Background: Chronic low-grade systemic inflammation is a characteristic of obesity that leads to various non-communicable diseases. Weight loss and SCFAs are potential strategies for attenuating obese systemic inflammation. Methods: Blood samples were collected from 43 obese subjects (BMI ≥ 30 kg/m2) scheduled for laparoscopic bariatric sleeve surgery, 26 obese subjects at follow-up 12–18 months post-surgery and 8 healthy weight subjects (BMI 18.5–24.9 kg/m2). Monocytes were isolated from blood and adipose tissue macrophages from visceral adipose tissue of obese subjects only. Isolated cells stimulated with 1 ng/mL LPS and treated simultaneously with 300 mM of sodium acetate or 30 mM of sodium propionate or butyrate and supernatant were harvested after 15 h incubation. TNF-α and IL-6 cytokines were measured via ELISA and mRNA gene expression of FFAR2 and FFAR3, HDAC1, HDAC2 and HDAC9, RELA and NFKB1 and MAPK1 via RT-qPCR. Results: TNF-α and IL-6 production and NFKB1 and RELA mRNA expression were significantly decreased in follow-up subjects compared to baseline. SCFAs significantly reduced TNF-α and IL-6 and altered FFAR and HDAC mRNA expression in monocytes and macrophages from obese subjects. Conclusion: Weight loss and ex vivo SCFA treatments were successful in combatting systemic inflammation in obesity. Results highlighted molecular changes that occur with weight loss and as a result of SCFA treatment.

BackgroundObesity is a common co-morbidity in asthma and associated with poorer asthma control, more frequent/severe exacerbations, and reduced response to asthma pharmacotherapy.ObjectiveThis review aims to compare use of all classes of asthma medications in obese (BMI≥30 kg·m−2) versus healthy weight (BMI<25 kg·m−2) subjects with asthma.DesignDatabases including CINAHL, Cochrane, EMBASE, and MEDLINE were searched for English language studies up to July 2019 that recorded medication use or dose in obese and healthy weight adults with asthma. A critical appraisal checklist was utilised for scrutinising methodologic quality of eligible studies. Meta-analysis was performed and heterogeneity was examined with the use of the χ2 test. This review was conducted based on a published protocol (PROSPERO: CRD42020148671).ResultsMeta-analysis showed that obese subjects are more likely to use asthma medications including; short-acting β2-agonists [odds ratio (OR)=1.75; 95% CI:1.17, 2.60; p=0.006, I2=41%] and maintenance oral corticosteroids (OR=1.86; 95% CI:1.49, 2.31; p<0.001, I2=0%) compared to healthy weight subjects. Inhaled corticosteroid dose (µg·day−1) was significantly higher in obese subjects (mean difference=208.14; 95% CI:107.01, 309.27; p<0.001, I2=74%). FEV1% predicted was significantly lower in obese subjects (mean difference=−5.32%; 95% CI:−6.75, −3.89; p<0.001, I2=42%), however, no significant differences were observed in FEV1/FVC% between groups.ConclusionsWe found that obese subjects with asthma have higher use of all included asthma medication classes and higher ICS doses than healthy weight asthma subjects, despite lower FEV1 and a similar FEV1/FVC%. A better understanding of the factors driving increased medication use is required to improve outcomes in this subgroup of asthmatics.

Context Short-chain fatty acids (SCFAs) derived from microbial fermentation of prebiotic soluble fibers are noted for their anti-inflammatory benefits against obese systemic inflammation. Objective A systematic review and meta-analysis were undertaken to investigate the effect of SCFAs and prebiotic interventions on systemic inflammation in obesity. Data Sources Relevant studies from 1947 to August 2019 were collected from the Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and Cochrane databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study Selection Of 61 included studies, 29 were of humans and 32 of animals. Data Extraction Methodological quality of studies was assessed using the critical appraisal checklist of the Academy of Nutrition and Dietetics. Data pertaining to population, intervention type and duration, and markers of systemic inflammation were extracted from included studies. Results Of 29 included human studies, 3 of 4 SCFA interventions and 11 of 25 prebiotic interventions resulted in a significant decrease in ≥1 biomarker of systemic inflammation. Of 32 included animal studies, 10 of 11 SCFA interventions and 18 of 21 prebiotic interventions resulted in a significant reduction of ≥1 biomarker of systemic inflammation. Meta-analysis revealed that prebiotics in humans reduced levels of plasma high-sensitivity C-reactive protein (standard mean difference [SMD], −0.83; 95%CI: −1.56 to −0.11; I2: 86%; P = 0.02) and plasma lipopolysaccharide (SMD, −1.20; 95%CI: −1.89 to −0.51; I2: 87%; P = 0.0006), and reduced TNF−α levels in animals (SMD, −0.63; 95%CI: −1.19 to −0.07; P = 0.03). Heterogeneity among supplement types, duration, and dose across studies was significant. Conclusion Evidence from this review and meta-analysis supports the use of SCFAs and prebiotics as novel aids in treatment of obese systemic inflammation. Systematic Review Registration PROSPERO registration no. CRD42020148529.

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