Biomedical Engineering Reference
In-Depth Information
C. Osteoporosis
The prevalence of osteoporosis is increased in patients with COPD
(128,129). This can be due to multiple causes, including malnutrition, seden-
tarism, smoking, steroid treatment, and systemic inflammation (129-131).
Thus, excessive osteoporosis in relation to age can also be considered a
systemic effect of COPD (88). In fact, it is interesting to note that emphy-
sema and osteoporosis are both characterized by net loss of lung or bone
tissue mass and, pictorially, an osteoporotic bone looks quite similar to
an emphysematous lung. It is therefore tempting to speculate that, perhaps,
both conditions share common mechanisms explaining the accelerated loss
of tissue mass or its defective repair.
D. Anemia
Many chronic diseases are characterized by some degree of anemia (132).
This has been seldom studied in COPD, but there is some evidence in the
literature to suggest that mild anemia may not be uncommon in these
patients (133). The pathogenesis of this phenomenon is unclear but it is
likely to be related to the systemic inflammation present in COPD, as in
other chronic conditions (132). A better understanding of anemia in COPD
is potentially important because its therapeutic correction may have a signif-
icant clinical impact. After all, oxygen therapy is only one way to increase
oxygen delivery to tissues. Increasing hemoglobin values (using erythropoie-
tin therapy, for instance Ref. 132) is another strategy.
VI. CONCLUSIONS
Available evidence indicates that COPD is associated to important systemic
effects. This chapter reviews the more commonly accepted systemic effects
of COPD and identifies some potentially new ones. It also discusses the
mechanisms underlying all of them. However, there are more questions than
answers. Therefore, a better understanding of the pathogenesis of these
systemic effects of COPD may allow the development of new therapeutic
strategies that, eventually, can contribute to improve the health status
and prognosis of the patients suffering this devastating disease.
ACKNOWLEDGMENTS
This work was supported, in part, by Red Respira (RTIC C03
=
11, Fondo de
Investigaci´n Sanitaria), SEPAR and ABEMAR. The authors wish to
express their gratitude to Drs. B. Togores, M. Carrera, F. Barb´, E. Sala
and B. Cosio (Hospital Universitario Son Dureta, Palma de Mallorca) for
their helpful comments and suggestions.
