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Chronic obstructive pulmonary disease: effects beyond the lungs
Vijay P Balasubramanian1, Basil Varkey
1Department of Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee 53226, USA. bvarkey@mcw.edu
Current Opinion in Pulmonary Medicine
|February 4, 2006
Summary
Chronic obstructive pulmonary disease (COPD) causes systemic muscle dysfunction and cachexia through inflammation and oxidative stress, impacting mortality. These effects extend beyond the lungs, highlighting a common inflammatory link.
Area of Science:
- Pulmonary Medicine
- Muscle Physiology
- Systemic Inflammation
Background:
- Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory condition.
- COPD affects skeletal muscles, leading to dysfunction and wasting (cachexia).
- Cachexia in COPD is an independent predictor of mortality.
Purpose of the Study:
- To review the systemic effects of COPD.
- To focus on musculoskeletal effects and cachexia in COPD patients.
- To explore the underlying mechanisms of muscle dysfunction and cachexia.
Main Methods:
- Literature review of systemic effects in COPD.
- Analysis of studies on muscle fiber changes, oxidative stress, and protein degradation.
- Examination of factors contributing to cachexia, including cytokines and hormonal imbalances.
Main Results:
- COPD causes muscle dysfunction via shifts in fiber type, reduced oxidative capacity, and protein loss through the ubiquitin-proteasome pathway.
- Neutrophils in COPD patients show enhanced chemotaxis and reactive oxygen species production.
- Tumor necrosis factor-alpha contributes to muscle protein loss and oxidative stress, fueling inflammation.
Conclusions:
- Inflammation, both within and outside the lungs, is a common factor linking the systemic effects of COPD.
- Muscle wasting (cachexia) is multifactorial, involving cytokines, protein degradation, and neurohormonal changes.
- Understanding these systemic effects is crucial for managing COPD and improving patient outcomes.