Special Consideration in Treating Patients of Overlap Between Asthma and COPD

Abstract

Asthma and chronic obstructive pulmonary disease (COPD) are distinct in pathobiological characteristics. Asthma is a disease with its origins in child hood, is related to allergies and eosinophils, and is best treated by targeting inflammation, whereas COPD is related to adults who smoke and to neutrophils, and is best treated with bronchodilators and the removal of risk factors. However, this distinction is not always clear-cut and there is a considerable overlap in pathogenesis and clinical features; patients with severe asthma may present with fixed airway obstruction while patients with COPD may have hyperresponsiveness and eosinophilia (Kim & Rhee, 2010). In fact, the classification of patients having asthma or COPD may vary day-to-day based on established diagnostic criteria, due to their overlap and inherent variability in bronchodilator responsiveness (Calverley et al., 2003). Moreover, several hypotheses/theories have been proposed to explain whether they are in a single disease entity.