Recent findings suggest that obese asthma patients may not respond well to glucocorticoids. These findings were based on a study conducted by researchers at National Jewish Health, led by associate professor of Medicine E. Rand Sutherland, MD, MPH and his colleagues. They employed nonsmoking adults with asthma, and measured dexamethasone response of cells in the blood and the lungs.
Obese people with asthma had significantly worse asthma control. Steroids interfere with inflammatory signaling pathways by increasing the level of MAP kinase phosphatase-1 (MKP-1). Dexamethasone increased the levels of MKP-1 by 5.27 times in cultured cells from lean asthma patients while in obese and overweight asthma patients, there was a 41 percent smaller response. This is because the heavier a person is, the lesser their cells will likely to respond to steroid treatment.
These findings should be considered by doctors in carefully evaluating response to treatment in overweight and obese patients. They must consider optimizing therapeutic regimens for this particular group.
Overweight and obese asthmatics on the other hand, must carefully discuss it with their doctor if they think that their current treatment plan is not effective rather than simply discontinuing their medication or increasing their dosage.
From Science Daily:
“This study identifies what could be a significant issue for the 20 million Americans with asthma; specifically, the main controller medication might be less effective if you are overweight or obese,” said Dr. Sutherland. “These findings should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics and consider optimizing therapeutic regimens as indicated. We also hope they will spur additional research into the treatment of obese patients with asthma.”
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