Asthma and Obesity: Weight Loss and Inflammatory Markers

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

Abstract
The 1 year study is designed to evaluate the effect of weight loss on the clinical manifestation of inflammation in obese asthmatic children. The study will be conducted by clinical researchers at Louisiana State University in New Orleans. The Tulane-LSU Clinical Research Center at Charity Hospital will be both co-sponsor and site for the study.

Asthma and obesity are leading health problems nationwide, especially among Louisiana children. Several studies have shown an association between asthma and obesity, with a positive impact of 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.

The applicants 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