THE ROLE OF OBESITY-RELATED CHRONIC INFLAMMATION IN THE PATHOGENESIS AND SEVERITY OF ASTHMA IN ADULTS: A SYSTEMATIC REVIEW

Emilia Koziara; Mateusz Gadzina; Wojciech Sontag; Julia Gawlak; Zofia  Tarnawska; Karolina Figiel; Mateusz  Gawin; Mateusz  Zawisza; Aleksandra  Golec; Maciej Krzesimir Kuswik

doi:10.31435/ijitss.3(51).2026.6618

Authors

Emilia Koziara Samodzielny Publiczny Zakład Opieki Zdrowotnej MSWiA im. Sierżanta Grzegorza Załogi w Katowicach, Katowice, Poland https://orcid.org/0009-0005-4454-6085
Mateusz Gadzina Samodzielny Publiczny Zakład Opieki Zdrowotnej MSWiA im. Sierżanta Grzegorza Załogi w Katowicach, Katowice, Poland https://orcid.org/0009-0001-6153-4896
Wojciech Sontag Zagłębiowskie Centrum Onkologii Szpital Specjalistyczny im. Sz. Starkiewicza, Dąbrowa Górnicza, Poland https://orcid.org/0009-0004-6749-0224
Julia Gawlak Szpital Specjalistyczny im. Jędrzeja Śniadeckiego w Nowym Sączu, Nowy Sącz, Poland https://orcid.org/0009-0002-4586-4200
Zofia Tarnawska Samodzielny Publiczny Szpital Kliniczny im. Andrzeja Mielęckiego Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Poland https://orcid.org/0009-0004-2265-8089
Karolina Figiel Szpital Powiatowy w Chrzanowie, Chrzanów, Poland https://orcid.org/0009-0002-2227-5198
Mateusz Gawin Sosnowiecki Szpital Miejski sp. z o. o. w restrukturyzacji, Sosnowiec, Poland https://orcid.org/0009-0006-7409-9586
Mateusz Zawisza Górnośląskie Centrum Medyczne im. Prof. Leszka Gieca Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Poland https://orcid.org/0009-0003-1981-6640
Aleksandra Golec Górnośląskie Centrum Medyczne im. Prof. Leszka Gieca Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Poland https://orcid.org/0009-0004-9105-350X
Maciej Krzesimir Kuswik University Hospital in Poznań, ul. Przybyszewskiego, Poznań, Poland https://orcid.org/0009-0006-1925-204X

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6618

Keywords:

Asthma, Obesity, Chronic Inflammation, Adipokines, Severe Asthma, Adults

Abstract

Obesity and asthma are common chronic conditions that frequently coexist in adults and contribute to a substantial clinical and public health burden. Although excess body weight affects asthma through mechanical effects on lung volumes and airway closure, current evidence increasingly supports the role of obesity-related chronic low-grade inflammation as a central mechanism linking obesity with asthma development, severity, symptom burden, exacerbation risk, and therapeutic response. This systematic review summarizes contemporary evidence on the role of adipose-tissue inflammation, adipokines, cytokine signaling, metabolic dysfunction, oxidative stress, and immune dysregulation in the pathogenesis and clinical expression of obesity-related asthma in adults. A structured literature search was performed using major biomedical databases, with priority given to systematic reviews, meta-analyses, clinical reviews, cohort studies, mechanistic studies, and current asthma guidelines. The available literature indicates that obesity-related asthma is not a single uniform phenotype but a heterogeneous clinical entity involving overlapping inflammatory, metabolic, mechanical, and behavioral pathways. Increased systemic inflammatory activity, altered leptin and adiponectin signaling, elevated interleukin-6, neutrophilic airway inflammation, insulin resistance, and comorbidities such as obstructive sleep apnea and gastroesophageal reflux may all contribute to worse asthma control. Clinical management should therefore extend beyond inhaled pharmacotherapy and include assessment of obesity as a treatable trait, weight management, comorbidity screening, lifestyle intervention, and individualized evaluation of inflammatory phenotype. Future studies should clarify causal mechanisms and determine which interventions most effectively improve asthma outcomes in adults with obesity.

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