Asthma and Obesity:
Impact of weight loss on inflammatory markers and
clinical manifestations of asthma in children.

Cleveland Moore, MD, Principal Investigator
Lauren K. Carlisle, MD
Paulina Rojas, MD
John Estrada, MD

Abstract
Asthma and obesity are amoung the most common diseases in children. Several studies have shown an association between asthma and obesity, with a positive impact on weight loss on asthma symptoms, severity and pulmonary function; although the mechanisms linking both diseases are unclear. Inflammatory response is a well known component of asthma, and recent studies have found that a chronic inflammatory state is present in obese subjects. Inflammation in obese children may contribute to asthma symptoms.

We postulate that: 1) Inflammatory markers present in serum and airways of obese asthmatic children are increased when compared to those of non-obese and non-asthmatic children, and 2) Weight loss in obese asthmatic children decreases inflammation and improves asthma.

This pilot study consists of 2 phases:

Phase I - Aimed at determining systemic and airway inflammatory markers in 4 groups of children: healthy controls, non-obese asthmatics, obese non-asthmatics and obese asthmatics.

Phase II - Aimed at evaluating the impact of weight loss on serum and airway inflammatory markers, pulmonary function tests (PFTs), asthma quality of life and asthma severity. This phase will compare 2 groups of children: obese non-asthmatic vs. obese asthmatics

Each study group will enroll 10 children, ages 10 to 18 years. Inflammatory markers to be measured in serum include: C-Reactive Protein, Interleukin-6, Adiponectin and Leptin. Airway inflammation will be indirectly measured by exhaled Nitric Oxide.

Obese children (non-asthmatic and asthmatics) will undergo a 10 week weight reduction program consisting of diet, exercise and behavior modification. Serum and airway inflammatory markers will be measured at 2 week intervals. PFTs, asthma severity and asthma quality of life will be evaluated pre- and post-weight loss intervention.

Analysis of variance (ANOVA) will be used to evaluate differences among groups in phase I. Independent T-test will be used to compare inflammatory markers pre- and post-weight loss in phase II.

Collaboration:
Angela Cemo, MPH, Tulane-Charity-LSU GCRC
Janet Hughes, PhD, Tulane-Charity-LSU GCRC
Choots de Garcia, MPH, Tulane-Charity-LSU GCRC

Sponsor: NIAID
Duration: 07/03 - 06/04