C. E. Bolton and J. R. Cockcroft
arterial stiffness (17). This is supported by recent animal
(18) and human (19) data. However, as yet it remains unclear whether inflammation increases elastin breakdown and
fragmentation providing the substrate for calcification or
whether calcified elastin promotes inflammation. In subjects
with COPD, different factors may also influence deposition
of aortic calcification in specific areas such as vascular inflammation (20, 21) or systemic factors such as low bone
mineral density (22, 23). Recent animal data suggests that inflammation promotes both vascular calcification and osteoporosis (24), both associated with COPD.
DECLARATION OF INTEREST
The authors report no conflicts of interest. The authors alone
are responsible for the content and writing of the paper.
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