Continuous positive airway pressure for asthma: not a big stretch?

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Abstract
However, the pro-inflammatory effects of obesity are not the only way in which obesity contributes to the development of asthma. The effect of obesity on lung mechanics may be just as or even more important. With obesity, lung volumes (especially functional residual capacity; FRC) decrease as a result of increased abdominal and chest wall pressure. Since airway calibre is a function of lung volume 6, 7, obesity contributes to smaller airway calibre. Smaller airway calibre is likely to unload the airway smooth muscle, increase actin–myosin cross-bridging and allow for increased shortening when activated 8, 9. Deep breathing has been found to be a potent bronchodilator by periodically stretching the airway smooth muscle and disturbing actin–myosin attachments, making contractions less forceful and the airway more compliant 8. Obesity also decreases the volume of tidal breathing and, therefore, is likely to decrease the tidal stresses on airway smooth muscle, which allows the muscle to become stiff and hyperresponsive 8.

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