The Asthma Phenotype in the Obese: Distinct or Otherwise?

Abstract

Asthma is a heterogenous disorder that can be classified into several different phenotypes. Recent cluster analyses have identified an “obese-asthma” phenotype which is characterized by late onset, female predominance and lack of atopy. In addition, obesity among early-onset asthmatics clearly exists and heightens the clinical presentation. Observational studies have demonstrated that asthma among the obese has a clinical presentation that is more severe, harder to control, and is not as responsive to standard controller therapies. While weight loss studies have demonstrated improvement in asthma outcomes, further studies need to be performed. The current knowledge of the existence of two obesity-asthma phenotypes (early- versus late-onset asthma) should encourage investigators to study these entities separately since just as they have distinct presentations, their course, response to therapies, and weight loss strategies may be different as well.

What the Genetic Background of Individuals with Asthma and Obesity Can Reveal: Is β2-Adrenergic Receptor Gene Polymorphism Important?

“…Moreover, the asthma-obesity phenotype is characterized as severe asthma. 69 The same is true for the association of ADRB2 polymorphisms and asthma severity 70 or lung functions 58 ; however, more than a single polymorphism, a specific haplotype is conclusive.…”

Association between obesity and asthma – epidemiology, pathophysiology and clinical profile

“…Obesity-induced asthma has been proposed as one of many distinctive asthma phenotypes (23,(151)(152)(153) . Classification of obesityinduced asthma as a distinct phenotype means that this group of asthmatics have a distinct clinical and immunological profile that differs from other phenotypes.…”

The Asthma–Obesity Epidemic

“…[2][3][4] While the relationship between obesity and asthma is alarming because of the number of people affected, what makes this even more concerning is the fact that asthma among the obese is characterized by worse asthma control, decreased response to asthma medications, and higher rates of healthcare utilization. [5][6][7][8][9][10] Obesity is associated with severe, difficult-to-control asthma.…”