes and capacity.…”

Association of Obstructive Sleep Apnea Risk With Asthma Control in Adults

“…Continuous positive airway pressure (CPAP) treatment of OSA in patients with asthma improves outcomes, including asthma symptoms, [7][8][9] rescue bronchodilator use, 7 peak expiratory flow rates (PEFRs), 7 and asthma-specifi c quality of life assessed with validated instruments. 10,11 Although important, these studies included small numbers of participants selected primarily for nocturnal symptoms and used nonrandomized designs. Additionally, OSA was recently identifi ed as an important risk factor for frequent exacerbations in patients with diffi cult-to-treat asthma.…”