Abstract
Asthma is characterized by inflammation involving eosinophils and Th2 cytokines of the central to peripheral airways, with high reversibility of the airflow obstruction (hereafter simply, airflow reversibility). On the other hand, chronic obstructive pulmonary disease (COPD) is characterized by inflammation involving neutrophils and inflammatory cytokines of the peripheral airways to the alveoli, with low or no airflow reversibility. The asthma-COPD overlap syndrome (ACOS) is characterized by features of both and associated with moderate airflow reversibility. ACOS does not uniformly have the features of asthma or COPD, and its features depend on the type and major site of airway inflammation. The medical costs of ACOS are higher than those of either asthma or COPD. Under such circumstances, the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) have provided guidelines for the management of ACOS. It is important to combine treatments for both COPD and asthma and not use treatment for either alone in patients with AOCS.
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References
Saglani S, Lloyd CM. Eosinophils in the pathogenesis of paediatric severe asthma. Curr Opin Allergy Clin Immunol. 2014;14:143–8.
Koch S, Finotto S. Role of interferon-λ in allergic asthma. J Innate Immun. 2015;7:224–30.
Fahy JV. Type 2 inflammation in asthma–present in most, absent in many. Nat Rev Immunol. 2015;15:57–65.
Wang F, Ni SS, Liu H. Pollutional haze and COPD: etiology, epidemiology, pathogenesis, pathology, biological markers and therapy. J Thorac Dis. 2016;8:E20–30.
Papaiwannou A, Zarogoulidis P, Porpodis K, Spyratos D, Kioumis I, Pitsiou G, Pataka A, Tsakiridis K, Arikas S, Mpakas A, Tsiouda T, Katsikogiannis N, Kougioumtzi I, Machairiotis N, Siminelakis S, Kolettas A, Kessis G, Beleveslis T, Zarogoulidis K. Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review. J Thorac Dis. 2014;6 Suppl 1:S146–51.
Orie NG, Slutter HJ, de Vries, Tammeling GJ. Chronic nonspecific respiratory diseases. Ned Tijdschr Geneeskd. 1961;105:2136–9. Article in Dutch.
Sluiter HJ, Koëter GH, de Monchy JG, Postma DS, de Vries K, Orie NG. The Dutch hypothesis (chronic non-specific lung disease) revisited. Eur Respir J. 1991;4:479–89.
Hernández G, Avila M, Pont A, Garin O, Alonso J, Laforest L, Cates CJ, Ferrer M, ASTRO-LAB group. Long-acting beta-agonists plus inhaled corticosteroids safety: a systematic review and meta-analysis of non-randomized studies. Respir Res. 2014;15:83.
Nelson HS, Gallegos CM, Silveira LJ, Newell JD, Gelfand EW. Effect of the inhaled corticosteroid mometasone on small airway patency in patients with asthma. Allergy Asthma Proc. 2009;30:284–92.
Tabberer M, Brooks J, Wilcox T. A meta-analysis of four randomized clinical trials to confirm the reliability and responsiveness of the Shortness of Breath with Daily Activities (SOBDA) questionnaire in chronic obstructive pulmonary disease. Health Qual Life Outcomes. 2015;13:177.
The Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2015. Diagnosis of Diseases of Chronic Airflow Limitation: Asthma COPD and Asthma-COPD Overlap Syndrome (ACOS) Available http://www.ginasthma.org/local/uploads/files/ACOS_2015.pdf. Accessed Jan 31 2016.
Burrows B, et al. Epidemiologic observations on eosinophilia and its relation to respiratory disorders. Am Rev Respir Dis. 1980;122:709–19.
Taylor RG, Gross E, Joyce H, Holland F, Pride NB. Smoking, allergy, and the differential white blood cell count. Thorax. 1985;40:17–22.
Reid L. The role of chronic bronchitis in the production of “chronic obstructive pulmonary emphysema”. J Am Med Womens Assoc. 1965;20:633–8.
Elias JA, Kang MJ, Crothers K, Homer R, Lee CG. State of the art. Mechanistic heterogeneity in chronic obstructive pulmonary disease: insights from transgenic mice. Proc Am Thorac Soc. 2006;3:494–8.
Kesten S, Rebuck AS. Is the short-term response to inhaled β-adrenergic agonist sensitive or specific for distinguishing between asthma and COPD? Chest. 1994;105:1042–5.
Gelb AF, Zamel N. Unsuspected pseudophysiologic emphysema in chronic persistent asthma. Am J Respir Crit Care Med. 2000;162:1778–82.
Matsumoto K, Seki N, Fukuyama S, Moriwaki A, Kan-o K, Matsunaga Y, Noda N, Yoshida M, Koto H, Takata S, Nakanishi Y, Kiyohara Y, Inoue H, Hisayama Pulmonary Physiology Study Group. Prevalence of asthma with airflow limitation, COPD, and COPD with variable airflow limitation in older subjects in a general Japanese population: the Hisayama Study. Respir Investig. 2015;53:22–9.
Andersén H, Lampela P, Nevanlinna A, Säynäjäkangas O, Keistinen T. High hospital burden in overlap syndrome of asthma and COPD. Clin Respir J. 2013;7:342–6.
de Marco R, Pesce G, Marcon A, Accordini S, Antonicelli L, Bugiani M, Casali L, Ferrari M, Nicolini G, Panico MG, Pirina P, Zanolin ME, Cerveri I, Verlato G. The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population. PLoS One. 2013;8, e62985.
Menezes AM, Montes de Oca M, Pérez-Padilla R, Nadeau G, Wehrmeister FC, Lopez-Varela MV, Muiño A, Jardim JR, Valdivia G, Tálamo C, PLATINO Team. Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma. Chest. 2014;145:297–304.
Cosio BG, Soriano JB, López-Campos JL, Calle-Rubio M, Soler-Cataluna JJ, de-Torres TP, Marín JM, Martínez-Gonzalez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I, Casanova C, CHAIN Study. Defining the asthma-COPD overlap syndrome in a COPD cohort. Chest. 2016;149:45–52.
Hardin M, Silverman EK, Barr RG, Hansel NN, Schroeder JD, Make BJ, Crapo JD, Hersh CP, COPDGene Investigators. The clinical features of the overlap between COPD and asthma. Respir Res. 2011;12:127.
Wurst KE, Kelly-Reif K, Bushnell GA, Pascoe S, Barnes N. Understanding asthma-chronic obstructive pulmonary disease overlap syndrome. Respir Med. 2016;110:1–11.
Gibson PG, McDonald VM. Asthma-COPD overlap 2015: now we are six. Thorax. 2015;70:683–91.
Soriano JB, Vestbo J, Pride NB, Kiri V, Maden C, Maier WC. Survival in COPD patients after regular use of fluticasone propionate and salmeterol in general practice. Eur Respir J. 2002;20:819–25.
Milanese M, Di Marco F, Corsico AG, Rolla G, Sposato B, Chieco-Bianchi F, Costantino MT, Crivellaro MA, Guarnieri G, Scichilone N, ELSA Study Group. Asthma control in elderly asthmatics. An Italian observational study. Respir Med. 2014;108:1091–9.
Ohta K, Ichinose M, Nagase H, Yamaguchi M, Sugiura H, Tohda Y, Yamauchi K, Adachi M, Akiyama K, Japanese Society of Allergology. Japanese guideline for adult asthma 2014. Allergol Int. 2014;63:293–333.
Kauppi P, Kupiainen H, Lindqvist A, Tammilehto L, Kilpeläinen M, Kinnula VL, Haahtela T, Laitinen T. Overlap syndrome of asthma and COPD predicts low quality of life. J Asthma. 2011;48:279–85.
Alshabanat A, Zafari Z, Albanyan O, Dairi M, FitzGerald JM. Asthma and COPD Overlap Syndrome (ACOS): a systematic review and meta analysis. PLoS One. 2015;10, e0136065.
Gerhardsson de Verdier M, Andersson M, Kern DM, Zhou S, Turnceli O. Asthma and chronic obstructive pulmonary disease overlap syndrome: doubled costs compared with patients with asthma alone. Value Health. 2015;18:759–66.
Shaya FT, Dongyi D, Akazawa MO, Blanchette CM, Wang J, Mapel DW, Dalal A, Scharf SM. Burden of concomitant asthma and COPD in a Medicaid population. Chest. 2008;134:14–9.
Magnussen H, Bugnas B, van Noord J, Schmidt P, Gerken F, Kesten S. Improvements with tiotropium in COPD patients with concomitant asthma. Respir Med. 2008;102:50–6.
Yoshida M, Nakano T, Fukuyama S, Matsumoto T, Eguchi M, Moriwaki A, Takata S, et al. Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. Pulm Pharmacol Ther. 2013;26:159–66.
Alvarado-Gonzalez A, Arce I. Tiotropium bromide in chronic obstructive pulmonary disease and bronchial asthma. J Clin Med Res. 2015;7:831–9.
Lim HS, Choi SM, Lee J, Park YS, Lee SM, Yim JJ, Yoo CG, Kim YW, Han SK, Lee CH. Responsiveness to inhaled corticosteroid treatment in patients with asthma-chronic obstructive pulmonary disease overlap syndrome. Ann Allergy Asthma Immunol. 2014;113:652–7.
To T, Zhu J, Larsen K, Simatovic J, Feldman L, Ryckman K, Gershon A, Lougheed MD, Licskai C, Chen H, Villeneuve PJ, Crighton E, Su Y, Sadatsafavi M Williams D, Carlsten C, Canadian Respiratory Research Network. Progression from asthma to Chronic Obstructive Pulmonary Disease (COPD): is air pollution a risk factor?. Am J Respir Crit Care Med. 2016 [Epub ahead of print].
de Marco R, Marcon A, Rossi A, Antó JM, Cerveri I, Gislason T, Heinrich J, Janson C, Jarvis D, Kuenzli N, Leynaert B, Probst-Hensch N, Svanes C, Wjst M, Burney P. Asthma, COPD and overlap syndrome: a longitudinal study in young European adults. Eur Respir J. 2015;46:671–9.
Spears M, McSharry C, Chaudhuri R, Weir CJ, de Wet C, Thomson NC. Smoking in asthma is associated with elevated levels of corticosteroid resistant sputum cytokines-an exploratory study. PLoS One. 2013;8, e71460.
Spears M, Donnelly I, Jolly L, Brannigan M, Ito K, McSharry C, Larfferty J, Chaudhuri R, Braganza G, Adcock IM, Barnes PJ, Wood S, Thomson NC. Effect of low-dose theophylline plus beclometasone on lung function in smokers with asthma: a pilot study. Eur Respir J. 2009;33:1010–7.
Rhee CK, Yoon HK, Yoo KH, Kim YS, Lee SW, Park YB, et al. Medical utilization and cost in patients with overlap syndrome of chronic obstructive pulmonary disease and asthma. COPD. 2013;11:163–70.
Izquierdo-Alonso JL, Rodriguez-Gonzálezmoro JM, de Lucas-Ramos P, Unzueta I, Ribera X, Antón E, et al. Prevalence and characteristics of three clinical phenotypes of chronic obstructive pulmonary disease (COPD). Respir Med. 2013;107:724–31.
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Watanabe, H. (2017). The Asthma–COPD Overlap Syndrome (ACOS): What Is the Significance COPD Associated with Asthma?. In: Nakamura, H., Aoshiba, K. (eds) Chronic Obstructive Pulmonary Disease. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-10-0839-9_16
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DOI: https://doi.org/10.1007/978-981-10-0839-9_16
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