Cargando…

Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity

Asthma is a common, chronic airway inflammatory disease marked by airway hyperresponsiveness, inflammation, and remodeling. Asthma incidence has increased rapidly in the past few decades and recent multicenter analyses have revealed several unique asthma endotypes. Of these, type-2 high asthma with...

Descripción completa

Detalles Bibliográficos
Autores principales: Womble, Jack T, McQuade, Victoria L, Ihrie, Mark D, Ingram, Jennifer L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364356/
https://www.ncbi.nlm.nih.gov/pubmed/34408442
http://dx.doi.org/10.2147/JAA.S318017
_version_ 1783738516092485632
author Womble, Jack T
McQuade, Victoria L
Ihrie, Mark D
Ingram, Jennifer L
author_facet Womble, Jack T
McQuade, Victoria L
Ihrie, Mark D
Ingram, Jennifer L
author_sort Womble, Jack T
collection PubMed
description Asthma is a common, chronic airway inflammatory disease marked by airway hyperresponsiveness, inflammation, and remodeling. Asthma incidence has increased rapidly in the past few decades and recent multicenter analyses have revealed several unique asthma endotypes. Of these, type-2 high asthma with comorbid obesity presents a unique clinical challenge marked by increased resistance to standard therapies and exacerbated disease development. The extrinsic coagulation pathway plays a significant role in both type-2 high asthma and obesity. The type-2 high asthma airway is marked by increased procoagulant potential, which is readily activated following damage to airway tissue. In this review, we summarize the current understanding of the role the extrinsic coagulation pathway plays in the airway of type-2 high asthma with comorbid obesity. We propose that asthma control is worsened in obesity as a result of a systemic and local airway shift towards a procoagulant and anti-fibrinolytic environment. Lastly, we hypothesize bariatric surgery as a treatment for improved asthma management in type-2 high asthma with comorbid obesity, facilitated by normalization of systemic procoagulant and pro-inflammatory mediators. A better understanding of attenuated coagulation parameters in the airway following bariatric surgery will advance our knowledge of biomolecular pathways driving asthma pathobiology in patients with obesity.
format Online
Article
Text
id pubmed-8364356
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-83643562021-08-17 Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity Womble, Jack T McQuade, Victoria L Ihrie, Mark D Ingram, Jennifer L J Asthma Allergy Review Asthma is a common, chronic airway inflammatory disease marked by airway hyperresponsiveness, inflammation, and remodeling. Asthma incidence has increased rapidly in the past few decades and recent multicenter analyses have revealed several unique asthma endotypes. Of these, type-2 high asthma with comorbid obesity presents a unique clinical challenge marked by increased resistance to standard therapies and exacerbated disease development. The extrinsic coagulation pathway plays a significant role in both type-2 high asthma and obesity. The type-2 high asthma airway is marked by increased procoagulant potential, which is readily activated following damage to airway tissue. In this review, we summarize the current understanding of the role the extrinsic coagulation pathway plays in the airway of type-2 high asthma with comorbid obesity. We propose that asthma control is worsened in obesity as a result of a systemic and local airway shift towards a procoagulant and anti-fibrinolytic environment. Lastly, we hypothesize bariatric surgery as a treatment for improved asthma management in type-2 high asthma with comorbid obesity, facilitated by normalization of systemic procoagulant and pro-inflammatory mediators. A better understanding of attenuated coagulation parameters in the airway following bariatric surgery will advance our knowledge of biomolecular pathways driving asthma pathobiology in patients with obesity. Dove 2021-08-10 /pmc/articles/PMC8364356/ /pubmed/34408442 http://dx.doi.org/10.2147/JAA.S318017 Text en © 2021 Womble et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Womble, Jack T
McQuade, Victoria L
Ihrie, Mark D
Ingram, Jennifer L
Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title_full Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title_fullStr Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title_full_unstemmed Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title_short Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity
title_sort imbalanced coagulation in the airway of type-2 high asthma with comorbid obesity
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364356/
https://www.ncbi.nlm.nih.gov/pubmed/34408442
http://dx.doi.org/10.2147/JAA.S318017
work_keys_str_mv AT womblejackt imbalancedcoagulationintheairwayoftype2highasthmawithcomorbidobesity
AT mcquadevictorial imbalancedcoagulationintheairwayoftype2highasthmawithcomorbidobesity
AT ihriemarkd imbalancedcoagulationintheairwayoftype2highasthmawithcomorbidobesity
AT ingramjenniferl imbalancedcoagulationintheairwayoftype2highasthmawithcomorbidobesity