Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma
Evidence from large epidemiological studies has shown that obesity may predispose to increased Th2 inflammation and increase the odds of developing asthma. On the other hand, there is growing evidence suggesting that metabolic dysregulation that occurs with obesity, and more specifically hyperglycem...
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/12/2/437 |
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| author | Konstantinos Bartziokas Andriana I. Papaioannou Fotios Drakopanagiotakis Evanthia Gouveri Nikolaos Papanas Paschalis Steiropoulos |
| author_facet | Konstantinos Bartziokas Andriana I. Papaioannou Fotios Drakopanagiotakis Evanthia Gouveri Nikolaos Papanas Paschalis Steiropoulos |
| author_sort | Konstantinos Bartziokas |
| collection | DOAJ |
| description | Evidence from large epidemiological studies has shown that obesity may predispose to increased Th2 inflammation and increase the odds of developing asthma. On the other hand, there is growing evidence suggesting that metabolic dysregulation that occurs with obesity, and more specifically hyperglycemia and insulin resistance, may modify immune cell function and in some degree systemic inflammation. Insulin resistance seldom occurs on its own, and in most cases constitutes a clinical component of metabolic syndrome, along with central obesity and dyslipidemia. Despite that, in some cases, hyperinsulinemia associated with insulin resistance has proven to be a stronger risk factor than body mass in developing asthma. This finding has been supported by recent experimental studies showing that insulin resistance may contribute to airway remodeling, promotion of airway smooth muscle (ASM) contractility and proliferation, increase of airway hyper-responsiveness and release of pro-inflammatory mediators from adipose tissue. All these effects indicate the potential impact of hyperinsulinemia on airway structure and function, suggesting the presence of a specific asthma phenotype with insulin resistance. Epidemiologic studies have found that individuals with severe and uncontrolled asthma have a higher prevalence of glycemic dysfunction, whereas longitudinal studies have linked glycemic dysfunction to an increased risk of asthma exacerbations. Since the components of metabolic syndrome interact with one another so much, it is challenging to identify each one’s specific role in asthma. This is why, over the last decade, additional studies have been conducted to determine whether treatment of type 2 diabetes mellitus affects comorbid asthma as shown by the incidence of asthma, asthma control and asthma-related exacerbations. The purpose of this review is to present the mechanism of action, and existing preclinical and clinical data, regarding the effect of insulin resistance in asthma. |
| first_indexed | 2024-03-07T22:40:36Z |
| format | Article |
| id | doaj.art-54de20a3c38e419984659d8405f54583 |
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| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-07T22:40:36Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-54de20a3c38e419984659d8405f545832024-02-23T15:08:50ZengMDPI AGBiomedicines2227-90592024-02-0112243710.3390/biomedicines12020437Unraveling the Link between Ιnsulin Resistance and Bronchial AsthmaKonstantinos Bartziokas0Andriana I. Papaioannou1Fotios Drakopanagiotakis2Evanthia Gouveri3Nikolaos Papanas4Paschalis Steiropoulos5Private Pulmonologist, 42132 Trikala, Greece1st University Department of Respiratory Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 15772 Athens, GreeceDepartment of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDiabetes Centre, 2nd Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDiabetes Centre, 2nd Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDepartment of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, GreeceEvidence from large epidemiological studies has shown that obesity may predispose to increased Th2 inflammation and increase the odds of developing asthma. On the other hand, there is growing evidence suggesting that metabolic dysregulation that occurs with obesity, and more specifically hyperglycemia and insulin resistance, may modify immune cell function and in some degree systemic inflammation. Insulin resistance seldom occurs on its own, and in most cases constitutes a clinical component of metabolic syndrome, along with central obesity and dyslipidemia. Despite that, in some cases, hyperinsulinemia associated with insulin resistance has proven to be a stronger risk factor than body mass in developing asthma. This finding has been supported by recent experimental studies showing that insulin resistance may contribute to airway remodeling, promotion of airway smooth muscle (ASM) contractility and proliferation, increase of airway hyper-responsiveness and release of pro-inflammatory mediators from adipose tissue. All these effects indicate the potential impact of hyperinsulinemia on airway structure and function, suggesting the presence of a specific asthma phenotype with insulin resistance. Epidemiologic studies have found that individuals with severe and uncontrolled asthma have a higher prevalence of glycemic dysfunction, whereas longitudinal studies have linked glycemic dysfunction to an increased risk of asthma exacerbations. Since the components of metabolic syndrome interact with one another so much, it is challenging to identify each one’s specific role in asthma. This is why, over the last decade, additional studies have been conducted to determine whether treatment of type 2 diabetes mellitus affects comorbid asthma as shown by the incidence of asthma, asthma control and asthma-related exacerbations. The purpose of this review is to present the mechanism of action, and existing preclinical and clinical data, regarding the effect of insulin resistance in asthma.https://www.mdpi.com/2227-9059/12/2/437asthmainsulin resistanceantidiabetic drugsmetabolic dysfunctionobesity |
| spellingShingle | Konstantinos Bartziokas Andriana I. Papaioannou Fotios Drakopanagiotakis Evanthia Gouveri Nikolaos Papanas Paschalis Steiropoulos Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma Biomedicines asthma insulin resistance antidiabetic drugs metabolic dysfunction obesity |
| title | Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma |
| title_full | Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma |
| title_fullStr | Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma |
| title_full_unstemmed | Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma |
| title_short | Unraveling the Link between Ιnsulin Resistance and Bronchial Asthma |
| title_sort | unraveling the link between ιnsulin resistance and bronchial asthma |
| topic | asthma insulin resistance antidiabetic drugs metabolic dysfunction obesity |
| url | https://www.mdpi.com/2227-9059/12/2/437 |
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