Systemic inflammation in COPD

T here is a growing recognition that chronic obstructive pulmonary disease (COPD) is a condition that involves multiple organs and systems. In addition to emphysema and airway inflammation and remodelling, COPD is associated with various local and systemic complications including cachexia, weight loss, osteoporosis, muscle wasting, heart failure, atherosclerosis, dementia, depression, and cancer. Strikingly, these extrapulmonary manifestations of COPD account for the vast majority of morbidity and mortality in COPD patients. 5 Treatments that modify these complications may improve survival in patients with COPD, 6 whereas treatments that exclusively target the airways generally do not. 7