How to apply the personalized medicine in obesity-associated asthma?. (1st September 2020)

• Record Type: Journal Article
• Authors: Tiotiu, Angelica; Labor, Marina; Nedeva, Denislava; Novakova, Silviya; Oguzulgen, Ipek Kivilcim; Mihaicuta, Stefan; Braido, Fulvio
• Is Part Of: Expert review of respiratory medicine. Volume 14:Number 9(2020)
• Page Start: 905
• Page End: 915
• Publication Date: 2020-09-01
• Subjects: Obese-asthma phenotypes -- multidisciplinary team -- personalized medicine; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1080/17476348.2020.1780123
• Languages: English
• ISSNs: 1747-6348

Abstract

ABSTRACT: Introduction: Obesity-associated asthma (OA) is frequently severe, with an increased rate of hospitalizations, numerous comorbidities and low response to corticosteroids. Despite progress in applying for personalized medicine in asthma, no specific recommendations exist for the management of OA. Areas covered: The aim of this review is to summarize recent data about the relationship obesity-asthma, describe clinical characteristics, potential mechanisms involved and possible therapeutic interventions to improve OA outcomes. Extensive research in the PubMed was performed using the following terms: "asthma and obesity" and "obese asthma" in combination with "phenotypes", "airway inflammation", "biomarkers", "lung function", "weight loss", "lifestyle interventions", "therapies" Currently two phenotypes are described. Early-onset atopic asthma is conventional allergic asthma aggravated by the pro-inflammatory properties of adipose tissue in excess, while late-onset non-atopic asthma is due to airway dysfunction as a consequence of the chronic lung compression caused by the obese chest walls. Previous data showed that different therapeutic strategies used in weight loss have a positive impact on OA outcomes. Expert opinion: The presence of a multidisciplinary team (chest physician, nutritionist, exercise physiologist, physiotherapist, psychologist, bariatric surgeon) and the collaboration between different specialists are mandatory to optimize the management and to apply the personalized medicine in OA.