chronic obstructive pulmonary disease effects beyond the lungs慢性阻塞性肺疾病肺以外的影响.pdfVIP

Essay Chronic Obstructive Pulmonary Disease: Effects beyond the Lungs Peter J. Barnes* National Heart Lung Institute, Imperial College, London, United Kingdom Chronic obstructive pulmonary disease not yet certain, but a potential mechanism resents accelerated ageing of the lung and (COPD) is a growing global epidemic that is systemic inflammation. Other possible that many of the comorbidities associated is particularly important in developing mechanisms (which are not mutually exclu- with COPD, such as osteoporosis, cardiac countries. Morbidity and mortality from sive) include shared genetic predispositions, failure, and diabetes, are also diseases of COPD will rise as populations age and physical inactivity secondary to airway accelerated ageing and may be a conse- mortality from cardiovascular and infec- obstruction, and chronic hypoxia. Several quence of reduced synthesis of anti-ageing tious diseases falls. Whereas cigarette smok- inflammatory cytokines, including tumour molecules, such as sirtuins [6]. There may ing is the commonest cause of COPD in necrosis factor-a (TNFa), interleukin(IL)-6, be genetic factors that increase suscepti- developed countries, COPD is also seen in CXCL8 (IL-8), and IL-18, and acute phase bilities to develop certain comorbidities nonsmokers, particularly in developing proteins, such as C-reactive protein (CRP), and there may be common genetic factors countries, yet very little is know about this serum amyloid A, and fibrinogen, are linked to increased susceptibilities of form of COPD. COPD is primarily increased within the circ