Asthma-Chronic Obstructive Pulmonary Disease Overlap

Sunita Sharma; Sandhya Khurana; Alex D Federman; Juan Wisnivesky; Fernando Holguin

doi:10.1016/j.iac.2020.07.002

Asthma-Chronic Obstructive Pulmonary Disease Overlap

Immunol Allergy Clin North Am. 2020 Nov;40(4):565-573. doi: 10.1016/j.iac.2020.07.002.

Authors

Sunita Sharma¹, Sandhya Khurana², Alex D Federman³, Juan Wisnivesky³, Fernando Holguin⁴

Affiliations

¹ Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, 12700 East 19th Avenue, MS C272, Aurora, CO 80045-2563, USA. Electronic address: sunita.sharma@cuanschutz.edu.
² Division of Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA.
³ Division of General Internal Medicine, Icahn School of Medicine at Mt. Sinai, 1 Gustave L. Levy Place, Box 1232, New York, NY 10029, USA.
⁴ Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, 12700 East 19th Avenue, MS C272, Aurora, CO 80045-2563, USA.

PMID: 33012320
DOI: 10.1016/j.iac.2020.07.002

Abstract

Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) defines a subgroup of patients with asthma who have persistent airflow obstruction or patients with COPD who may exhibit variable airflow limitation and/or evidence of type 2 inflammation. Additional investigations are needed to determine whether ACO represents a distinct disorder with unique underlying pathophysiology, whether ACO patients should be managed differently from those with asthma or COPD, and whether the diagnosis affects long-term outcomes. This article presents the data about the clinical features of ACO, the current information regarding the underlying pathophysiology of the syndrome, and current understanding of therapeutic options.

Keywords: Asthma; Asthma-chronic obstructive pulmonary disease overlap; Chronic obstructive pulmonary disease; Disease severity.

Publication types

Review

MeSH terms

Administration, Inhalation
Adrenergic beta-Agonists / administration & dosage*
Air Pollution / adverse effects
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome / diagnosis
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome / epidemiology
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome / immunology*
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome / therapy
Biomarkers / blood
CD8-Positive T-Lymphocytes / immunology
CD8-Positive T-Lymphocytes / metabolism
Chemotaxis / immunology
Diagnosis, Differential
Glucocorticoids / administration & dosage*
Hospitalization / statistics & numerical data
Humans
Interleukins / immunology
Interleukins / metabolism
Lung / immunology
Lung / pathology
Neutrophils / immunology
Neutrophils / metabolism
Particulate Matter / adverse effects
Prevalence
Respiratory Function Tests
Risk Factors
Severity of Illness Index
Signal Transduction / drug effects
Signal Transduction / immunology
Smoking / adverse effects
Smoking / epidemiology
Symptom Flare Up
Treatment Outcome

Substances

Adrenergic beta-Agonists
Biomarkers
Glucocorticoids
Interleukins
Particulate Matter