This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is very strong evidence from epidemiological and basic science studies to suggest that obesity may increase the risk of asthma. This has very important implications for the health of the US population given the current parallel epidemics of obesity and asthma. Understanding the physiological and inflammatory changes induced by obesity would make an important contribution to our understanding of the relationship between obesity and asthma. It is also important to understand why some obese people develop asthma, but others do not. We hypothesize that obese people with asthma have altered adipose tissue related inflammation compared to obese people without asthma. We also hypothesize that weight loss will improve physiological and inflammatory measures of asthma We have assembled a multi-disciplinary team, including surgeons, endocrinologists and pulmonologists to study patients undergoing gastric bypass surgery for extreme obesity. We are studying obese patients with asthma before surgery and in the 12 months after surgery: we are studying (i) their lung function with sophisticated physiological techniques before and after surgery (ii) adipose-related inflammation by in vitro studies on visceral and subcutaneous fat collected at the time of surgery (iii) circulating pro-inflammatory factors produced by adipose tissue and (iv) inflammation in the lung by bronchoscopy with isolation of cells by bronchoalveolar lavage for in vitro studies. As a comparison group we are also studying obese patients without asthma to determine if there are differences in adipose tissue-related factors that could explain why they do not have asthma.