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УЖМБС 2020, 5(3): 68–73
https://doi.org/10.26693/jmbs05.03.068
Medicine. Reviews

Markers of systemic inflammation in COPD patients with obesity

Kuznetsova L.1, Gopko О. 2, Savchenko L.2
Abstract

Chronic obstructive pulmonary disease is one of the most common respiratory diseases in which comorbid pathology is detected in almost 90% of patients. Particular attention in the clinic of internal medicine deserves a coexisting with alimentary obesity due to the following risk factors: population aging, hypodynamia, over-nutrition, which contributes to the progression of comorbid pathology and the development of complications. The chronic inflammatory process is the main link in the pathogenesis of chronic obstructive pulmonary disease, which causes structural changes of the respiratory tract and lungs (bronchial obstruction and loss elasticity of the lung parenchyma) against the background of systemic inflammation, especially in overweight patients. So, the purpose of the work was to analyze literature data on the common markers of systemic inflammation in chronic obstructive pulmonary disease patients with obesity. High sensitivity C-reactive protein is an acute-phase protein synthesized mainly by hepatocytes in response to the bronchopulmonary tissue damage by the inflammatory process. The research has demonstrated the relationship between the high sensitivity C-reactive protein and functional ventilatory capacity, clinical chronic obstructive pulmonary disease severity. Adipose tissue is considered as an endocrine organ and a source of biologically active substances: adipokines, bioactive peptides, free fatty acids, monocytic chemotactic factor-1 (monocyte chemotactic protein-1), pro-inflammatory cytokines, involved in systemic inflammation in many pathological conditions, including respiratory diseases. There are many works focused on the study of leptin as a pleiotropic hormone determining the state of immune homeostasis and angiogenesis. However, a remarkable discovery was the determination of the leptin role in the respiratory tract. Leptin is a stimulator of ventilation, a factor determining the processes of maturation and development of the lungs, as well as respiratory diseases, including obstructive sleep apnea syndrome, bronchial asthma, chronic obstructive pulmonary disease and lung cancer. It should be noted that leptin is involved in airway inflammation in chronic obstructive pulmonary disease, possibly due to the regulation of infiltration and apoptosis of immune cells in the submucosal basis of the bronchi. Conclusion. Thus, obesity has a significant effect on the intensity of systemic inflammation in patients with chronic obstructive pulmonary disease. High sensitivity C-reactive protein and leptin are the common biomarkers of systemic inflammation that can be used to assess the severity of chronic obstructive pulmonary disease and obesity.

Keywords: chronic obstructive pulmonary disease, obesity, high sensitivity C-reactive protein, leptin

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