Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 10 » Issue 1

Clinical, physiological, and radiological features of asthma–chronic obstructive pulmonary disease overlap syndrome

Authors Suzuki T, Tada Y, Kawata N, Matsuura Y, Ikari J, Kasahara Y, Tatsumi K

Received 30 December 2014

Accepted for publication 19 March 2015

Published 15 May 2015 Volume 2015:10(1) Pages 947—954

DOI https://doi.org/10.2147/COPD.S80022

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Toshio Suzuki, Yuji Tada, Naoko Kawata, Yukiko Matsuura, Jun Ikari, Yasunori Kasahara, Koichiro Tatsumi

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan

Background: Asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is associated with rapid decline in lung function, poorer health-related quality-of-life outcomes, and frequent exacerbations, compared to COPD alone. Although the numbers of patients with ACOS have increased, there is little established evidence regarding diagnostic criteria and treatment options. Thus, the aim of our study was to clarify the clinical, physiological, and radiological features of patients with ACOS.
Methods: We examined a total of 100 patients with COPD and 40 patients with ACOS, who were selected based on clinical criteria. All patients underwent baseline testing, including a COPD assessment test, pulmonary function tests, and multidetector row computed tomography imaging. Percentage of low attenuation volume, percentage of wall area, and percentage of total cross-sectional area of pulmonary vessels less than 5 mm2 (%CSA <5) were determined using multidetector row computed tomography. ACOS patients were administered a fixed dose of budesonide/formoterol (160/4.5 µg, two inhalations; twice daily) for 12 weeks, after which the ACOS patients underwent multidetector row computed tomography to measure the same parameters.
Results: At baseline, the ACOS patients and COPD patients had a similar degree of airflow limitation, vital capacity, and residual volume. ACOS patients had higher COPD assessment test scores, percentage of wall area, and %CSA <5 than COPD patients. Compared to baseline, budesonide/formoterol treatment significantly increased the forced expiratory volume in 1 second and decreased the degree of airway wall thickness (percentage of wall area) as well as pulmonary microvascular density (%CSA <5) in ACOS patients.
Conclusion: Our results suggest that ACOS is characterized by an airway lesion–dominant phenotype, in contrast to COPD. Higher %CSA <5 might be a characteristic feature of ACOS.

Keywords: budesonide/formoterol, cross-sectional area (CSA), pulmonary vessels, percentage of wall area (WA%)

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other article by this author:

Influence of pulmonary emphysema on COPD assessment test-oriented categorization in GOLD document

Suzuki T, Tada Y, Kawata N, Ikari J, Kasahara Y, Sakurai Y, Iesato K, Nishimura R, West J, Tatsumi K

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1199-1205

Published Date: 19 June 2015

Readers of this article also read:

Biomarker-based detection of asthma–COPD overlap syndrome in COPD populations

Tamada T, Sugiura H, Takahashi T, Matsunaga K, Kimura K, Katsumata U, Takekoshi D, Kikuchi T, Ohta K, Ichinose M

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:2169-2176

Published Date: 9 October 2015

Discrepancies between modified Medical Research Council dyspnea score and COPD assessment test score in patients with COPD

Rhee CK, Kim JW, Hwang YI, Lee JH, Jung KS, Lee MG, Yoo KH, Lee SH, Shin KC, Yoon HK

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1623-1631

Published Date: 12 August 2015

What pulmonologists think about the asthma–COPD overlap syndrome

Miravitlles M, Alcázar B, Alvarez FJ, Bazús T, Calle M, Casanova C, Cisneros C, de-Torres JP, Entrenas LM, Esteban C, García-Sidro P, Cosio BG, Huerta A, Iriberri M, Izquierdo JL, López-Viña A, López-Campos JL, Martínez-Moragón E, Pérez de Llano L, Perpiñá M, Ros JA, Serrano J, Soler-Cataluña JJ, Torrego A, Urrutia I, Plaza V

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1321-1330

Published Date: 15 July 2015

COPD in patients with stable heart failure in the primary care setting

Valk MJ, Broekhuizen BD, Mosterd A, Zuithoff NP, Hoes AW, Rutten FH

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1219-1224

Published Date: 26 June 2015

Influence of pulmonary emphysema on COPD assessment test-oriented categorization in GOLD document

Suzuki T, Tada Y, Kawata N, Ikari J, Kasahara Y, Sakurai Y, Iesato K, Nishimura R, West J, Tatsumi K

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1199-1205

Published Date: 19 June 2015

Bronchial hyperresponsiveness, airway inflammation, and reversibility in patients with chronic obstructive pulmonary disease

Zanini A, Cherubino F, Zampogna E, Croce S, Pignatti P, Spanevello A

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1155-1161

Published Date: 17 June 2015