The primary controller medication for asthma, glucocorticoids, is 40 percent less effective in obese and overweight asthma patients when compared to asthmatic patients with normal weight, as per a finding disclosed by researchers at National Jewish Health.
This study, by Associate Professor of Medicine E. Rand Sutherland, MD, MPH and his colleagues at National Jewish Health, appeared in an issue of the American Journal of Respiratory and Critical Care Medicine.
From Medicalnewstoday.com:
The study at National Jewish Health sought to understand why glucocorticoids, commonly called steroids, might be less effective in overweight and obese asthma patients. Dr. Sutherland and his colleagues enrolled 45 nonsmoking adults, 33 of whom had asthma, and measured the response of cells in the blood and the lungs to the steroid dexamethasone.
Steroids interfere with inflammatory signaling pathways by raising the level of a molecule known as MAP kinase phosphatase-1 (MKP-1). When the researchers applied the steroid dexamethasone to cultures of the participants’ blood cells, they found that steroids did not increase MKP-1 as effectively in overweight and obese asthmatics when compared to lean asthmatics. Dexamethasone increased the levels of MKP-1 by 5.27 times in cultured blood cells from lean asthma patients, whereas MKP-1 levels in overweight and obese asthmatics increased by only 3.11 times, a 41 percent smaller response. The heavier a person was the less their cells were likely to respond to dexamethasone. This negative relationship between weight and response to steroids did not occur in participants who did not have asthma.
“Steroids were clearly less effective in overweight and obese asthma patients,” said Dr. Sutherland. “Previous studies have suggested a link between weight and response to steroids in patients, and this study suggests a potential mechanism by which this occurs. It also suggests that future research should be directed specifically to understanding how asthma medications work in overweight and obese asthmatics.
It was also said that inhaled steroids are still very much effective for treating overweight and obese asthmatics.
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