cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыханияcfpd-199Research ArticleОБЗОРЫREVIEWSПАТОГЕНЕТИЧЕСКИЕ АСПЕКТЫ ФЕНОТИПА БРОНХИАЛЬНОЙ АСТМЫ, АССОЦИИРОВАННОЙ С ОЖИРЕНИЕМPATHOGENETIC ASPECTS OF THE PHENOTYPE OF BRONCHIAL ASTHMA ASSOCIATED WITH OBESITYУксуменкоА. А.UksumenkoA. A.anna_uksumenko@mail.ruАнтонюкМ. В.AntonyukM. V.noemail@neicon.ruВладивостокский филиал Федерального государственного бюджетного научного учреждения «Дальневосточный научный центр физиологии и патологии дыхания» - Научно-исследовательский институт медицинской климатологии и восстановительного лечениРоссияVladivostok Branch of Far Eastern Scientific Center of Physiology of Respiration - Research Institute of Medical Climatology and Rehabilitation TreatmentRussian Federation201918112019071112119Copyright © Уксуменко А.А., Антонюк М.В., 20192019Уксуменко А.А., Антонюк М.В.Uksumenko A.A., Antonyuk M.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/199

В настоящее время параллельно росту распространенности бронхиальной астмы (БА) наблюдается увеличение числа больных ожирением. Результаты многочисленных исследований свидетельствуют о том, что фенотип БА в сочетании с ожирением имеет четко очерченные клинические особенности - более тяжелое течение с частыми обострениями и снижением контроля над заболеванием. В статье рассматриваются основные патогенетические механизмы, обусловливающие развитие фенотипа БА в сочетании с ожирением. Описаны влияние избытка жировой ткани в грудной клетке на механику дыхания, взаимосвязь с гастроэзофагеальной рефлюксной болезнью и нарушением дыхания во сне. Показано, что для фенотипа БА с ожирением характерны воспаление жировой ткани, адипокиновый дисбаланс, инсулинорезистентность, нарушение обмена витамина D.Рассмотрены гендерные особенности и генетическая обусловленность БА, ассоциированной с ожирением. Понимание общих механизмов, лежащих в основе формирования БА и ожирения, несомненно, будет способствовать разработке новых терапевтических стратегий.

Currently, in parallel with the increase in the prevalence of asthma, there is an increase in the number of obese patients. The results of numerous studies indicate that the asthma phenotype in combination with obesity has well-defined clinical features - a more severe course with frequent exacerbations and reduced control of the disease. The article considers the main pathogenetic mechanisms that determine the development of the asthma phenotype in combination with obesity. The influence of excess adipose tissue in the chest on respiratory mechanics, the correlation of gastroesophageal reflux disease and respiratory depression in sleep are described. It is shown that the phenotype of asthma with obesity is characterized by inflammation of adipose tissue, adipokine imbalance, insulin resistance, and disturbance of vitamin D metabolism. Gender peculiarities and genetic condition of asthma associated with obesity are considered. Understanding general mechanisms underlying the formation of asthma and obesity will undoubtedly contribute to the development of new therapeutic strategies.

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The authors declare that there are no conflicts of interest present.