scholarly journals A study on overview of asthma-chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

2021 ◽  
Vol 6 (2) ◽  
pp. 117-120
Author(s):  
P Ajoy Kumar ◽  
Are Suryakari Sreekanth

Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another.There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other.  A prospective study included 70 patients with chronic airway diseases who were classified into three groups (COPD, asthma and ACO). They were selected from Department of Pulmonary Medicine, Kurnool Medical College outpatient clinic during the period from January 2019 to December 2019, where patients with COPD and ACO were diagnosed according to GOLD guidelines and patients with asthma were diagnosed according to GINA guidelines. Patients enrolled in the study were subjected to full history taking, clinical examination, full laboratory examination, plain chest radiography, spirometry before bronchodilator and after bronchodilator administration (reversibility test) and sputum analysis for counting eosinophils cells.  This study was conducted on 70 patients with chronic airway diseases (COPD, asthma and asthma COPD overlap) were selected. It included 47(67.1%) males and 23(32.8%) females. In our study, 30 (42.8%) patients as having COPD, 19(27.1%) patients were diagnosed as having asthma and 21(30%) patients were diagnosed as having ACO. Regarding the age difference between groups, it was found that patients who were diagnosed as having ACO were older than asthmatic patients with mean age of 49.43±5.83 and 47.23±6.73years, respectively. The men age of patients with COPD was 57.32±6.74 which was older than both ACO and asthmatic patients.  ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

2021 ◽  
Vol 6 (2) ◽  
pp. 71-74
Author(s):  
Venkatesh B.C ◽  
Raju C.H

There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. This is prospective, observational and descriptive study conducted at MNR Medical College and Hospital, Sangareddy, India from June 2020 to December 2020 among chronic airway diseases who were classified into three groups (COPD, Asthma, and Asthma and COPD overlap (ACO)). Patients with COPD and ACO were diagnosed according to GOLD guidelines 2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines 2020. : Regarding the age difference between groups, it was found that patients who were diagnosed as having COPD and ACO were with mean age of 57.23±8.54 and 56.26±7.73 years, respectively. The men age of patients of Asthma was 57.51±8.43. In our study, 28 (30%) patients as having COPD, 39 (45.5%) patients were diagnosed as having ACO, 23 (24.4%) patients were diagnosed as having asthma. In our study comparison of groups regarding history of atopy. We found that 71.7% of ACO group, 78.2% of asthma group and 25% of COPD group had a positive history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.7 % of ACO group, 73.9% of asthma group and 32.1% of COPD group had positive sputum eosinophils.  ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.


2019 ◽  
Vol 316 (2) ◽  
pp. L369-L384 ◽  
Author(s):  
Linsey E. S. de Groot ◽  
T. Anienke van der Veen ◽  
Fernando O. Martinez ◽  
Jörg Hamann ◽  
René Lutter ◽  
...  

Oxidative stress is a common feature of obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD). Lung macrophages are key innate immune cells that can generate oxidants and are known to display aberrant polarization patterns and defective phagocytic responses in these diseases. Whether these characteristics are linked in one way or another and whether they contribute to the onset and severity of exacerbations in asthma and COPD remain poorly understood. Insight into oxidative stress, macrophages, and their interactions may be important in fully understanding acute worsening of lung disease. This review therefore highlights the current state of the art regarding the role of oxidative stress and macrophages in exacerbations of asthma and COPD. It shows that oxidative stress can attenuate macrophage function, which may result in impaired responses toward exacerbating triggers and may contribute to exaggerated inflammation in the airways.


2012 ◽  
Vol 153 (47) ◽  
pp. 1847-1854 ◽  
Author(s):  
Balázs Antus

In recent years induced sputum analysis has become a non-invasive method for the assessment of airway inflammation in obstructive airway diseases. Sputum induction is safe and well tolerated by the patients. The method has been standardized, and this has markedly improved the quality and reproducibility of sputum samples. Identification of sputum eosinophilia has the greatest clinical relevance as it predicts a favorable response to corticosteroids. Treatment strategy aiming normalisation of sputum eosinophil cell count may reduce the rate of exacerbations in asthma. Profiling inflammatory mediators in sputum supernatant provides new insights into the pathogenesis of asthma and chronic obstructive pulmonary disease. Cell type analysis in spontaneous sputum may also provide much information about inflammatory processes in the airways. Based on the results of clinical studies sputum analysis should be more often used in clinical settings in the future. Orv. Hetil., 2012, 153, 1847–1854.


2020 ◽  
Vol Volume 15 ◽  
pp. 3803-3826 ◽  
Author(s):  
Mehak Passi ◽  
Sadia Shahid ◽  
Sankarakuttalam Chockalingam ◽  
Isaac Kirubakaran Sundar ◽  
Gopinath Packirisamy

2008 ◽  
pp. 48-52
Author(s):  
E. V. Privalova ◽  
T. V. Vavilova ◽  
N. A. Kuzubova

The aim of this study was to investigate morphological and functional erythrocyte parameters in smokers with chronic obstructive pulmonary disease (COPD). We measured erythrocyte parameters (RBC, HGB, HCT, MCV, MCH, MCHC, RDW-SD) using the automatic hematological analyzer Sysmex XT-2000i. Sixty-nine patients participated in the study. The patients were divided into 3 groups: 34 patients with COPD (mean age 63 yrs, median smoking history 36 packyrs); 15 smokers without bronchial obstruction (mean age 56 yrs, median smoking history 28 packyrs) and 20 nonsmokers of the sane age without bronchial obstruction. Smokers with COPD and smokers without bronchial obstruction had significantly higher erythrocyte parameters compared to those of nonsmokers. Smokers demonstrated higher HGB level that could be as a compensatory reaction to nicotine-related preclinical hypoxia. Marked increase in RBC number and anisocytosis (RDW-SD) reflected the erythron activation in smokers with COPD. These results suggest that measurement of erythrocyte parameters could be useful to assess symptomatic erythrocytosis in COPD patients.


Genes ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 783 ◽  
Author(s):  
Ozretić ◽  
da Silva Filho ◽  
Catalano ◽  
Sokolović ◽  
Vukić-Dugac ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by a progressive decline in lung function due to airflow limitation, mainly related to IL-1β-induced inflammation. We have hypothesized that single nucleotide polymorphisms (SNPs) in NLRP genes, coding for key regulators of IL-1β, are associated with pathogenesis and clinical phenotypes of COPD. We recruited 704 COPD individuals and 1238 healthy controls for this study. Twenty non-synonymous SNPs in 10 different NLRP genes were genotyped. Genetic associations were estimated using logistic regression, adjusting for age, gender, and smoking history. The impact of genotypes on patients’ overall survival was analyzed with the Kaplan–Meier method with the log-rank test. Serum IL-1β concentration was determined by high sensitivity assay and expression analysis was done by RT-PCR. Decreased lung function, measured by a forced expiratory volume in 1 s (FEV1% predicted), was significantly associated with the minor allele genotypes (AT + TT) of NLRP1 rs12150220 (p = 0.0002). The same rs12150220 genotypes exhibited a higher level of serum IL-1β compared to the AA genotype (p = 0.027) in COPD patients. NLRP8 rs306481 minor allele genotypes (AG + AA) were more common in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of group A (p = 0.0083). Polymorphisms in NLRP1 (rs12150220; OR = 0.55, p = 0.03) and NLRP4 (rs12462372; OR = 0.36, p = 0.03) were only nominally associated with COPD risk. In conclusion, coding polymorphisms in NLRP1 rs12150220 show an association with COPD disease severity, indicating that the fine-tuning of the NLRP1 inflammasome could be important in maintaining lung tissue integrity and treating the chronic inflammation of airways.


2018 ◽  
Vol 125 (6) ◽  
pp. 1760-1766 ◽  
Author(s):  
Rachel E. Luehrs ◽  
John D. Newell ◽  
Alejandro P. Comellas ◽  
Eric A. Hoffman ◽  
Kelsey Warner ◽  
...  

Early stages of chronic obstructive pulmonary disease (COPD) are characterized by the loss and narrowing of terminal bronchioles in the lung, resulting in “air-trapping,” often occurring before overt emphysema manifests. Individuals with an airway-predominant phenotype of COPD display extensive lung air-trapping and are at greater cardiovascular disease (CVD) risk than COPD patients with an emphysema-predominant phenotype. We hypothesized that the degree of computed tomography (CT)-quantified lung air-trapping would be associated with greater aortic and carotid artery stiffness and lower endothelial function, known biomarkers of CVD risk. Lung air-trapping was associated with greater aortic stiffness (carotid femoral pulse wave velocity, CFPWV) ( r = 0.60, P = 0.007) and carotid β-stiffness ( r = 0.75, P = 0.0001) among adults with ( n = 10) and without ( n = 9) a clinical diagnosis of COPD and remained significant after adjusting for blood pressure (BP) and smoking history (pack-years) (carotid β-stiffness: r = 0.68, P < 0.01; CFPWV r = 0.53, P = 0.03). The association between lung air-trapping and carotid β-stiffness remained significant after additionally adjusting for age and forced expiratory volume 1(FEV1) ( r = 0.64, P = 0.01). In the COPD group only ( n = 10), lung air-trapping remained associated with carotid β-stiffness ( r = 0.82, P = 0.05) after adjustment for age, pack-years, and FEV1. In contrast, no association was observed between CFPWV and lung air-trapping after adjustment for BP, pack-years, age, and FEV1 ( r = 0.12, P = 0.83). Lung air-trapping was not associated with endothelial function (brachial artery flow-mediated dilation) in the entire cohort ( P = 0.80) or in patients with COPD only ( P = 0.71). These data suggest that carotid artery stiffness may be a mechanism explaining the link between airway-predominant phenotypes of COPD and high CVD risk. NEW & NOTEWORTHY Previous cross-sectional studies have demonstrated greater large elastic artery stiffness and lower endothelium-dependent dilation in chronic obstructive pulmonary disease (COPD) patients compared with controls. Furthermore, COPD patients with emphysema have greater aortic stiffness than non-COPD controls, and the degree of stiffness is associated with emphysema severity. The present study is the first to demonstrate that even before overt emphysema manifests, lung air-trapping is associated with carotid artery stiffness in COPD patients independent of blood pressure, age, or smoking history.


2013 ◽  
Vol 20 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Parameswaran Nair

Airway inflammation is a central feature of many airway diseases such as asthma, chronic bronchitis, bronchiectasis and chronic cough; therefore, it is only logical that it is measured to optimize its treatment. However, most treatment recommendations, including the use of anti-inflammatory therapies such as corticosteroids, are based on assessments of only airflow and symptoms. Over the past 10 years, methods have been developed to assess airway inflammation relatively noninvasively. Quantitative cell counts in sputum and the fraction of exhaled nitric oxide are the most validated tests. Judicious use of currently available drugs, such as corticosteroids, bronchodilators and antibiotics, and other anti-inflammatory therapies guided by sputum eosinophil and neutrophil counts, have been demonstrated to decrease exacerbations of asthma and chronic obstructive pulmonary disease, ameliorate cough, improve quality of life in patients with these diseases and is cost effective compared with treatment strategies based on guidelines that do not incorporate these measurements. Thus, it is unfortunate that this is not used more widely in the management of airway diseases, particularly in patients with severe asthma and chronic obstructive pulmonary disease who experience frequent exacerbations.


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