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Publication : Therapeutic ketosis decreases methacholine hyperresponsiveness in mouse models of inherent obese asthma.

First Author  Mank MM Year  2022
Journal  Am J Physiol Lung Cell Mol Physiol Volume  322
Issue  2 Pages  L243-L257
PubMed ID  34936508 Mgi Jnum  J:329530
Mgi Id  MGI:6850202 Doi  10.1152/ajplung.00309.2021
Citation  Mank MM, et al. (2021) Therapeutic Ketosis Decreases Methacholine Hyperresponsiveness in Mouse Models of Inherent Obese Asthma. Am J Physiol Lung Cell Mol Physiol
abstractText  Obese asthmatics tend to have severe, poorly controlled disease and exhibit methacholine hyperresponsiveness manifesting in proximal airway narrowing and distal lung tissue collapsibility. Substantial weight loss in obese asthmatics or in mouse models of the condition decreases methacholine hyperresponsiveness. Ketone bodies are rapidly elevated during weight loss, coinciding with or preceding relief from asthma-related comorbidities. As ketone bodies may exert numerous potentially therapeutic effects, augmenting their systemic concentrations is being targeted for the treatment of several conditions. Circulating ketone body levels can be increased by feeding a ketogenic diet or by providing a ketone ester dietary supplement, which we hypothesized would exert protective effects in mouse models of inherent obese asthma. Weight loss induced by feeding a low-fat diet to mice previously fed a high-fat diet was preceded by increased urine and blood levels of the ketone body, beta-hydroxybutyrate (BHB). Feeding a ketogenic diet for three weeks to high-fat diet-fed obese mice or genetically obese db/db mice increased BHB concentrations and decreased methacholine hyperresponsiveness without substantially decreasing body weight. Acute ketone ester administration decreased methacholine responsiveness of normal mice, and dietary ketone ester supplementation of high-fat diet-fed mice decreased methacholine hyperresponsiveness. Ketone ester supplementation also transiently induced an 'anti-obesogenic' gut microbiome with a decreased Fermicutes/Bacteroidetes ratio. Dietary interventions to increase systemic BHB concentrations could provide symptom relief for obese asthmatics without the need for the substantial weight loss required of patients to elicit benefits to their asthma through bariatric surgery or other diet or lifestyle alterations.
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