Obesity and Asthma

Epidemiological data indicates that obesity increases the prevalence and the incidence of asthma and reduces asthma control. Although the frequency of obesity in Japanese asthmatic patients is relatively low compared to Caucasian and other ethnic populations, similar relevance between obesity and asthma is reported from Japan. There are several proposed mechanisms for the relationship between obesity and asthma, such as changes of lung function, inflamma-tory factors including adipokines, co-morbidities, or common genetic backgrounds. The efficacy of the corticosteroid treatment is limited in obese asthmatic patients, and body weight control is the most effective treatment option. Especially, bariatric surgery can markedly improve the symptoms and lung function. Recent studies focusing on the heterogeneity of asthma suggest the impacts of obesity on non-atopic/ non-Th2 type asthma. We should consider the pathophysiology and molecular phenotype in obese asthmatic patients, and develop more targeted and personalized therapeutic strategies.