Severe asthma and asthma-COPD overlap: a double agent or identical twins?

Yang, Xia; Cao, Yuan; Xia, Lei; Li, Wen; Shen, Huahao

doi:10.21037/jtd.2017.11.113

Cited by 9 publications

(5 citation statements)

References 56 publications

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“…The reported prevalence of severe asthma is about 5%‐10% 7‐9 ; however, the disease burden associated with severe asthma is substantial, with the consumption of more healthcare resources than non‐severe asthma patients 10‐13 . In addition, compared with patients with milder asthma, those with severe asthma have worse symptoms with frequent exacerbation, lower quality of life, and airflow limitations, which are also characteristic of ACO patients 14 . Thus, the main challenge in real‐world practice is to distinguish patients with ACO from those with severe asthma only.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13] In addition, compared with patients with milder asthma, those with severe asthma have worse symptoms with frequent exacerbation, lower quality of life, and airflow limitations, which are also characteristic of ACO patients. 14 Thus, the main challenge in real-world practice is to distinguish patients with ACO from those with severe asthma only.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Specialist‐Diagnosed Asthma‐COPD Overlap in Severe Asthma: Observations from the Korean Severe Asthma Registry (KoSAR)

Lee

Kim

et al. 2020

Allergy

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Background: While the clinical characteristics and outcomes of asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have been frequently compared with those of COPD or asthma, the prevalence and features of ACO in patients with severe asthma are unclear. Objectives: Evaluation of the prevalence and clinical features of ACO using the Korean severe asthma registry. Methods: At the time of registration, ACO was determined in patients with severe asthma by attending specialists. Patients were classified into ACO and non-ACO groups, and the demographic and clinical characteristics of these two groups were compared. Results: Of 482 patients with severe asthma, 23.7% had ACO. Patients in the ACO group were more likely to be male (P < .001), older (P < .001), and ex-or current smokers (P < .001) compared with those in the non-ACO group. Patients in the ACO group had lower mean forced expiratory volume in 1 second (P < .001) and blood eosinophil percentage (P = .006), but higher blood neutrophil percentage (P = .027) than those in the non-ACO group. The ACO group used more inhaled long-acting muscarinic antagonist (P < .001), methylxanthine (P = .001), or sustained systemic corticosteroid (P = .002). In addition, unscheduled emergency department visits due to exacerbation were more frequent in the ACO group (P = .006). Conclusion: Among patients with severe asthma, those with ACO were older, predominantly male, and were more likely to have a smoking history than those with asthma only. Patients with ACO used more systemic corticosteroid and had more frequent exacerbations related to emergency department visits than those with severe asthma only.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of Specialist‐Diagnosed Asthma‐COPD Overlap in Severe Asthma: Observations from the Korean Severe Asthma Registry (KoSAR)

Lee

Kim

et al. 2020

Allergy

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“…Steroid resistance, which contributes to mortality and morbidity in patients with severe asthma, is also induced by CS [152] in a substantial proportion of patients with ACO that currently smoke. These similarities have led to the proposal that ACO represents a form of severe asthma and models of severe asthma could potentially be adapted for studies on ACO [153,154]. Although caution must be taken to differentiate asthma with fixed airway obstruction from ACO in animal models.…”

Section: Animal Studies Of Acomentioning

confidence: 99%

Asthma-COPD overlap: current understanding and the utility of experimental models

Donovan

Kim

et al. 2021

Eur Respir Rev

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Pathological features of both asthma and COPD coexist in some patients and this is termed asthma-COPD overlap (ACO). ACO is heterogeneous and patients exhibit various combinations of asthma and COPD features, making it difficult to characterise the underlying pathogenic mechanisms. There are no controlled studies that define effective therapies for ACO, which arises from the lack of international consensus on the definition and diagnostic criteria for ACO, as well as scant in vitro and in vivo data. There remain unmet needs for experimental models of ACO that accurately recapitulate the hallmark features of ACO in patients. The development and interrogation of such models will identify underlying disease-causing mechanisms, as well as enabling the identification of novel therapeutic targets and providing a platform for assessing new ACO therapies. Here, we review the current understanding of the clinical features of ACO and highlight the approaches that are best suited for developing representative experimental models of ACO.

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“…While patients with an explicit diagnosis of ACO have yet not been studied systematically (51), the underlying pathobiology and first case reports appear to underline the potential of BT in this patient group (70)(71)(72).…”

Section: Bronchial Thermoplasty (Bt)mentioning

confidence: 99%

Chronic obstructive pulmonary disease phenotypes: imprint on pharmacological and non-pharmacological therapy

Bakeer¹,

Funk

Valipour

2020

Ann Transl Med

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Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease associated with significant morbidity and mortality. Over the past few years, there has been cumulating interest in describing this heterogeneity and using this information to group patients into different COPD phenotypes. The term phenotype is defined as single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes. It describes also the physical appearance or biochemical characteristics which result from the genotype-environment interaction. Furthermore, it clearly identifies subgroups with a significant impact in the prognosis. Recently, approaches to COPD phenotyping have been significantly enhanced in tandem with developments in understanding the disease's various pathological, clinical and genetic features. This knowledge inspired the researchers to investigate more tailored therapeutic strategies that could not only give a more potent effect but also help to avoid the traditional therapy's undesirable side effects. Eventually, it could be said that the phenotypic approach to COPD in the last decade had a huge impact on daily practice and management delivered to COPD patients. In this review, we highlight the impact of pharmacological and non-pharmacological treatment options on COPD outcomes, using a personalized treatment strategy based on different phenotypes.

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Severe asthma and asthma-COPD overlap: a double agent or identical twins?

Cited by 9 publications

References 56 publications

Characteristics of Specialist‐Diagnosed Asthma‐COPD Overlap in Severe Asthma: Observations from the Korean Severe Asthma Registry (KoSAR)

Characteristics of Specialist‐Diagnosed Asthma‐COPD Overlap in Severe Asthma: Observations from the Korean Severe Asthma Registry (KoSAR)

Asthma-COPD overlap: current understanding and the utility of experimental models

Chronic obstructive pulmonary disease phenotypes: imprint on pharmacological and non-pharmacological therapy

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