Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands.
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, the Netherlands.
Eur J Pharmacol. 2019 Jan 5;842:99-110. doi: 10.1016/j.ejphar.2018.10.001. Epub 2018 Oct 15.
COPD is a chronic lung disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities. Furthermore, COPD is often characterized by extrapulmonary manifestations and comorbidities worsening COPD progression and quality of life. A neglected comorbidity in COPD management is mental health impairment defined by anxiety, depression and cognitive problems. This paper summarizes the evidence for impaired mental health in COPD and focuses on current pharmacological intervention strategies. In addition, possible mechanisms in impaired mental health in COPD are discussed with a central role for inflammation. Many comorbidities are associated with multi-organ-associated systemic inflammation in COPD. Considering the accumulative evidence for a major role of systemic inflammation in the development of neurological disorders, it can be hypothesized that COPD-associated systemic inflammation also affects the function of the brain and is an interesting therapeutic target for nutra- and pharmaceuticals.
COPD 是一种慢性肺部疾病，其特征是持续的呼吸道症状和气流受限，这是由于气道和/或肺泡异常所致。此外，COPD 通常还伴有肺外表现和合并症，这些会使 COPD 的进展和生活质量恶化。在 COPD 管理中被忽视的合并症是心理健康受损，其表现为焦虑、抑郁和认知问题。本文总结了 COPD 患者心理健康受损的证据，并重点介绍了当前的药物干预策略。此外，还讨论了 COPD 患者心理健康受损的可能机制，其中炎症起着核心作用。许多合并症与 COPD 中的多器官相关的系统性炎症有关。鉴于系统性炎症在神经障碍发展中的重要作用的累积证据，可以假设 COPD 相关的系统性炎症也会影响大脑的功能，并且是营养和药物治疗的一个有趣的治疗靶点。
