Article information
Muscle function is essential for both ventilation (respiratorymuscles) and interacting with the environment (peripheralmuscles). One of the systemic manifestations of chronicobstructive pulmonary disease (COPD) is skeletal muscledysfunction. While the causes of this dysfunction are poorlyunderstood, various local and systemic factors appear to playa role. Among the systemic factors are those arising from thelung disease itself, which increases respiratory muscle activity, leads to unfavorable geometric relationships, and results in areduction in the patient's use of the peripheral musculature. Other systemic factors include inflammation and oxidativestress, malnutrition, impaired gas exchange, comorbidity, andcertain myotoxic drugs. Local factors include muscleinflammation and oxidative stress, apoptosis, injury, andimpaired regenerative capacity. All of these factors interactin different ways in each muscle group, giving rise to variousphenotypes and specific contractile capacities.
Key words:
Respiratory muscles
Peripheral muscles
Muscledysfunction
Lung disease
La función muscular es esencial tanto para la ventilación(músculos respiratorios) como para la vida de relación(músculos periféricos). Los pacientes con enfermedad pul-monar obstructiva crónica (EPOC), en el contexto de suafectación sistémica, presentan disfunción muscular. Lascausas de ésta no están totalmente definidas, aunque pare-cen intervenir diferentes factores tanto sistémicos como lo-cales. Entre los primeros figuran los derivados de la propiaenfermedad pulmonar: aumento de la actividad y geometríadesfavorable para los músculos respiratorios, y disminuciónde la actividad para los periféricos. También son factoresgenerales la inflamación-estrés oxidativo, las alteracionesnutricionales y del intercambio de gases, la comorbilidad ylos fármacos miotóxicos. En cuanto a los locales, incluyeninflamación-estrés oxidativo en los músculos, apoptosis ydaño con baja capacidad regenerativa. Estos factores inter-accionarían de forma diferenciada en cada grupo musculary darían lugar a fenotipos y capacidad contráctil específicos.
Palabras clave:
Músculos respiratorios
Músculos periféricos. Disfunción muscular
Enfermedad pulmonar
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