Gut Damage Due to Obesity can Make Asthma Worse

There is significant association between obesity and severity of asthma

Highlights:

Asthma is condition where airways narrow and breathing becomes difficult
Weight gain has been associated with increased severity of asthma
In a recent study, 98 obese //individuals showed heightened severity of asthma due to increased levels of inflammation

Changes in gut function caused by weight gain are associated increased asthma severity, according to research to be presented at the Society for Endocrinology annual conference. The study reports a significant association of increasing body weight with higher levels of inflammation, signs of gut permeability, and poorer control of asthma.

What is Asthma?

Asthma is one of the most commonly seen inflammatory diseases and affects over 262 million people worldwide. In asthma, the air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. This causes symptoms such as cough, wheeze, shortness of breath and chest tightness. These symptoms are intermittent and are often worse at night or during exercise. Other common triggers can make asthma symptoms worse. Triggers vary from person to person, but can include viral infections (colds), dust, smoke, fumes, changes in the weather, grass and tree pollen, animal fur and feathers, strong soaps and perfume ().

Weight Gain and its Association with Asthma

Clinical obesity (BMI over 30 kg/m2) appears to be a critical risk factor for developing asthma in both children and adults ().

Weight gain has previously been shown to alter the composition of gut bacteria, which can lead to increased gut permeability. Having a ‘leaky gut’ can allow harmful bacteria to enter the bloodstream, triggering inflammatory responses throughout the body. Although asthma is common, if poorly controlled it can lead to serious complications including fatigue, lung infections and an increased risk of severe asthma attacks, which can be life threatening. How increased gut permeability may affect asthma control has not previously been investigated.

Relationship Between Asthma and Obesity
Obesity and asthma are interlinked. According to a study published in the journal of Obesity, it was found that overweight adolescents and children are likely to suffer from asthma.

‘Obesity can alter gut bacteria causing them to release inflammatory markers, making asthma much worse’

Researchers examined the relationship between body weight and gut permeability with the symptoms of 98 patients with severe asthma (). Patients with lean to obese body mass index (BMI) reported their symptoms using the Asthma Control Questionnaire-6. Blood tests were taken to measure levels of gut permeability markers (lipopolysaccharide binding protein (LPB)) and calprotectin), as well as markers of asthma-related inflammation (granzyme-A, IL-5, IL-6, CCL-4).

Patients with poorly controlled asthma had significantly higher levels of LBP and levels of LBP increased with increasing body weight. Increasing concentrations of LBP also correlated with higher levels of asthma-related inflammatory markers.

Lead researcher, Cristina Parenti, comments, “We have found a significant link between gut permeability, being overweight and poor asthma control, particularly in people with obesity. This suggests that dietary interventions to improve gut barrier function may be an effective, alternative treatment target for asthma patients who are overweight or have obesity”.

Childhood Obesity And Asthma: Which Came First?
For years, doctors have known that there is a link between childhood obesity and asthma.

These findings not only suggest that losing weight could improve symptoms for patients with severe asthma but also highlights the gut as a potential, alternative therapeutic target for improving asthma control in patients with obesity.

The current study included only a small number of patients with severe, uncontrolled asthma. The team now plan to recruit more patients to the study and to investigate the effects in participants with well-controlled asthma, over a range of BMIs, as well as examining whether targeting the gut can improve asthma control in affected patients.

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Youths and young adults born to parents with HIV but remained uninfected themselves still face a greatly heightened risk of obesity and asthma-like symptoms.

Cristina Parenti concludes, “Our initial findings show that increased gut permeability is likely to be a factor in worsening asthma symptoms in patients with obesity, so it will be interesting to look at whether dietary interventions can improve symptoms for these patients”.

References:

World Health Organization Asthma - (https://www.who.int/news-room/fact-sheets/detail/asthma)
Adiposity and Asthma in a Nationwide Study of Children and Adults in the United States - (https://pubmed.ncbi.nlm.nih.gov/29144884/)
Investigating the effect of obesity on gut damage, systemic inflammation, enhanced asthma severity due to gut derived bacteria, endotoxin - (https://www.endocrine-abstracts.org/ea/0086/ea0086p211)

Father's Obesity in Puberty Doubles Asthma Risk in His Future Offspring
Boys who are obese in pre-puberty are at two times higher risk of having children with asthma than those who are not. Therefore, future fathers need to plan for their children´s health beginning in their own childhood.

Source-Medindia