Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.

Hdl Handle:
http://hdl.handle.net/10147/207644
Title:
Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.
Authors:
McNicholas, Walter T
Affiliation:
Pulmonary and Sleep Disorders Unit, St. Vincent's University Hospital, Conway, Institute of Biomolecular and Biomedical Research, University College Dublin,, Dublin, Ireland. walter.mcnicholas@ucd.ie
Citation:
Am J Respir Crit Care Med. 2009 Oct 15;180(8):692-700. Epub 2009 Jul 23.
Journal:
American journal of respiratory and critical care medicine
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207644
DOI:
10.1164/rccm.200903-0347PP
PubMed ID:
19628778
Abstract:
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome represent two of the most prevalent chronic respiratory disorders in clinical practice, and cardiovascular diseases represent a major comorbidity in each disorder. The two disorders coexist (overlap syndrome) in approximately 1% of adults but asymptomatic lower airway obstruction together with sleep-disordered breathing is more prevalent. Although obstructive sleep apnea syndrome has similar prevalence in COPD as the general population, and vice versa, factors such as body mass index and smoking influence relationships. Nocturnal oxygen desaturation develops in COPD, independent of apnea/hypopnea, and is more severe in the overlap syndrome, thus predisposing to pulmonary hypertension. Furthermore, upper airway flow limitation contributes to nocturnal desaturation in COPD without apnea/hypopnea. Evidence of systemic inflammation in COPD and sleep apnea, involving C-reactive protein and IL-6, in addition to nuclear factor-kappaB-dependent pathways involving tumor necrosis factor-alpha and IL-8, provides insight into potential basic interactions between both disorders. Furthermore, oxidative stress develops in each disorder, in addition to activation and/or dysfunction of circulating leukocytes. These findings are clinically relevant because systemic inflammation may contribute to the pathogenesis of cardiovascular diseases and the cell/molecular pathways involved are similar to those identified in COPD and sleep apnea. However, the pathophysiological and clinical significance of systemic inflammation in COPD and sleep apnea is not proven, and thus, studies of patients with the overlap syndrome should provide insight into the mechanisms of systemic inflammation in COPD and sleep apnea, in addition to potential relationships with cardiovascular disease.
Language:
eng
MeSH:
Anoxia/physiopathology; Cardiovascular Diseases/complications/*physiopathology; Humans; Inflammation/*physiopathology; Oxidative Stress/physiology; Pulmonary Disease, Chronic Obstructive/complications/*physiopathology; Sleep Apnea, Obstructive/complications/*physiopathology; Syndrome
ISSN:
1535-4970 (Electronic); 1073-449X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcNicholas, Walter Ten_GB
dc.date.accessioned2012-02-01T10:33:47Z-
dc.date.available2012-02-01T10:33:47Z-
dc.date.issued2012-02-01T10:33:47Z-
dc.identifier.citationAm J Respir Crit Care Med. 2009 Oct 15;180(8):692-700. Epub 2009 Jul 23.en_GB
dc.identifier.issn1535-4970 (Electronic)en_GB
dc.identifier.issn1073-449X (Linking)en_GB
dc.identifier.pmid19628778en_GB
dc.identifier.doi10.1164/rccm.200903-0347PPen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207644-
dc.description.abstractChronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome represent two of the most prevalent chronic respiratory disorders in clinical practice, and cardiovascular diseases represent a major comorbidity in each disorder. The two disorders coexist (overlap syndrome) in approximately 1% of adults but asymptomatic lower airway obstruction together with sleep-disordered breathing is more prevalent. Although obstructive sleep apnea syndrome has similar prevalence in COPD as the general population, and vice versa, factors such as body mass index and smoking influence relationships. Nocturnal oxygen desaturation develops in COPD, independent of apnea/hypopnea, and is more severe in the overlap syndrome, thus predisposing to pulmonary hypertension. Furthermore, upper airway flow limitation contributes to nocturnal desaturation in COPD without apnea/hypopnea. Evidence of systemic inflammation in COPD and sleep apnea, involving C-reactive protein and IL-6, in addition to nuclear factor-kappaB-dependent pathways involving tumor necrosis factor-alpha and IL-8, provides insight into potential basic interactions between both disorders. Furthermore, oxidative stress develops in each disorder, in addition to activation and/or dysfunction of circulating leukocytes. These findings are clinically relevant because systemic inflammation may contribute to the pathogenesis of cardiovascular diseases and the cell/molecular pathways involved are similar to those identified in COPD and sleep apnea. However, the pathophysiological and clinical significance of systemic inflammation in COPD and sleep apnea is not proven, and thus, studies of patients with the overlap syndrome should provide insight into the mechanisms of systemic inflammation in COPD and sleep apnea, in addition to potential relationships with cardiovascular disease.en_GB
dc.language.isoengen_GB
dc.subject.meshAnoxia/physiopathologyen_GB
dc.subject.meshCardiovascular Diseases/complications/*physiopathologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInflammation/*physiopathologyen_GB
dc.subject.meshOxidative Stress/physiologyen_GB
dc.subject.meshPulmonary Disease, Chronic Obstructive/complications/*physiopathologyen_GB
dc.subject.meshSleep Apnea, Obstructive/complications/*physiopathologyen_GB
dc.subject.meshSyndromeen_GB
dc.titleChronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.en_GB
dc.contributor.departmentPulmonary and Sleep Disorders Unit, St. Vincent's University Hospital, Conway, Institute of Biomolecular and Biomedical Research, University College Dublin,, Dublin, Ireland. walter.mcnicholas@ucd.ieen_GB
dc.identifier.journalAmerican journal of respiratory and critical care medicineen_GB
dc.description.provinceLeinster-

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