Obesity and Asthma: Metabolic Dysregulation

Among otherwise healthy individuals, obesity can be a risk factor for incident asthma, while for subjects with asthma, it is a potential comorbidity associated with more severe respiratory symptoms, reduced response to inhaled steroids, and more frequent asthma exacerbations. The mechanisms explaining these associations are likely multifactorial and not fully understood; however, we do know that excess body weight alone is not sufficient given that most obese persons do not develop asthma, and not every obese asthmatic has more severe disease. This complex phenomenon raises the possibility that obesity-related changes in metabolic dysregulation, such as the metabolic syndrome (MetSyn), play a fundamental pathophysiological role. This chapter outlines how MetSyn, and its individual components, is clinically and mechanistically linked with increased asthma morbidity. It also discusses recent developments on mitochondrial dysfunction, nitric oxide metabolism, and untargeted metabolomics.