Neurohumoral activation as a link to systemic manifestations of chronic lung disease
Neurohumoral activation as a link to systemic manifestations of chronic lung disease
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DOI：
10.1378/chest.128.5.3618
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发表时间：
2005-11-01
期刊：
影响因子：
9.6
通讯作者：
Somers, VK
中科院分区：
文献类型：
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作者：
Andreas, S;Anker, SD;Somers, VK
COPD是全球死亡和残疾的主要原因。COPD的治疗可改善肺功能，但不太可能减缓疾病的稳定下降过程或降低死亡率。在COPD中，可以在肺外发现许多异常。这些包括全身性炎症、恶病质和骨骼肌功能障碍。因此，COPD被称为全身性疾病。令人信服的数据表明，COPD引起神经体液激活。根据慢性心力衰竭和其他以神经体液激活为特征的疾病的先例，我们提出神经体液激活的负面后果，即炎症、恶病质、对通气的影响和骨骼肌功能障碍，引起了一个自我延续的循环，该循环有助于COPD的发病机制，并且可能涉及呼吸肌功能障碍以及全身炎症。这一概念可能有助于进一步解释COPD患者心血管疾病发病率和死亡率的增加。目前，关于针对神经道德激活和COPD的治疗的效果知之甚少。随着对COPD这方面的了解越来越多，新的见解可能会指导新的治疗方法。
COPD is a major cause of death and disability worldwide. Treatment of COPD improves lung function but is unlikely to slow the steady downhill course of the disease or reduce mortality. in COPD, numerous abnormalities can be found outside the lung. These include systemic inflammation, cachexia, and skeletal muscle dysfunction. Thus, COPD has been called a systemic disease. Convincing data demonstrate that COPD causes neurohumoral activation. By precedents derived from chronic heart failure and other diseases characterized by neurolmmoral activation, we propose that the negative consequences of neurohumoral activation, namely inflammation, cachexia, effects on ventilation, and skeletal muscle dysfunction, give rise to a self-perpetuating cycle that contributes to the pathogenesis of COPD, and which may involve respiratory muscle dysfunction as well as systemic inflammation. This concept may further help explain the increased cardiovascular morbidity and mortality in COPD patients. Currently, little is known about the effect of treatments directed at neurolmmoral activation and COPD. As this aspect of COPD becomes better understood, new insights may direct novel therapeutic approaches.