Systemic manifestations and comorbidities of COPD

  title={Systemic manifestations and comorbidities of COPD},
  author={Peter John Barnes and Bartolom{\'e} R. Celli},
  journal={European Respiratory Journal},
  pages={1165 - 1185}
Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the “spill-over” of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and… 
Chronic obstructive pulmonary disease: an update of treatment related to frequently associated comorbidities
The concepts of systemic inflammation in COPD and current evidence for treatment of its related comorbidities are explored and it is expected that successful anti-inflammatory therapy in one organ may also influence others.
Systemic manifestations of COPD.
Any patient with COPD should be carefully evaluated for comorbidities and the systemic consequences of COPD since they not only influence the prognosis but also have an impact on disease management.
COPD: a multifactorial systemic disease
It is reasonable to consider COPD, and emphysema in particular, as ‘a disease with a significant systemic component’ if not a ‘systemic disease’ per se.
Preclinical murine models of Chronic Obstructive Pulmonary Disease.
Systemic inflammation in chronic obstructive pulmonary disease and asthma: relation with comorbidities.
Research should elucidate the complex relationship between obstructive lung disease, coexisting conditions, systemic inflammation accompanying these different conditions, and the causative role of systemic inflammation for comorbidities in COPD and asthma.
[Comorbidities of COPD].
Comorbidities of COPD
Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately, leading to increased hospitalisations and healthcare costs.
Pulmonary comorbidities associated with chronic obstructive pulmonary disease
All patients with COPD should be carefully evaluated to identify pulmonary comorbidities, since they not only influence the prognosis but also have an impact on disease management.
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An interdisciplinary team with good cooperation should prepare a plan of COPD treatment with simultaneous therapy of comorbidities, which is necessary to monitor the risk of CVD and their influence on the COPD course.


Complex chronic comorbidities of COPD
The current authors believe that lung function measurement, noninvasive assessment of cardiovascular and metabolic functions, and circulating inflammatory markers (e.g. C-reactive protein) might help to better characterise patients with COPD.
Future treatments for chronic obstructive pulmonary disease and its comorbidities.
  • P. Barnes
  • Biology, Medicine
    Proceedings of the American Thoracic Society
  • 2008
Current therapies for COPD, including inhaled corticosteroids, long-acting beta(2)-agonists, and theophylline, have the potential to reduce systemic features of COPD and comorbid diseases and the development of antioxidants, including nuclear factor erythroid-2-related factor 2 activators is a priority.
Mortality in COPD: role of comorbidities
The current paper reviews the role of comorbidities in chronic obstructive pulmonary disease mortality, the putative underlying pathogenic link between chronic obstructives pulmonary disease and comorbrid conditions (i.e. inflammation), and the tools used to predict Chronic obstructivemonary disease mortality.
Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis
Reduced lung function is associated with increased levels of systemic inflammatory markers which may have important pathophysiological and therapeutic implications for subjects with stable COPD.
Systemic inflammation in chronic obstructive pulmonary disease: the role of exacerbations.
Understanding of the systemic manifestations of chronic obstructive pulmonary disease exacerbations can be greatly enhanced if what is known about the basic science of systemic mediators with the translational science of their role in COPD exacerbations are integrated.
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Preliminary evidence suggests that anaemia in COPD patients may be more prevalent than expected, concerning 10–15% of patients suffering from severe forms of the disease, and the need to study the prevalence of anaemia, and its physiological and clinical impact in chronic obstructive pulmonary disease.
Killer cells in chronic obstructive pulmonary disease.
The focus of the present review is directed towards the role of CD8(+) T-lymphocytes, NK (natural killer) cells and NKT cells (NK T-cells) in COPD, which could all play an important part in the pathogenesis of COPD.
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CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction and among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)% predicted of less than 50.