Simple weight reduction may be one way to manage asthma, according to researchers who identified key asthma related genes — IL-4, LIGHT (TNFSF14), MMP-9 and CCR-2; plasma NOM and MMP-9 — increased in the obese, obese type 2 diabetics (T2DM) and in morbidly obese patients prior to and after gastric bypass surgery (RYGB).
Investigators noted that, after RYGB surgery and weight loss, the expression of these factors in mononuclear cells (MNC) and plasma concentrations fall significantly.
Among the study’s 38 participants — 23 obese and 15 morbidly obese with Type 2 diabetes — the expression of interleukin (IL)-4, matrix metalloproteinase (MMP)-9, and chemokine receptor (CCR)-2 messenger RNA in mononuclear cells was significantly higher than among 22 healthy-weight participants.
Levels of LIGHT (TNFSF14), a recently described ligand that is involved in bronchial remodeling, were also significantly greater in all obese participants, as were plasma levels of nitric oxide metabolites (NOM; NO2/NO3) and MMP-9.
Following RYGB in 15 patients, there were significant reductions in bodyweight, BMI, and improvements in diabetes-related parameters such as glucose, insulin and glycated hemoglobin, as well as reductions in major oxidative and inflammatory markers.
“If these changes in gene expression are reflected in the clinical changes in the patient, they may provide a useful indication of the clinical activity of asthma,” the authors wrote. “Gastric bypass surgery may provide a potential therapeutic approach to asthma in the morbidly obese.”