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Asthma-COPD Overlap

  • COPD and Asthma (A Zeki, Section Editor)
  • Published:
Current Pulmonology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

There is currently no universal definition for asthma-COPD overlap (ACO). However, several statements and guidelines have been developed. We reviewed publications to reflect current consensus on definition, pathobiology, evaluation, and management of patients with ACO with discussion of knowledge gaps.

Recent Findings

Patients with ACO demonstrate features of both asthma and COPD. However, there is controversy about whether ACO is recognized as a unique entity. While phenotypes of ACO are present, this is an area under investigation to better elucidate the endotype, or the biologic pathway driving the specific phenotype. At present, management approaches focus upon targeting features of asthma and COPD amenable to treatment, such as use of inhaled corticosteroids to treat eosinophilic inflammation, or bronchodilators to improve lung function.

Summary

ACO represents a continuum of different diseases that may share biological mechanisms and require individualized treatment. Future research should be directed to determining phenotypes associated with ACO, their corresponding pathobiology, management, and long-term outcomes to address this common condition with a high burden of disease.

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Fig. 1

Adapted from 2015 GOLD guidelines [10]

Fig. 2

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Asthma and Airway Disease Research Center, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ, USA

    Afshin Sam & Monica Kraft

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  1. Afshin Sam
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Correspondence to Monica Kraft.

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The authors have reported: Over the last 3 years, M. K. has received research funds for the study of asthma from the National Institutes of Health, Chiesi, Sanofi, Roche, and AstraZeneca paid to the University of Arizona; consulting fees from AstraZeneca, Sanofi, Regeneron, and TEVA; and royalties from Elsevier from a book about asthma she edited. A.S. collaborates as sub-investigator on Sanofi and AstraZeneca studies of COPD and has not received funding.

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Sam, A., Kraft, M. Asthma-COPD Overlap. Curr Pulmonol Rep 11, 1–14 (2022). https://doi.org/10.1007/s13665-021-00284-0

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