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REVIEW

HIGHLIGHTED TOPIC
The Respiratory Muscles in Chronic Obstructive Pulmonary Disease

Comparative assessment of the quadriceps and the diaphragm in patients with COPD

¹Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Canada; and ²Department of Pulmonary Diseases, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands

Submitted 19 February 2009 ; accepted in final form 6 April 2009

ABSTRACT

Chronic obstructive pulmonary disease (COPD) and other chronic diseases such as heart failure are accompanied by skeletal muscle alterations that further enhance morbidity and mortality in affected individuals. Several studies have highlighted important structural and biochemical modifications in limb and respiratory muscles in COPD. Reviewing the similarities and differences between the two most studied muscles in COPD, the quadriceps and the diaphragm, may be helpful in providing important clues about the mechanisms underlying muscle changes associated with this disease. Although oxidative stress is present in both muscles, other muscle alterations are clearly distinct between the quadriceps and the diaphragm. For example, the oxidative metabolism varies in opposite directions, the diaphragm exhibiting increased resistance to fatigue while the quadriceps in COPD is characterized by premature fatigability. Differences in muscle phenotypic expression between the diaphragm and the quadriceps indicate that, in addition to systemic factors, the local microenvironment must participate in the reorganization seen in these two skeletal muscles in COPD.

chronic obstructive pulmonary disease; muscle dysfunction; cell signaling

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