Systemic Inflammation in COPD

Abstract

In Brief Chronic obstructive pulmonary disease (COPD) has classically been considered to be an intrathoracic condition characterized by nonfully reversible airway obstruction. However, COPD has been recently recognized as a multicomponent disorder, associated with systemic inflammation and extrapulmonary manifestations. The present review analyzes current evidence on systemic inflammation concomitant with COPD, and discusses its possible biologic and clinical implications as well as possible therapeutic approaches. Some degree of systemic inflammation appears to be present in most of COPD patients, being characterized by the presence of increased plasma levels of proinflammatory mediators and/or markers (such as C-reactive protein, fibrinogen, different cytokines, and white cells). Many of these biomarkers further increase during exacerbations, and can be modulated by exercise, smoking habit, and different drugs. Moreover, patients with COPD frequently exhibit extrapulmonary manifestations. This includes nutritional-body composition abnormalities, skeletal muscle dysfunction, osteoporosis, cardiovascular events, hemostatic disorders, renal dysfunction, and hormonal dysregulation. Further studies are needed to elucidate the mechanisms and consequences of the systemic inflammatory response and extrapulmonary manifestations associated with COPD, thus contributing to the development of novel therapeutic strategies. Chronic obstructive pulmonary disease, a lung disease characterized by nonfully reversible airway obstruction, is associated with systemic inflammation and extrapulmonary manifestations. The aim of the present review is to analyze the current evidence on the biological and clinical implications, and therapeutic approaches of the systemic inflammation associated with chronic obstructive pulmonary disease.