Effects of inhaled therapy on biomarkers of systemic inflammation in stable chronic obstructive pulmonary disease

In chronic obstructive pulmonary disease (COPD) airways inflammation is associated in more advanced stages with systemic inflammation. COPD-associated systemic inflammation syndrome is defined currently with rather non-specific biomarkers such as C-reactive protein (CRP) but there are also other 'organ-specific' biomarkers such as surfactant protein-D which are still not well characterized but might represent more appropriate and reliable alternatives to the non-specific biomarkers. Inhaled therapies are the mainstay in stable COPD and they were demonstrated to reduce airway inflammation and more recently in the case of inhaled corticosteroids alone or combined with long-acting beta-2 agonists to reduce systemic inflammation as well. This paper focuses on current and potential biomarkers of systemic inflammation in COPD and on the systemic anti-inflammatory effects of inhaled therapies in stable COPD.