scholarly journals A Case series on Asthma-COPD overlap (ACO) is independent from other chronic obstructive diseases (COPD and Asthma)

2021 ◽  
Vol 5 (1) ◽  
pp. 054-058
Author(s):  
Khanduja Divya ◽  
Pandhi Naveen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Case Series ◽  
Early Morning ◽  
Poor Quality ◽  
Primary Diagnosis ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bronchodilator Response

As we know that, Asthma and chronic obstructive pulmonary diseases are well characterized diseases, they can co-exist as asthma-COPD overlap (ACO). The co-existence of asthma-chronic obstructive pulmonary disease overlap (ACO) in chronic obstructive pulmonary disease (COPD) patients is often unrecognized. In patients with a primary diagnosis of COPD or Asthma, the identification of ACO has got implication for better prognosis and treatment. Such patients experience frequent exacerbations, poor quality of life, rapid decline in lung function and high mortality than COPD or Asthma alone. Inhalational steroids provide significant alleviation of symptoms in such patients and some studies suggest that the most severe patients may respond to biological agents indicated for severe asthma. Patients who have asthma with a COPD component tend to present with severe hypoxia because of Irreversible/fixed airway obstruction and impairment of the alveolar diffusion capacity by emphysematous changes. In contrast, patients with COPD who have an asthma component not only have exertional dyspnoea but also develop paroxysmal wheezing or dyspnoea at night or in the early morning. The criteria to diagnose asthma-COPD overlap (ACO) include positive bronchodilator response, sputum eosinophilia or previous diagnosis of asthma, high IgE and/or history of atopy. There is scarcity of literature available in country like India. We highlight the importance of identification of Asthma COPD overlap as different phenotype from COPD or asthma alone as it is challenging to diagnose ACO in India. We report 3 cases having both the features of asthma and COPD, later diagnosed with Asthma-COPD overlap.

scholarly journals Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease

2015 ◽  
Vol 3 (3) ◽  
pp. 89-92 ◽  
Author(s):  
Pan-wen Tian ◽  
Fu-qiang Wen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Poor Quality ◽  
High Rate ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mucus Hypersecretion ◽  
Phosphodiesterase 4 Inhibitors ◽  
Airway Mucus

Abstract Airway mucus hypersecretion is one of the most important features of chronic obstructive pulmonary disease (COPD). Airway mucus hypersecretion in COPD patients results in outcomes such as rapid decline of lung function, poor quality of life, and high rate of acute exacerbation, hospitalization and mortality. Nonpharmacologic treatments for airway mucus hypersecretion in COPD include smoking cessation and physical rehabilitation. Pharmacologic therapies include expectorants, mucolytics, methylxanthines, beta-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics. Novel drugs with promising prospects are currently under clinical trials.

SLOWING THE DETERIORATION OF ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE OBSERVED DURING BRONCHODILATOR THERAPY BY ADDING INHALED CORTICOSTEROIDS: A 4-YEAR PROSPECTIVE STUDY

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 269-270
Author(s):  
Peter Cvietusa ◽  
Joseph Spahn ◽  
William R. Otto
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Bronchial Hyperreactivity ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Exacerbation Rate ◽  
Obstructive Pulmonary Disease ◽  
Bronchodilator Therapy ◽  
Inhaled Steroids

Purpose of the Study. To determine if the deterioration in lung function, seen in adults with asthma or chronic obstructive pulmonary disease (COPD), could be reversed or slowed by the addition of inhaled beclomethasone. Many short-term studies have shown the benefits of inhaled steroids in asthma; in particular, their ability to improve pulmonary function, decrease bronchial hyperreactivity, and reduce symptoms. Few studies have evaluated the long-term effects of inhaled steroids on the clinical course of either asthma or COPD. Methods. This report is an extension of a 2-year study that followed 160 patients with asthma or COPD on bronchodilator therapy alone. From this group, 56 patients who displayed a rapid decline in pulmonary function (FEV1 ≥ 80 ml/year) and a high exacerbation rate (≥1/year) were selected to receive additional treatment with beclomethasone dipropionate 400 µg two times daily over 4 years. FEV1 and airways responsiveness to histamine were measured every 6 months and at 1 and 13 months upon completion of the study. Peak flows and symptom scores were recorded weekly, and compliance, inhaler technique, and adverse affects were monitored every 3 months. Findings. During the first 6 months of beclomethasone treatment, both groups showed a significant improvement in pre- and postbronchodilator FEV1 with the most significant change noted in the asthma group. Thereafter, the FEV1 began to decline again, as it had in the first 2 years of the study, but at a rate that was 33% slower. In addition to slowing the decline in FEV1, inhaled beclomethasone resulted in a substantial decrease in the degree of bronchial hyperreactivity, and peak flow rates improved.

scholarly journals A Brief Review of Chronic Obstructive Pulmonary Disease

2012 ◽  
Vol 19 (6) ◽  
pp. 381-384 ◽  
Author(s):  
James C Hogg
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive Lung Disease ◽  
Disease Stage ◽  
Rapid Decline ◽  
Chronic Obstructive ◽  
Intact Specimen ◽  
Tissue Samples ◽  
Obstructive Pulmonary Disease ◽  
Computed Tomography Scanning

A recent study, based on a combination of multidetector computed tomography scanning of an intact specimen with microcomputed tomography and histological analysis of lung tissue samples, reported that the number of terminal bronchioles were reduced from approximately 44,500/lung pair in control (donor) lungs to approximately 4800/lung pair in lungs donated by individuals with very severe (Global initiative for chronic Obstructive Lung Disease stage 4) chronic obstructive pulmonary disease (COPD) treated by lung transplantation. The present short review discusses the hypothesis that a rapid rate of terminal bronchiolar destruction causes the rapid decline in lung function leading to advanced COPD. With respect to why the terminal bronchioles are targeted for destruction, the postulated mechanisms of this destruction and the possibility that new treatments are able to either prevent or reverse the underlying cause of airway obstruction in COPD are addressed.

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