title: Muscle function in COPD: a complex interplay.
abstract: The skeletal muscles play an essential role in life, providing the mechanical basis for respiration and movement. Skeletal muscle dysfunction is prevalent in all stages of chronic obstructive pulmonary disease (COPD), and significantly influences symptoms, functional capacity, health related quality of life, health resource usage and even mortality. Furthermore, in contrast to the lungs, the skeletal muscles are potentially remedial with existing therapy, namely exercise-training. This review summarizes clinical and laboratory observations of the respiratory and peripheral skeletal muscles (in particular the diaphragm and quadriceps), and current understanding of the underlying etiological processes. As further progress is made in the elucidation of the molecular mechanisms of skeletal muscle dysfunction, new pharmacological therapies are likely to emerge to treat this important extra-pulmonary manifestation of COPD.
authors.affiliation: NIHR Respiratory Biomedical, Research Unit, Royal Brompton, and Harefield NHS Foundation, Trust and Imperial College, London.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Donaldson
authors.forename: Matthew
authors.initials: M
authors.lastname: Maddocks
authors.forename: Dario
authors.initials: D
authors.lastname: Martolini
authors.forename: Michael I
authors.initials: MI
authors.lastname: Polkey
authors.forename: William D-C
authors.initials: WD
authors.lastname: Man
mesh_terms: D000818:Animals; D003964:Diaphragm / Q000503:physiopathology; D005081:Exercise Therapy; D017079:Exercise Tolerance; D006801:Humans; D008168:Lung / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology*; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D052097:Quadriceps Muscle / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index