RESUMO
Asthma associated with obesity is considered the most severe phenotype and can be challenging to manage with standard medications. Marine-derived 1-O-alkyl-glycerols (AGs), as precursors for plasmalogen synthesis, have high biological activity, making them a promising substance for pharmacology. This study aimed to investigate the effect of AGs from squid Berryteuthis magister on lung function, fatty acid and plasmalogen levels, and cytokine and adipokine production in obese patients with asthma. The investigational trial included 19 patients with mild asthma associated with obesity who received 0.4 g of AGs daily for three months in addition to their standard treatment. The effects of AGs were evaluated at one and three months of treatment. The results of the study demonstrated that intake of AGs increased the FEV1 and FEV1/VC ratios, and significantly decreased the ACQ score in 17 of the 19 patients after three months of treatment. The intake of AGs increased concentration of plasmalogen and n-3 PUFA in plasma, and modified leptin/adiponectin production by adipose tissue. The supplementation of AGs decreased the plasma levels of inflammatory cytokines (TNF-α, IL-4, and IL-17a), and oxylipins (TXB2 and LTB4), suggesting an anti-inflammatory property of AGs. In conclusion, 1-O-alkyl-glycerols could be a promising dietary supplement for improving pulmonary function and reducing inflammation in obese asthma patients, and a natural source for plasmalogen synthesis. The study highlighted that the beneficial effects of AG consumption can be observed after one month of treatment, with gradual improvement after three months of supplementation.
Assuntos
Asma , Ácidos Graxos , Animais , Ácidos Graxos/uso terapêutico , Plasmalogênios/metabolismo , Plasmalogênios/uso terapêutico , Glicerol , Decapodiformes/metabolismo , Obesidade/complicações , Obesidade/tratamento farmacológico , Asma/tratamento farmacológico , Inflamação/tratamento farmacológico , CitocinasRESUMO
PROBLEM: Recent identification of the early-onset obese-asthma phenotype has spurred exploration of ways to promote effective, long-term management behaviors for children with this comorbid presentation. Few studies have examined the needs of children with both asthma and obesity and little is known about optimal management options for this unique population. Therefore, the authors aimed to review, critique, and synthesize existing published research on health-management programs designed for children with comorbid asthma and obesity in order to describe the state of the science and recommend next steps in creating pediatric management programs. ELIGIBILITY CRITERIA: Articles selected for a full-text review were pediatric-focused, included children with both asthma and obesity diagnoses, and discussed the implementation and evaluation of a management program or the evaluation of a management behavior. SAMPLE: Fifteen articles were selected for review based on the inclusion criteria. RESULTS: Studies that included current evidence-based elements had better results than those that did not include such elements. CONCLUSIONS: Based on this review, it is recommended that researchers use theory based, multicomponent, multimodal, family-focused, behaviorally-based interventions that address systems-level influences, social determinates of health, and children's developmental needs over time. Additionally, there is a need for studies with sample sizes adequate for power analyses that include the youngest children with asthma and obesity. IMPLICATIONS: The need for effective programs for pediatric obese-asthma phenotype management creates the opportunity for nursing-led research and interventions to foster long-term health promotion for affected children and families.
Assuntos
Asma , Pesquisa em Enfermagem , Envio de Mensagens de Texto , Asma/diagnóstico , Asma/epidemiologia , Asma/terapia , Criança , Humanos , Obesidade , FenótipoRESUMO
Obesity is the most common asthma co-morbidity; it has been associated with increased risk for asthma exacerbations, worse respiratory symptoms and poor control. The exact mechanisms remain elusive and are probably multifactorial, stemming from mechanical alterations of the airways and lung parenchyma, to systemic and airway inflammatory and metabolic dysregulation that adversely influences lung function and or response to therapy. However, the fact that not every obese asthmatic is equally affected by weight gain highlights the many challenges and complexities in understanding this association. The factors that determine susceptibility may not depend on being obese alone, but rather the interactions with other phenotypical characteristics, such as age of asthma onset, gender and race to name a few. Inability to account for asthma phenotypes that are differentially affected by increasing body mass index (BMI) may contribute to the lack of consistent results across studies. This review will provide a succinct summary of obesity-related mechanisms and the clinical impact on asthma including highlights on recent progress.