Influence of distinct asthma phenotypes on lung function following weight loss in the obese

Chapman, DG; Irvin, CG; Kaminsky, DA; Forgione, PM; Bates, JHT; Dixon, AE

Influence of distinct asthma phenotypes on lung function following weight loss in the obese

Chapman, DG

Irvin, CG Kaminsky, DA Forgione, PM Bates, JHT Dixon, AE

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Publication Type:: Journal Article
Citation:: Respirology, 2014, 19 (8), pp. 1170 - 1177
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Chapman, DG https://orcid.org/0000-0002-8211-1817	en_US
dc.contributor.author	Irvin, CG	en_US
dc.contributor.author	Kaminsky, DA	en_US
dc.contributor.author	Forgione, PM	en_US
dc.contributor.author	Bates, JHT	en_US
dc.contributor.author	Dixon, AE	en_US
dc.date.available	2014-06-30	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	Respirology, 2014, 19 (8), pp. 1170 - 1177	en_US
dc.identifier.issn	1323-7799	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118815
dc.description.abstract	© 2014 Asian Pacific Society of Respirology. Background and objective: 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. Methods: 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 forced vital capacity (FVC) and forced expiratory volume in 1 s/FVC, respectively, divided by dose. Resting airway mechanics were measured by forced oscillation technique. Results: Weight loss reduced sensitivity to airway closure in TH2-low but not TH2-high obese asthmatics (pre-post mean change ± 95% confidence interval: 1.8 ± 0.8 doubling doses vs -0.3 ± 1.7 doubling doses, P = 0.04).However, there was no effect ofweight 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 (20 Hz) improved in TH2-high but not in TH2-low obese asthmatics (pre-post change median interquartile range: 1.5 (1.3-2.8) cmH2O/L/s vs 0.6 (-1.8-0.8) cmH2O/L/s, P = 0.03). Conclusions: TH2-low obese asthmatics appear to be characterized by increased small airway responsiveness and abnormalities in resting airway function that may persist followingweight loss.However, this was not the case for TH2-high obese asthmatics, highlighting the complex interplay between IgE status and asthma pathophysiology in obesity.	en_US
dc.relation.ispartof	Respirology	en_US
dc.relation.isbasedon	10.1111/resp.12368	en_US
dc.subject.classification	Respiratory System	en_US
dc.subject.mesh	Respiratory System	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Asthma	en_US
dc.subject.mesh	Respiratory Hypersensitivity	en_US
dc.subject.mesh	Obesity	en_US
dc.subject.mesh	Weight Loss	en_US
dc.subject.mesh	Immunoglobulin E	en_US
dc.subject.mesh	Bronchial Provocation Tests	en_US
dc.subject.mesh	Forced Expiratory Volume	en_US
dc.subject.mesh	Age of Onset	en_US
dc.subject.mesh	Phenotype	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Bariatric Surgery	en_US
dc.title	Influence of distinct asthma phenotypes on lung function following weight loss in the obese	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	19	en_US
utslib.for	110203 Respiratory Diseases	en_US
utslib.for	110303 Clinical Microbiology	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

© 2014 Asian Pacific Society of Respirology. Background and objective: 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. Methods: 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 forced vital capacity (FVC) and forced expiratory volume in 1 s/FVC, respectively, divided by dose. Resting airway mechanics were measured by forced oscillation technique. Results: Weight loss reduced sensitivity to airway closure in TH2-low but not TH2-high obese asthmatics (pre-post mean change ± 95% confidence interval: 1.8 ± 0.8 doubling doses vs -0.3 ± 1.7 doubling doses, P = 0.04).However, there was no effect ofweight 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 (20 Hz) improved in TH2-high but not in TH2-low obese asthmatics (pre-post change median interquartile range: 1.5 (1.3-2.8) cmH2O/L/s vs 0.6 (-1.8-0.8) cmH2O/L/s, P = 0.03). Conclusions: TH2-low obese asthmatics appear to be characterized by increased small airway responsiveness and abnormalities in resting airway function that may persist followingweight 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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http://hdl.handle.net/10453/118815