Emerging therapies for the treatment of skeletal muscle wasting in chronic obstructive pulmonary disease

Pharmacol Ther. 2016 Oct:166:56-70. doi: 10.1016/j.pharmthera.2016.06.013. Epub 2016 Jun 29.

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that constitutes a major global health burden. A significant proportion of patients experience skeletal muscle wasting and loss of strength as a comorbidity of their COPD, a condition that severely impacts on their quality of life and survival. At present, the lung pathology is considered to be largely irreversible; however, the inherent adaptability of muscle tissue offers therapeutic opportunities to tackle muscle wasting and potentially reverse or delay the progression of this aspect of the disease, to improve patients' quality of life. Muscle wasting in COPD is complex, with contributions from a number of factors including inflammatory cytokines, oxidative stress, growth and anabolic hormones, nutritional status, and physical activity. In this review, we discuss current and emerging therapeutic approaches to treat muscle wasting in COPD, including a number of pharmacological therapies that are in development for muscle atrophy in other pathological states that could be of relevance for treating muscle wasting in COPD patients.

Keywords: Chronic obstructive pulmonary disease (COPD); Comorbidities; Pulmonary rehabilitation; Skeletal muscle; Therapeutic strategies; Wasting.

Publication types

  • Review

MeSH terms

  • Anabolic Agents / pharmacology
  • Anabolic Agents / therapeutic use
  • Animals
  • Antioxidants / pharmacology
  • Antioxidants / therapeutic use
  • Cytokines / metabolism
  • Disease Progression
  • Exercise
  • Glutathione / biosynthesis
  • Humans
  • Inflammation / physiopathology
  • Inflammation Mediators / metabolism
  • Muscle, Skeletal / metabolism
  • Myostatin / antagonists & inhibitors
  • NADPH Oxidases / antagonists & inhibitors
  • NF-E2-Related Factor 2 / agonists
  • Oxidative Stress / physiology
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation
  • Quality of Life
  • Severity of Illness Index
  • Wasting Syndrome / drug therapy*
  • Wasting Syndrome / etiology*
  • Wasting Syndrome / physiopathology
  • Wasting Syndrome / rehabilitation

Substances

  • Anabolic Agents
  • Antioxidants
  • Cytokines
  • Inflammation Mediators
  • Myostatin
  • NF-E2-Related Factor 2
  • NADPH Oxidases
  • Glutathione