Deterioration of limb muscle function during acute exacerbation of chronic obstructive pulmonary disease
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Important features of both stable and acute exacerbation of COPD are skeletal muscle weakness and wasting. Limb muscle dysfunction during an exacerbation has been linked to various adverse outcomes, including prolonged hospitalization, readmission, and mortality. The contributing factors leading to muscle dysfunction are similar to those seen in stable COPD: disuse, nutrition/energy balance, hypercapnia, hypoxemia, electrolyte derangements, inflammation, and drugs (i.e., glucocorticoids). These factors may be the trigger for a downstream cascade of local inflammatory changes, pathway process alterations, and structural degradation. Ultimately, the clinical effects can be wide ranging and include reduced limb muscle strength. Current therapies, such as pulmonary/physical rehabilitation have limited impact due to low participation rates. Recently, novel drugs have been developed in similar disorders and learnings from these studies can be used as a foundation to facilitate discovery in patients hospitalized with a COPD exacerbation. Nevertheless, investigators should approach this patient population with knowledge of the limitations of each intervention. In this concise clinical review, we provide an overview of acute muscle dysfunction in patients hospitalized with acute exacerbation of COPD (AECOPD) and a strategic approach to drug development in this setting.
Date Issued
2017-10-24
Date Acceptance
2017-10-17
Citation
American Journal of Respiratory and Critical Care Medicine, 2017, 197 (4), pp.433-449
ISSN
1073-449X
Publisher
American Thoracic Society
Start Page
433
End Page
449
Journal / Book Title
American Journal of Respiratory and Critical Care Medicine
Volume
197
Issue
4
Copyright Statement
© 2017 American Thoracic Society
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29064260
Subjects
COPD
drug development
exacerbations
pharmacological interventions
skeletal muscle
11 Medical And Health Sciences
Respiratory System
Publication Status
Published
Coverage Spatial
United States