To what extent and why are COPD and Willis-Ekbom disease associated?

Abstract

Out of 76 COPD cases included in our study, 26.3 % (n = 20) were diagnosed with RLS/WED (mean age 60.4 ± 7.5 years, 20 males). The cases with RLS/WED had significantly lower body mass index (BMI) than cases without RLS/WED (p = 0.009). There were no significant differences between cases with and without RLS/WED with respect to PFT, dyspnea scales, and arterial blood gas values. However, ESS was significantly different (p = 0.016). There were no significant differences in RLS/WED scores and mean hs-CRP levels between COPD stages (p = 0.424; p = 0.518, respectively), while ESS was significantly different (p = 0.016). ESS was significantly higher in stage B COPD than in stages A and D (p = 0.005, p = 0.008, respectively). Based on our model, we found that exacerbations and iron binding capacity (UIBC) were predictive factors for RLS/WED (p < 0.100) CONCLUSION: RLS/WED is a common disease in cases with stable COPD. Despite our hypothesis suggesting that the prevalence of RLS/WED in COPD is related with systemic inflammation, we did not find a significant association between hs-CRP and COPD cases with RLS/WED. However, we did find that UIBC is a predictive factor for the development of RLS/WED. Nonetheless, further studies are needed to understand the relationships between UIBC, low BMI, and the development of RLS/WED in COPD.

LAG3/CD4 Genes Variants and the Risk for Restless Legs Syndrome

“…The possible role of inflammatory factors in the pathogenesis of RLS, suggested by the frequent association of RLS with several inflammatory diseases [ 7 , 11 ], and the increase in inflammatory markers in patients with RLS or iRLS, such as CRP/hsCRP, NLR, and several cytokines found in several (although not all) studies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ], makes it reasonable to investigate possible genetic susceptibility factors related to inflammation. In this regard, the proteins encoded by LAG3/CD4 genes play an important role in inflammatory and immune responses.…”

“…The neurochemical characteristics of RLS are also not fully known, although the most important are dopaminergic dysfunction and iron deficiency, and a possible contribution of other neurotransmitter systems (the GABAergic, glutamatergic and adenosinergic systems, at least) has been described [ 6 ]. Several recent findings suggest a role of inflammatory factors in the etiopathogenesis of RLS: RLS is associated to several inflammatory and autoimmune diseases, including chronic liver disease [ 7 ], Sjogren’s syndrome [ 7 ], rheumatoid arthritis [ 7 ], sarcoidosis [ 7 ], systemic lupus erythematous [ 7 ], inflammatory bowel disease [ 7 , 8 ], multiple sclerosis [ 9 ], mastocytosis [ 10 ], and chronic obstructive pulmonary disease [ 11 ]. There is a description of patients suffering from recurrent and severe RLS always coinciding with infectious-inflammatory conditions [ 12 ].…”

“…Another three studies in patients with chronic kidney disease did not show significant differences in serum/plasma hsCRP between patients with and without RLS [ 20 , 21 , 22 ]. Mandal et al [ 11 ] showed a lack of significant differences in serum/plasma hsCRP levels in patients with chronic obstructive pulmonary disease with and without RLS. There is a description of a higher neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, in patients with RLS than in controls in a cross-sectional [ 23 ] and a prospective longitudinal study [ 14 ], although in the latter the statistical significance disappeared after adjusting for sex, age, body mass index and smoking status [ 14 ].…”

“…RLS is associated to several inflammatory and autoimmune diseases, including chronic liver disease [ 7 ], Sjogren’s syndrome [ 7 ], rheumatoid arthritis [ 7 ], sarcoidosis [ 7 ], systemic lupus erythematous [ 7 ], inflammatory bowel disease [ 7 , 8 ], multiple sclerosis [ 9 ], mastocytosis [ 10 ], and chronic obstructive pulmonary disease [ 11 ].…”

“…Another three studies in patients with chronic kidney disease did not show significant differences in serum/plasma hsCRP between patients with and without RLS [ 20 , 21 , 22 ]. Mandal et al [ 11 ] showed a lack of significant differences in serum/plasma hsCRP levels in patients with chronic obstructive pulmonary disease with and without RLS.…”