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Vol. 45. Issue S4.
EPOC y comorbilidad: una visión global
Pages 14-17 (March 2009)
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Vol. 45. Issue S4.
EPOC y comorbilidad: una visión global
Pages 14-17 (March 2009)
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EPOC e inflamación sistémica. Una vía de enlace para la comorbilidad
COPD and systemic inflammation. A link for comorbidity
Alvar Agustí
Institut del Tòrax, Hospital Clínic, Universitat de Barcelona, CIBER Enfermedades Respiratorias, Fundación Caubet-Cimera, Illes Balears, España
Article information

Los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) presentan con frecuencia otras enfermedades crónicas (comorbilidad) que contribuyen a empeorar su situación clínica y su pronóstico. La inflamación sistémica puede ser un elemento patogénico importante. Este artículo revisa de forma crítica algunos de los aspectos oscuros que todavía existen en este contexto. Por ejemplo, no hay una definición precisa de inflamación sistémica en la EPOC, su prevalencia es altamente dependiente del marcador inflamatorio (o combinación de marcadores) que se utilice para identificarla, su origen es posiblemente multifactorial y la evidencia que soporta una relación entre inflamación sistémica y la presencia de comorbilidad en pacientes con EPOC es circunstancial. Finalmente, aunque existen varios estudios que han evaluado el efecto de los glucocorticoides inhalados en la inflamación sistémica, sus resultados son contradictorios. Por todo ello, la asociación entre inflamación sistémica y comorbilidad en la EPOC es tentadora, pero todavía no se ha demostrado.

Palabras clave:
Bronquitis crónica
Enfisema pulmonar
Enfermedades crónicas

Patients with chronic obstructive pulmonary disease (COPD) frequently have other chronic diseases (comorbidity) that worsen their clinical status and prognosis. Systemic inflammation may be an important pathogenic factor. The present article critically reviews some of the less well known areas in this context. For example, there is no clear definition of systemic inflammation in COPD, its prevalence is highly dependent on the inflammatory marker (or combination of markers) used in its identification, its origin is probably multifactorial and the evidence supporting an association between systemic inflammation and the presence of comorbidity in COPD is circumstantial. Finally, although several studies have evaluated the effect of inhaled glucocorticosteroids on systemic inflammation, the results are contradictory. Therefore, the association between systemic inflammation and comorbidity in COPD is a tempting, but unproven, one.

Key words:
Chronic bronchitis
Pulmonary emphysema
Chronic diseases
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