Systemic and Local Inflammation in Asthma and Chronic Obstructive Pulmonary Disease: Is There a Connection? (original) (raw)

Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) and probably asthmaare associated with low-grade systemic inflammatory changes. In patients with COPD, systemic inflammation is considered a key factor in the pathogenesis of the multicomponent disease manifestations. Spillover of inflammatory mediators into the circulation is generally considered to be the sourceofthissystemicinflammation.Despitethisattractivehypoth- esis, the nature of systemic inflammation in COPD and asthma remains unclear. Available scientific data challenge the spill-over hypothesis. Interventions with biologicals such as TNF-a do not modify local or systemic inflammation in these inflammatory re- spiratory diseases. Adipose tissue-mediated inflammation is dis-