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Airflow obstruction: is it asthma or is it COPD?

Authors Rogliani P, Ora J, Puxeddu E, Cazzola M

Received 16 September 2016

Accepted for publication 25 October 2016

Published 30 November 2016 Volume 2016:11(1) Pages 3007—3013

DOI https://doi.org/10.2147/COPD.S54927

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Professor Hsiao-Chi Chuang

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Mario Cazzola

Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy

Abstract: Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating asthma from COPD in the presence of fixed airflow obstruction. Nonetheless, the presentations of asthma and COPD can converge and mimic each other, making it difficult to give these patients a diagnosis of either condition. The association of asthma and COPD in the same patient has been designated mixed asthma–COPD phenotype or overlap syndrome. However, since the absence of a clear definition and the inclusion of patients with different characteristics under this umbrella term, it may not facilitate treatment decisions, especially in the absence of clinical trials addressing this heterogeneous population. We are realizing that neither asthma nor COPD are single diseases, but rather syndromes consisting of several endotypes and phenotypes, consequently comprising a spectrum of diseases that must be recognized and adequately treated with targeted therapy. Therefore, we must treat patients by personalizing therapy on the basis of those treatable traits present in each subject.

Keywords: airway obstruction, asthma, ACOS, chronic obstructive pulmonary disease

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