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For the Patient The full report is titled: “The chronic obstructive pulmonary disease–asthma overlap syndrome”. It is in the January-February 2015 issue of Allergy Asthma Proceedings (volume 36, pages 11 to 18). The author is Sidney S. Braman.

The asthma-COPD overlap syndrome (ACOS): Is it asthma? Is it COPD? Or is it both? Asthma and chronic obstructive pulmonary disease (COPD) are two types of pulmonary disorders where the normal flow of air into the lungs is blocked making it hard to breathe. Although the precise causes for each are unknown, both conditions are known to be initiated by inflammation of the lining tissues of the lungs and to be influenced by many factors including genetics, allergy, smoking and other environmental exposures. In the United States, the prevalence of asthma has increased by nearly 75% in the past 2 decades with a disproportionately higher occurrence afflicting young children, African-Americans, and Hispanics, particularly in disadvantaged inner city populations. COPD is the third leading cause of death in the United States, accounting for nearly 125,000 deaths nationwide in 2007. Although asthma and COPD have clear differences, some manifestations of both disorders may coexist in a given patient, and this has been called the asthma–COPD overlap syndrome (ACOS). The greater understanding and appreciation of the similarities and differences between asthma and COPD as well as the recent recognition of ACOS are providing new diagnostic and therapeutic opportunities for the patient who suffers from these chronic lung disorders. In a recent review article featured in this issue of the Proceedings, Dr. Braman presents the impact of population age, health-care utilization, disease-related quality of life, mortality and treatment recommendations in the asthma– COPD overlap syndrome (ACOS).

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For the Patient is provided to physicians so that the patients can better understand the language of modern medicine.

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For the Patient is written by the editors (Bellanti, JA and Settipane, RA) and provided to practitioners so that patients can better understand the usefulness of new information resulting from medical research. For the Patient is intended for informational purposes only. This educational synopsis is not meant as a substitute for medical advice. If you have questions regarding this material or are in need of medical advice, please contact your physician. Reproduction is limited to notfor-profit educational purposes only. All other reproductions must be approved by OceanSide Publications.

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Why did the Researchers do this Particular Study? This study explores the similarities and differences of asthma and COPD and describes how these features might help distinguish the subgroup of patients with the asthma–COPD overlap syndrome (ACOS). Who or What was Proposed to be Studied? Since no universally accepted diagnostic criteria exist for this overlap syndrome, just as there is no blood test or other technologic assessment that provides a simple way to distinguish asthma from COPD, a practical approach offered by Dr. Braman is to study patients with a diagnosis of COPD by Global Initiative for Chronic Obstructive Lung Disease criteria and asthma defined by subject report of a physician diagnosis of asthma before the age of 40 years. How was the Study Done? Dr. Braman also proposes inclusion of patients who meet other criteria for COPD (fixed airflow obstruction) and who also have typical features of asthma using a history of wheezing, family history of allergy and blood findings of elevated numbers of blood cells known as eosinophils characteristically found in patients with allergic disease. What are the Limitations of the Proposed Study? The major limitation of the proposed study is the challenge of identifying sufficient numbers of subjects with standardized risk factors as well as the potential problem of study restriction to one geographic area. What are the Implications of the Study? New therapeutic approaches may also arise from a greater understanding and appreciation of the similarities between asthma and COPD. Although there are highly effective treatments for mild asthma, there are relatively few for patients with severe asthma and for patients who smoke. Because of the similarities with COPD, however, it is likely that future investigations will yield new anti-inflammatory treatments that will be effective not only in COPD and refractory asthma but also for patients with the asthma–COPD overlap syndrome (ACOS).

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For the patient. The asthma-COPD overlap syndrome (ACOS): Is it asthma? Is it COPD? Or is it both?

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