Table of Contents
Journal of Allergy
Volume 2013 (2013), Article ID 714595, 5 pages
Review Article

Arginine and Nitric Oxide Pathways in Obesity-Associated Asthma

Division of Pulmonary, Allergy & Critical Care, Asthma Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA

Received 20 February 2013; Accepted 2 April 2013

Academic Editor: Allan Linneberg

Copyright © 2013 Fernando Holguin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Obesity is a comorbidity that adversely affects asthma severity and control by mechanisms that are not fully understood. This review will discuss evidence supporting a role for nitric oxide (NO) as a potential mechanistic link between obesity and late-onset asthma (>12 years). Several studies have shown that there is an inverse association between increasing body mass index (BMI) and reduced exhaled NO. Newer evidence suggests that a potential explanation for this paradoxical relationship is related to nitric oxide synthase (NOS) uncoupling, which occurs due to an imbalance between L-arginine (NOS substrate) and its endogenous inhibitor, asymmetric di-methyl arginine (ADMA). The review will propose a theoretical framework to understand the relevance of this pathway and how it may differ between early and late-onset obese asthmatics. Finally, the paper will discuss potential new therapeutic approaches, based on these paradigms, for improving the respiratory health of obese subjects with asthma.