Fast Five Quiz: Severe Asthma Phenotypes

Zab Mosenifar, MD


April 05, 2021

Figure 2. Chest x-ray shows a patient with asthma with a right middle lobe (RML) collapse.

Obesity is frequently seen in patients with severe asthma, and researchers have identified at least two separate obese asthma phenotypes: an early-onset, allergic phenotype and a late-onset, female-dominated, nonallergic phenotype.

Severe early-onset obese asthma is normally triggered by allergens but is exacerbated by obesity. It is associated with eosinophilia and high serum IgE titers.

In patients with severe obese asthma, response to corticosteroids appears to be muted, resulting in their diminished efficacy. The reason for this may be twofold: First, obesity itself has been shown to reduce the response to steroids. Second, many patients with obese asthma are nonatopic, and steroids target the immune processes that mediate allergic responses.

Learn more about the phenotypes of severe asthma.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.