Bronchial asthma and obesity in children. Mechanisms of interrelation

Bronchial asthma and obesity are diseases that form a stable inflammatory process in the body. In the first case, it is concentrated mainly in the walls of the respiratory tract, in the second case — more common, affecting many organs and systems. The conditions for maintaining such inflammation and its further strengthening may be: the involvement of large amounts of adipose tissue in this process; the participation of factors of innate and adaptive immunity in it. At the same time, the formation, the course of bronchial in children, the severity of allergic inflammation in the lung tissue and the degree of bronchial hyperreactivity significantly depend on the severity of hyperplasia of adipose tissue and the activity of the inflammatory process in it. Weight of adipose tissue in a child is one of the factors of severe uncontrolled, resistant to therapy forms of bronchial asthma in obese patients since childhood. It is possible to distinguish the endotype of bronchial asthma-BA + obesity, which is characterized by: later onset of the disease; severe bronchial hyperreactivity; prevalence of Th1-TH 17 immune response; uncontrolled course; torpidness to therapy with inhaled glucocorticosteroids; high doses of drugs necessary to achieve control over the disease; improved response to therapy with inhaled glucocorticosteroids against the background of weight loss and the use of vitamin D.