Persistent endothelial dysfunction turns the frequent exacerbator COPD from respiratory disorder into a progressive pulmonary and systemic vascular disease

The role of the endothelium in asthma and chronic obstructive pulmonary disease (COPD)

“…Endothelial dysfunction is associated with severity of COPD and is related to FEV1 [64–66]. Dysfunction is also related to clinical outcomes: patients with increased endothelial dysfunction have reduced 6 minute walk test (6MWT) results and a worse overall prognosis [67, 68]. Endothelial dysfunction is also increased in patients with exacerbations of COPD [69, 70].…”

“…Endothelial dysfunction is also increased in patients with exacerbations of COPD [69, 70]. Therefore it has been postulated that increased endothelial dysfunction may induce the development of systemic atherosclerosis and therefore the increased cardiac events seen in these patients [68]. …”

Smoking, Respiratory Diseases and Endothelial Dysfunction

“…They are able to interfere with cellular structure and processes of intercellular signaling by stimulating apoptosis, lipid peroxidation in cellular membrane, DNA and RNA strings' rupture and mitochondrial respiratory chain disruption. Tobacco smoke components are not the only factors directly responsible for stimulating and damaging endothelium in case of respiratory diseases; there are also endogenous factors, such as cellular and non-cellular inflammation mediators, bacterial toxins, immune complexes, hypoxemia, free radicals and shear stress alteration in endothelium [6][7][8][9][10][11][12].…”

Lung function and endothelial dysfunction: Is there a relationship without the presence of lung disease?

“…This is defined as disturbed endothelial‐dependent vasodilatation resulting in the breakdown of the microvascular endothelial barrier . In COPD, endothelial dysfunction is associated with forced expiratory volume in 1 s (FEV 1 ) and emphysema and is related to prognosis . The evidence of endothelial dysfunction in asthma is weaker, but one study suggested that it is greater in asthmatic patients compared to controls and worsens as the disease progresses .…”

“…3 In COPD, endothelial dysfunction is associated with forced expiratory volume in 1 s (FEV 1 ) and emphysema and is related to prognosis. [4][5][6] The evidence of endothelial dysfunction in asthma is weaker, but one study suggested that it is greater in asthmatic patients compared to controls and worsens as the disease progresses. 7 There is evidence that endothelial dysfunction occurs early in the disease process as it is already present in the pulmonary arteries of patients with early COPD.…”