Influence of distinct asthma phenotypes on lung function following weight loss in the obese.
Influence of distinct asthma phenotypes on lung function following weight loss in the obese.
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DOI：
10.1111/resp.12368
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发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Dixon AE
中科院分区：
文献类型：
--
作者：
Chapman DG;Irvin CG;Kaminsky DA;Forgione PM;Bates JH;Dixon AE
肥胖哮喘患者似乎有两种不同的临床表型-早发性哮喘和高血清IgE（TH 2-高）和迟发性哮喘和低血清IgE（TH 2-低）。本研究的目的是确定在两种表型的肥胖性哮喘中，减肥对小气道功能的影响。TH 2-低（n=8）和TH 2-高（n=5）肥胖哮喘患者在减肥手术前和手术后12个月接受乙酰甲胆碱激发。剂量反应斜率作为气道闭合和狭窄敏感性的指标，分别测量为最大%下降FVC和FEV 1/FVC除以剂量。采用强迫振荡技术测定静息气道力学。体重减轻降低了TH 2-低而非TH 2-高肥胖哮喘患者对气道关闭的敏感性（前后平均变化± 95%CI：1.8 ± 0.8倍剂量vs-0.3 ± 1.7倍剂量，p=0.04）。然而，体重减轻对两组中气道狭窄的敏感性没有影响（p=0.8，TH 2-低：0.8 ± 1.0倍剂量，TH 2-高：-1.1 ± 2.5倍剂量）。相比之下，TH 2高而TH 2低的肥胖哮喘患者的呼吸阻力（20 Hz）改善（前后变化中位数[IQR]：1.5 [1.3 - 2.8] cmH 2 O/L/s vs 0.6 [-1.8-0.8] cmH 2 O/L/s，p=0.03）。TH 2-低肥胖哮喘患者似乎以小气道反应性增加和静息气道功能异常为特征，这些异常可能在体重减轻后持续存在。然而，TH 2高肥胖哮喘患者的情况并非如此，这突出了IgE状态和肥胖哮喘病理生理之间的复杂相互作用。
There appears to be two distinct clinical phenotypes of obese patients with asthma – those with early-onset asthma and high serum IgE (TH2-high) and those with late-onset asthma and low serum IgE (TH2-low). The aim of the present study was to determine in the two phenotypes of obese asthma the effect of weight-loss on small airway function. TH2-low (n=8) and TH2-high (n=5) obese asthmatics underwent methacholine challenge before and 12 months following bariatric surgery. Dose response slopes as measures of sensitivity to airway closure and narrowing were measured as maximum %fall FVC and FEV1/FVC, respectively, divided by dose. Resting airway mechanics were measured by forced oscillation technique. Weight-loss reduced sensitivity to airway closure in TH2-low but not TH2-high obese asthmatics (pre-post mean change ± 95%CI: 1.8 ± 0.8 doubling doses vs −0.3 ± 1.7 doubling doses, p=0.04). However, there was no effect of weight loss on the sensitivity to airway narrowing in either group (p=0.8, TH2-low: 0.8 ± 1.0 doubling doses, TH2-high: −1.1 ± 2.5 doubling doses). In contrast, respiratory resistance (20Hz) improved in TH2-high but not in TH2-low obese asthmatics (pre-post change median [IQR]: 1.5 [1.3 – 2.8] cmH2O/L/s vs 0.6 [−1.8 – 0.8] cmH2O/L/s, p=0.03). TH2-low obese asthmatics appear to be characterised by increased small airway responsiveness and abnormalities in resting airway function that may persist following weight loss. However, this was not the case for TH2-high obese asthmatics, highlighting the complex interplay between IgE status and asthma pathophysiology in obesity.
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影响因子：
3.2
作者：
Mahadev, Sriram;Farah, Claude S.;Salome, Cheryl M.
通讯作者：
Salome, Cheryl M.
影响因子：
3.7
作者：
Oppenheimer, Beno W.;Berger, Kenneth I.;Goldring, Roberta M.
通讯作者：
Goldring, Roberta M.
DOI：
10.1016/j.jaci.2011.03.036
发表时间：
2011-06
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Holguin F;Bleecker ER;Busse WW;Calhoun WJ;Castro M;Erzurum SC;Fitzpatrick AM;Gaston B;Israel E;Jarjour NN;Moore WC;Peters SP;Yonas M;Teague WG;Wenzel SE
通讯作者：
Wenzel SE
影响因子：
3.3
作者：
D'Angelo, E;Pecchiari, M;Milic-Emili, J
通讯作者：
Milic-Emili, J
影响因子：
14.2
作者：
Hohlfeld, JM;Schmiedl, A;Krug, N
通讯作者：
Krug, N