Asthma-COPD overlap is not a homogeneous disorder: further supporting data

Abstract

Asthma-COPD ovelap (ACO) is an umbrella term that encompasses patients with COPD and eosinophilic inflammation (e-COPD) and smoking asthmatics with non-fully reversible airflow obstruction (SA). We compared the clinical characteristics and the inflammatory profile of e-COPD and SA. Patients classified as e-COPD were older and more often male and showed significantly impaired pulmonary function (likely explained by a heavier smoking habit). On the contrary, SA had more atopic features, more reversibility of airflow obstruction and higher IgE levels. The concentrations of IL-5, IL-13, IL-8, IL-6, TNF-α, IL17 in serum were similar between the 2 groups. However, Th2-related biomarkers (periostin, FeNO and blood eosinophils) shower higher median values in e-COPD patients. Our findings reinforce the notion that ACO is a heterogeneous disorder and, as a consequence, it might be unacceptable to offer the same treatment for two related but different conditions.

Common manifestation of airway diseases: chronic obstructive pulmonary disease and asthma bronchiale

“…According to dutch hypothesis asthma bronchiale, chronic bronchitis and emphysema are a common genetical disease with different manifestations, in pathogenesis airway hyperreactivity is the main factor. [3][4][5][6][7][8] According to british hypothesis chronic bronchitis, emphysema and asthma bronchialeare three different disease with three different clinical manifestations, three different origin and three different prognosis. Reversibility can help to differentiation.…”

“…Reversibility can help to differentiation. [3][4][5][6][7][8][9] In the opposite part, international guidelines are dealing with asthma bronchiale and COPD common manifestation. According to GINA 2017, inhalatory exposition of injurable materials (mainly smoking) can cause a mixed inflammatory typical process of asthma bronchiale and COPD in patients with asthma bronchiale.…”

“…Clinical symptoms can hardly differentiate COPD and asthma bronchial. [1][2][3][4][5][6][7][8] Significant smoking anamnesis can support COPD origin, but some asthma bronchialetic patients are smoker, also. 9 Most of the asthma bronchialetic patients have paroxismatic dyspnoic wheezing in the early morning or after exercise.…”

“…9 Most of the asthma bronchialetic patients have paroxismatic dyspnoic wheezing in the early morning or after exercise. [1][2][3][4][5][6][7][8][9] In COPD, the dyspnoea is progressive and it is manifested during exercise at first. Hey fever with obstructive pulmonary disease support the definition of allergic asthma bronchiale bronchiale, but there is a significant portion of COPD patients with hey fever as co-morbidity.…”

“…10 Asthma bronchiale and COPD together show similar clinical feature as asthma bronchiale. [1][2][3][4][5][6][7][8] Lung function is crucial for differentiation. In asthma bronchiale, most of the cases have reversible airway obstruction, lung function goes to normal values.…”