Systemic Inflammation in Chronic Obstructive Pulmonary Disease and Asthma: Relation with Comorbidities

Abstract

Markers of systemic inflammation have been shown to be elevated in blood of patients with chronic obstructive pulmonary disease (COPD) when compared with control subjects without COPD. The origin of systemic inflammation in COPD is unclear. COPD is often accompanied by other chronic diseases that are also associated with systemic inflammation, such as chronic heart failure, diabetes, and arteriosclerosis. Physical inactivity and metabolic syndrome are relevant conditions leading to systemic inflammation in the general population. Recent data indicate that physical inactivity and coexisting metabolic syndrome are also independently related to systemic inflammation in patients with COPD. Concerning asthma, only limited data about systemic inflammatory markers exist. Some studies found systemic inflammatory markers to be elevated in patients with nonallergic asthma and obese patients with asthma. Further 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.

Asthma and comorbid medical illness

“…This might question the importance of the systemic inflammation in asthma, as recent studies have suggested a connection between comorbidities and systemic inflammation in COPD [2][3][4]. In particular, our data indicate that in asthmatic patients there is no real association of their respiratory disease with acute or old myocardial infarction.…”

“…Comorbidities, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes, may frequently occur in patients with chronic obstructive pulmonary disease (COPD) [2][3][4]. It has been suggested that comorbidities in COPD should be defined as the presence of one or more distinct disorders (or diseases) in addition to COPD, regardless of whether the comorbid conditions are directly or indirectly related to COPD, and a distinct disorder or disease is not part of the spectrum of the natural history of COPD [1].…”

C-reactive protein levels, airflow obstruction, and chronic kidney disease

“…COPD and asthma are conditions with many comorbidities, albeit asthma to a lesser extent than COPD [28][29][30][31]. To date, very limited data have been gathered on the association between asthma and CKD.…”

“…The results of a more recent study indicate that asthma is weakly associated with diabetes mellitus, dyslipidemia, and cardiovascular and hypertensive disease [32]. Although asthma has been proposed to have many comorbidities [29][30][31][32], its association with CKD has not been entirely elucidated, and the underlying mechanisms remain unknown. Further research is needed to determine the interrelationships between COPD, asthma, and CKD.…”

Evaluation of physical activity in patients with chronic obstructive pulmonary disease: recommendations of European Respiratory Society

“…В 4 исследованиях с участием больных ХОБЛ пока зано, что системное воспаление низкой интенсив ности связано со снижением уровня ФА даже при учете сопутствующих факторов [79,94,119,133]. В чем причина такой взаимосвязи -в противовоспа лительном влиянии регулярной ФА или в механиз мах системного воспаления при ХОБЛ -предстоит выяснить в будущих исследованиях [134].…”