1. Pathobiological mechanisms underlying metabolic syndrome (MetS) in chronic obstructive pulmonary disease (COPD): clinical significance and therapeutic strategies
- Author
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Steven Bozinovski, Ross Vlahos, Stavros Selemidis, and Stanley M H Chan
- Subjects
0301 basic medicine ,obesity ,immunometabolism ,AECOPD, Acute exacerbation of chronic obstructive pulmonary disease ,Comorbidity ,Disease ,GOLD, Global initiative for chronic obstructive lung disease ,VLDL, Very low density lipoprotein ,Pulmonary Disease, Chronic Obstructive ,FEV1, Forced expiratory volume in the first second ,0302 clinical medicine ,CVD, Cardiovascular disease ,Pharmacology (medical) ,Wasting ,Cause of death ,Metabolic Syndrome ,COPD ,oxidants ,Smoking ,HIF, Hypoxia-inducible factor ,NAFLD, Non-alcoholic fatty liver disease ,3. Good health ,030220 oncology & carcinogenesis ,CRP, C-reactive protein ,medicine.symptom ,medicine.medical_specialty ,COPD, Chronic obstructive pulmonary disease ,Article ,COPD comorbidities ,03 medical and health sciences ,IL-8, Interleukin 8 ,AMPK, Adenosine monophosphate-activated protein kinase ,medicine ,Animals ,Humans ,Clinical significance ,MetS, Metabolic syndrome ,Intensive care medicine ,Disease burden ,TNF-α, Tumour necrosis factor-α ,metabolic dysregulation ,Pharmacology ,business.industry ,medicine.disease ,respiratory tract diseases ,030104 developmental biology ,LDL, Low density lipoprotein ,AM, Alveolar macrophages ,Metabolic syndrome ,business ,ROS, Reactive oxygen species ,SREBP-1c, Sterol response element binding protein-1c - Abstract
Chronic obstructive pulmonary disease (COPD) is a major incurable global health burden and is currently the 4th largest cause of death in the world. Importantly, much of the disease burden and health care utilisation in COPD is associated with the management of its comorbidities (e.g. skeletal muscle wasting, ischemic heart disease, cognitive dysfunction) and infective viral and bacterial acute exacerbations (AECOPD). Current pharmacological treatments for COPD are relatively ineffective and the development of effective therapies has been severely hampered by the lack of understanding of the mechanisms and mediators underlying COPD. Since comorbidities have a tremendous impact on the prognosis and severity of COPD, the 2015 American Thoracic Society/European Respiratory Society (ATS/ERS) Research Statement on COPD urgently called for studies to elucidate the pathobiological mechanisms linking COPD to its comorbidities. It is now emerging that up to 50% of COPD patients have metabolic syndrome (MetS) as a comorbidity. It is currently not clear whether metabolic syndrome is an independent co-existing condition or a direct consequence of the progressive lung pathology in COPD patients. As MetS has important clinical implications on COPD outcomes, identification of disease mechanisms linking COPD to MetS is the key to effective therapy. In this comprehensive review, we discuss the potential mechanisms linking MetS to COPD and hence plausible therapeutic strategies to treat this debilitating comorbidity of COPD.
- Published
- 2019
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