title: Molecular and biological pathways of skeletal muscle dysfunction in chronic obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease (COPD) will be a major leading cause of death worldwide in the near future. Weakness and atrophy of the quadriceps are associated with a significantly poorer prognosis and increased mortality in COPD. Despite that skeletal muscle dysfunction may affect both respiratory and limb muscle groups in COPD, the latter are frequently more severely affected. Therefore, muscle dysfunction in COPD is a common systemic manifestation that should be evaluated on routine basis in clinical settings. In the present review, several aspects of COPD muscle dysfunction are being reviewed, with special emphasis on the underlying biological mechanisms. Figures on the prevalence of COPD muscle dysfunction and the most relevant etiologic contributors are also provided. Despite that ongoing research will shed light into the contribution of additional mechanisms to COPD muscle dysfunction, current knowledge points toward the involvement of a wide spectrum of cellular and molecular events that are differentially expressed in respiratory and limb muscles. Such mechanisms are thoroughly described in the article. The contribution of epigenetic events on COPD muscle dysfunction is also reviewed. We conclude that in view of the latest discoveries, from now, on new avenues of research should be designed to specifically target cellular mechanisms and pathways that impair muscle mass and function in COPD using pharmacological strategies and/or exercise training modalities.
authors.affiliation: Department of Respiratory Medicine, Muscle and Respiratory System Research Unit (URMAR), Institute of Medical Research of Hospital del Mar (IMIM)-Hospital del Mar, Barcelona, Spain Department of Health Sciences (CEXS), Universitat Pompeu Fabra, Barcelona, Spain Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain ebarreiro@imim.es.
authors.forename: Esther
authors.initials: E
authors.lastname: Barreiro
authors.affiliation: Department of Respiratory Medicine, Muscle and Respiratory System Research Unit (URMAR), Institute of Medical Research of Hospital del Mar (IMIM)-Hospital del Mar, Barcelona, Spain Department of Health Sciences (CEXS), Universitat Pompeu Fabra, Barcelona, Spain Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
mesh_terms: D006801:Humans; D009119:Muscle Contraction / Q000502:physiology*; D009124:Muscle Proteins / Q000378:metabolism*; D018482:Muscle, Skeletal / Q000378:metabolism / Q000503:physiopathology*; D009133:Muscular Atrophy / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*
chemical_list: D009124:Muscle Proteins
keywords: COPD; epidemics; molecular and cellular events; muscle adaptation; muscle atrophy; respiratory and peripheral muscle dysfunction