The global rise in obesity has emerged as a significant health concern, amplifying susceptibility to various diseases, including asthma. Epidemiological evidence demonstrates a higher prevalence of asthma among obese individuals, with obesity exacerbating asthma severity and control. This review aims to explore the interplay between asthma and obesity assessed by objective imaging methods and discusses the consistency between anthropometric and imaging methods. A literature search was conducted with the main keywords "asthma", "obesity", and "imaging techniques" using databases such as PubMed, Web of Sciences, and Scopus for the relevant articles published up to January 2024. The consistency between Body Mass Index (BMI), Waist Circumference (WC), and results from imaging techniques is uncertain. Unlike anthropometric methods, imaging methods provide us with the exact location of adipose tissue as well as fat and lean mass distinction, which can be further correlated with different airway parameters and respiratory system functions and dysfunctions. Studies indicate that the relationship between lung functions and obesity is more complex in females. Abdominal visceral fat is supposed to be the major asthma predictor already in the pediatric population. The connection between obesity and asthma is already evident in children and adolescents. Imaging methods can measure visceral and subcutaneous fat mass and both contribute to the association between obesity and lung functions. These methods are more accurate and reproducible but require more time and expertise. Key words Asthma, Obesity, Magnetic resonance imaging, Dual-energy, X-ray absorptiometry, Bioimpedance analysis.
- MeSH
- Asthma * diagnostic imaging epidemiology physiopathology MeSH
- Body Mass Index MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Obesity * diagnostic imaging complications MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Kazuistika prezentuje případ seniora s manifestací těžkého refrakterního převážně neatopického eosinofilního astmatu ve vysokém věku téměř současně s progresí chronické rinosinusitidy s nosní polypózou. Během dvou let se nemocný dostal na 5. stupeň léčebného schématu dle doporučení Personalizovaného managementu astmatu (GINA) s nutností opakované terapie systémovými kortikoidy pro těžké exacerbace. Po nasazení biologické léčby.
This case report describes the case of a senior with severe refractory mainly non-atopic eosinophilic adult-onset asthma (in senior age), which comes almost simultaneously with the progression of chronic rhinosinusitis with nasal polyposis. Within two years, the asthma became refractory for treatment and the patient reached level 5 of the treatment scheme according to Asthma management guidelines (GINA) with repeated need for systemic corticosteroids due to severe exacerbations. After the use of biological treatment – dupilumab – the asthma was completely controlled with an improvement in the quality of life.
- Keywords
- dupilumab,
- MeSH
- Biological Therapy * MeSH
- Asthma * diagnostic imaging diagnosis drug therapy MeSH
- Eosinophils MeSH
- Adrenal Cortex Hormones administration & dosage adverse effects therapeutic use MeSH
- Remission Induction MeSH
- Comorbidity MeSH
- Humans MeSH
- Nasal Polyps MeSH
- Rhinosinusitis MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Anti-Asthmatic Agents administration & dosage MeSH
- Pulmonary Atelectasis diagnostic imaging MeSH
- Biological Therapy methods MeSH
- Asthma * diagnostic imaging drug therapy pathology MeSH
- Bronchiectasis diagnostic imaging drug therapy MeSH
- Diagnosis, Differential MeSH
- Middle Aged MeSH
- Humans MeSH
- Disease Progression MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Doporučený postup diagnostiky a léčby těžkého astmatu je společným dokumentem České pneumologické a ftizeologické společnosti a České společnosti alergologie a klinické imunologie. Prezentována je první část, která je určena alergologům a pneumologům v běžné ambulantní praxi. Jejím posláním je poskytnout těmto lékařům vodítko k identifikaci dospělých astmatiků, kteří by měli být odesláni na specializovaná pracoviště Národních center pro těžké astma (NCTA). Nepojednává komplexně o exaktní diagnostice, ale uvádí minimum toho, co by mělo být před odesláním do centra provedeno, a jakými podklady pacienta doprovodit.
Asthma bronchiale – chronické zánětlivé onemocnění dýchacích cest – je dnes vnímáno jako syndrom. Charakteristická je bronchiální hyperreaktivita, která je doprovázena obstrukční ventilační poruchou. Ta se zcela upraví spontánně nebo adekvátní léčbou. Asthma bronchiale postihuje osoby všech věkových skupin. Symptomy onemocnění nemusejí být zcela typické a onemocnění někdy není včas diagnostikováno. Cílem terapie je mít astma zcela pod kontrolou a zabránit závažným a prudkým exacerbacím. Optimálně zvolená léčba umožnuje nemocným vést plnohodnotný život.
Today, bronchial asthma – a chronic inflammatory disease of airways – is perceived as a syndrome. The characteristic symptom is bronchial hyperreactivity that is accompanied by obstructive lung disease. It can spontaneously improve or with a help of adequate therapy. Bronchial asthma affects people of all ages. The symptoms of the disease do not have to be entirely typical and sometimes the disease is not diagnosed in time. The goal of the therapy is for the asthma is entirely under control and to prevent severe and rapid exacerbations. Optimally chosen therapy allows the patients to have a full life.
- MeSH
- Adrenergic beta-2 Receptor Agonists administration & dosage pharmacology MeSH
- Anti-Asthmatic Agents administration & dosage MeSH
- Administration, Inhalation MeSH
- Biological Therapy MeSH
- Asthma * diagnostic imaging drug therapy classification MeSH
- Glucocorticoids administration & dosage pharmacology MeSH
- Humans MeSH
- Nebulizers and Vaporizers MeSH
- Disease Progression MeSH
- Respiratory Function Tests methods MeSH
- Forced Expiratory Volume drug effects MeSH
- Check Tag
- Humans MeSH
V České republice žije minimálně 10 000 nemocných, kteří splňují kritérium těžkého refrakterního astmatu. Tyto nemocné je nutné léčit podle stupně 5 doporučeného postupu GINA a ČIPA 2017 a využít všechny účinné léčebné modality. Novinkou je doporučení vyhnout se vysokým dávkám perorálních kortikosteroidů pro jejich závažné nežádoucí účinky a dát přednost biologické léčbě (anti‑IgE, anti‑IL‑5, anti‑IL4–13). V přehledu uvádíme základní charakteristiky těžkého astmatu, včetně fenotypů, a vliv perorálních kortikosteroidů na lidský organismus.
There are at least 10 000 patients in the Czech Republic who meet the criteria of severe refractory asthma. These patients should be treated according to GINA and CIPA 2017 recommended (steps 5) and take advantage of all effective treatment modalities. The novelty is the recommendation to avoid high doses of oral corticosteroids for their serious side effects and to prefer biologic treatment (anti‑IgE, anti‑IL‑5, anti‑IL4‑13). In the overview we present the basic characteristics of severe asthma, including phenotypes, and the effect of oral corticosteroids on the human organism.
- MeSH
- Biological Therapy methods MeSH
- Asthma * diagnostic imaging drug therapy classification MeSH
- Eosinophilia drug therapy immunology classification MeSH
- Phenotype MeSH
- Glucocorticoids administration & dosage adverse effects MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
