Proceedings of the American Thoracic Society
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The Proceedings of the American Thoracic Society 6:638-647 (2009)
© 2009 The American Thoracic Society
doi: 10.1513/pats.200907-073DP
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Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease

Is There a Connection?

Emiel F. M. Wouters1, Niki L. Reynaert1, Mieke A. Dentener1 and Juanita H. J. Vernooy1

1 NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands

Correspondence and requests for reprints should be addressed to Prof. Dr. E. F. M. Wouters, M.D., Ph.D., Maastricht University Medical Center + (MUMC+), Dept. of Respiratory Medicine, P.O. Box 5800 6202 AZ, Maastricht, The Netherlands. E-mail: e.wouters{at}mumc.nl

ABSTRACT

Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) and probably asthma are associated with low-grade systemic inflammatory changes. In patients with COPD, systemic inflammation is considered a key factor in the pathogenesis of the multicomponent disease manifestations. Spillover of inflammatory mediators into the circulation is generally considered to be the source of this systemic inflammation. Despite this attractive hypothesis, the nature of systemic inflammation in COPD and asthma remains unclear. Available scientific data challenge the spill-over hypothesis. Interventions with biologicals such as TNF-{alpha} do not modify local or systemic inflammation in these inflammatory respiratory diseases. Adipose tissue–mediated inflammation is discussed as a connecting link of systemic inflammation in asthma and COPD.

Key Words: COPD • asthma • local inflammation • systemic inflammation • adipocyte dysfunction






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