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Eur Respir J 2003; 21:347-360
Copyright ©ERS Journals Ltd 2003

Systemic effects of chronic obstructive pulmonary disease

A.G.N. Agustí1, A. Noguera2, J. Sauleda1, E. Sala1, J. Pons3 and X. Busquets3

1 Servei de Pneumología, 2 Analisis Cliniques and 3 Unidad de Investigación, Hospital Universitari Son Dureta, Palma de Mallorca, Spain

CORRESPONDENCE: A.G.N. Agustí, Servei de Pneumología, Hospital Universitari Son Dureta, Andrea Doria 55, 07014, Palma de Mallorca, Spain. Fax: 34 971175228. E-mail: aagusti@hsd.es

Keywords: chronic bronchitis, chronic obstructive pulmonary disease, emphysema, inflammation

Received: May 11, 2001
Accepted August 20, 2002

This study was supported, in part, by Fondo de Investigación Sanitaria, Sociedad Española de Neumología y Cirugía Torácica (SEPAR) and Associació Balear per l'Estudi de les Malalties Respiratories (ABEMAR).

Abstract

Chronic obstructive pulmonary disease (COPD) is characterised by an inappropriate/excessive inflammatory response of the lungs to respiratory pollutants, mainly tobacco smoking.

Recently, besides the typical pulmonary pathology of COPD (i.e. chronic bronchitis and emphysema), several effects occurring outside the lungs have been described, the so-called systemic effects of COPD. These effects are clinically relevant because they modify and can help in the classification and management of the disease.

The present review discusses the following systemic effects of chronic obstructive pulmonary disease: 1) systemic inflammation; 2) nutritional abnormalities and weight loss; 3) skeletal muscle dysfunction; and 4) other potential systemic effects. For each of these, the potential mechanisms and clinical implications are discussed and areas requiring further research are highlighted.




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