Fig. 1

Mechanisms of Obese Asthma. A variety of mechanisms have been proposed as drivers of the physiologic and clinical observations in obese asthmatics, including changes in adipokines; T-helper type 1 (Th-1) skewed airway inflammation; lower asymmetric dimethylarginine (ADMA) to L-arginine ratio resulting in increased oxidative stress and decreased physiologic nitric oxide (NO), a mediator in smooth muscle dilatation; reduced functional residual capacity and expiratory reserved volume due to excess abdominal adiposity; interleukin-17 (IL-17) associated airway inflammation; steroid resistance and dampened response to mitogen-activated protein (MAP) kinase phosphatase-1 (MKP-1)