Asthma and chronic obstructive pulmonary disease (COPD) are highly
prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway
obstruction and airway hyperresponsiveness. However, the distinction between the two obstructive disease is not always clear. Multiple epidemiological studies
demonstrate that in elderly people with obstructive airway disease, as many as
half or more may have overlapping diagnoses of asthma and COPD. A COPD-Asthma overlap syndrome is defined as an
airflow obstruction that is not completely reversible, accompanied by symptoms
and signs of increased obstruction reversibility. For the clinical
identification of overlap syndrome
COPD-Asthma Spanish guidelines proposed six diagnostic criteria The major
criteria include very positive bronchodilator test (increase in FEV1 ≥15% and
≥400 ml), eosinophilia in sputum and
personal history of asthma. Minor criteria include high total IgE, personal
history of atopy and positive bronchodilator test (increase in FEV1 ≥12% and
≥200 ml) on two or more occasions. The overlap syndrome COPD-Asthma is
associated with enhanced response to inhaled corticosteroids due to the
predominance of eosinophilic bronchial inflammation.
The furture clinical studies and multicenter clinical trials should lead
to the investigation of disease mechanisms and simultaneous development of the
novel treatment.
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