Epidemiological studies report that overweight or obese asthmatic subjects have more severe disease than those of a healthy weight. We postulated that accumulation of adipose tissue within the airway wall may occur in overweight patients and contribute to airway pathology. Our aim was to determine the relationship between adipose tissue within the airway wall and body mass index (BMI) in individuals with and without asthma. Transverse airway sections were sampled in a stratified manner from post mortem lungs of control subjects (n=15) and cases of nonfatal (n=21) and fatal (n=16) asthma. The relationship between airway adipose tissue, remodelling and inflammation was assessed. The areas of the airway wall and adipose tissue were estimated by point count and expressed as area per mm of basement membrane perimeter (Pbm). The number of eosinophils and neutrophils were expressed as area densities. BMI ranged from 15 to 45 kg·m−2 and was greater in nonfatal asthma cases (p<0.05). Adipose tissue was identified in the outer wall of large airways (Pbm >6 mm), but was rarely seen in small airways (Pbm <6 mm). Adipose tissue area correlated positively with eosinophils and neutrophils in fatal asthma (Pbm >12 mm, p<0.01), and with neutrophils in control subjects (Pbm >6 mm, p=0.04). These data show that adipose tissue is present within the airway wall and is related to BMI, wall thickness and the number of inflammatory cells. Therefore, the accumulation of airway adipose tissue in overweight individuals may contribute to airway pathophysiology. In individuals with elevated BMI, adipose tissue accumulates within the airway wall, correlates with greater wall thickness and airway inflammation and represents a new mechanism for airway pathophysiology in obese asthmatic patients http://bit.ly/2maDoSp

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脂肪气道：对阻塞性疾病的影响

流行病学研究报告称，超重或肥胖的哮喘患者比健康体重的患者病情更严重。我们推测，超重患者可能会发生气道壁内脂肪组织的积聚，并导致气道病变。我们的目的是确定气道壁内的脂肪组织与患有和不患有哮喘的个体的体重指数 (BMI) 之间的关系。从对照受试者 (n=15) 和非致命 (n=21) 和致命 (n=16) 哮喘病例的死后肺中以分层方式对横向气道切片进行采样。评估了气道脂肪组织、重塑和炎症之间的关系。气道壁和脂肪组织的面积通过点数估计，并表示为每毫米基底膜周长 (Pbm) 的面积。嗜酸性粒细胞和嗜中性粒细胞的数量表示为面积密度。BMI 范围为 15 至 45 kg·m-2，并且在非致死性哮喘病例中更高（p<0.05）。在大气道外壁（Pbm > 6 mm）中发现脂肪组织，但在小气道（Pbm <6 mm）中很少见到。脂肪组织面积与致命性哮喘中的嗜酸性粒细胞和中性粒细胞呈正相关（Pbm > 12 mm，p < 0.01），与对照受试者中的中性粒细胞（Pbm > 6 mm，p = 0.04）呈正相关。这些数据表明，脂肪组织存在于气道壁内，并且与 BMI、壁厚和炎症细胞的数量有关。因此，超重个体气道脂肪组织的积累可能会导致气道病理生理。在 BMI 升高的个体中，脂肪组织积聚在气道壁内，