A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma

• Published in: Journal of allergy and clinical immunology Vol. 127; no. 5; pp. 1133 - 1140
• Main Authors: Wood, Lisa G., Garg, Manohar L., Gibson, Peter G.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2011; Elsevier; Elsevier Limited
• Subjects: Adult; airway inflammation; Allergy and Immunology; Asthma; Asthma - immunology; Asthma - physiopathology; Biological and medical sciences; Bronchi - drug effects; Bronchi - immunology; Bronchi - physiopathology; Bronchodilator Agents - pharmacology; bronchodilator recovery; bronchodilators; C-reactive protein; Chronic obstructive pulmonary disease, asthma; Dietary fat; Dietary Fats - administration & dosage; Dietary Fats - immunology; Dietary Fats - pharmacology; enzyme-linked immunosorbent assay; fat intake; Fatty acids; Fatty Acids - blood; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; gene expression; Humans; Immune system; Immunity, Innate - drug effects; Immunopathology; inflammation; Inflammation - immunology; innate immunity; interleukin-6; lung function; Male; Medical sciences; messenger RNA; Middle Aged; neutrophils; Neutrophils - immunology; Obesity - complications; Obesity - immunology; Oils & fats; patients; Pneumology; quantitative polymerase chain reaction; Respiratory System - drug effects; Respiratory System - immunology; Respiratory System - physiopathology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sputum - immunology; Toll-like receptor 4; Trans fats; trans fatty acids; Treatment Outcome; tumor necrosis factor-alpha; airway inflammation; CRP; DRS; MUFA; SFA; NF-κB; innate immunity; HCHF; TLR; neutrophils; BMI; fatty acids; PUFA; Toll-like receptor 4; eNO; Dietary fat; asthma; ACQ; AHF-NonO; TE; FVC; AHF-O; ALF; bronchodilator recovery; AHF; Total energy; C-reactive protein; Forced vital capacity; Monounsaturated fatty acid; Asthma low-fat/low-energy; Body mass index; Asthma high-fat/high energy—nonobese; Toll-like receptor; Healthy controls high-fat; Exhaled nitric oxide; Polyunsaturated fatty acid; Asthma high-fat; Nuclear factor-κB; Asthma Control Questionnaire; Dose response slope; Saturated fatty acid; Asthma high-fat/high energy—obese; Toll like receptor 4; Granulocyte; Lipids; Natural immunity; Respiratory system; Recovery; Respiratory tract; Immunology; Bronchus disease; Obstructive pulmonary disease; Lung disease; Immunopathology; Nutrition; Respiratory disease; Bronchodilator; Increase; Inflammation; Fatty acids; Feeding; Asthma; Diet; Fat; Neutrophil
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2011.01.036

Dietary fat activates systemic innate immune responses, but the effect on airway responses is unknown. To examine effects of a high-fat versus low-fat meal on systemic and airway inflammation in asthma. Nonobese subjects with asthma were randomized to consume a high-fat (n = 19; 48% [49 g] fat) or low-fat (n = 18; 15% [3 g] fat) meal. Fourteen obese patients with asthma and 21 healthy controls also consumed a high-fat meal. Another group of patients with asthma consumed a high-trans (n = 5; 5.2 g trans fat) or nontrans (n = 5, <0.3 g trans fat) fatty acid meal. Lung function was measured at baseline (prebronchodilator) and 2, 3, and 4 hours after bronchodilator. Airway inflammation was assessed by using induced sputum cell counts and Toll-like receptor 4 mRNA expression by real-time PCR. Systemic inflammation was measured by ELISA quantification of plasma TNF-α, high-sensitivity C-reactive protein, and IL-6 concentrations. In patients with asthma, at 4 hours postmeal, increases in sputum % neutrophils and Toll-like receptor 4 mRNA expression were higher and increases in FEV 1/forced vital capacity (FVC) were lower in the high-fat versus low-fat groups. Changes in plasma fatty acids correlated with changes in sputum % neutrophils and were negatively associated with changes in % FEV 1, % FVC, and FEV 1/FVC. After the high-trans fatty acid meal, sputum % neutrophils were significantly higher than after the nontrans meal. A high-fat meal augments neutrophilic airway inflammation, with the effect dependent on the type of fat consumed. A high-fat meal also suppresses bronchodilator recovery in asthma. Modifying dietary fat intake may be useful in asthma.