Background

Asthma is a chronic inflammatory condition characterized by T-helper (T_H) 2 polarization. In children, the prevalence of obesity is associated with an increased incidence of asthma. Notably, obesity is linked with T_H1-mediated inflammation and has been identified as a major risk factor for asthma.

Objective

To investigate the impact of obesity on T_H1 (tumor necrosis factor α, interferon gamma, interleukin (IL)-6, IL-8) and T_H2 (IL-4, IL-5, IL-10, IL-13) immune responses in children with asthma.

Methods

We searched the MEDLINE and gray literature electronic databases for eligible studies from inception up until April 2020. The quality of included studies and evidence was independently assessed by 2 reviewers. The random-effects model was used in this meta-analysis, and outcomes were reported as standardized mean difference (SMD) and 95% confidence interval (CI).

Results

Overall, 5 studies comprising 482 participants met the inclusion criteria. The meta-analysis revealed an increased T_H2-mediated immune response in lean people with asthma compared with controls without asthma (SMD: −1.15 [95% CI: −1.93, 0.36]; I² = 93%; p^H < .001). However, in obese people with asthma, there was polarization toward T_H1 immune response compared with lean people with asthma (SMD: −0.43 [95% CI: −0.79, −0.08]; I² = 88%, p^H < .001).

Conclusion

This meta-analysis reveals that there are differences in immune responses mediated by T-helper cells in lean and obese children with asthma. Moreover, and not unique to asthma, obesity polarizes the immune response toward T_H1 rather than the classical T_H2. This could be an important aspect to understand to establish effective therapeutic targets for obese children with asthma.

中文翻译：

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儿童肥胖相关哮喘的特征在于T辅助1而不是T辅助2的免疫反应：一项荟萃分析。

背景

哮喘是一种慢性炎症性疾病，其特征是T-helper（T _H）2极化。在儿童中，肥胖症的患病率与哮喘的发病率增加有关。值得注意的是，肥胖与T _H 1介导的炎症有关，已被确定为哮喘的主要危险因素。

目的

研究肥胖对T _H 1（肿瘤坏死因子α，干扰素γ，白介素（IL）-6，IL-8）和T _H 2（IL-4，IL-5，IL-10，IL-13）的影响）小儿哮喘的免疫反应。

方法

我们从MEDLINE和灰色文献电子数据库中搜索了从开始到2020年4月的合格研究。纳入的研究和证据的质量由2位审阅者独立评估。在该荟萃分析中使用了随机效应模型，结果以标准均数差（SMD）和95％置信区间（CI）表示。

结果

总体而言，由482名参与者组成的5项研究符合纳入标准。荟萃分析显示，与没有哮喘的对照组相比，患有哮喘的瘦人中T _H 2介导的免疫反应增加（SMD：-1.15 [95％CI：-1.93，0.36]；I ²  = 93％； p ^H <。 001）。但是，与肥胖的哮喘患者相比，肥胖的哮喘患者对T _H 1免疫反应存在两极分化（SMD：-0.43 [95％CI：-0.79，-0.08]；I ²  = 88％，p ^H <。 001）。

结论

这项荟萃分析显示，在肥胖和肥胖的哮喘儿童中，T辅助细胞介导的免疫反应存在差异。而且，肥胖症不仅对哮喘有独特的作用，而且会极化针对T _H 1的免疫反应，而不是经典的T _H 2。这对于了解为肥胖的哮喘儿童建立有效的治疗目标可能是一个重要方面。