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Complex chronic comorbidities of COPD
Open accessAbstract
Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke. The systemic inflammation induced by smoking may also cause chronic heart failure, metabolic syndrome and other chronic diseases, which may contribute to the clinical manifestations and natural history of COPD. Thus COPD can no longer be considered a disease only of the lungs, as it is often associated with a wide variety of systemic consequences. A better understanding of the origin and consequences of systemic inflammation, and of potential therapies, will most likely lead to better care of patients with COPD. Medical textbooks and clinical guidelines still largely ignore the fact that COPD seldom occurs in isolation. As the diagnosis and assessment of severity of COPD may be greatly affected by the presence of comorbid conditions, 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 these patients. Similarly, preventive and therapeutic interventions should address the patient in their complexity.
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“Patients with COPD are more likely to have coronary artery disease,(8,10) lung cancer,(11,12) metabolic syndrome,(13,14) osteoporosis,(15,16) diabetes mellitus,(8,17) and hypertension(8,18) than persons without COPD, resulting in some suggesting COPD be considered a multisystem inflammatory disorder rather than a cond…”
InfluentialMuscle and Blood Redox Status after Exercise Training in Severe COPD Patients
Rodriguez, D. A., Kalko, S., Puig-Vilanova, E., Perez-Olabarría, M., Falciani, F., Gea, J., Cascante, M., Barreiro, E., & Roca, J. (2012) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2011.09.022 · Cited by 102
McDonald, V. M., Simpson, J. L., Higgins, I., & Gibson, P. G. (2010) · Age and Ageing · doi:10.1093/ageing/afq134 · Cited by 88
Endothelial Dysfunction and Specific Inflammation in Obesity Hypoventilation Syndrome
Borel, J., Roux‐Lombard, P., Tamisier, R., Arnaud, C., Monneret, D., Arnol, N., Baguet, J.-P., Levy, P. A., & Pépin, J. (2009) · PLoS ONE · doi:10.1371/journal.pone.0006733 · Cited by 84
“Not only obesity but many other systemic diseases like diabetes, COPD, cardiovascular diseases or sleep apnea are associated with an underlying pro-inflammatory state [8,29,30].”
BackgroundSandelowsky, H., Weinreich, U. M., Aarli, B. B., Sundh, J., Høines, K. J., Stratelis, G., Løkke, A., Janson, C., Jensen, C., & Larsson, K. (2021) · BMC Family Practice · doi:10.1186/s12875-021-01583-w · Cited by 106
“age, smoking, systemic inflammation) or by one disease increasing the risk severity of the other [18, 141].”
BackgroundMAGNUSSEN, H., & Watz, H. (2009) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200906-053dp · Cited by 80
“The question arises whether systemic inflammation is the result of a spill-over of local inflammation to the systemic compartment or whether systemic inflammation might be a systemic component of COPD not necessarily related to the local inflammatory processes in the lung (2, 15, 16).”
BackgroundCoronary artery disease concomitant with chronic obstructive pulmonary disease
Roversi, S., Roversi, P., Spadafora, G., Rossi, R., & Fabbri, L. M. (2013) · European Journal of Clinical Investigation · doi:10.1111/eci.12181 · Cited by 82
Increased Sympathetic Nerve Activity in COPD is Associated with Morbidity and Mortality
Andreas, S., Haarmann, H., Klarner, S. F., Hasenfuss, G. P., & Raupach, T. (2013) · Lung · doi:10.1007/s00408-013-9544-7 · Cited by 79
“Although COPD primarily affects the lungs, it has recently become clear that systemic effects of COPD significantly contribute to its severity and overall mortality [1, 4].”
BackgroundBiomarkers in chronic obstructive pulmonary disease
Rosenberg, S. R., & Kalhan, R. (2012) · Translational research · doi:10.1016/j.trsl.2012.01.019 · Cited by 78
Controversies in treatment of chronic obstructive pulmonary disease
Rabe, K. F., & Wedzicha, J. A. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61295-6 · Cited by 75
Burgel, P., Paillasseur, J.-L., & Roche, N. (2014) · BioMed Research International · doi:10.1155/2014/420134 · Cited by 76
“, diabetes, dyslipidemia, and metabolic syndrome), and cancer have been found highly prevalent among COPD patients [5, 6].”
BackgroundWhy Does Lung Function Predict Mortality? Results From the Whitehall II Cohort Study
Sabia, S., Shipley, M. J., Elbaz, A., Marmot, M. G., Mika Kivimaki, B., Kauffmann, F., & Singh‐Manoux, A. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq294 · Cited by 76
Validity and Responsiveness of the Depression Anxiety Stress Scales-21 (DASS-21) in COPD
Yohannes, A. M., Dryden, S., & Hanania, N. A. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.12.010 · Cited by 79
Network medicine, multimorbidity and the lung in the elderly
Faner, R., Cruz, T., López-Giraldo, A., & Agustí, A. G. N. (2014) · European Respiratory Journal · doi:10.1183/09031936.00078714 · Cited by 74
Koskela, J. T., Kilpeläinen, M., Kupiainen, H., Mazur, W., Sintonen, H., Boezen, M., Lindqvist, A. E., Postma, D. S., & Laitinen, T. (2014) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-14-102 · Cited by 73
“and addiction diseases [1-5].”
The cardiopulmonary continuum systemic inflammation as ‘common soil’ of heart and lung disease
Ukena, C., Mahfoud, F., Kindermann, M., Kindermann, I., Bals, R., Voors, A. A., van Veldhuisen, D. J., & Böhm, M. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.04.082 · Cited by 75
Nakanishi, K., Takeda, Y., Tetsumoto, S., Iwasaki, T., Tsujino, K., Kuhara, H., Jin, Y., Nagatomo, I., Kida, H., Goya, S., et al. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201007-1091oc · Cited by 73
Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease
Goudis, C. A., Konstantinidis, A. K., Ntalas, I. V., & Korantzopoulos, P. G. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.06.096 · Cited by 72
“Thus, cardiovascular and pulmonary risk factors create a “cardiopulmonary continuum” through shared systemic inflammatory processes, inducing cascades of events which underpin chronic diseases including COPD, CAD, and HF [84,85].”
BackgroundExercise intolerance and systemic manifestations of pulmonary emphysema in a mouse model
Lüthje, L., Raupach, T., Michels, H., Unsöld, B. W., Hasenfuss, G. P., Kögler, H., & Andreas, S. (2009) · Respiratory Research · doi:10.1186/1465-9921-10-7 · Cited by 74
“Although COPD affects primarily the lungs it recently became clear that systemic effects of COPD significantly contribute to its severity and mortality [1,6].”
BackgroundNatural Histories of Chronic Obstructive Pulmonary Disease
Rennard, S. I., & Vestbo, J. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200804-035qc · Cited by 72
The diagnosis and treatment of COPD and its comorbidities
Kahnert, K., Jörres, R. A., Behr, J., & Welte, T. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2023.0027 · Cited by 204
Clinical relevance of plasma miR-106b levels in patients with chronic obstructive pulmonary disease
Soeda, S., Ohyashiki, J. H., Ohtsuki, K., Umezu, T., Setoguchi, Y., & Ohyashiki, K. (2013) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2013.1251 · Cited by 69
Fruchter, O., Yigla, M., & Kramer, M. R. (2014) · The American Journal of the Medical Sciences · doi:10.1097/maj.0000000000000332 · Cited by 70
Fabbri, L. M., Boyd, C. M., Boschetto, P., Rabe, K. F., Buist, A. S., Yawn, B. P., Leff, B. A., Kent, D. M., & Schünemann, H. J. (2012) · Proceedings of the American Thoracic Society · doi:10.1513/pats.201208-063st · Cited by 74
Kerley, C. P., Cahill, K., Bolger, K., McGowan, A., Burke, C., Faul, J., & Cormican, L. (2015) · Nitric Oxide · doi:10.1016/j.niox.2014.12.010 · Cited by 69
Marco, E., Sánchez‐Rodríguez, D., Dávalos‐Yerovi, V., Durán, X., Pascual, E. M., Muniesa, J. M., Rodriguez, D. A., Aguilera-Zubizarreta, A., Escalada, F., & Duarte, E. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.09.014 · Cited by 70
COPD and the metabolic syndrome: an intriguing association
Clini, E. M., Crisafulli, E., Radaeli, A., & Malerba, M. (2011) · Internal and Emergency Medicine · doi:10.1007/s11739-011-0700-x · Cited by 69
“decade, however, it has been increasingly recognized that the presence of common factors in COPD and in other chronic extra-pulmonary diseases, together with the frequent co-existence of these conditions in the same adult individual, supports the hypothesis of a common process sharing their pathogenesis in the same pa…”
BackgroundB-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review
Hawkins, N. M., Khosla, A., Virani, S., McMurray, J. J. V., & FitzGerald, J. M. (2017) · BMC Pulmonary Medicine · doi:10.1186/s12890-016-0345-7 · Cited by 67
“Many of these factors are present in stable COPD and common non-infective precipitants of exacerbation [32, 41, 63].”
BackgroundComorbidity in chronic obstructive pulmonary disease
Negewo, N. A., McDonald, V. M., & Gibson, P. G. (2015) · Respiratory Investigation · doi:10.1016/j.resinv.2015.02.004 · Cited by 69
“Clinical decision making is further complicated by the lack of adequate recommendations in the existing guidelines regarding the management of COPD patients, who may also suffer from other comorbid conditions [103].”
BackgroundManagement of the COPD Patient with Comorbidities: An Experts Recommendation Document
Iglesias, J. R., Díez‐Manglano, J., Garcı́a, F. L., Peromingo, J. A. D., Almagro, P., & Aguilar, J. M. V. (2020) · International Journal of COPD · doi:10.2147/copd.s242009 · Cited by 74
Young, R. P., Hopkins, R. J., & Eaton, T. E. (2009) · Postgraduate Medical Journal · doi:10.1136/pgmj.2008.078477 · Cited by 64
Ställberg, B., Janson, C., Larsson, K., Johansson, G. S., Κostikas, Κ., Gruenberger, J.-B., Gutzwiller, F. S., Jørgensen, L., Uhde, M., & Lisspers, K. (2018) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-018-0101-y · Cited by 64
Multimorbidity in Patients with Chronic Obstructive Pulmonary Disease
Divo, M. J., & Celli, B. R. (2020) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2020.06.002 · Cited by 70
Metadata
- Authors
- Fabbri, L. M., Luppi, F., Beghé, B., & Rabe, K. F.
- Affiliations
- University of Modena and Reggio Emilia (IT)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2007-12-31
- Volume
- 31
- Issue
- 1
- Pages
- 204-212
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2165340553
- Cited by
- 660
- References
- 139
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 20 · 2023: 17 · 2022: 26 · 2021: 19 · 2020: 35 · 2019: 25 · 2018: 36 · 2017: 48 · 2016: 31 · 2015: 50 · 2014: 68 · 2013: 55 · 2012: 59
- FWCI
- 28.24
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- chronic obstructive pulmonary disease, comorbidities, systemic inflammation, chronic heart failure, metabolic syndrome, cigarette smoking, C-reactive protein, inflammatory markers, COPD severity assessment, cardiovascular function, COPD management
- MeSH terms
- Chronic Disease, Health Status, Humans, Inflammation, Lung, Models, Biological, Prognosis, Risk Factors, Smoking, Pulmonary Medicine, Comorbidity, Guidelines as Topic, Pulmonary Disease, Chronic Obstructive, Overweight
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