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Clinical Phenotype of Asthma. Adiposity. Asthma. Physiological Phenotype of Asthma. ?. Inflammatory Phenotype of Asthma. Is the asthma phenotype in the obese UNIQUE?. Disproportionate symptoms Dynamic hyperinflation with bronchoprovocation ? Lack of eosinophilic inflammation
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Clinical Phenotype of Asthma Adiposity Asthma Physiological Phenotype of Asthma ? Inflammatory Phenotype of Asthma
Is the asthma phenotype in the obese UNIQUE? • Disproportionate symptoms • Dynamic hyperinflation with bronchoprovocation • ? Lack of eosinophilic inflammation • Effect of Innate immunity • Lower exhaled NO levels • Poor response to inhaled corticosteroids • Preserved response to LRA
Developing relevant biomarkers for studying this association • New Physiologic Markers • Dynamic Hyperinflation • Role of Impulse Oscillometry not studied • Sputum Inflammatory Markers • Sputum eosinophil granular protein • Sputum cytokines and adipokine levels • Exhaled Breath Condensate Markers • pH; 8-Isoprostane
Asthma Asthma Controls Controls Obesity phenotype matters? • Central adiposity • Lean mass • May be more important than fat mass in predicting asthma in women • Mass matters • Pathological and not physiological fat matters • Need for studying CT/MRS