Pathogenetic aspects of chronic pancreatitisand chronic obstructive pulmonary disease comorbidity
A review of the literature considers the question of the involvement of certain mechanisms in the comorbid course of chronic pancreatitis with chronic obstructive pulmonary disease (COPD). Attention is drawn to the fact that the common mechanisms of development can reveal the essence of adaptation processes or serve for their use in developing strategies and treatments, prevention and rehabilitation of patients in polymorbidity with an individual approach. The authors attempted to consider the development and progression of diseases from the perspective of theory of syntropic and interference mechanisms. Significance of oxidative stress, chronic systemic inflammation (including C-reactive protein in the development ofinsulin resistance), endothelial dysfunction, microcirculatory disorders and hypoxia was considered. Emphasis is placed on the fact that microcirculatory disorders and hypoxia, as well as C-reactive protein effect on the formation of insulin resistance can be considered as transsyndromal mechanisms in comorbid flow of chronic pancreatitis with COPD. This is important for the tactics and strategy of medical rehabilitation activities conducted in patients suffering from chronic pancreatitis with COPD, as it prevents polypharmacy.