Cachexia in chronic obstructive pulmonary disease: new insights and therapeutic perspective

Abstract

Cachexia and muscle wasting are well recognized as common and partly reversible features of chronic obstructive pulmonary disease (COPD), adversely affecting disease progression and prognosis. This argues for integration of weight and muscle maintenance in patient care. In this review, recent insights are presented in the diagnosis of muscle wasting in COPD, the pathophysiology of muscle wasting, and putative mechanisms involved in a disturbed energy balance as cachexia driver. We discuss the therapeutic implications of these new insights for optimizing and personalizing management of COPD-induced cachexia.

Keywords: COPD; Cachexia; Emphysema; Energy balance; Lung cancer; Muscle.

Figure 1

Pulmonary and extra‐pulmonary cross‐talk in COPD cachexia. (A) Altered brain responses to food stimuli; (B) muscle fibre type shifting and oxidative metabolism; (C) altered adipose tissue metabolism; (D) adipose tissue wasting; (E) limb muscle dysfunction; (F) respiratory muscle dysfunction; (G) osteoporosis; (H) altered gut integrity and reduced splanchnic extraction.