AAAAI: Corticosteroid Response in Asthma Impacted by BMI

For children, high BMI linked to decreased CS response, increased requirement for inhaled CS

MONDAY, March 5 (HealthDay News) -- For children with asthma, an increased body mass index (BMI) is associated with a decreased response to corticosteroids (CS) and increased daily requirements for inhaled CS (ICS), according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from March 2 to 6 in Orlando, Fla.

To investigate whether BMI affects the CS response in children with asthma, Rolando A. Nunez, M.D., from National Jewish Health in Denver, and colleagues studied peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage (BAL) cells from 61 children with asthma, aged 2 to 18 years, who underwent clinically indicated bronchoscopies.

The researchers found that 34 children had normal weight, 13 were overweight, and 14 were obese. Fifty-six participants used ICS. BMI percent correlated significantly with plasma leptin (P = 0.0001), daily ICS dose (P = 0.0035), and dexamethasone-induced mitogen-activated protein kinase phosphatase-1 (MKP-1) in PBMC and BAL cells (P = 0.0009 and 0.0205, respectively). There was a negative association between MKP-1 induction and the daily requirement of ICS (P = 0.0303).

"Chronic inflammation, as seen in obese patients, is thought to interfere with the body's response to corticosteroids, leading to a higher corticosteroid requirement in patients with asthma," a co-author said in a statement. "More studies are needed to find out if the response to the medication might improve if obese children with asthma lose weight."

Abstract No. 482
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