Systemic effects of chronic obstructive pulmonary disease
1Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK. david.halpin@rdeft.nhs.uk
Expert Review of Respiratory Medicine
|May 19, 2010
Summary
Chronic obstructive pulmonary disease (COPD) involves systemic inflammation and oxidative stress, leading to extrapulmonary effects like muscle dysfunction and weight loss. Treatments targeting these systemic aspects can improve COPD outcomes.
Area of Science:
- Pulmonology
- Internal Medicine
- Systemic Manifestations of Disease
Background:
- Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary inflammation and oxidative stress.
- These processes extend beyond the lungs, causing significant systemic (extrapulmonary) effects.
- These systemic effects contribute to disease severity and impact patient prognosis.
Purpose of the Study:
- To review the extrapulmonary manifestations of COPD.
- To explore the underlying mechanisms, including systemic inflammation and oxidative stress.
- To discuss the impact of these systemic effects on patient outcomes and therapeutic strategies.
Main Methods:
- Literature review of studies on COPD and its systemic effects.
- Analysis of mechanisms contributing to skeletal muscle dysfunction, weight loss, cardiovascular disease, osteoporosis, and CNS abnormalities.
- Evaluation of current and novel therapeutic approaches.
Main Results:
- COPD is associated with skeletal muscle dysfunction (loss of mass, type 1 fiber reduction), weight loss, cardiovascular disease, osteoporosis, endothelial dysfunction, and CNS abnormalities.
- Systemic inflammation and oxidative stress are key contributors to these extrapulmonary effects.
- These systemic manifestations are linked to worse prognosis and can be influenced by treatments.
Conclusions:
- Systemic effects are integral to the pathophysiology and clinical course of COPD.
- Treatments such as pulmonary rehabilitation, nutritional support, inhaled corticosteroids, bisphosphonates, and potentially statins can address these systemic aspects.
- Addressing systemic manifestations is crucial for comprehensive COPD management and improving patient outcomes.
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