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Study suggests asthma in obesity related to airway narrowing rather than inflammation

Obesity Alters Airway Muscle Function, Increases Asthma Risk

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New research, led by Rutgers Robert Wood Johnson Medical School second-year resident Sarah Orfanos, suggests that obesity changes how airway muscles function, increasing the risk of developing asthma. The study is published ahead of print in the American Journal of Physiology—Lung Cellular and Molecular Physiology.

The prevalence of asthma and obesity—as both separate and coexisting conditions—has grown considerably in the United States in recent years. Obesity is a major risk factor for asthma, in part, because of the systemic and localized inflammation of the airways that occurs in people with a high body mass index.

People with obesity “also manifest a higher risk of severe asthma, decreased disease control and decreased response to corticosteroids therapy,” explained the bicoastal team of scientists who conducted the research. However, previous studies suggest that some people with obesity may have a type of asthma that is not caused by airway inflammation, but by hyperresponsiveness—a higher-than-normal response to an allergen—in the airway smooth muscle. Hyperresponsiveness causes the airways to narrow, obstructing ease of breathing, and can occur when the muscles contract or begin to spasm.

The research team combined human airway smooth muscle cells with histamine, a chemical the immune system makes in response to an allergen, and carbachol, a drug that stimulates the part of the nervous system that controls the airways. Stimulating airway cells with these substances causes the cells to release calcium, which mimics muscle contraction. They found that muscle cells from obese donors released more calcium and had greater shortening—a function that occurs during muscle contraction—than the cells from normal-weight donors. In addition, the cells from female obese donors released more calcium than cells from male obese donors.

The results suggest that obesity “makes a unique and identifiable mark on the airway smooth muscle cells, which can lead to new ways to improve asthma management without the use of steroids,” explained Reynold Panettieri Jr., director of Rutgers Institute for Translational Medicine and Science and corresponding author of the study.

Read the full article, “Obesity increases airway smooth muscle responses to contractile agonists,” published ahead of print in the American Journal of Physiology—Lung Cellular and Molecular Physiology.

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