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Inflammation in COPD: a link to systemic comorbidities

CORRESPONDENCE: S. I. Rennard University of Nebraska Medical Center 985885 Nebraska Medical Center, Omaha, NE, 68198-5885, USA, Fax: 1 402559487. E-mail: srennard{at}unmc.edu

Chronic obstructive pulmonary disease (COPD) has been defined as a preventable and treatable disease characterised by progressive airflow limitation that is not fully reversible and associated with an abnormal inflammatory response in the lungs.

Results from a large number of recent studies have characterised the inflammatory processes underlying COPD. Inflammatory cells, most notably CD8+ T-lymphocytes, macrophages and neutrophils, as well as a large number of chemokines, cytokines and proteinases, are believed to play a role.

The inflammatory processes in COPD contribute to remodelling of pulmonary tissues, leading to the irreversible airflow limitation characteristic of this disease. Inflammation may also contribute to the comorbidities often observed in COPD patients. Patients with COPD often have cardiovascular disease, changes in body composition, osteoporosis and anaemia. The same inflammatory processes that characterise COPD are also risk factors for these comorbidities.

Ongoing studies are evaluating a wide range of new therapies for chronic obstructive pulmonary disease. Some of these have the potential to blunt the inflammatory processes underlying chronic obstructive pulmonary disease and potentially the associated comorbid conditions. These therapies may significantly improve survival, function and quality of life for patients with this disease.

KEYWORDS: Chronic obstructive pulmonary disease, inflammation, respiratory disease, smoking cessation, systemic disease, systemic inflammation