Bronchial asthma and obesity: features of systemic inflammation depending on the time of asthma onset

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Abstract

BACKGROUND: Bronchial asthma (asthma) is a complex, heterogeneous, multifactorial chronic disease. The pathophysiological mechanisms of the interaction between asthma and obesity have attracted considerable attention.

AIM: The work aimed to assess the characteristics of the cytokine profile in patients with asthma and obesity depending on the time of asthma onset.

METHODS: A total of 180 individuals were examined: 150 patients with asthma of varying severity were stratified by body mass index and divided into two study groups: those with a body mass index of 18.5–25 kg/m2 (n = 52, Asthma group) and those with a body mass index of 30–35 kg/m2 (n = 98). The control group consisted of 30 individuals. Patients with asthma and obesity (body mass index > 30 kg/m2) were further subdivided into two groups according to the time of asthma onset: Obesity + Asthma and Asthma + Obesity (with asthma duration of approximately 10 years). Asthma severity was assessed using the Asthma Control Test (ACT) and the Asthma Control Questionnaire (ACQ-5). Spirometry with bronchodilator testing was performed, and venous blood was collected to determine cytokine profile parameters (tumor necrosis factor-alpha; interleukins IL-2, IL-4, IL-6, IL-8, IL-10, IL-17; interferon-gamma) and markers of systemic inflammation (C-reactive protein, fibrinogen).

RESULTS: The asthma–obesity phenotype was characterized by a more severe course and poorer disease control, with the Obesity + Asthma group showing the most pronounced bronchial obstruction. Analysis of the cytokine profile revealed a significant imbalance between proinflammatory and anti-inflammatory cytokines, most pronounced in the Obesity + Asthma group. The findings underscore the importance of determining cytokine ratio indices with opposing activities (IL-2/IL-4, IL-2/IL-10, IL-8/IL-10, IL-6/IL-10, tumor necrosis factor-alpha/IL-10) to assess the severity of the inflammatory process and guide treatment strategies.

CONCLUSION: Obesity contributes to the development and maintenance of systemic inflammation, aggravating the course and progression of asthma.

About the authors

Dmitry А. Anikin

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Author for correspondence.
Email: anikin27111994@mail.ru
ORCID iD: 0000-0002-1598-436X
SPIN-code: 3045-8493

MD

Russian Federation, 1 Partizana Zeleznyak st, Krasnoyarsk, 660022; Krasnoyarsk

Irina A. Soloveva

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Email: acad-prorector@krasgmu.ru
ORCID iD: 0000-0002-1999-9534
SPIN-code: 8713-5470

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

Irina V. Demko

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Email: demko64@mail.ru
ORCID iD: 0000-0001-8982-5292
SPIN-code: 6520-3233

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

Elena A. Sobko

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Email: sobko29@mail.ru
ORCID iD: 0000-0002-9377-5213
SPIN-code: 9132-6756

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

Natalia V. Gordeeva

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Email: natagorday@yandex.ru
ORCID iD: 0000-0002-0586-8349
SPIN-code: 7914-7630

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

Angelina Yu. Kraposhina

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Clinical Regional Hospital

Email: angelina-maria@inbox.ru
ORCID iD: 0000-0001-6896-877X
SPIN-code: 8829-9240

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

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Supplementary files

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2. Fig. 1. Asthma control levels in the study groups based on AST test data.

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3. Fig. 2. Pulmonary function parameters in the study groups based on spirometry data. BA – bronchial asthma, FEV1 – forced expiratory volume in 1 second, FVC – forced vital capacity.

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4. Fig. 3. Statistically significant correlations between clinical data and cytokine concentrations in the study groups. BA – bronchial asthma, IL – interleukin, FEV1 – forced expiratory volume in 1 second, TNF-α – tumor necrosis factor alpha, SABA – short-acting β2-agonists, CRP – C-reactive protein; p < 0.01.

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