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Asthma COPD Overlap Syndrome (ACOS)

Jing Gao, Hiroshi Iwamoto, Jukka Koskela, Harri Alenius, Noboru Hattori, Nobuoki Kohno, Tarja Laitinen, Witold Mazur, Ville Pulkkinen
Asthma-COPD overlap syndrome (ACOS) is a commonly encountered chronic airway disease. However, ACOS is still a consensus-based clinical phenotype and the underlying inflammatory mechanisms are inadequately characterized. To clarify the inflammatory mediatypical for ACOS, five biomarkers, namely interleukin (IL)-13, myeloperoxidase (MPO), neutrophil gelatinase-associated lipocalin (NGAL), chitinase-like protein (YKL-40), and IL-6, were selected. This study hypothesized that sputum biomarkers relevant for airway inflammation in asthma (IL-13), COPD (MPO, NGAL), or in both asthma and COPD (YKL-40, IL-6) could be used to differentiate ACOS from COPD and asthma...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Gary P Anderson
In recent years, thousands of publications on chronic obstructive pulmonary disease (COPD) and its related biology have entered the world literature, reflecting the increasing scientific and medical interest in this devastating condition. This article is a selective review of several important emerging themes that offer the hope of creating new classes of COPD medicines. Whereas basic science is parsing molecular pathways in COPD, its comorbidities, and asthma COPD overlap syndrome (ACOS) with unprecedented sophistication, clinical translation is disappointingly slow...
2016: F1000Research
Esther I Metting, Johannes C C M In 't Veen, P N Richard Dekhuijzen, Ellen van Heijst, Janwillem W H Kocks, Jacqueline B Muilwijk-Kroes, Niels H Chavannes, Thys van der Molen
The aim of this study was to develop and explore the diagnostic accuracy of a decision tree derived from a large real-life primary care population. Data from 9297 primary care patients (45% male, mean age 53±17 years) with suspicion of an obstructive pulmonary disease was derived from an asthma/chronic obstructive pulmonary disease (COPD) service where patients were assessed using spirometry, the Asthma Control Questionnaire, the Clinical COPD Questionnaire, history data and medication use. All patients were diagnosed through the Internet by a pulmonologist...
January 2016: ERJ Open Research
Feng-Jia Chen, Xin-Yan Huang, Yang-Li Liu, Geng-Peng Lin, Can-Mao Xie
BACKGROUND: Fractional exhaled nitric oxide (FeNO) is an easy, sensitive, reproducible, and noninvasive marker of eosinophilic airway inflammation. Accordingly, FeNO is extensively used to diagnose and manage asthma. Patients with COPD who share some of the features of asthma have a condition called asthma-COPD overlap syndrome (ACOS). The feasibility of using FeNO to differentiate ACOS patients from asthma and COPD patients remains unclear. METHODS: From February 2013 to May 2016, patients suspected with asthma and COPD through physician's opinion were subjected to FeNO measurement, pulmonary function test (PFT), and bronchial hyperresponsiveness or bronchodilator test...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Borja G Cosio, Joan B Soriano, Jose Luis López-Campos, Myriam Calle, Juan José Soler, Juan Pablo de-Torres, Jose Maria Marín, Cristina Martínez, Pilar de Lucas, Isabel Mir, Germán Peces-Barba, Nuria Feu-Collado, Ingrid Solanes, Inmaculada Alfageme
RATIONALE: The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes. OBJECTIVE: We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes...
2016: PloS One
Elena P Kalinina, Yulia K Denisenko, Tatyana I Vitkina, Elena G Lobanova, Tatyana P Novgorodtseva, Marina V Antonyuk, Tatyana A Gvozdenko, Vera V Knyshova, Anna V Nazarenko
Background. Comorbidity of chronic obstructive pulmonary disease (COPD) and asthma (asthma COPD overlap syndrome, ACOS) is a significant problem in pulmonary practice, whose pathogenetic issues are not clarified yet. Objective. To study the features of the regulation of immune response in patients with comorbid COPD and asthma. Methods. We assessed the levels of CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD19(+), CD25(+), HLA-DR, total IgE, TNF-α, IL-4, IFN-γ, TXB2, and LTB4 in patients with comorbid COPD and asthma...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Tadahiro Goto, Carlos A Camargo, Kohei Hasegawa
PURPOSE: Recent studies propose TH2-mediated inflammation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). However, little is known about whether fractional exhaled nitric oxide (FeNO) differs between patients with ACOS and those with COPD alone. To address this knowledge gap, a nationally representative sample was analyzed to determine the difference in FeNO levels between patients with ACOS and those with COPD alone in the US population. PATIENTS AND METHODS: This is a cross-sectional analysis of the National Health and Nutrition Examination Survey from 2007 through 2012...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Seiichi Kobayashi, Masakazu Hanagama, Shinsuke Yamanda, Masatsugu Ishida, Masaru Yanai
BACKGROUND: The clinical phenotypes and underlying mechanisms of asthma-COPD overlap syndrome (ACOS) remain elusive. This study aimed to investigate a comparison of COPD patients with and without ACOS, focusing on inflammatory biomarkers, in an outpatient COPD cohort. METHODS: We conducted a cross-sectional study analyzing prospectively collected data from the Ishinomaki COPD Network registry. All participants were diagnosed with COPD, confirmed by using spirometry, and were aged 40-90 years and former smokers...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Sevket Ozkaya, Adem Dirican, Tibel Tuna
Airway obstruction is variable in asthma, while it is progressive and persistent in chronic bronchitis and emphysema. However, some of the patients presenting with symptoms of chronic airway diseases have clinical features of both asthma and COPD. The group with "Asthma-COPD Overlap Syndrome" (ACOS) phenotype was characterized by definitely irreversible airway obstruction accompanied by symptoms and signs of reversibility. In this study, we aimed to classify obstructive airway diseases by clinical, radiological, and pulmonary function tests...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Jun-Jun Yeh, Yu-Chiao Wang, Chia-Hung Kao
PURPOSE: We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE). METHODS: From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876)...
2016: PloS One
Maria E Laucho-Contreras, Maria Montes de Oca, Caroline A Owen
BACKGROUND: Although some patients with obstructive lung disease (OLD) have features of both asthma and chronic obstructive pulmonary disease (COPD), the term "asthma-COPD overlap syndrome (ACOS)" was coined only relatively recently. However, there are gaps in our knowledge of the clinical features, pathogenesis, prognosis, and management of ACOS patients. OBJECTIVES: To review the literature on ACOS to determine the extent to which the clinical features, pathologic mechanisms, clinical outcomes, and current therapeutic approaches for ACOS differ from those in patients with asthma alone or COPD alone...
September 6, 2016: Current Pharmaceutical Design
Christian Taube
No abstract text is available yet for this article.
September 2016: Deutsche Medizinische Wochenschrift
Christian Taube
Asthma and COPD are two distinct diseases but sometimes patient can show clinical features of asthma and COPD. For this group the term asthma-COPD-overlap syndrome (ACOS) has been created. However, the variability of defining criteria leads to a broad heterogeneity of patients assigned to this syndrome. Therefore, the introduction of the term ACOS is of limited value for a more individualized treatment of patients with obstructive airway disease.
August 2016: Deutsche Medizinische Wochenschrift
Denis Caillaud, Pascal Chanez, Roger Escamilla, Pierre-Régis Burgel, Isabelle Court-Fortune, Pascale Nesme-Meyer, Gaëtan Deslee, Thierry Perez, Jean-Louis Paillasseur, Christophe Pinet, G Jebrak, Nicolas Roche
BACKGROUND: Some studies suggest that ACOS is associated with worse outcomes than COPD. The goal of this study was to further explore the clinical characteristics and survival of patients with ACOS identified in a real-life cohort of COPD patients. METHODS: Data from the French COPD cohort "Initiatives BPCO" (n=998 patients) were analyzed to assess the frequency of ACOS defined as a physician diagnosis of asthma before the age of 40 years and to analyze its impact...
August 9, 2016: Allergy
Ai-Xia Huang, Li-Wen Lu, Wen-Juan Liu, Mao Huang
BACKGROUND The aim of this study was to investigate the plasma inflammatory cytokine levels and their correlations with pulmonary function in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). MATERIAL AND METHODS Between January 2013 and December 2014, a total of 96 patients with asthma, acute exacerbation of chronic obstructive pulmonary disease (AECOPD), or ACOS were enrolled, and 35 healthy people were included as a control group. Fasting plasma interleukin (IL)-4, IL-8, IL-10, and tumor necrosis factor alpha (TNF-α) levels were detected using enzyme-linked immunosorbent assay (ELISA)...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Paolo Montuschi, Mario Malerba, Giuseppe Macis, Nadia Mores, Giuseppe Santini
Combining individual drugs in a single inhaler is the most convenient way to deliver triple therapy. A long-acting muscarinic receptor antagonist (LAMA) added to an inhaled corticosteroid (ICS)/long-acting β2-adrenoceptor agonist (LABA) fixed-dose combination (FDC) can improve efficacy of pharmacological treatment of patients with chronic obstructive pulmonary disease (COPD). New inhaled ICS/LABA/LAMA FDCs, including fluticasone furoate/vilanterol/umeclidinium, budesonide/formoterol/glycopyrronium and beclometasone/formoterol/glycopyrronium, are in Phase III of clinical development for COPD...
July 21, 2016: Drug Discovery Today
Jun-Jun Yeh, Yu-Chiao Wang, Chia-Hung Kao
PURPOSE: The association between asthma-chronic obstructive pulmonary diseases (COPD) overlap syndrome (ACOS) and tuberculosis (TB) has yet to be studied. METHODS: The newly diagnosed TB patients (age > 20 y) treated from January 2000 to December 2008 were included (ACOS cohort, n = 10 751; non-ACOS cohort, n = 42 966). The non-ACOS cohort involved patients with confirmed absence of ACOS. We calculated incidence rate ratios (IRRs) for TB in the ACOS and non-ACOS cohorts by using poisson regression analysis...
2016: PloS One
Mario Cazzola, Paola Rogliani
The association of asthma and chronic obstructive pulmonary disease (COPD) in the same patient, which is designated as mixed asthma-COPD phenotype or overlap syndrome (ACOS), remains a controversial issue. This is primarily because many conflicting aspects in the definition of ACOS remain, and it is extremely difficult to summarize the distinctive features of this syndrome. Furthermore, we are realizing that asthma, COPD, and ACOS are not single diseases but rather syndromes consisting of several endotypes and phenotypes and, consequently, comprising a spectrum of diseases...
June 4, 2016: Journal of Allergy and Clinical Immunology
Konstantinos Kostikas, Andreas Clemens, Francesco Patalano
The term asthma-COPD overlap syndrome (ACOS) is one of multiple terms used to describe patients with characteristics of both COPD and asthma, representing ~20% of patients with obstructive airway diseases. The recognition of both sets of morbidities in patients is important to guide practical treatment decisions. It is widely recognized that patients with COPD and coexisting asthma present with a higher disease burden, despite the conceptual expectation that the "reversible" or "treatable" component of asthma would allow for more effective management and better outcomes...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Claudio Sorino, Claudio Pedone, Nicola Scichilone
BACKGROUND: The coexistence of asthma and chronic obstructive pulmonary disease (asthma-COPD overlap syndrome: ACOS) is increasingly recognized but data about its prevalence and long-term mortality are needed. METHODS: Prevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged >65years, enrolled in the SA.R.A. study, with complete clinical, lung functional and follow-up data. Physical performance, disease-related disability, and health-related quality of life (HRQL) were also evaluated...
June 26, 2016: European Journal of Internal Medicine
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