Clinical Course of Chronic Obstructive Pulmonary Disease: Review of Therapeutic Interventions

2006 ◽  
Vol 119 (10) ◽  
pp. 46-53 ◽  
Author(s):  
Antonio Anzueto
2020 ◽  
Author(s):  
Rizwan Qaisar ◽  
Mughal Qayyum ◽  
Tahir Muhammad

Abstract Background The potential contribution of chronic dysregulation of sarcoplasmic reticulum (SR) protein homeostasis (a condition called SR stress) to skeletal muscle loss is poorly understood. We investigated the degree of activation of SR stress in locomotor muscles of patients with chronic obstructive pulmonary disease (COPD), a respiratory disease with systemic manifestations. Methods We analyzed the markers of SR stress and associated pathologies in vastus lateralis muscles of 60-65 years old male healthy controls and patients with mild (COPD stages 1 & 2) and advanced (COPD stages 3 & 4) COPD (N = 6-8 / group). Results Skeletal muscle proteins expressions of GRP94, BiP, CHOP and ATF were significantly elevated in advanced COPD (≈53%, ≈3.6 fold, ≈3.5 fold and ≈3.2 fold, respectively) compared with healthy controls. The expression of downstream markers of SR stress including apoptosis, inflammation and autophagy was increased, while the maximal activity of SR Ca2+ ATPase (SERCA) enzyme was significantly reduced in advanced COPD (≈41%) than healthy controls. Single muscle fiber diameter and cytoplasmic domain per myonucleus were significantly smaller (≈14% and 13%, respectively) in patients with advanced COPD than healthy controls. These changes in SR dysfunction were accompanied by substantially elevated levels of global oxidative stress including lipid peroxidation and mitochondrial ROS production. Conclusion Taken together, our data suggests that the muscle weakness in advanced COPD is in part driven by elevated SR stress and its pathological consequences. The data provided can lead to potential therapeutic interventions of SR dysfunction for muscle detriment in COPD.


2018 ◽  
Vol 28 (3) ◽  
pp. 359-367 ◽  
Author(s):  
A. V. Budnevskiy ◽  
Е. S. Ovsyannikov ◽  
Ya. S. Shkatova

This is a review of experimental and clinical studies investigated effects of obesity on clinical course of chronic obstructive pulmonary disease (COPD); pathophysiological mechanisms of this effect, and relationships between melatonin level and the course of COPD have been also discussed. Associations between severity of COPD, rate of exacerbations and blood levels of most important adipokines, such as leptin and adiponectin, and relationships between melatonin levels and those adipokines were published. Conflicting results were obtained in studies of effects of obesity on clinical course of COPD. The "obesity paradox", that is a reduction in mortality and milder bronchial obstruction in obese COPD patients, has been identified in several studies. Despite contradictory results, obesity is likely to improve prognosis of COPD due to decrease in the systemic inflammation. Levels of leptin and adiponectin increase in acute exacerbation of COPD and then decrease to the baseline. Moreover, melatonin is suggested to play a great role for COPD course, mostly due to antiinflammatory and antioxidant activities. According to results of several studies, melatonin could affect blood levels of adiponectin and lectin; this could indirectly influence on the systemic inflammation in COPD. Further studies are needed to elicit these relationships. 


2019 ◽  
pp. 18-22
Author(s):  
L. S. Babinets ◽  
О. S. Kvasnitska

Background. A combination of chronic pancreatitis and chronic obstructive pulmonary disease is quite common in clinical practice. This has a negative effect on the clinical course of both diseases. Smoking increases risk of chronic pancreatitis development. Purpose of the study. The purpose of this investigation is to learn smoking influence on clinical course and life quality of patients with comorbidity of chronic pancreatitis and chronic obstructive pulmonary disease. Material and methods. 141 patients with chronic pancreatitis with chronic obstructive pulmonary disease and without it had been examinated. 98 patients with chronic pancreatitis with chronic obstructive pulmonary disease were included to the main group. Both diseases were at phase of remission. Results and discussion. 29 (20.6 %) active smokers were among them. All of them are men. The main syndromes in patients with chronic pancreatitis with chronic obstructive pulmonary disease are dyspeptic (85.7%) and astenic (94.9 %), pain syndrome was registered in 83.7 % patients, the equivalents of pain were observed in 16.3 % of patients. Conclusions. Significant decreasing of life quality in patients with comorbidity of chronic pancreatitis and chronic obstructive pulmonary disease was proved: scales of physical functioning, role physical functioning and general health status were significantly decreased in patients with concomitant COPD (р <0.05). Analysis of the GSRS questionnaire revealed a significant (p <0.05) increasing in three of the five scales presented in patients with chronic pancreatitis and COPD, indicating a deterioration of quality of life in case of comorbidity. There were revealed significant decreasing of physical functioning scale and general health status scale (questionnaire SF‑36) and increasing of all scales in GSRS scales (except for the diarrheal syndrome scale). Significant (p <0.05) moderate correlations were found between the scales of physical functioning and role physical functioning and smoking experience, and moderate correlations with the smoking experience of the dyspeptic syndrome score.


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