title: Inflammation in COPD: implications for management.
abstract: Chronic obstructive pulmonary disease (COPD) is recognized by the Global Initiative for Chronic Obstructive Lung Disease guidelines as an inflammatory disease state, and treatment rationales are provided accordingly. However, not all physicians follow or are even aware of these guidelines. Research has shown that COPD inflammation involves multiple inflammatory cells and mediators and the underlying pathology differs from asthma inflammation. For these reasons, therapeutic agents that are effective in asthma patients may not be optimal in COPD patients. COPD exacerbations are intensified inflammatory events compared with stable COPD. The clinical and systemic consequences believed to result from the chronic inflammation observed in COPD suggest that inflammation intensity is a key factor in COPD and exacerbation severity and frequency. Although inhaled corticosteroids are commonly used and are essential in asthma management, their efficacy in COPD is limited, with only a modest effect at reducing exacerbations. The importance of inflammation in COPD needs to be better understood by clinicians, and the differences in inflammation in COPD versus asthma should be considered carefully to optimize the use of anti-inflammatory agents.
authors.affiliation: University at Buffalo, Buffalo, NY 14215, USA. ssethi@buffalo.edu
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sethi
authors.forename: Donald A
authors.initials: DA
authors.lastname: Mahler
authors.forename: Philip
authors.initials: P
authors.lastname: Marcus
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Owen
authors.forename: Barbara
authors.initials: B
authors.lastname: Yawn
authors.forename: Stephen
authors.initials: S
authors.lastname: Rennard
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D056151:Airway Remodeling / Q000502:physiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016207:Cytokines / Q000378:metabolism; D004804:Eosinophils / Q000378:metabolism; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D008214:Lymphocytes / Q000378:metabolism; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009504:Neutrophils / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D016207:Cytokines; D005938:Glucocorticoids; D018727:Muscarinic Antagonists