Asthma drug shows promise in treating obesity and diabetes

ANN ARBOR, Mich. — After 12 weeks of taking an anti-inflammatory asthma drug, obese patients with type 2 diabetes (link is external) showed a clinically significant drop in blood glucose.

Photo of Elif Oral
Michigan Medicine endocrinologist Elif Oral, M.D., leads clinical trial of asthma drug that shows promise as an obesity and diabetes medication.

The drug amlexanox, prescribed in Japan to treat asthma, appeared to free the metabolic system to burn more energy. A subset of patients had improved fatty liver disease and insulin sensitivity, a response seen among those who started the clinical trial with higher levels of inflammation in their fat tissue than others.

While the discovery at Michigan Medicine and the University of California at San Diego (link is external) is not ready for the clinic, it reveals an inflammatory link between obesity and type 2 diabetes.

Inflammation is the body’s natural response to injury and illness, but chronic inflammation caused by obesity is believed to promote insulin resistance, a main feature of diabetes.

“We are beginning to understand the role this form of internal inflammation plays in the development of chronic diseases like diabetes,” says lead study author Elif Oral, M.D., director of the MEND Obesity and Metabolic Disorder Program at Michigan Medicine (link is external). “Ultimately we may be able to personalize therapy based on the degree of inflammation present at baseline – which is a new concept.”

Oral is an endocrinologist and translational scientist at Michigan Medicine, the University of Michigan (link is external)’s academic medical center where the clinical trial was conducted and analyzed.

Tissue analysis was led by study author Alan R. Saltiel, Ph.D. (link is external), at U-C San Diego, along with scientists at the Salk Institute for Biological Sciences.

In the Cell Metabolism study, researchers identified a molecular signature in obese patients with type 2 diabetes who responded to the drug amlexanox.

“When we looked at the drug-treated group we saw a bimodal distribution, that is, there were some responders and some nonresponders. We didn’t understand why, so we did a molecular analysis from biopsies of fat cells we took from patients at the beginning and end of the study,” says Saltiel, director of…