Concomitant bronchial asthma and chronic obstructive pulmonary disease: issues of diagnosis and therapy
Vitebsk State Medical University, Vitebsk, Belarus
Bronchial asthma and chronic obstructive pulmonary disease (COPD) are conditions with unique pathophysiological mechanisms and clinical symptoms, airway obstruction being a shared characteristic of both. Concomitant asthma and COPD (Asthma-COPD Overlap, ACO) is not a separate disease, but represents several variously overlapping phenotypes and endotypes of asthma and COPD. The prevalence of ACO according to population studies ranges from 0.9% to 11.1%, 11.1-61.0% in patients with asthma and 4.6-66% in patients with COPD. The diagnosis of ACO presents difficulties for clinical practitioners due to a lack of universal definition and specific biomarkers of the condition, as well as a wide spectrum of phenotypes. The article considers modern concepts of phenotypes, endotypes, ACO biomarkers, an overview of ACO, patient stratification approaches for choice of optimal therapy.